Family members' perspectives of hope when supporting a relative experiencing mental health problems.

Current research views hope as a process that plays a positive role in the recovery of individuals with mental health problems. However, little attention has been given to the role of hope in the lives of their families. We aimed to address that gap.

Visitor restrictions during the COVID-19 pandemic: An ethical case study.

To prevent and reduce the transmission of the coronavirus to vulnerable populations, the World Health Organization recommended the restriction of visitors to nursing homes. It was recognised that such restrictions could have profound impact on residents and their families. Nonetheless, these measures were strictly imposed over a prolonged period in many countries; impeding families from remaining involved in their relatives' care and diluting the meaningful connections for residents with society.

Ethical frameworks for quality improvement activities: an analysis of international practice.

Purpose: To examine international approaches to the ethical oversight and regulation of quality improvement and clinical audit in healthcare systems.

Data Sources: We searched grey literature including websites of national research and ethics regulatory bodies and health departments of selected countries.

Study Selection: National guidance documents were included from six countries: Ireland, England, Australia, New Zealand, the United States of America and Canada.

Covid-19: Ethical Challenges for Nurses.

The Covid-19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered.

The Role, Education, and Experience of Health Care Assistants in End-of-Life Care in Long-Term Care: A Scoping Review.

The changing age profile of the human population globally means that the requirement for residential long-term care (LTC) for older adults is escalating, with an associated increase in deaths in these facilities. Health care assistants (HCAs), whose main role is provision of direct care to residents, comprise the largest staff cohort in residential care for older adults. The purpose of this scoping review was to explore three key areas related to HCAs: their role and responsibilities, end-of-life (EOL) education, and their views and experiences of caring for residents at EOL.

Ethical arguments for access to abortion services in the Republic of Ireland: recent developments in the public discourse.

The Republic of Ireland has some of the most restrictive abortion legislation in the world which grants to the 'unborn' an equal right to life to that of the pregnant woman. This article outlines recent developments in the public discourse on abortion in Ireland and explains the particular cultural and religious context that informs the ethical case for access to abortion services. Our perspective rests on respect for two very familiar moral principles - autonomy and justice - which are at the centre of social and democratic societies around the world.

The Standard Account of Moral Distress and Why We Should Keep It.

In the last three decades, considerable theoretical and empirical research has been undertaken on the topic of moral distress among health professionals. Understood as a psychological and emotional response to the experience of moral wrongdoing, there is evidence to suggest that-if unaddressed-it contributes to staff demoralization, desensitization and burnout and, ultimately, to lower standards of patient safety and quality of care. However, more recently, the concept of moral distress has been subjected to important criticisms.

Addressing ethical concerns arising in nursing and midwifery students' reflective assignments.

Background: Written reflections on practice are frequently requirements of nursing curricula. They are widely accepted as necessary for improving critical thinking and problem-solving skills. Faculty, are expected to review reflections and provide feedback that helps professional development and facilitates good practice.

Challenges in implementing an advance care planning programme in long-term care.

Background: A high prevalence of cognitive impairment and frailty complicates the feasibility of advance care planning in the long-term-care population. Research aim: To identify challenges in implementing the 'Let Me Decide' advance care planning programme in long-term-care.

Research Design: This feasibility study had two phases: (1) staff education on advance care planning and (2) structured advance care planning by staff with residents and families.

[Decision-making processes in nursing and activities at the end of life in intensive care–An international comparative study].

Background: Intensive care units (ICUs) are traditionally settings that offer high technologically advanced treatment for those who are in critical situations due to an illness or accident. Questions regarding the withdrawal and withholding as well as the ending of life sustaining treatment are related to ethical dilemmas. Nurses’ decision-making processes and nursing activities in different countries are scarcely studied.

Negotiated reorienting: a grounded theory of nurses' end-of-life decision-making in the intensive care unit.

Background: Intensive care units (ICUs) focus on treatment for those who are critically ill and interventions to prolong life. Ethical issues arise when decisions have to be made regarding the withdrawal and withholding of life-sustaining treatment and the shift to comfort and palliative care. These issues are particularly challenging for nurses when there are varying degrees of uncertainty regarding prognosis.

Moral distress: a review of the argument-based nursing ethics literature.

Aim: The aim of this review is to examine the ways in which the concept of moral distress has been delineated and deployed in the argument-based nursing ethics literature. It adds to what we already know about moral distress from reviews of the qualitative and quantitative research.

Data Sources: CINAHL, PubMed, Web of Knowledge, EMBASE, Academic Search Complete, PsycInfo, Philosophers' Index and Socindex.

A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress.

Purpose: The purpose of this study was to investigate moral distress in Irish psychiatric nurses.

Design: A qualitative descriptive methodology was used.

Findings: The study confirmed the presence of moral distress and the situations that gave rise to moral distress within psychiatric nurses working in acute care settings.

Moral instability: the upsides for nursing practice.

This article briefly outlines some of the key problems with the way in which the moral realm has traditionally been understood and analysed. I propose two alternative views of what is morally interesting and applicable to nursing practice and I indicate that instability has its upsides. I begin with a moral tale - a 'Good Samaritan' story - which raises fairly usual questions about the nature of morality but also the more philosophically fundamental question about the relationship between subjectivity and moral agency.

Fetal umbilical cord blood erythropoietin, interleukin-6, pH, pO(2), pCO(2), and base excess levels in histologic and/or clinical chorioamnionitis: is the response only inflammatory?

Objective: To determine the correlation of histological chorioamnionitis (CA) with and without clinical CA with umbilical cord blood gases, erythropoietin (EPO), and interleukin-6 (IL-6) levels.

Methods: Umbilical artery blood gas analysis (pH, pO(2), pCO(2), BE) and umbilical vein EPO and IL-6 levels were measured in 202 infants from normal, histological, and no clinical CA and histological plus clinical CA pregnancies.

Results: Umbilical artery blood gas analyses were not different between normal controls and histological and clinical CA groups.

Gender and power: the Irish hysterectomy scandal.

In April 2004 the Irish Government commissioned Judge Maureen Harding Clark to compile a report to ascertain the rate of caesarean hysterectomies at Our Lady of Lourdes Hospital in Drogheda, Republic of Ireland. The report came about as a result of complaints by midwives into questionable practices that were mainly (but not solely) attributed to one particular obstetrician. In this article we examine the findings of this Report through a feminist lens in order to explore what a feminist reading of the Report and the events that led to the inquiry will bring to light.

Moral distress reconsidered.

Moral distress has received much attention in the international nursing literature in recent years. In this article, we describe the evolution of the concept of moral distress among nursing theorists from its initial delineation by the philosopher Jameton to its subsequent deployment as an umbrella concept describing the impact of moral constraints on health professionals and the patients for whom they care. The article raises worries about the way in which the concept of moral distress has been portrayed in some nursing research and expresses concern about the fact that research, so far, has been largely confined to determining the prevalence of experiences of moral distress among nurses.

Why are fewer medical students in Florida choosing obstetrics and gynecology?

Objectives: To determine why there has been a decrease in the amount of applicants to Florida-based obstetrics and gynecology (OB/GYN) residency programs, and how this has been affected by the current medical liability climate.

Methods: Fourth year Florida medical students were surveyed about their concerns of a career in OB/GYN. The students were then grouped into three categories: students never interested in OB/GYN, students at one point interested in OB/GYN, and students pursuing a career in OB/GYN.

Are placental chorionic capillary nucleated red blood cell counts useful compared to umbilical cord blood tests?

Objective: To compare measurement of fetal nucleated red blood cell (NRBC) counts in paired histologic samples of the placenta and umbilical cord bloods.

Method: Forty-five randomly selected pregnancies had two determinations of the NRBC count. A sample of umbilical venous blood had a NRBC count measured and sections of the placenta were examined for their villous capillary NRBC counts.

Prediction of ABOG written examination performance from the third-year CREOG in-training examination results.

Objective: To study the ability of the Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training examination score to predict American Board of Obstetrics and Gynecology (ABOG) written examination performance.

Study Design: Twenty-six physicians took the CREOG examination during the third year of their residency and the ABOG written examination during their fourth year. These 2 test scores were compared.