| 1. |
- Abraha, Aynalem, et al.
(författare)
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Breaking bad news in cancer care: preferences of patients, family caregivers and general public in Ethiopia
- 2021
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Ingår i: International Conference on Communication in Healthcare (ICCH) 2020 Part 2, 15-16 April, 2021.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This study explores the preferences of cancer patients, family caregivers, and the general public regarding breaking bad news in an Ethiopian oncology setting. The research was conducted at Tikur Anbessa (Black Lion) Specialized Hospital. The sample consists of patients with a confirmed cancer diagnosis, their family caregivers, and representatives from the general public with 150 subjects per cohort. A comparative cross-sectional study design and a multivariable analysis were used. The patients would like to be informed, which contradicts the perceptions of family caregivers. This creates an ethical dilemma for staff in terms of how much they involve their patients in clinical decision-making. The patients also indicate that information not to be withheld from them. In contrast, the general public prefers information about poor life expectancy to be communicated to family only, which may reflect widespread public perception of cancer as a deadly disease. The findings indicate the complexity of communication concerning breaking bad news in oncology care in Ethiopia. It requires oncologists to probe patient attitudes before information disclosure in order to find a balance between involving patients in communication at the same time as keeping a constructive alliance with family caregivers.
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| 2. |
- Abraha Woldemariam, Aynalem, et al.
(författare)
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Breaking Bad News in Cancer Care: Ethiopian Patients Want More Information Than What Family and the Public Want Them to Have.
- 2021
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Ingår i: JCO global oncology. - 2687-8941. ; 7, s. 1341-1348
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the preferences of patients with cancer, family caregivers, and the general public regarding breaking bad news in an Ethiopian oncology setting.The study was conducted at Tikur Anbessa (Black Lion) Specialized Hospital. The sample consists of patients with a confirmed cancer diagnosis, their family caregivers, and representatives from the general public with 150 subjects per cohort. The study used a comparative cross-sectional design and multivariable data analysis.The patients would like to be informed, which contradicts the preferences of family caregivers. This creates an ethical dilemma for staff in terms of how much they involve their patients in clinical decision making. The patients also indicate that information should not be withheld from them. By contrast, the general public prefers information about poor life expectancy to be communicated to family only, which may reflect a widespread public perception of cancer as a deadly disease.The findings indicate the complexity of communication-related preferences concerning breaking bad news in oncology care in Ethiopia. It requires oncologists to probe patient attitudes before information disclosure to find a balance between involving patients in communication at the same time as keeping a constructive alliance with family caregivers.
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| 3. |
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| 4. |
- Behdadi, Dorna, 1988, et al.
(författare)
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A Normative Approach to Artificial Moral Agency
- 2020
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Ingår i: Minds and Machines. - : Springer Science and Business Media LLC. - 0924-6495 .- 1572-8641. ; 30:2, s. 195-218
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Tidskriftsartikel (refereegranskat)abstract
- This paper proposes a methodological redirection of the philosophical debate on artificial moral agency (AMA) in view of increasingly pressing practical needs due to technological development. This “normative approach” suggests abandoning theoretical discussions about what conditions may hold for moral agency and to what extent these may be met by artificial entities such as AI systems and robots. Instead, the debate should focus on how and to what extent such entities should be included in human practices normally assuming moral agency and responsibility of participants. The proposal is backed up by an analysis of the AMA debate, which is found to be overly caught in the opposition between so-called standard and functionalist conceptions of moral agency, conceptually confused and practically inert. Additionally, we outline some main themes of research in need of attention in light of the suggested normative approach to AMA.
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| 5. |
- Berbyuk Lindström, Nataliya, 1978, et al.
(författare)
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Person- and Family-Centeredness in Ethiopian Cancer Care: Improving Communication, Ethics, Decision Making and Health
- 2020
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Ingår i: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 9:5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cancer is a major burden in Ethiopia. The Oncology Department of Tikur Anbessa (Black Lion) Specialized Hospital (TASH) in Addis Ababa is the country's sole specialist unit for cancer care. With only a handful of oncologists, a lack of resources, and a huge patient load, the work is challenging, especially in terms of achieving effective and ethical patient consultations. Patients, usually accompanied by family members, often wait for a long time to receive medical attention and frequently depart without treatment. Handling consultations effectively is essential in order to help patients as much as possible within such limitations. OBJECTIVE: The project addresses three main aims: (1) to enhance and expand the understanding of communicative and associated ethical challenges in Ethiopian cancer care; (2) to enhance and expand the understanding of the implications and use of person- and family-centered solutions to address such communicative challenges in practice, and (3) to plan and evaluate interventions in this area. METHODS: This project develops and consolidates a research collaboration to better understand and mitigate the communicative challenges in Ethiopian cancer care, with a focus on the handling and sharing of decision making, and ethical tensions between patients, staff, and family. Using theoretical models from linguistics, health communication, and health care ethics, multiple sources of data will be analyzed. Data sources currently include semi-structured interviews with the Ethiopian staff, patients, and family caregivers (91), survey data on cancer awareness (150) and attitudes to breaking bad news (450), and video-recordings of medical consultations (45). In addition, we will also develop clinical and methodological solutions to formulate educational interventions. RESULTS: The project was awarded funding by the Swedish Research Council in December 2017 for the period 2018-2021. The research ethics board in Sweden and in Ethiopia approved the conduct of the project in May 2018. The results from the studies will be published in 2020 and 2021. CONCLUSIONS: The project is a first step towards producing unique and seminal knowledge for the specific context of Ethiopia in the area of physician-patient communication research and ethics. It contributes to an understanding of the complexity around the role of family and ethical challenges in relation to patient involvement and decision making in Ethiopia. Improved knowledge in this area can provide a fundamental model for ways to improve cancer care in many other low resource settings in Africa and the Middle East, which share central cultural prerequisites (such as a strong patriarchal family structure, combined with strong and devout religiosity). The project will also serve to develop greater understanding about current challenges in Western health systems associated with greater family and patient participation in decision making. In addition, the project will also contribute to improving the education of Ethiopian health professionals working in cancer care by developing a training program to help them better understand and respond to identified challenges associated with communication.
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| 6. |
- Bergström, Martin, et al.
(författare)
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Interventions in Foster Family Care: A Systematic Review
- 2020
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Ingår i: Research on social work practice. - : SAGE Publications. - 1049-7315 .- 1552-7581. ; 30:1, s. 3-18
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Foster family care is associated with adverse short- and long-term consequences for the child. A systematic review was conducted on interventions for foster children and foster careers. Method: A comprehensive search process was used to find eligible interventions evaluated in randomized controlled trials or quasi-experimental studies. The quality of studies was assessed with GRADE, and effects were synthesized using meta-analytic methods. Results: In all, 28 publications of 18 interventions, including 5,357 children, were identified. Only three specific interventions had sufficient confidence of evidence. No study had examined tools for foster parent selection nor had evaluated preservice programs related to outcomes. Discussion: These analyses provide new insights and hope into the field of systematic interventions in foster care. The overall results indicate that it is possible to improve eight outcomes but cannot point out which programs are superior. Ethically, social care organizations should systematically collect knowledge about effects and side effects.
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| 7. |
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| 8. |
- Bergström, Martin, et al.
(författare)
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Treatment Foster Care Oregon for seriously delinquent adolescents: A systematic review and assessment including economic and ethical aspects
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Approximately 2,000 adolescents are annually placed in residential care in Sweden due to their behavior problems. Those adolescents also have substantially increased risks of mental and physiological problems at time of care entry, while in care and in adulthood. An alternative to residential care is Treatment Foster Care Oregon, TFCO (previously called Multidimensional Treatment Foster Care). TFCO has been available in Sweden since the beginning of the 2000s. This report reviews and synthesizes the evidence regarding TFCO for seriously delinquent adolescents.
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| 9. |
- Boman, Åse, 1957-, et al.
(författare)
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Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background
- 2017
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Ingår i: Sage Open medicine. - : SAGE Publications. - 2050-3121 .- 2050-3121. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: The pediatric diabetes team aims to support health, quality of life, and normal growth and development among adolescents with type 1 diabetes mellitus. Adolescents with an immigrant background have been found less successful in self-care. Previous research indicated that adolescents who had integrated the disease as a part of their self-image reasoned differently about their self-care to those who had not. Objective: The aim of this study was to identify elements in the patient–pediatrician consultations that might influence such integration of the disease among adolescents with type 1 diabetes mellitus. Methods: A total of 12 pediatrician–adolescent consultations were video-recorded and analyzed. The adolescents all had an immigrant background. Results: Integration of the disease appeared enabled when responsibility was shared; when hope, autonomy, and emotions were confirmed; and when the pediatrician asked probing questions. Letting objective data dominate the adolescent’s experiences, using risk as a motivator, neutralizing emotions in relation to having diabetes, and confirming forgetfulness, may instead inhibit disease integration. Conclusion: An extended person-centered approach with focus on the adolescent’s experiences of everyday life with a chronic disease and less attention on physical parameters in the pediatrician–adolescent consultations may increase integration of the disease.
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| 10. |
- Brax, David, 1979, et al.
(författare)
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The Philosophical Aspects of Hate Crime and Hate Crime Legislation: Introducing the Special Symposium on the Philosophy of Hate Crime
- 2015
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Ingår i: Journal of Interpersonal Violence. - : SAGE Publications. - 0886-2605 .- 1552-6518. ; 30:10, s. 1687-1695
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In this introduction to the special symposium on the philosophy of hate crime, we provide an overview of the main philosophical aspects of hate crime and hate crime legislation. We point out that there are two overarching philosophical issues that span over the literature: the Conceptual Question—concerning what hate crime is—and the Normative Question—concerning the status of hate crimes and the justification of hate crime legislation. We also provide brief summaries of the articles in the special section and point to their relations to the broader themes.
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