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Ethical Competence and Moral Distress in the Health Care Sector : A Prospective Evaluation of Ethics Rounds
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- Kälvemark Sporrong, Sofia, 1965- (författare)
- Uppsala universitet,Institutionen för folkhälso- och vårdvetenskap
- Arnetz, Bengt (preses)
- Höglund, Anna T (preses)
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- ISBN 9789155467975
- Uppsala : Acta Universitatis Upsaliensis, 2007
- Engelska 67 s.
- Serie: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 224
- Doktorsavhandling (övrigt vetenskapligt/konstnärligt)
Abstract
Ämnesord
Stäng
- Ongoing structural and financial changes in the health care sector have resulted in increased risks for ethical dilemmas and moral distress. It is purported that increased ethical competence will help staff manage ethical dilemmas and hence decrease moral distress. To enhance ethical competence several approaches may be used – theoretical education, and methods focusing on reflection and decision-making abilities.Ethics rounds are a widespread systematic method hypothesized to improve ethical competence, nurture a reflective climate, and help in ethical decision-making. Despite its popularity, its effects on moral distress have hitherto never been evaluated in a controlled study.The purpose of this thesis was to evaluate the impact of an intervention, including ethics rounds; the hypothesis being that the intervention would decrease perceived moral distress. An additional aim was exploring the concept of moral distress in various health care establishments, including pharmacies.Focus groups were conducted to explore the concept of moral distress. To evaluate the intervention a scale assessing staff-perceived moral distress was designed, validated, and implemented.Results showed that moral distress is evident in diverse health care settings. Some factors associated with this were lack of resources, conflicts of interest, and rules that are incompatible with practice. An expanded definition of moral distress was presented.The training program was much appreciated by participants. However, no significant effects on perceived moral distress were found. Reasons could be that the intervention was too short or otherwise ineffective, there is no association between ethical competence and moral distress, the assessment scale was not sensitive enough, or management was not sufficiently involved.There is a need to further refine the various aspects of ethical dilemmas in clinical settings, and to evaluate the most efficient means to enhance skills for dealing with ethical dilemmas, for the benefit of staff, patients, institutions, and society.
Nyckelord
- Social medicine
- Moral distress
- Ethics rounds
- Ethical competence
- Professional ethics
- Clinical practice
- Pharmacy practice
- Work organization
- Sweden
- Socialmedicin
Publikations- och innehållstyp
- vet (ämneskategori)
- dok (ämneskategori)
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