Moral distress has been widely reviewed across many care contexts and among a range of disciplines. Interest in this area has produced a plethora of studies, commentary and critique. An overview of the literature around moral distress reveals a commonality about factors contributing to moral distress, the attendant outcomes of this distress and a core set of interventions recommended to address these. Interventions at both personal and organizational levels have been proposed. The relevance of this overview resides in the implications (...) moral distress has on the nurse and the nursing workforce: particularly in regard to quality of care, diminished workplace satisfaction and physical health of staff and increased problems with staff retention. (shrink)

Based on Moscovici’s classical study on the cultivation of psychoanalytic ideas in France in the 1950’s and our own research on modern biotechnology, we propose a paradigm for researching social representations. Following a consideration of the nature of representations and of the ‘iconoclastic suspicion’ that haunts them, we propose a model of the emergence of meaning relating three elements: subjects, objects, and projects. The basic unit of analysis is the elongated triangle of mediation : subject 1, object, project, and subject (...) 2, captured in the image of a ‘Toblerone’. Such social units cultivate, that is produce, circulate and receive representation which may be embodied in four modes–habitual behaviour, individual cognition, informal communication and formal communication–and in three mediums–words, visual images or non-linguistic sounds. We propose an operational definition of a ‘social representation’ as the comparison of four characteristics of communication systems: the content structures , the typified processes , and their functions , within the context of segmented social milieus. Seven implications for research on social representations are outlined: content and process; segmentation by social milieus rather than taxonomies; cultivation studies within social milieus; multi-method analysis; time structures and longitudinal data; the crossover of cultural projects and trajectories; the disinterested research attitude. This ideal type paradigm leads to an operational clarification to identify new research questions, and to guide the design and evaluation of studies on social representations. (shrink)

The aim of this review was to analyse the empirical studies that focus on ethics in nursing care for older people, scoping the need and areas for further study. A search of the MEDLINE and CINAHL databases (earliest to August 2009) was conducted using the the keywords: ethic* and nursing or care or caring and elderly or aged or older. After a four-stage process, 71 empirical articles were included in the review, with informants ranging from elderly people to relatives, caregivers, (...) managers and students in care settings. The review focusses on the concepts, contexts, methods and validity of these studies. Based on the analysis, the reviewed research seems to be fragmented and multifaceted, focussing on selected issues such as autonomy, self-determination and informed consent. No large research programs or research traditions were found so it was not possible to draw any conclusions about suitable methods, study designs or instruments of measurement for use in this research area. (shrink)

These are strange and unprecedented times in the wake of the COVID-19 pandemic. Most frontline healthcare professionals have never witnessed anything like this before. As a result, staff may experience numerous and continuous traumatic events, which in many instances, will negatively affect their psychological well-being. Particularly, nurses face extraordinary challenges in response to shifting protocols, triage, shortages of resources, and the astonishing numbers of patients who require care in expedited time constraints. As most healthcare workers are passionate nursing professionals, frustration (...) and often a sense of powerlessness occur when they find themselves unable to provide needed care to their patients. The overwhelming number of deaths, patients isolated and dying alone, and the ever-present fear of being infected and then infecting colleagues, family, friends due to the lack of protective gear or known protocols takes its toll on emotional and psychological well-being. For nurses, the experience of this significant (hopefully once-in-a-lifetime) event can inflict on-going moral injury. Nurses affected by this trauma require education, coping tools, and therapy to help avoid or alleviate the adverse effects on their well-being. Institutions must provide these resources to tend to the well-being of their healthcare staff, during and beyond the pandemic. This article aims to investigate moral distress—considering it as a moral injury—and offer tools and recommendations to support healthcare nurses as they respond to this crisis and its aftermath. (shrink)

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. Specifically, some authors argue that the (...) standard account of moral distress elucidated by Jameton :542–551, 1984) does not refer to a discrete phenomenon and/or that it is not sufficiently broad and that this makes measuring its prevalence among health professionals, and other groups of workers, difficult if not impossible. In this paper, we defend the standard account of moral distress. We understand it as a concept that draws attention to the social, political and contextual determinants of moral agency and brings the emotional landscape of the moral realm to the fore. Given the increasing pressure on health professionals worldwide to meet efficiency, financial and corporate targets and reported adverse effects of these for the quality and safety of patient care, we believe that further empirical research that deploys the standard account moral distress is timely and important. (shrink)

Age attitudes and age stereotypes in the workplace can lead to discrimination and impaired productivity. Previous studies have predominantly assessed age stereotypes with explicit measures. However, sole explicit measurement is insufficient because of social desirability and potential inaccessibility of stereotypical age evaluations to introspection. We aimed to advance the implicit and explicit assessment of work-related evaluations of age groups and age stereotypes and report data collected in three samples: students (n = 50), older adults (n = 53), and workers (n (...) = 93). Evaluative age attitudes were measured implicitly with an Implicit Association Test. Regardless of group, age, and condition (neutral or semantically biased stimuli), the results confirm a stable, moderate implicitly measurable preference for younger over older workers. Whereas explicit measures of general age preferences showed no clear age preference, differentiated explicit measures of work-related age stereotypes also revealed stable preferences in all three samples: Younger workers were rated higher on performance and adaptability and older workers were rated higher on competence, reliability, and warmth. The explicit-implicit correlations were relatively low. Although explicit work-related age stereotypes are differentiated, the stable implicitly measured age bias raises concern. We suggest to apply implicit and explicit measures in the field of ageism in the workplace. (shrink)