Everyday ethics in case management : experiences of moral distress by professionals in a community health care setting / by Kristen Dawn Jessiman.
Notice bibliographique
Résumé
Academic research has recognized and explored ethical issues and experiences of moral distress in acute care settings for many years now. The same cannot be said for ethical issues in the community care setting. Perhaps more than ever, as treatments and care are shifted out of institutions and into the home, today?s health care professionals face unique and difficult ethical issues. The purpose of this study was to examine \nexperiences of moral distress related to everyday ethical issues by analyzing data collected from a cohort of professional case managers working in a community health care setting in northern Ontario, Canada. The objectives of the study were to investigate the nature of ethical issues in the community health care setting; explore experiences of everyday ethical issues and moral distress; identify barriers to ethical practice and \nevaluate the available resources. \nQuantitative and qualitative data were gathered using an original, selfadministered questionnaire developed by the researcher. This questionnaire was distributed to case managers employed at North West (Thunder Bay and region) and North East (Sudbury and region) Community Care Access Centres. The response rate to the questionnaire was 31%, representing 66 participants from a pool of 215 potential participants. The results showed that everyday ethical issues were prevalent in this professional setting, often encountered on a weekly basis. Participants described a moderate to high level of confidence to identify, address, and resolve everyday ethical issues in their practice. Ethical issues were described as a combination of the theoretical categories of autonomy, beneficence, nonmaleficence, and justice, therefore representing \ncomplex, multi-factorial scenarios. \nExperiences of moral distress were described as occurring with moderate to high frequency and intensity, most commonly expressed with emotional symptoms. The most influential coping strategies were identified as ?talking to colleagues? and utilizing ?supportive leaders?. Barriers to ethical practice included the lack of resources, restrictions based on policy and regulations, and issues related to conflict and communication. Experiences of moral distress were closely related to a lack of resources and time constraints. \nRecommendations for further research include the need to identify interventions to increase ethical competence and to provide opportunities to encourage healing from experiences of moral distress. The researcher recommends that community agencies adopt strategies which foster opportunities to identify and discuss experiences of everyday ethical issues and moral distress. Avenues which may increase capacity for ethical competence may include; formal educational opportunities; agency commitment to the ongoing development of an active ethics committee; informal collaboration among colleagues, supervisors, and organizational leaders; and attention to maintaining or improving the work environment to encourage successful coping, enhanced confidence and empowerment. While issues of increased workload, lack of time, and inadequate \nresources are unlikely to ever be resolved in the near future, opportunities to problem solve and share strategies provide much needed support for health care professionals working in the community care setting. Further studies using qualitative methodologies of storytelling and reflection will provide further insight into experiences of moral distress and its unique manifestation in the community care setting in northern Ontario. \nStudy area : Northwestern Ontario (Thunder Bay region) and Northeastern Ontario (Sudbury region).
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».