Dissertations / Theses on the topic 'Medical personnel Professional ethics'
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Lau, Sze-fei Sophia, and 劉思妃. "Government professionals and value conflicts in the civil service: a Hong Kong study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B42128626.
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Hällsten, Freddy. "Det dygdiga personalansvaret : om chefers ansvarstagande för personal utifrån etiska perspektiv /." Göteborg : BAS, 2003. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=010659224&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Griffiths, Debra. "Agreeing on a way forward: management of patient refusal of treatment decisions in Victorian hospitals." Thesis, full-text, 2008. https://vuir.vu.edu.au/2036/.
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The purpose of this study is to investigate and develop a substantive theory, of the processes adopted by nurses and medical practitioners when patients with serious illness refuse medical treatment. The study seeks to identify the main constraints confronting nurses and medical practitioners and to explain the key factors that moderate the processes of dealing with refusal decisions. Using a grounded theory method, a sample of 18 nurses and 6 medical practitioners from two public hospitals in Melbourne were interviewed. In addition, observations and documentary evidence were utilised.
The basic social psychological problem shared by nurses and medical practitioners is conceptualized as Competing Perspectives: Encountering Refusal of Treatment, which reflects the diverse perceptions and beliefs that confront participants when patients decide to forgo therapy. In utilizing the grounded theory method of analysis, it is recognised that participants deal with this problem through a basic social psychological process conceptualized as Endeavouring to Understand Refusal: Agreeing on a Way Forward. This core variable represents the manner in which
participants, to varying extents, deal with the situations they face and it incorporates the various influences which moderate their activities. Endeavouring to Understand
Refusal: Agreeing on a Way Forward comprises a series of three transitions. The first involves a struggle for participants to come to terms with, or even recognize that
patients are rejecting treatment. The second transition illustrates the varied responses of participants as they interact with patients, relatives and each other, in order to clarify and validate decisions made during episodes of care. The third transition reflects the degree to which patients and family members are incorporated into
treatment decisions, and highlights a shift in emphasis, from a focus on the disease state, to the patient as a person with individualistic thoughts and wishes.
The remaining social processes evident in the study consist of four categories. The first, Seeking Clarification, embodies exploration undertaken by participants and
their recognition that treatment is actually being refused. The second category, Responding to Patients and Families, demonstrates the level of expertise of participants communicating, and their ability to encourage reciprocity in the professional-patient relationship. The third category, Advocating, highlights the extent and manner in which patient and family wishes are promoted to members of
the treating team. The fourth category, Influencing, reveals the ability of participants to utilize a degree of authority or power in order to shape particular outcomes.
The findings also indicate that over arching the core variable and categories are various contextual determinants that moderate the way nurses and medical practitioners deal with patient refusal of treatment. These determinants are
categorized into three main influences: The Context of Work, describes the of the environment and organisational factors pertinent to public hospitals; Beliefs and
Behaviours, illustrates the perceptions of, and values held, by four key groups involved in decisions, namely, nurses, medical practitioners, patients, and family
members; and Legal and Ethical Frameworks, examines the existing principles that support or guide professional practice in situations where patients with serious
illness refuse medical treatment.
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Animasaun, Emmanuel Dare. "Professional Medical Ethicist: A Weed or Desired Member in Medical Ethics Debates?" Thesis, Linköping University, Centre for Applied Ethics, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-6635.
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We now live in an era of experts on virtually everything, among which we have professional medical ethicists, who gained prominence in the late 60s due to dramatic advances in medical technology. Before then, medical ethics issues were not thought as separable from the warp and woof of the everyday life. Medical technology’s advancement cascades legions of moral problems in medicine and biomedical research. Series of innovative interventions in medicine raise throngs of ethical questions. In most cases that have to do with issues of life and death, there are perceived moral conflicts. Due to this swath of problematic issues that need solutions, some apologists favour medical ethics experts as fit for the job, while critics argue that no one has the knowledge or skill for dealing with moral quandaries because objective truth is not feasible in ethics and moral judgment is relative to cultures, beliefs and values. The necessity for medical ethicists to take active role in Medical Ethics Debates, either in Committees at the institutional level, or at any other decision-making mechanisms is justified in this thesis. In addition to this, the thesis also justifies medical ethicists’ role as expert consultants to clinicians and individuals alike This justification is based on complex moral problems accentuated by medical technology, which are far from being easily solved through mere appeal to individual reason, but rather by involving medical ethicists based on their specialized knowledge and high level understanding of research and practice. Although critics question the authority with which experts speak on these issues, nevertheless, the thesis unravels the roles, functions, significance and components of expert’s expertise that separate him/her from the crowd. Arguments are critically analysed and medical ethicists’ limits and professional flaws are addressed, with a view to establishing a virile foundation for the profession of medical ethics.
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Lolley, Sarah. "Medical professionalism and the fictional TV medical drama House MD." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=112537.
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This thesis is an exploration and analysis of what audiences may be learning about medical professionalism from the fictional television (TV) medical drama House MD. Fictional TV medical dramas are an important form of medical narrative in that they are usually created by writers with no medical training. As such, they carry a higher risk of portraying the practice of medicine inaccurately. A review of the scholarly literature reveals that there is a precedent for fictional TV medical dramas to affect viewers' perception of the practice of medicine and health behaviours, and viewers' understanding of medical ethics issues. It also reveals strong empirical evidence that TV medical dramas can affect audience's perceptions of physicians' character. A thorough review of the first two seasons of House MD reveals 20 lessons on professionalism (i.e. lessons on interactions with colleagues and patients, medical ethics, and professional competence) that the title character, Gregory House, is imparting to viewers. All 20 lessons are in direct conflict with established charters on professionalism. Arguments are made for the programme's potential to negatively affect patient access to care, physician-patient relations, interactions between healthcare professionals, and applications to medical school.
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Edwards, Kelly Alison. "Teaching for professional responsibility in medical practice /." Thesis, Connect to this title online; UW restricted, 2000. http://hdl.handle.net/1773/7649.
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Descombes, Christine Ruth Elisabeth Hermine. "Before ethics? : a study of the ethos of the medical profession." Thesis, Open University, 2002. http://oro.open.ac.uk/19903/.
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The thesis makes a distinctive contribution to the field of professional ethics; offering a more nuanced understanding of the role of a profession’s ethos in relation to its ethics. In so doing, it also offers a valuable insight into GP thinking at what proved to be a unique moment in the history of that branch of the medical profession. Using historical and empirical data, the thesis first traces the development of the medical profession’s ethos - Its belief in itself as a noble, superior profession, of special dignity and worth. It then shows the influence of that ethos in areas of professional decision-making that have had a particular impact on the provision of health care within the LJK over the past 50 years. Taking the profession’s ethos as a benchmark, the study explores the nature of the profession’s response to the creation, control and, in recent years, major reform of the NHS which reform introduced a new emphasis on management. The latter provides a case study that relates the theoretical material to an historical situation This includes a number of interviews with GPs that point to the beliefs and values influencing their decisions in relation to the reforms, as they affected general practice. The study concludes that, although a profession dependant on attracting clients may find it necessary to subscribe to a set of ethical principles that draws on outside beliefs and values, it is the ethics derived from its own internal ethos that will take precedence in guiding everyday thinking and practice
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Chase, Nicole Marie. "A cognitive development approach to professional ethics training for counselor education students." W&M ScholarWorks, 1998. https://scholarworks.wm.edu/etd/1539618273.
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The study examined the effects of integrating a cognitive-developmental approach with professional ethics training on the moral and conceptual development, self-presentation styles, and ethical decision-making skills of graduate counseling students. The sample was comprised of students who enrolled in counseling courses at the College of William and Mary. The ethics intervention group was compared to two groups; one group who received the traditionally taught ethics course, and one group who had not taken the ethics course at William and Mary. Instruments used included the Defining Issues Test (DIT), Paragraph Completion Method (PCM), and Concern For Appropriateness scale (CFA). Students were also administered an adapted format of the Moral Judgment Interview that depicted ethical dilemmas in counseling. The intervention methodologies used included the components of Deliberate Psychological Education (DPE), moral discussions, and a Conceptual Matching Model approach.;The results failed to support expectations that students in the intervention group would obtain significantly higher DIT and PCM post-test scores than the other two groups. A significant inverse relationship was only found between CFA and PCM pre-test scores. Stages 3-3 /4 levels of reasoning were largely used in responding to ethical dilemmas. A qualitative analysis of interview and journal responses indicated that the intervention course did impact students' personal and professional growth.
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O'Connell-Spalla, Joan. "Medical Laboratory Testing Personnel: Perception of Professional Status and Engagement in Professional Development and Career Advocacy." Youngstown State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1627410209680141.
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Bond, Tim. "HIV counselling : ethical issues in an emerging professional role." Thesis, Durham University, 1998. http://etheses.dur.ac.uk/985/.
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The development of HIV counselling has been one of the major public policy innovations in response to the challenges posed by HIV and AIDS in Britain. This research, using a participative and qualitative methodology, examines how HIV counsellors have conceptualised their approach to the ethical issues associated with their innovatory role. The research takes an overview of two separate phases of fieldwork conducted in 1990 and 1994. The first phase concentrated on establishing the background of self-identified HIV counsellors and how they related to the wider counselling movement which had already developed a distinctive ethic founded on respect for individual autonomy. Their general identification with the wider counselling movement raised issues how this ethic could govern their work with clients affected by HIV. The second phase concentrated on the management of confidentiality within multidisciplinary teams. The results of the research are set within the wider ethical and socio-historical context of AIDS policy development in Britain and explore changes in how HIV counsellors conceptualise ethical issues in the local context of their work. The methodology is that of `descriptive ethical inquiry' accompanied by examination of how this type of inquiry relates to moral philosophy and social sciences. The method of participative research adopted is consultative and careful consideration is given to how this type of research relates to comparable procedures used in the production of professional codes of ethics.
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Eklöf, Motzi. "Läkarens ethos : studier i den svenska läkarkårens identiteter, intressen och ideal 1890-1960 /." Linköping : Tema, Univ, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7905.
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Beaugard, Carol R. "How hospital nurses reason about ethical dilemmas of practice /." Access Digital Full Text version, 1990. http://pocketknowledge.tc.columbia.edu/home.php/bybib/10937985.
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List, Christina D. "All in the PR family : a comparison of levels of professionalism among corporate public relations personnel and public relations agency practitioners in the state of Indiana." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/845923.
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This study compared the levels of professionalism among Indiana corporate and agency public relations practitioners. The entire population, 339 individuals, was contacted via telephone and administered McLeod and Hawley's professional orientation instrument, yielding 183 usable responses.Respondents rated the importance of 24 items on a 5point Likert scale, and provided information on age, education, undergraduate major, salary, and length of time with current organization, in public relations, and in the workforce.Professionalism scores were calculated by subtracting the sum of answers to the non-professional items from the sum of answers to the professional items. Scores were ranked, then divided at the median. "Professionals" fell at or above the median; "semi-professionals" fell below the median,following McLeod/Hawley methodology.A multiple regression analysis determined the only significant relationship between level of professionalism and demographics occurred with undergraduate major--a slight negative correlation. Frequency distribution showed journalism/public relations majors had higher percentages of professionals than either English or other majors.Department of Journalism
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Bernard, Julia M., A. N. Manick, and Maike Klein. "Ethics, Legal and Professional Issues in Mediation and Parent Coordination." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/929.
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Book Summary:Ethics and Professional Issues in Couple and Family Therapy, Second Edition builds upon the strong foundations of the first edition. This new edition addresses the 2015 AAMFT Code of Ethics as well as other professional organizations’ codes of ethics, and includes three new chapters: one on in-home family therapy, a common method of providing therapy to clients, particularly those involved with child protective services; one chapter on HIPAA and HITECH Regulations that practicing therapists need to know; and one chapter on professional issues, in which topics such as advertising, professional identity, supervision, and research ethics are addressed. This book is intended as a training text for students studying to be marriage and family therapists.
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Smith, Jennifer Marion. "Resolving inter-cultural value conflicts in Canadian healthcare practice." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/mq27378.pdf.
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Aagard, Erik A. "A pre-design study of patient and medical professional atitudes and reactions towards the colors of medical scrubs." Columbus, Ohio : Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1218038251.
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Kwizera, Alice Stella. "Quality of work and work life: understanding the work ethic of medical professionals in selected hospitals in the Eastern Cape region of South Africa." Thesis, Rhodes University, 2012. http://hdl.handle.net/10962/d1003111.
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This thesis reports a study of work ethic values, beliefs and attitudes held by medical professionals in selected hospitals in the Eastern Cape, South Africa. The study was in response to the public outcry about the declining work ethic and poor service delivery in South Africa’s healthcare sector. Scholarly interest in the work ethic and its role in economic development dates back to Max Weber’s classical work, which was the starting point for my study. The German economic sociologist published his seminal essay on The Protestant Ethic and the Spirit of Capitalism in 1904/1905. Since that time, Weber’s ideas on the Protestant work ethic continue to inform and influence studies of the contemporary work ethic, which is thought to have become secularised. My study was informed by data collected in 2009 through a questionnaire survey and personal interviews. A total of 174 doctors and nurses, working in four urban, periurban and rural hospitals near East London, completed a self-administered questionnaire. The questionnaire replicated the Multi-Dimensional Work Ethic Profile (MWEP) developed by Miller, Woehr and Hudspeth in 2001/2002. The instrument examines seven critical dimensions of the work ethic, namely self-reliance, morality, (foregoing) leisure, hard work, centrality of work in life, not wasting time, and delay of gratification. In addition, I conducted personal interviews in the same four hospitals with 41 hospital managers, doctors, nurses, and patients to discuss their understanding of the work ethic and its practical application. The study found that both doctors’ and nurses’ overall work ethic scores on the MWEP scale were above average. Although there was no significant difference between the overall work ethic scores of the two professions, doctors scored significantly higher than nurses on the ‘hard work’ and ‘self reliance’ dimensions of the work ethic scale. In the qualitative study, the doctors’ work ethic was rated much more highly than the nurses’ by their superiors and patients; and the work ethic of nurses in the urban hospitals was rated much lower than that of their rural colleagues. In contradiction to the idea of the secularization of the contemporary work ethic, religiosity and religious beliefs were influential in the endorsement of work ethic principles. In line with the notion that ‘happy’ workers are more productive, job and life satisfaction were found to be strong correlates of the work ethic of medical professionals.
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Turner, Melissa L. "The influence of religious faith in the attitudes of PR practitioners toward ethical behavior." Virtual Press, 2005. http://liblink.bsu.edu/uhtbin/catkey/1313953.
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This research examined at the influence of a public relations professional's personal faith on their professional ethical attitudes. The research question for this study stated: Does a public relations practitioner's religious faith directly influence their ethical practice?A Q-study was completed by forty-five public relations professionals. Data analysis yielded two factors the "God Centered" and the "Profession Driven". The God Centered participants mutually agreed upon statements that placed their faith in a central part of their professional career, and agreed they were accountable to God for their professional career. The second group that emerged were identified as Profession Driven, representing their association with professional based ethics. The respondents in this factor indicated that they strongly agree with the professional provisions suggested in the PRSA Code of Ethics 2000, placing an emphasis on honest counsel, loyalty, and fairness. The second factor viewpoint also strongly agreed that personal goals and values directly influenced their professional ethics.These two factors and the previous literature illustrated the influence of personal standards when making professional ethical decisions.Department of Journalism
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Abdul, Rouf P. V. "Exploring patient and health professional use, views and attitudes towards complementary and alternative medicines during pregnancy." Thesis, University of Aberdeen, 2015. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=228640.
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The aim of this doctoral research was to explore CAM use in pregnancy from the perspectives of pregnant women and health professionals. The research was conducted in four phases: a systematic review of the published literature from 2008-2012; cross sectional surveys of two cohorts of women during the first and last trimester; and a cross sectional survey of health professionals (midwives, obstetricians, anaesthetists) at Aberdeen Maternity Hospital. The systematic review reported a significant proportion of women used CAM during pregnancy with prevalence rates ranging from 5.8% to 74.2%. The study of health professionals identified that more than 30% of respondents have prescribed, referred or advised the use of CAM to pregnant women. The main associated factor for CAM use was, 'personal use of CAM', with an odds ratio of 8.26 (95% CI 3.09–22.05; P < 0.001). Two thirds of women (63%) reported using CAM, excluding vitamins and minerals, during early pregnancy. The independent predictors of CAM use identified were: use by family and friends (OR 4.1, 95% CI 2.3–7.3, p < 0.001); ethnicity (non-white British) (OR 3.4, 95% CI 1.8–6.8, p < 0.001); and use prior to pregnancy (OR 2.4, 95% CI 1.2–4.8, p = 0.014). Two thirds of women (61.4%) reported using CAM, excluding vitamins and minerals, during the third trimester. The independent associated factors for CAM medicine use identified were: CAM use before pregnancy (odds ratio [OR] 4.36, 95% confidence interval [CI] 2.39–7.95, P<0.001); a university education (OR 2.41, 95% CI 1.46–4.0, P<0.001), and CAM use by family or friends (OR 2.36, 95% CI 1.61–3.47,P<0.001). The lack of an evidence based approach together with the reliance on the advice of family and friends is of concern given the lack of robust data of efficacy and safety. To date, four peer reviewed papers from this doctoral research have been published.
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Esser, Jan Hendrik. "Who cares? : moral reflections on business in healthcare." Thesis, Stellenbosch : Stellenbosch University, 2001. http://hdl.handle.net/10019.1/52612.
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Thesis (MPhil)--University of Stellenbosch, 2001.ENGLISH ABSTRACT: This evaluation serves the purpose of illuminating concepts and ideas behind the moral impact of business values in healthcare and to establish a framework for the analysis of moral dilemmas found in the sphere ofbio-medical ethics. The historic developments of business in healthcare are examined, looking at how and why business became an integral part of the health care system. The concept of "managed healthcare" is introduced and used as the context in which the different institutional role-players are brought together. Managed healthcare is defined by a discussion of the different organisational structures through which it manifests itself. The policies, procedures and regulations that managed healthcare organisations implement and control to fulfil their general function are also examined. Some normative aspects pertaining to the concept of managed health care are explored, including the institutional values of business and that of medicine. A brief discussion of the economic system in which the business agents or role players function are included in the evaluation of the institutional values of business. Further arguments are made to show how the healthcare system with all its role players displays the characteristics of a complex system. Discussions on the fundamental values of medicine concentrate on the basic ideas behind virtues and principles of medical ethics. It is argued that the development of these virtues and principles are important foundations on which the medical profession stands. The moral impact of combining these institutional values within the context of managed healthcare relationships is examined and some important moral dilemmas or conflicts are identified. It is further argued that the fundamental relationships between all the role players in the health care system have changed as all the agents function within a complex system, giving rise to new organisational structures and relationships, with new conceptual roles, ideals, values and practices.
AFRIKAANSE OPSOMMING: Hierdie evaluasie het dit ten doelom sekere konsepte en idees agter die morele impak van besigheidswaardes in gesondheidsorg te illumineer en om 'n raamwerk daar te stel vir die verdere analise van morele dilemmas in die sfeer van bio-mediese etiek. Die historiese ontwikkeling van besigheid in gesondheidsorg word verken deur die redes aan te voer waarom besigheid deel van die gesondheidsorgsisteem geword het. Die konsep "bestuurde gesondheidsorg" word gebruik as die konteks waarin die verskillende institusionele rolspelers bymekaar gebring word. Bestuurde gesondheidsorg word gedefinieer deur die verskillende organisatoriese strukture waardeur dit manifesteer. Die prosedures, regulasies en bereid wat bestuurde gesondheidsorgorganisasies implementeer om hul funksies te vervul word ook verken. Normatiewe aspekte van bestuurde gesondheidsorg word verken, waarby ingesluit word die institusionele waardes van besigheid sowel as dié van medisyne. 'n Kort beskrywing van die ekonomiese sisteem waarin die besigheidsagente, of rolspelers funksioneer word ingesluit by die evaluasie van die institusionele waardes van besigheid. Verdere argumente word gevoer om te wys daarop hoe die gesondheidsorgsisteem met al sy rolspelers die karakter toon van 'n komplekse sisteem. Die basiese idees agter deugsaamheid en morele beginsels van bio-mediese etiek word bespreek om die fundamentele waardes van medisyne te beskryf. Daar word geargumenteer dat die ontwikkeling van hierdie waardes 'n belangrike fondament is waarop die mediese professie staan. Die morele impak van die kombinasie tussen die institusionele waardes van besigheid en medisyne binne die konteks van bestuurde gesondheidsorg word geevalueer en belanrike morele dilemmas en konflikte word geidentifiseer. Verder word geargumenteer dat die fundamenrele verhouding tussen al die rol spelers in die gesondheidsisteem verander het danksy die funksionering van die agente binne hierdie komplekse sisteem. Dit lei op sy beurt na veranderinge in organisatoriese strukture en verhoudinge met nuwe konsepsuele rolle, idiale, waardes en praktyke.
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Mahal, Dawn. "Resistance to change in primary care : an exploration of the role of professional identity." Thesis, University of Stirling, 2017. http://hdl.handle.net/1893/27608.
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This thesis contributes to the academic knowledge in the field of professional identity and organisational change. This thesis also has a practical implication as the findings helped to shape an organisational change within the co-funders organisation. The research was guided by the wish to explore the extent to which professional identity affects the willingness of those within Primary healthcare Units to accept fundamental changes in their working practices. Specifically, the aim was to establish the relationship of professional identity to processes of change. As the owners of small businesses who contract their services to the Health Board, the opinions of General Practitioners (GPs) were deemed to be of particular interest. The study was undertaken using a mixed method design, based upon a Constructivist grounded theory methodology. This was chosen as the ideal vehicle to examine the complex nature of identity within healthcare professionals and how they viewed organisational changes. Research started with unstructured interviews (n-14) and the analysis of the data obtained was fed into a questionnaire (n-97). The questionnaire offered validation of the initial findings. The findings of the research showed that professional identity has a bearing on the willingness of professionals to accept changes to their working environment. The resistance demonstrated by Healthcare staff, and specifically, GPs, to organisational change could be linked to feeling a perceived threat to their professional identity. Therefore, to undertake a successful organisational change, change managers must recognise that identity is vitally important and can affect the success or failure of an organisational change. Consideration of how any change may be perceived by professionals, within an identity context, must be built into the organisational change programme and revisited regularly during the change programme.
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Glasberg, Ann-Louise. "Stress of conscience and burnout in healthcare : the danger of deadening one's conscience." Doctoral thesis, Umeå : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1111.
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Newham, Roger Alan. "The good health care professional : a critique of Edmund Pellergrino's approach to essentialist medical ethics and the virtues." Thesis, Keele University, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.540622.
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In England, medical, nursing and other healthcare professions are required by their codes of professional ethics to have a working knowledge of moral principles and to be able to apply them in practice. Little, if anything, is said explicitly by these professions about the virtues. However, much is said about the character of the doctor or the nurse, and their supposed ability to recognise moral issues in their professional work and make morally good decisions. Edmund Pellegrino has questioned the appropriateness of applying moral principles to medical practice in contemporary times without a firm foundation. He attempts to restore the moral foundation of the profession of medicine, by restricting an account of the good to the profession which he claims, unlike ethics in general, there can be agreement on norms. From this position, moral principles in medical ethics can be justified, agreed upon, and provide firm action guidance in practice, as well as provide an independent ground for medical virtues. I will claim that Pellegrino's concern about disagreement and a loss of norms in ethics in general is not resolved in the restricted field of professional medical ethics and that his understanding of principles and the link with virtue is confused. Then, using virtue terms Pellegrino himself thinks necessary for making good decisions in practice, I will show how a certain account of the virtues can provide a plausible account of how we can become good healthcare workers and so support Pellegrino's goal; though it will not support his confidence in supplying both clear, moral, and normative constraints in a code of professional medical ethics and firm decision-making in practice.
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Sontyale, Ulungile Klaas. "Occupational stressors that influence professional health workers." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1098.
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Background: Despite the prevalence of HIV/AIDS stabilizing and slightly decreasing in certain provinces, there are a number of People Living With HIV/AIDS (PLWHA) in South Africa. Many people seek help at primary health clinics and hospitals and receive chronic care at these facilities. Caring for these chronic patients and new patients entering the health system can be stressful to the health professionals who are involved. Many studies that have been conducted have focused on the clinical aspects of individual patients, while few studies have focused on the experiences and stressors of health professionals looking after PLWHA. To ensure quality of care for patients with HIV/AIDS, it is important to understand the experiences of health professionals looking after HIV/AIDS patients and how stressful experiences may influence their attitude towards these patients. Aim: The aim of this study is to report the factors health professionals perceive as occupational stressors caring for people living with HIV/AIDS in the public health sector of the Nelson Mandela Metropolitan Municipality. Research design and Methodology: A quantitative, descriptive and non-experimental research design was followed. A pilot study was conducted to determine the clarity of questions, effectiveness of the instructions, completeness of the response sets, the time required to complete the questionnaires and the success of the data collection. The primary method of data collection was self-administered questionnaires. The questionnaires were dispatched to 30 health professionals at the public health facilities in the Nelson Mandela Metropolitan Municipality. A descriptive statistical analysis was done using a Statistical Package. This revealed the following findings. Findings: The following are the findings that were perceived to be occupational stressors: organizational factors, job design factors, career and promotional factors, role-related factors and cultural factors. iv Conclusion and recommendations: There are occupational stressors that affect health care professionals working in an HIV/AIDS setting. The following are the recommendations to rectify or to improve the situation: • Improve the communication of goals and objectives; • Redesign the job; • Human-resources development ; • Improvement of salaries; • Career planning and mentoring; and • Sensitisation of employees to cultural differences.
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Patterson, Spencer D. "Putting on White Coats: Professional Socialization of Medical Students Through Narrative Pedagogy in Standardized Patient Labs." Ohio University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1339729044.
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Baker-Salisbury, Mollie. "Teaching Empathy: The Impact of a Service-Learning Requirement on Medical Student Attitudes, Skills, and Professional Identity." Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/554044.
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Urban BioethicsM.A.
As medical students undergo their clinical years, they exhibit a well-documented loss of idealism, increasingly negative attitudes towards poor and underserved patients, and less interest in working with these patients. Here we describe the pilot year of a longitudinal service-learning requirement implemented as a part of the medical student pre-clinical curriculum. We hypothesized that increased non-clinical contact would decrease the formation of negative attitudes towards underserved patients. Students completed service hours at assigned community sites each semester along with written reflections. Surveys were administered to track attitudes towards the underserved. Written reflections were analyzed qualitatively for thematic content as well as feedback on the experience. The requirement was largely acceptable to medical students, and many found value and enjoyment in the experience. The most common critique was that the required hours were insufficient to develop continuity, and that students desired more thorough briefing beforehand to increase their effectiveness. Students reported practicing clinical skills and communication skills. They identified social determinants of health and learned about their patients. They reflected on their professional identity, motivations for entering medicine, and specialty choices. Students experienced moments of connection and belonging, as well as feelings of guilt, otherness, and awareness of privilege. We continue to explore how working collaboratively and learning reciprocally with community members outside of the hospital and clinic may teach students cultural humility and help insulate students from cynicism and negative views of poor and medically underserved patients.
Temple University--Theses
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Corbillon-Gulin, Ramon. "A study of how European Union IPRA practitioners viewed ethical issues : values, standards, social responsibility, and control." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1014808.
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The lack of studies relating to the ethical needs and values of public relations professionals in the European Union indicated the need for a research study to ascertain: 1. the experience of European Union public relations professionals in confronting and resolving ethical issues, 2. what the needs are in charting an ethical course for individual professional conduct, 3.what the needs are to guide organizations in the ethical performance of public relations, and 4. the social responsibility of public relations.Nearly all of the quantitative studies have been devoted to an examination of the views of members of American public relations associations. Numerous authors have pointed out the value of ethical standards and of a means of enforcement of the standards for professions. In spite of an ongoing professional dialogue as to the need, little progress has been made in defining sanctions against those who violate ethical principles while defining themselves as public relations counselors.This study was based on a mail survey created and distributed by Sharpe in the Fall of 1993. Three questions from the 1972 Newsom's research study were added. Threehundred and fifty-five public relations practitioner members of the International Public Relations Association within the European Union in 1995 were identified as the population for this study. A 35.2% response rate was attained after two mailings.The typical respondent was male, had been in the profession from 10 to 30 years, held an accreditation, was a specialist and identified himself as a counselor. He related that he confronted ethical issues with frequency particularly in relation to relationships with clients, the news media, and customers. The majority of the ethical issues, which would have or had transgressed the organizational policies and personal/religious principles, consisted of: misleading information, promising more than could and was delivered, supporting a program with which he disagreed in principle, withholding information, and failure to accept responsibilities. He said that he resolved the last ethical issue encountered, which involved their organization's management performance, by pointing out the ethical issue and influencing an ethical action. He placed some value on both IPRA Codes. He saw all ethical issues as ethically wrong, especially those relating to sexual harassment, the sale of unsafe products and services, discrimination, establishing different pay scales for men and women doing the same work, withholding information for gain at expense of others, and promotion and sale of products in other countries that are unacceptable in the EU that place people at risk. He viewed the public relations profession as having a leading role in improving relationships between peoples of different races within a country and between countries. He saw public opinion as an effective control over public relations performance. Finally, he would recommend the establishment and communication of the organization's ethics code and performance policies so organizational management would be recognized for public relations performance. The employment of public relations officials with professional memberships obligating them to uphold a code of ethical conduct was viewed as a criteria that organizations should establish as evidence of the organization's commitment to ethical public relations.Department of Journalism
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Fields, Tifney L. "An ethical comparison among public relations practitioners and students in the Indianapolis area." Virtual Press, 2007. http://liblink.bsu.edu/uhtbin/catkey/1365178.
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This study has presented insights into emotional perceptions surrounding ethical practices in the public relations field. The evidence resulting from the Q-sort process alluded to the grouping of practitioners as Truth Seers and students as Pragmatists. The Truth Seers revealed complete, balanced and consistent feelings identifying truth as the primary motivation for personal decision making. The Pragmatists were conversely found to believe that while truth was the basis of decision making, it was often necessary to make decisions or be confronted with moral choices that were not the most ethical out of necessity of circumstance. These groupings were general and did not apply toward all of the students or practitioners who participated. No definitive partition was established only a general theory.Department of Journalism
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Fitzgerald, Anneke. "Doctors and nurses working together : a mixed method study into the construction and changing of professional identities /." View thesis, 2002. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031020.092051/index.html.
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Thesis (Ph.D.) -- University of Western Sydney, 2002.A thesis presented to the University of Western Sydney in partial fulfilment of the requirements for the degree of Doctor of Philosophy, November, 2002. Bibliography : p 261-271.
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Gunn, Michelle. "Bedside rationing: Reconciling medical practitioners perceived duties to the individual and community." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/234107/1/Michelle_Gunn_Thesis.pdf.
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Widespread use of technology, and rapidly growing health care expenditure, is driving the need for macro-level policy and funding decisions about resource allocation to achieve public health cost containment. Medical practitioners face dilemmas meeting competing expectations when rationing at the bedside, yet this has attracted limited attention in Australia and internationally. It is unknown how orthopaedic surgeons perceive their legal and ethical obligations to the individual patient, and broader community, and how they reconcile competing obligations when rationing. This mixed methods research, focused on Australian orthopaedic surgeons, explores law, ethics and professional practices around the resource allocation decisions they make.
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Liddle, Keir. "The impact of leadership on the delivery of high quality patient centred care in allied health professional practice." Thesis, University of Stirling, 2018. http://hdl.handle.net/1893/28081.
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The Healthcare Quality Strategy for NHS Scotland, relates its overall vision of healthcare quality to six dimensions of care as: Safe, Efficient, Effective, Equitable, Timely and Patient Centred. Patient Centred Care also underpins many subsequent policies such as the management of Long Term Conditions (Scottish Government, 2008) and the Chief Medical Officers Realistic Medicine report (Barlow, et al., 2015) Leadership styles and associated policies and procedures are often assumed to inhibit or encourage the delivery of quality Patient Centred Care and the NHS invests millions of pounds per year in Leadership training. At a clinical team and management level there are behaviours and initiatives that can arguably have positive and negative impacts on the ability of individual practitioners to provide quality Patient Centred Care. However there have been no attempts to empirically test the association between (good) Leadership and quality Patient Centred Care. Without any evidence of such a relationship, NHS investment of substantial resources may be misguided. Additionally, much of the focus of research in both Leadership and Patient Centred Care has focused on medical practitioners and nurses. There is little research that focuses on the impact of allied health professionals' (a term describing 12 differing health care professional groups representing over 130,000 clinicians throughout the United Kingdom) practice on the quality of person centred care and how this is affected by Leadership structures and styles. This study aimed to explore whether there is a direct or indirect link between (transformational) Leadership and achieving the delivery of high quality Patient Centred Care (PCC) in allied health professional (AHP) practice. Aim The aim of this thesis was to explore whether it was possible to empirically demonstrate a relationship between Leadership (good or bad) and Patient Centred Care, and to do this in relation to Allied Health Professional practice. Research questions I. Is there a relationship between Transformational Leadership and Patient Centred Care in AHP practice? II. How do AHP’s conceptualise Leadership and its impact on their ability to deliver PCC? III. Do local contexts influence the ability of leaders to support Patient Centred Care? Study one Study one was designed to answer research question one: exploring the relationship between transformational Leadership and Patient Centred Care using survey design. Two groups of Allied Health Professionals were selected to take part in the study: Podiatrists and Dieticians. Clinical team leaders from across 12 Podiatry teams and 12 Dietetic teams completed a survey composed of measures of transformational Leadership and self-monitoring. Clinicians from these teams were also be asked to complete questionnaires on their perception of their clinical leaders’ transformational Leadership skills. This allowed comparison of self-assessed Leadership and team assessed Leadership. Clinicians were also asked to collect patient experience measures from 30 of their patients. Study Two Study Two was designed to answer research questions 2 and 3: how do AHPs conceptualise Leadership and how do they view the link between Leadership and their ability to deliver Patient Centred Care; and how might local context impact on professional Leadership and therefore its potential to enable or inhibit Patient Centred Care. In depth interviews were conducted with clinicians and clinical team leaders to explore the barriers and facilitators to effective Leadership, teamwork and the provision of quality care. Interviews were conducted with 21 Podiatrists and 12 Dieticians and analysed using a framework analysis approach. Results I. Is there a relationship between Patient Centred Care and transformational Leadership in AHP practice? The theory that there is a link between transformational Leadership and Patient Centred Care was confirmed. A significant relationship was discovered for the dietetics group linking Transformational Leadership with patient centred quality of care measures. There was also a relationship in the podiatry group that was suggestive of a relationship. II. How do AHP’s conceptualise Leadership and its impact on their ability to deliver PCC? AHP’s in both groups had broadly similar conceptualisations of Leadership and both groups played down the role of Leadership in the delivery of Patient Centred Care. A far more salient factor in achieving the delivery of high quality Patient Centred Care for the AHP’s interviewed was professional autonomy. III. Do local contexts influence the ability of leaders to support Patient Centred Care? A number of contextual issues related to both Patient Centred Care and Leadership were identified from the qualitative analysis. These were centred on systemic factors, relating to management and bureaucracy, and individual factors, such as relationships within teams. In Podiatry a major shift in the context of care was ongoing during the study, namely a greater emphasis on encouraging patients to self-care. This affected the relationships between patients and Podiatrists, and Podiatrists and managers, in a way that Podiatrists felt it negatively impacted on their ability to provide quality Patient Centred Care. Conclusion A weak relationship was observed between Transformational Leadership styles and the delivery of Patient Centred Care in two Allied Health Professional groups. Professional autonomy was identified as being more likely to facilitate delivery of person centred care. Organisational issues and intervening policy directives can impact on the delivery of Patient Centred Care, regardless of Leadership. Recommendations Further work exploring the link between Leadership and Patient Centred Care is required. The concept of professional autonomy should be fostered within Leadership programs to enhance delivery of Patient Centred Care. The impact of individual policies, such as moves towards more self-care, on quality criteria need to be more fully considered. Whilst such policies may make care more efficient, there may be negative consequences for other quality care criteria, such as Patient Centred Care.
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Lau, Sze-fei Sophia. "Government professionals and value conflicts in the civil service : a Hong Kong study /." Click to view the E-thesis via HKUTO, 1998. http://sunzi.lib.hku.hk/hkuto/record/B42128626.
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Dahlqvist, Vera. "Samvete i vården : att möta det moraliska ansvarets röster /." Umeå : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1478.
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Fitzgerald, Anneke. "Doctors and nurses working together : a mixed method study into the construction and changing of professional identities." Thesis, View thesis, 2002. http://handle.uws.edu.au:8081/1959.7/789.
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This research investigates the relevance of professional subcultures in a climate of change at a large hospital in South-Western Sydney and addresses the question : 'How do changes associated with health reform impact upon cultural interdependence between professional identities?'. As a corollary, cultural interdependence between professional identities may have profound consequences for health reform and for hospital management. By exploring the two main ideas, Professional Sub-group culture and change, this research draws from existing theory in areas such as organisational culture and cultural change, professional identities and health reform. The thesis addresses three anthropological perspectives of cultural change. It addresses the integration perspective as a homogenous unity by analysing the organisation-wide key ideas (or myths) that make action possible, often espoused by senior management. It addresses the fragmentation perspective as a gathering of transient concerns, by acknowledging the ambiguity and anxiety associated with a state of constant flux. It analyses the differentiation perspective as a collection of subcultures and its commonalities and differences. The change discussed in the thesis was not of an archetypal nature. There was no transformation of the organisational business model at government level. However, at lower levels, actors in the organisation experienced jolts through decreed change from a small district level hospital to a large tertiary level trauma centre. This research re-evaluates the theory on professional identity by establishing to what extent environmental changes and organisational changes impact upon professional identity from three cultural perspectives. This research does this by first assessing the health care organisation for existence of occupational subcultures through survey. The research continues by investigating the relationships between occupational groups through focus group discussion and in-depth interviews. Participant observation is used to illustrate and reflect commonality and diversity. This combination of methods facilitates the analysis of change and professional identity
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Yung, Nancy. "The right to be killed : reassessing the case for the moral right to voluntary active euthanasia." Thesis, University of Oxford, 2015. https://ora.ox.ac.uk/objects/uuid:2aa54686-b621-4323-b836-ce6099b5d2fd.
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This thesis defends an individual's moral right to be aided in dying by a physician (that is, voluntary active euthanasia, or VAE), but departs significantly from the view in its favor generally accepted in the bioethics literature. The prevailing view appeals to both respect for an individual's autonomy and promotion of an individual's well-being as necessary conditions for a right to VAE, so as to justify the right only for those suffering grave illnesses and/or disabilities. The author argues that such a view is logically untenable; one or another aspect must be given up. Since invoking the premise that certain individuals would be better off dead necessarily relies on controversial assumptions about both the value of life and the nature and value of death, about which reasonable people disagree, it is the justification from an individual's best interest which must be excluded in a liberal society. The author endorses a self-determination justification for the right to VAE, but rejects understanding this in terms of respecting personal autonomy, instead making the case for a right to VAE grounded in self-ownership. The author's main conclusion is that the right to VAE is a general right applying to all competent adults, not only those suffering grave illnesses or disabilities, or those whose choice for VAE is an exercise of autonomy. Moreover, by analyzing the basis of physician authority over prescription medicine and how this can be justified to a society of self-owners, she maintains that individuals have not only the right to choose VAE without state interference, but also the right to be provided VAE by doctors. Nevertheless, both rights are compatible with reasonable limitations to protect both the interests of VAE seekers and the rights of others.
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Mrara, Msibulele Theophilus. "An investigation of turnover and retention factors of health professional staff within the Eastern Cape Department of Health." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1003875.
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Health Professionals are critical in the provision of health services, more especially when it comes to nurses who are next to the patient most of the time. It is critically important for the Eastern Cape Department of Health to ensure that skilled health professionals such as doctors, pharmacists, nurses and the like are retained and the staff turnover regarding this category of staff is appropriately managed. The difficulty to attract and retain health professionals is negatively affecting service delivery in the Eastern Cape department of Health and leaves the department with an unacceptably high vacancy rate. This often put more of a burden on to the health professionals who remain within the organization. Some of them will end up leaving the organization. There is a great shortage of health professionals in South Africa and it becomes easier for the health professionals to get employment elsewhere, particularly in the private sector which appears to have a competitive advantage as compared to the public sector. In this study, both quantitative and qualitative methods were used to gather information through the utilization of a questionnaire and interviews were conducted mainly to confirm the results obtained. The results of the study have assisted to reflect factors that could be influencing the health professionals to leave health facilities of the Eastern Cape Department of Health. The respondents were drawn from the two areas within the Health Department, and these are, Mthatha and Port Elizabeth areas. One hundred (100) questionnaires were issued to the health professionals and sixty three responded. Documents that were received from the department were helpful in determining the turnover rate. The study has revealed that the Eastern Cape Department of Health may succeed in retaining the health professionals if they can be made to feel that their job is important. It appears that health professionals would like to be given enough opportunity to perform their functions and participate in the decision making processes of the department. Some factors may be contributing to the staff turnover and these are, lack of career opportunities to develop, challenges in the workplace, conflict with the management and colleagues. It is always important for the organizations to recognize its employees by giving them space to practice their profession and create a comfortable workplace that could have an impact in influencing the employee to remain within the organization. Employee turnover can be minimized, if employees can be exposed to a healthy workplace environment that will assist if fostering happiness, and in the process, enhance their motivation. It is imperative for the Eastern Cape Department of Health to focus on the training and development of its employees in order to increase the efficiency and competitiveness. As the employees gain the necessary skills to perform their job, productivity may improve. The performance of the employees should be properly managed, and the resultant incentives and rewards must be fairly distributed. This could promote harmony in the workplace and that could help in building relationships among employees. If employees are satisfied, there is an increased chance that they will stay within the organization and it becomes difficult for other competitors to attract them. Employees must be given adequate space to participate in the decision making processes of the organization, and by doing so, their loyalty to the organization could be increased.
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Бурнос, Євгенія Юріївна, Евгения Юрьевна Бурнос, Yevheniia Yuriivna Burnos, and Разі Мохамед. "Професійна комунікативна компетентність іноземних студентів-медиків." Thesis, Сумський державний університет, 2021. https://essuir.sumdu.edu.ua/handle/123456789/84424.
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Особливість навчання мовленнєвої компетентності полягає в розвитку і
вдосконаленні механізмів мови, формуванні професійно-значущих
комунікативних умінь і навичок клінічного мислення. До професійно-
комунікативних компетенцій належать уміння усвідомлювати і чітко визначати
своє мовне завдання; уміння чітко планувати хід бесіди; уміння подавати такі
репліки-стимули, на які б давалися відповідні репліки-реакції бажаної
функціональної спрямованості, а також навички вести діалог (ставити
конкретні запитання, які б направляли відповіді пацієнта в рамки. Встановлені
самим студентом; ставити уточнювальні запитання, в яких студент сам
використовує знайому лексику і знайомі граматичні конструкції).
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Law, Lik-hang Darick, and 羅力恒. "Attitudes toward rape and sexual assault: a comparative analysis of professional groups in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B29705113.
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Batista, Anne Aires Vieira. "Formação de recursos humanos em saúde : o ensino da ética e a prática profissional." Universidade Federal de Sergipe, 2011. https://ri.ufs.br/handle/riufs/3745.
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This study aimed at getting acquainted with the opinions of physicians and nurses regarding the teaching of Ethics as a response to the needs of professional practice, indentifying ethical conflicts within these professional's practice and getting to know both unfavorable and favorable conditions to the maintenance of ethical affairs within the workplace. The survey was carried out in the city of Aracaju, State of Sergipe and the units of observation were health institutions of the same city. The study sample was simple-random and had nurses and physicians of these health institutions as its respondents. The results showed that the teaching of Ethics in medical and nursing schools is not consistent with the reality experienced by these professionals and the interconnections between theory and practice, as well as the restrictive approach to a particular term or subject and not as a fix element throughout the entire course, is inexistent. Therefore, the respondents which have been experiencing different kinds of ethical conflicts in their workplace routine such as: Inappropriate behaviors towards patients, negligence, inaccuracy, troubled multiprofessional affairs, have been enduring the task of assisting the patients under inappropriate working conditions. They have trouble in making proper decisions since their training process lacked support. Besides ethical conflicts, the workers also reported some unfavorable conditions for the maintenance of ethical relationships in the workplace, such as inappropriate workplace condition and remuneration, hierarchical conflicts, both inappropriate personal and professional practices, the lack of technical ability combined with the ignorance on the ethic code and their careers legislation, among other matters. Therefore, in the light of the demands experienced by physicians and nurses in their working routine, it is reiterated the need for boosting the teaching of Ethics through more dynamic methodologies, interconnected to professional practice situations, as well as becoming a theme for debate throughout the entire undergraduate course. Through this perspective, the training critical, reflexive, ethical and social responsible professionals is definitely a possibility to be believed.O presente estudo pretendeu conhecer a percepção de médicos e enfermeiros sobre o ensino da ética como resposta às necessidades da prática, identificar situações de conflitos éticos na prática destes profissionais e conhecer as condições desfavoráveis e favoráveis para a manutenção das relações éticas no ambiente de trabalho. A pesquisa foi realizada na cidade de Aracaju-SE, sendo as unidades de observação as instituições de saúde desta. A amostra foi casual simples e foi composta por médicos e enfermeiros lotados nas respectivas instituições de saúde. Através dos resultados obtidos, percebeu-se que o ensino da ética nos cursos de graduação em medicina e enfermagem não é condizente com a realidade vivida por esses profissionais, faltando a correlação entre a teoria e a prática, com abordagem restrita a um período ou a uma disciplina específica, sem permear por todo o curso. Com isto, os respondentes que vivenciam diversos conflitos éticos em seu cotidiano de trabalho tais como: a atitude profissional inadequada com o paciente, a negligência, a imperícia, as relações multiprofissionais conflituosas, submetem a prestar assistência em condições inadequadas de trabalho, entre outros, têm dificuldade em tomar decisões adequadas, visto que não tiveram o devido respaldo no processo de formação. Além dos conflitos éticos, os profissionais também referiram algumas condições desfavoráveis para a manutenção das relações éticas no ambiente de trabalho, entre elas foram destacadas as condições de trabalho e remuneração inadequadas, os conflitos hierárquicos, a prática profissional e pessoal inadequada, o despreparo e a inabilidade técnica associados ao desconhecimento do código de ética e da legislação das respectivas profissões, dentre outros. Assim sendo, diante das demandas vivenciadas no cotidiano dos médicos e enfermeiros, reafirma-se a necessidade de valorizar o ensino da ética através de metodologias mais dinâmicas, correlacionadas com as situações da prática profissional, sendo discutida durante todo o curso de graduação. Através disto, acredita-se na possibilidade de formar profissionais críticos, reflexivos, com maior responsabilidade ética e social.
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Read, Gary Frank Hoyland. "A qualitative study aimed at describing & interpreting the changing symbolic meanings of HIV/AIDS which encountering HIV-positive patients introduces into the personal & professional identities of selected health care professionals." Thesis, Rhodes University, 1993. http://hdl.handle.net/10962/d1002550.
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This study aimed at describing and interpreting the changing symbolic meanings of the Acquired Immunodefiency Syndrome (AIDS) which encountering a Human Immunodefiency Virus (HIV)-positive patient introduced into the personal and professional identities of six health care professionals in a subregion of the Eastern Cape. With the exponential increase of HIV/AIDS in South Africa, medical practitioners have become increasingly exposed to HIV infected patients. This study has considered the psychological structures developed by practitioners in an attempt to control and understand their situation in the context of HIV/AIDS. In order to describe these psychological structures the existential phenomenological approaches of L. Binswanger (in Needleman, 1963), A. Giorgi (1975) and F.J.Wertz (1985) were employed. Through these procedures, the structure of the experience of encountering an HIV infected patient was elucidated. This comprised the first goal of this study. The second goal focused on interpreting these descriptions by way of the symbolic meanings and definitions implicit in the structure of this experience. For this latter purpose the approach of symbo1ic interactionism was used, in particu1ar the understandings outlined by H. Blumer (1969). This theory was seen as appropriate in that the encounter between the practitioner and patient was primarily located in interpersonal parameters. The findings were discussed in terms of the two dominant metaphorical frameworks used by the subjects to comprehend the disease - namely the perspectives of society and the biomedical model. These two frameworks were critically evaluated in the context of HIV/AIDS, the needs of HIV infected individuals as well as the needs of the general practitioner. The process of the encounter was found to be very significant for practitioners in terms of their conceptualisations of HIV/AIDS. Old understandings were reinterpreted within the interpersonal context and replaced with more appropriate symbolic metaphors upon which to base practise. This study has revealed these new understandings were limited and constrained with regard to understanding and treating HIV/AIDS in that the subjects were still influenced by the metaphors of the biomedical model. These constraints were examined in the light of both personal and professional meanings and identities. This study concluded by making suggestions for modification of the medical practitioner's role in the context of HIV/AIDS.
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Munro, Susan 1938. "The education of the health care professional in terminal care in the light of the emotional impact of the nature of the work /." Thesis, McGill University, 1986. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=65973.
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Snyman, Margaretha Alberta. "Assessment of professional behaviour in occupational therapy education: investigating assessors’ understanding of constructs and expectations of levels of competence." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20037.
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Thesis (MPhil)--Stellenbosch University, 2012.ENGLISH ABSTRACT: The development of professional behaviour is one of the core components of occupational therapy education. The assessment of professional behaviour poses a problem as the constructs and expectations are not clearly defined; this results in compromised inter-rater reliability. The purpose of the study was to investigate assessors’ understanding of the constructs and the expectations deployed during the assessment of professional behaviour of third and fourth year occupational therapy students during clinical practice. A case study design was used in the qualitative study. Clinical supervisors were involved in: (1) a focus group interview to scrutinise the usefulness of the current assessment instrument and (2) a participatory discussion to determine their understanding of the constructs of professional behaviour and the level of expectations to be set for third and fourth year students respectively. This study confirms that the development of effective assessment of professional behaviour entails a number of pivotal steps that include developing a shared definition of the constructs thereof and the expectations at different levels of undergraduate training, the refinement of the assessment instrument and training of assessors in the use of this assessment instrument.
AFRIKAANSE OPSOMMING: Die ontwikkeling van professionele gedrag is een van die kern komponente in arbeidsterapie opleiding. Die assessering daarvan bied egter uitdagings aangesien die konstrukte en verwagtings nie duidelik gedefinieer is nie; dit het gekompromiteerde geldigheid en betroubaarheid tot gevolg aangesien verskillende assessore die professionele gedrag van studente verskillend assesseer. Hierdie studie het die ondersoek van kliniese toesighouers se begrip van die konstrukte en hul verwagtings tydens die assessering van professionele gedrag van derde- en vierdejaar arbeidsterapiestudente tydens kliniese prakties ten doel gehad. ‘n Gevallestudie ontwerp het die basis van ‘n kwalitatiewe ondersoek gevorm. Kliniese toesighouers is betrek in: (1) ‘n fokusgroeponderhoud om die bruikbaarheid en gebruikersvriendelikheid van die huidige assesseringsinstrument te bepaal; en (2) ‘n deelnemende groepbespreking om hul begrip van die konstrukte van professionele gedrag en die verwagte vlakke van funksionering vir onderskeidelik derde- en vierdejaar studente te ondersoek. Hierdie studie bevestig dat die ontwikkeling van effektiewe assessering van professionele gedrag ‘n aantal essensiële stappe behels. Hierdie stappe sluit die ontwikkeling van ‘n gedeelde definisie van die konstrukte en verwagtinge van professionele gedrag in, asook die verskil in verwagtinge op die onderskeie vlakke van voorgraadse opleiding, die verfyning van die bestaande assesseringsinstrument en die opleiding van assessore in die gebruik daarvan.
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Marín, Donato Katherine. "Ideas y expectativas en relación a la Responsabilidad Social de estudiantes de primer año de carreras de la salud. Un estudio de caso." Doctoral thesis, Universitat de Barcelona, 2018. http://hdl.handle.net/10803/586158.
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Un foco de preocupación de la Educación Superior es la formación universitaria en Responsabilidad Social (RS), siendo pertinente al momento de reflexión que se vive en Chile en torno al rol de las universidades y de su contribución a la sociedad.
Este estudio indaga en las ideas o imaginario sobre la RS que traen los estudiantes que ingresan a las carreras de la salud en la Facultad de Medicina Clínica Alemana- Universidad del Desarrollo (FM CAS-UDD).
El proyecto se sitúa en el paradigma interpretativo, apelando a la búsqueda de la resolución de un problema que requiere una investigación sensible a la subjetividad, la pluralidad de ideas y la complejidad de las situaciones, en contraposición a un modelo positivista de causas y efectos. Se plantea este trabajo como una investigación cualitativa, específicamente como estudio de caso.
El trabajo de campo se desarrolla al interior de la FM CAS-UDD, en Santiago de Chile. Se invita a participar a los estudiantes de primer año de las carreras de Enfermería, Fonoaudiología, Kinesiología, Medicina, Odontología y Tecnología Médica. Como estrategias de recolección de información, se utilizan grupos focales, conversaciones informales y diario del investigador. Se aplican los criterios de rigor metodológico, propuestos por Guba (1983), y se lleva a cabo un proceso de análisis con tres niveles, realizando una reducción de datos desde la extracción de unidades de significado, categorización de las mismas, agrupamiento en metacategorías y establecimiento de núcleos temáticos emergentes. Mediante todo el proceso de investigación se utiliza el sistema de identificadores establecido, con el objeto de asegurar la confidencialidad de la información aportada por los participantes.
10 Los principales resultados giran en torno a cuatro núcleos temáticos, a saber: dimensiones que conforman la RS, cómo se aprende la RS, profesionales de la salud y RS, y finalmente motivaciones relacionadas con RS para estudiar carreras de la salud.
La motivación de la autora para llevar a cabo este proyecto, es la convicción de que el paso de los estudiantes por la universidad es una oportunidad para su transformación en profesionales que puedan contribuir a la construcción de una sociedad más digna, equitativa y cohesionada.A focus of concern for Higher Education is university instruction in Social Responsibility (SR), being relevant to the moment of reflection perceived in Chile around the role of universities and their contribution to society. This study investigates the ideas or imaginary about SR that bring the students that enroll themselves in the careers of the health in the Faculty of Medicine – Clínica Alemana Universidad del Desarrollo (FM CAS-UDD). The project is situated in the interpretative paradigm, appealing to the search of the resolution of a problem that requires a sensitive investigation to subjectivity, plurality of ideas and complexity of situations, in contrast to a causes and effect positivist model. This work is proposed as qualitative research, specifically as a case study. The fieldwork is developed within the FM CAS-UDD, in Santiago, Chile. First-year students of Nursing, Phono audiology, Kinesiology, Medicine, Dentistry and Medical Technology careers are invited to participate. As strategies for collecting information, focus groups, informal conversations and the researcher's diary are used. The criteria of methodological rigor, proposed by Guba (1983), are applied and an analysis process carried out with three levels, making a reduction of data from the extraction of significant units, their categorization, grouping into metacategories and definition of emerging thematic nuclei. Throughout the research process, the identifier system is used, in order to ensure the confidentiality of the information provided by the participants. Main results revolve around four thematic areas, namely: dimensions that make up the SR, how the SR is learned, health professionals and RS, and finally motivations related to RS to study careers in health. 12 The motivation of the author to carry out this project, is the conviction that the passage of students through the university is an opportunity for their transformation into professionals who can contribute to the construction of a more dignified, equitable and cohesive society.
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Reversat, Bernard. "La réflexion éthique au service de l'analyse des pratiques professionnelles sur un territoire de santé." Thesis, Aix-Marseille, 2017. http://www.theses.fr/2017AIXM0621/document.
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Le sens de l’exercice soignant se fonde sur le “vivre ensemble” et se nourrit d’un important besoin de réflexion éthique que l’on retrouve tant chez les étudiants qu’auprès des professionnels de santé. Pour autant, l’exercice de la réflexion et le développement de la formation à l’éthique ont été peu présents en formation initiale et dans le parcours de la majorité des professionnels en activité. La posture individuelle réflexive ne suffit pas et doit être complétée par une démarche collective de réflexion éthique associant le patient, sa famille ou ses proches, au dialogue interdisciplinaire. La commission « éthique et professions de santé » (rapport A Cordier 2003) a identifié un manque de lieux et de temps pour les soignants, leur permettant de « formaliser » leur réflexion éthique. Cette thèse se propose d’identifier les dispositifs à construire, au travers de séquences de simulation en santé, afin d’accompagner les acteurs du soin dans cette démarche de questionnement à priori mais aussi à postériori,.Des questionnaires seront utilisés afin d’enrichir et de conforter l’hypothèse centrale.Un autre axe de recherche tentera d’objectiver les variations du niveau de pertinence des principes éthiques en jeu, en fonction des contextes et ceci au travers d’observations menées lors de réunions pluridisciplinaires, entre professionnels du soin..Enfin et en réponse à la question de départ, il apparait qu’un programme de Développement Professionnel Continu (DPC), conçu comme « nouvel espace de la réflexion » semble être une opportunité à saisir, pour aider les acteurs du soin à clarifier les situations et à construire en collégialité, le sens de leur pratiqueThe meaning of the nursing exercise is based on the notion of “living together” and feeds on an important need for ethical reflection both from students and healthcare professionals. However, the reflection exercise and the development of training in the field of ethics have been scarce in initial training and in the career path of most of professionals in service. The individual reflexive position is not sufficient and must be completed by a collective approach of ethical reflection in which the patient, his/her family or his/her close relations are associated with interdisciplinary dialogue. The “Ethics and Health Professions” committee (as per the A Cordier report in 2003) pointed out a lack of locations and time for the nursing staff, which could allow them to “formalize” their ethical reflection. This thesis suggests identifying the systems to be created in order, for example of the sequences of simulation in health, to accompany nursing players in this questioning approach a priori but also exposit. Questionnaires will be used to enhance and consolidate the main assumption. Another research focus will attempt to objectify changes in the level of relevance of ethical principles involved, according to contexts and through observations conducted during multidisciplinary meetings between health professionals. This approach will attempt to validate another hypothesis. Finally, to answer the initial question, it appears that a Continuous Professional Development program (DPC), designed as a “new area for reflection” seems to be an opportunity that must be seized, to help care providers to clarify situations et build their practice purpose in a collegial manner
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Bremer, Anders. "Vid existensens gräns : Etiskt vårdande och professionellt ansvar vid hjärtstopp utanför sjukhus." Doctoral thesis, Högskolan i Borås, Institutionen för vårdvetenskap, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-16285.
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Aim: To describe and interpret patients’, family members’ and ambulance personnel’s experiences with regard to survival, attendance, and caring at cardiac arrests and deaths, and to analyze ethical conflicts that arise in relation to families and how the personnel’s ethical competence can affect caring and the ability to handle ethical problems. Method: The three interview studies were guided by a reflective lifeworld approach grounded in phenomenology and analyzed by searching for the essence of the phenomenon in two studies and by attaining a main interpretation in one study. In the fourth study, the general approach was supplemented by “reflective equilibrium” that guided the ethical analysis. Results: The survivors are striving towards a good life by means of efforts to reach meaning and coherence, facing existential fear and insecurity as well as gratitude and the joy of life. Family members lose everyday control through feelings of unreality, inadequacy and overwhelming responsibility. Ambulance personnel’s care mediates hope and despair until the announcement of survival or death. After the event, family members risk involuntary loneliness and anxiety about the future. For the ambulance personnel, caring for families involves a need for mobility in decision making, forcing the personnel to balance their own perceptions, feelings and reactions against interpretative reasoning. To base decision making on emotional reactions creates the risk of erroneous conclusions and a care relationship with elements of dishonesty, misdirected benevolence and false hopes. Identification with family members can promote recognition of and response to their existential needs, but also frustrate meeting family members emotions’ and handling one’s own vulnerability and inadequacy. It was found that futile cardiopulmonary resuscitation, administered to patients for the benefit of family members, is not an acceptable moral practice, due both to norms of not deliberately treating persons as mere means and to norms of taking care of families. Conclusions: Ethical conflicts exist when it comes to conveying realistic hope, relief from guilt, participation, responsibility for decision making, and fairness in the professional role. Ambulance personnel need support to enhance ethical caring competence and to deal with personal discomfort, as well as clear guidelines on family support.
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Pimentel, Déborah Mônica Machado. "A ética das relações: percepção de médicos e enfermeiros sobre os conflitos na prática profissional." Universidade Federal de Sergipe, 2013. http://ri.ufs.br:8080/xmlui/handle/123456789/3557.
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A cross-sectional study, qualitative, descriptive, willing to know, from the perception of physicians and nurses, the ethical relations in professional practice and identify ethical conflicts among health professionals and patients, and colleagues in the field. To achieve the objectives, a systematic review of the literature a study was conducted on 515 articles from the period 2004-2011 with methodology driven by Cochrane Handbook Publications. The simple and casual sample of field research was composed of nurses and doctors of health institutions in Aracaju city. It was used a collection instrument with the following variables: job profile, working conditions, ethical conflicts, contribution of ethical education at the undergraduate level for dealing with conflicts. The survey was complited by inviting professionals to participate in focus groups with sessions of two hours duration, with flexible script about favorable and unfavorable conditions to the maintenance of ethical relationships at work and ethics training to face the conflict. The categorical analysis technique was utilized to evaluate data. The results of the survey revealed that, from the point of view of professionals, ethics training does not meet the requirements of professional practice. As a solution, improving the disciplines of communication skills and medical humanities, a better preparation of teachers and the teaching of technical and scientific expertise are linked to ethical aspects, were suggestions discussed in all academic disciplines. Focus groups concluded that health professionals are more concerned with the diseases than patients in practice dehumanized. Lack of communication skills, coupled with neglect of interpersonal and interprofessional relationships, poor working conditions, conflicts of interest and favor relationship conflicts, promoting errors, complaints, discomfort, discredit to professionals and harm to patients. The professionals themselves have recognized the need to be more supervised and punished. The focus groups revealed ethical conflicts in interpersonal relationships more serious than those presented in the literature, demonstrating great pain, with relevant moral anguish. Both categories showed professional training as insufficient and responsible for the conflict, by not prioritizing ethics or the basic principles of bioethics.Estudo transversal, qualitativo, descritivo, com o objetivo de conhecer, a partir da perspectiva dos profissionais médicos e enfermeiros, as relações éticas na prática profissional e identificar os conflitos éticos entre profissionais de saúde e pacientes e entre os colegas da área. Para a consecução dos objetivos foi realizado uma revisão sistemática em 515 artigos sobre o tema, com metodologia orientada pelas publicações Cochrane Handbook, no período de 2004-2011. A amostra da pesquisa de campo foi casual simples e composta por enfermeiros e médicos de instituições de saúde da cidade de Aracaju. Para a coleta de dados foi usado um instrumento misto com as variáveis: perfil profissional, condições de trabalho, conflitos éticos, contribuição da formação ética no curso de graduação para o enfrentamento de conflitos. A partir da aplicação deste instrumento os profissionais foram convidados a participar de grupos focais com sessões de duas horas de duração, com roteiro flexível que abordaram as condições favoráveis e desfavoráveis à manutenção das relações éticas no trabalho e a formação ética para o enfrentamento dos conflitos. No tratamento dos dados foi usada a técnica da análise categorial. Os resultados dos questionários revelaram que na percepção dos profissionais o ensino da ética não atende às necessidades da prática profissional. Sugerem o aprimoramento das disciplinas de habilidades de comunicação e humanidades médicas, um melhor preparo dos professores e que o ensino das competências técnicas e científicas esteja associado aos aspectos éticos, discutidos em todas as disciplinas da formação acadêmica. Dos grupos focais extraiu-se que os profissionais de saúde estão mais preocupados com as doenças do que com os doentes, em prática desumanizada. A falta de habilidades de comunicação, aliada ao descaso com as relações interpessoais e interprofissionais, às más condições de trabalho, e aos conflitos de interesse favorecem os conflitos de relacionamento, promovendo erros, denúncias, desconforto, desprestigio para os profissionais e prejuízos para os pacientes. Os profissionais reconheceram a necessidade deles próprios serem mais fiscalizados e punidos. Os grupos focais revelaram conflitos éticos nas relações interpessoais mais graves do que os apresentados pela literatura, demonstrando grande sofrimento, com relevante angústia moral. Ambas as categorias profissionais apontaram a formação como insuficiente e responsável pelos conflitos, por não priorizar ética e tampouco os princípios básicos da bioética.
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Discher, Jennifer M. "A Narrative Analysis of Familial, Collegiate, and Professional Experiences that Enhance the Formation of Civic Engagement and Mission Commitment among Catholic Health Care Nurses." University of Toledo / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1318997506.
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Gibb, Winna. "Informed consent : a liberal perspective." Thesis, Queensland University of Technology, 1998.
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Williams, J. Gary. "Supervised autonomy : medical specialties and structured conflict in an Australian General Hospital /." Title page, contents and abstract only, 1991. http://web4.library.adelaide.edu.au/theses/09PH/09phw7242.pdf.
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Le, Roux-Kemp Andra. "A legal perspective on the power imbalances in the doctor-patient relationship." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/1330.
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Thesis (LLD (Public Law))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: The unique and intimate relationship that exists between a medical practitioner and his/her client is possibly one of the most important relationships that can come into being between any two people. This relationship is characterised and influenced by the qualities and attributes specific to the nature and historical development of medical care, as well as medical science in general. The doctor-patient relationship is also influenced by the social dynamics of a particular community, environmental factors, technological advances and the general social and commercial evolution of the human race. With regard to medical care and health service delivery, the doctor-patient relationship is furthermore vital to the quality of the care provided, as well as to the outcomes and relative success of the specific medical intervention or treatment. One of the distinct characteristics of the doctor-patient relationship is the power imbalance inherent in this relationship. The medical practitioner has expert knowledge and skill, while the patient finds himself or herself in an unusually dependent and vulnerable position. It is because of this important role that the doctor-patient relationship still plays in health service delivery today; the susceptibility of the relationship to a variety of influences, and the characteristic power imbalances inherent in this relationship, that a study of the doctor-patient relationship in South African medical- and health law is necessary. The characteristic power imbalances will be considered from a legal perspective in this dissertation. This study provides a comprehensive source of the doctor-patient relationship from a legal perspective. Where relevant, references are made to theories and principles from other disciplines, including sociology, economy and medical ethnomethodology. The prevalence and consequences of power imbalances in the doctor-patient relationship are identified and discussed with the aim of bringing these to the attention of both the legal fraternity, and medical practitioners. Specific problem areas are identified and solutions are offered, including the following: • The adverse consequences of power imbalances inherent in the doctor-patient relationship on the medical decision-making process are considered from various perspectives. With regard to these adverse consequences, the doctrine of informed consent is analysed and evaluated in great detail. • The influence of paternalistic notions in health service delivery; the business model of health service delivery and the effects of managed care and consumer-directed health care on the doctor-patient relationship and health service delivery in general are also analysed from a legal perspective, and specifically with regard to the power imbalances inherent in this relationship. • The role of autonomy, self-determination and dignity, as well as the principles of beneficence in medical practice, are reconsidered in an attempt to provide a solution for redressing the power imbalances inherent in the doctor-patient relationship. • The fiduciary nature of the doctor-patient relationship and the special role of trust in the relationship are emphasised throughout the dissertation as the focal point of departure in the doctor-patient relationship and the main constituent in any legal endeavor to redress the power imbalances inherent in it.
AFRIKAANS OPSOMMING: Die unieke en intieme verhouding wat bestaan tussen ‘n mediese praktisyn en ‘n pasiënt is wêreldwyd waarskynlik een van die belangrikste verhoudings wat tussen twee persone tot stand kan kom. Hierdie verhouding word gekenmerk en beïnvloed deur kwaliteite en eienskappe eie aan die besonderse aard en historiese ontwikkeling van gesondheidsorg, sowel as die mediese wetenskap in die algemeen. Die dokter-pasiënt verhouding word verder beïnvloed deur die sosiale dinamika van ‘n bepaalde gemeenskap, omgewingsfaktore, tegnologiese vooruitgang en die algemene sosiale en kommersiële ontwikkeling van die mensdom. Op die terrein van gesondheidsorg en mediese dienslewering is die dokter-pasiënt verhouding voorts ook sentraal tot die kwaliteit van die mediese sorg wat verskaf word, sowel as die uitkomste en relatiewe sukses van die spesifieke mediese behandeling. Een van die kenmerkende eienskappe van die dokter-pasiënt verhouding is die magswanbalans wat daar tussen dokter en pasiënt bestaan. Die mediese praktisyn beskik oor deskundige kennis en vaardighede, terwyl die pasiënt hom- of haarself in ‘n ongewone, afhanklike en kwesbare posisie bevind. Dit is dan veral weens die besondere rol wat hierdie verhouding steeds in hedendaagse gesondheidsorg speel, die beïnvloedbaarheid van hierdie verhouding deur ‘n verskeidenheid faktore, sowel as die kenmerkende magswanbalans inherent in die verhouding, dat ‘n ondersoek na die dokter-pasiënt verhouding in die Suid-Afrikaanse mediese reg noodsaaklik is. Hierdie kenmerkende magswanbalans sal vanuit ‘n regsperspektief verder in hierdie proefskrif ondersoek word. Hierdie studie bied ‘n omvattende bron van die dokter-pasiënt verhouding benader vanuit ‘n regsperspektief, terwyl verwysings na teorieë en beginsels van ander dissiplines soos die sosiologie, ekonomie en mediese etnometodologie ook waar nodig ingesluit word. Die voorkoms en gevolge van ‘n magswanbalans in die dokter-pasiënt verhouding word verder geïdentifiseer en bespreek ten einde dit onder die aandag te bring van beide regslui en medici. Spesifieke probleemareas wat geïdentifiseer is en die oplossings wat daarvoor aan die hand gedoen is sluit die volgende in: • Die nadelige gevolge van die bestaan van ‘n magswanbalans in die dokter-pasiënt verhouding op die mediese-besluitnemingsproses word bespreek vanuit verskillende persepktiewe. Met betrekking tot hierdie nadelige gevolge, word die leerstuk van ingeligte toestemming in besonder geanaliseer en geëvalueer. • Die invloed van ‘n paternalistiese benadering tot gesondheidsorg, die besigheids-model van gesondheidsorg, en die effek van bestuurde- en verbruikersgedrewe gesondheidsorg inisiatiewe op die dokter-pasiënt verhouding en die verskaffing van gesondheidsdienste in die algemeen word ook vanuit ‘n regsperspektief ge-analiseer. Spesifieke aandag word in dié verband gegee aan die invloede van hierdie benaderings en perspektiewe op die magswanbalans inherent aan die dokter-pasiënt verhouding. • Die besondere rol van autonomie, selfbeskikking en menswaardigheid, asook die beginsels van weldadigheid in gesondheidsorg, word heroorweeg in ‘n poging om ‘n meer gelyke distribusie van mag in die dokter-pasiënt verhouding te verseker. • Die fidusiêre aard van die dokter-pasiënt verhouding en die besondere rol wat vertroue in hierdie verhouding speel, word in hierdie proefskrif beklemtoon en word voorts as die basis van die dokter-pasiënt verhouding beskou. Vertroue, as ‘n kenmerk van die dokter-pasiënt verhouding, behoort ook die fokuspunt te wees van enige poging om die magswanbalans in die dokter-pasiënt verhouding aan te spreek.