Nursing

Background: School meal programs are not only government initiatives but also community-driven efforts. Aiming to combat food insecurity among school-aged children effectively, these programs are executed in conjunction with food bank initiatives. Various community groups play a crucial role in the success of both food security initiatives. There is a need to improve community engagement to successfully link school meal programs with food banks to build program synergy, combating food insecurity through a two-sided approach. Aim: This study aims to examine (...) community engagement in school meals program by analyzing its purposeful focus on creating jobs and income-generating opportunities for different community groups, i.e., youths, women, and others. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: Findings showed that the school meals program’s purposeful focus on creating jobs and income-generating opportunities for women in the community was positively associated with community engagement, thereby supporting the linkage between the programs and food banks. In contrast, providing jobs and income-generating opportunities for youths and other community groups had an ambiguous association with community engagement in school meal programs. Conclusions: Findings underscore the importance of creating jobs and income-generating opportunities for women to improve community engagement in school meal programs. Formulating strategies that empower woman’s entrepreneurship may foster their involvement and engagement in school meal programs, promising to successfully link these programs with food bank initiatives among implementing countries. (shrink)

Background: The feeding modalities used in school meal programs—such as breakfast, lunch, dinner, snacks, and take-home rations—are influenced by various factors, including supply chain constraints and technical challenges in food distribution. The methods of supply sourcing, whether through domestic or foreign food reserves via in-kind donations or purchases, play a critical role in shaping the feeding options provided. Aim: This study aims to examine the association between supply-sourcing strategies, i.e., domestic and foreign in-kind donations and national-international purchases, with the feeding (...) modalities applied in school meal programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of government representatives who manage large-scale school meal programs across 126 countries. Results: The findings revealed that sourcing supplies through in-kind donations from neighboring or distant countries showed a highly reliable negative association with the feeding modalities of school meal programs, while those from the national bodies showed an ambiguous relationship. The purchasing methods—whether domestic or foreign—tended to exhibit positive associations with feeding modalities, though these associations were only weakly reliable. Conclusions: The findings reveal substantial rooms to improve the effectiveness of supply purchasing strategies in enhancing school meal program feeding modalities. Further research is needed to examine the impact of sourcing supplies through domestic in-kind donations on feeding outcomes. Additionally, developing strategic plans to optimize the use of in-kind donations from international organizations is strongly recommended to avoid its negative consequences and further enhance program effectiveness. (shrink)

Background: The feeding modalities applied in countries with school meal programs are varied because these are shaped not only by the national commitments to alleviate food insecurity among children but also by resource availability from national and international agencies. In terms of financial resources, the USA plays a consistent role in providing donations, grants, loans, and loan guarantee programs to support global school feeding. The U.S. Department of Agriculture (USDA) oversees these funding sources for international school meal programs. Aim: This (...) study aims to examine the moderating effect of USDA funding on the relationship between supply purchasing methods and feeding modalities among countries implementing school meal programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: The findings indicated that USDA funding has the potential to positively moderate the relationship between foreign supply purchases and the feeding modalities of school meal programs. However, the direct association between foreign purchases and feeding modalities was unclear. Conversely, while USDA funding was found to have a negative moderation effect on the relationship between domestic supply purchases and feeding modalities, it is these domestic purchases that show potential for positively influencing the feeding modalities. Conclusions: Findings underscore the importance of supporting the World Bank and World Food Programme’s recommendation to rely more on local resources and capacities for developing long-term and sustainable school meal programs. Further exploration of the impact of foreign supply purchases on feeding modalities is needed. Formulating strategic plans to better leverage USDA funding for enhancing domestic supply purchases is highly recommended. (shrink)

Healthy eating has long been a focus of professionals and researchers, both to evaluate strategies for improvement and to gain a deeper understanding of its dynamics in order to develop effective promotion methods. This study aims to examine the roles of individuals’ information-seeking abilities and e-health literacy in fostering a healthy eating intention among Iranians. Employing Bayesian Mindsponge Framework analytics on a dataset of 9,755 Iranian participants, the study found positive associations between healthy eating information-seeking ability, e-health literacy, and healthy (...) eating intention among Iranian adults. However, the moderating effect of e-health literacy on the relationship between information-seeking ability and healthy eating intention remains ambiguous. We suggest that enhancing individuals' healthy eating information-seeking abilities and e-health literacy, alongside improving the availability, affordability, and accessibility of reliable healthy eating information, is essential for fostering healthy eating intentions. (shrink)

Bribing doctors for preferential treatment is rampant in the healthcare system of developing countries like Vietnam. Although bribery raises the out-of-pocket expenditures of patients, it is so common to be deemed an “envelope culture.” Given the little understanding of the underlying mechanism of the culture, this study employed the mindsponge theory for reasoning the mental processes of both patients and doctors for why they embrace the “envelope culture” and used the Bayesian Mindsponge Framework (BMF) analytics to validate our reasoning. Analyzing (...) responses from 1042 Vietnamese patients, we discovered that bribing doctors can help patients reduce the destitution risk induced by treatment. Such effect of doctor bribery remains consistent among patients that have to pay high daily costs (e.g., accommodation and subsistence fees) regardless of their employment status. Nevertheless, for patients with no or unstable jobs, their risks of destitution increase if they have to pay more thank-you money. These findings suggest that doctor bribery is an adaptive strategy for patients in an environment where the healthcare supply cannot meet the actual demand. Moreover, healthcare equity is greatly exacerbated due to the envelope culture, as vulnerable individuals are exposed to a greater threat of poverty. At the same time, those with good economic conditions get preferential treatment by paying a higher amount of thank-you money. Healthcare workers’ ethics must be the top priority for an equitable and proper healthcare system. (shrink)

Being compassionate and empathic while making rational decisions is expected from healthcare workers across different contexts. But the daily challenges that these workers face, aggravated by the recent COVID-19 crisis, can give rise to compassion and decision fatigue, which affects not only their ability to meet these expectations but has a significant negative impact on their wellbeing. Hence, it is vital to identify factors associated to their exhaustion. Here, we sought to describe levels of compassion and decision fatigue during the (...) pandemic, and to identify factors related to these forms of exhaustion. We collected data using self-reported questionnaires to measure compassion fatigue, decision fatigue, and grit in five intervals from April to November, 2020 (N = 856). Our results showed a negative correlation between grit and compassion and decision fatigue. We also found that under the circumstances studied grit tends to be higher in technicians, nurses, other professionals (psychologists, social workers), and workers at the Emergency Room (ER), and lower in general practitioners. Compassion fatigue tend to be higher for technicians, whereas decision fatigue was lower for specialists, general practitioners, and technicians, and higher for those working at private hospitals. (shrink)

Our general purpose is to show how a philosophically oriented theoretical foundation, drawn from a lifeworld perspective can serve as a coherent direction for caring practices in education. We argue that both caring and learning share the same ontological foundation and point to this intertwining from a philosophical perspective. We proceed by illustrating shared epistemological ground through some novel educational practices in the professional preparation of carers. Beginning in a phenomenologically oriented philosophical foundation, we will first unfold what this means (...) in the practice of caring, and secondly what it means for education and learning to care in humanly sensitive ways. We then share some ways that may be valuable in supporting learning and health that provides a basis for an existential understanding. We argue that existential understanding may offer a way to bridge the categorisations in contemporary health care that flow from problematic dualisms such as mind and body, illness and well-being, theory and practice, caring and learning. Ways of overcoming such dualistic splits and new existential understandings are needed to pave the way for a care that is up to the task of responding to both human possibilities and vulnerabilities, within the complexity of existence. As such, we argue that caring and learning are to be understood as an intertwined phenomenon of pivotal importance in education of both sensible and sensitive carers. Lifeworld led didactics and reflection, which are seen as the core of learning, constitute an important educational strategy here. (shrink)

The COVID-19 pandemic put immense pressure on healthcare systems globally, including those of highly developed countries like the United States and United Kingdom. During the pandemic, professional nursing organizations were the first to call attention to the disproportionate pandemic-related deaths among Filipino nurses. These organizations played a central role in addressing the various crises Filipino nurses faced due to their vulnerabilities as frontliners, ethnic minorities, and migrants in their host countries. Using the Volatile, Uncertain, Complexity, and Ambiguous (VUCA) framework, this (...) monograph assesses the pandemic-response actions and strategies of PNAA and PNAUK, two Filipino nursing associations in the US and UK. The major themes suggest that the two organizations are multifunctional entities with the capacity to act as lobbyists, research organizations, and decision-makers when adapting, strategizing, and coping with VUCA conditions. These findings corroborate previous findings on the potentiality of diasporic nursing organizations in addressing the gaps in government support for migrant workers in the healthcare industry. (shrink)

Artificial intelligence is now widely accessible and already being used by healthcare researchers throughout various stages in the research process, such as assisting with systematic reviews, supporting data collection, facilitating data analysis and drafting manuscripts for publication. The most common AI tools used are forms of generative AI such as ChatGPT, Claude and Gemini. Generative AI is a type of AI that can generate human-like text, audio, videos, code and images based on text-based prompts inputted by a human user. Generative (...) AI is trained on large amounts of data, and the outputs are sophisticated and can be indistinguishable from a response from a skilled human. In this article, we outline several AI applications that can be used in healthcare research, examining their benefits, limitations and outline best practices for maintaining research integrity and ethical standards. (shrink)

Illness and injury are often accompanied by experiences of bodily objectification. Medical treatments intended to restore the structure or function of the body may amplify these experiences of objectification by recasting the patient’s body as a biomedical object—something to be examined, measured, and manipulated. In this article, we contribute to the phenomenology of embodiment in illness and medicine by reexamining the results of a qualitative study of the experiences of nurses and patients isolated in an intensive care unit during the (...) first wave of COVID-19. Drawing upon the phenomenological concept of embodiment—as developed in the work of Edmund Husserl, Maurice Merleau-Ponty, Jean-Paul Sartre, and Emmanuel Levinas—we reconsider how bodily objectification manifests in complex clinical encounters. We show that, in these settings, objectification is not simply the unilateral act of a clinician objectifying a patient. Rather, both clinicians and patients reported a variety of objectifying experiences influenced by their interactions, the immediate context of the intensive care milieu, and the broader atmosphere of a global pandemic. In light of these findings, we argue that bodily objectification in illness and medicine can often be more complicated than typically presented in the phenomenological literature. (shrink)

The ever-growing volume of scientific research challenges for traditional publishing models. This necessitates innovative approaches to journal editing and adopting by Artificial Intelligence (AI) in publication. This scoping review aims to explore the emerging trends shaping the field of journal editing by AI. Literature employed to search relevant databases published between 2008 and 2024. A total of 25 studies met the inclusion criteria. The review synthesizes key trends of inclusion of the technological tools integration for manuscript processing, the rise of (...) open-access publishing models, and evolving considerations around research ethics. The study underscores the pivotal role of emerging trends in shaping the future of scientific publishing. It offers valuable perspectives for editors to adeptly maneuver through the evolving terrain of scholarly communication. By suggesting possible best practices, it serves as a beacon for maintaining editorial excellence. Furthermore, it identifies critical domains warranting deeper exploration, thereby setting the stage for continuous advancement in the field. This forward-looking approach not only facilitates informed decision-making but also fosters a proactive stance towards embracing change in scientific discourse. (shrink)

Drawing inspiration from the philosophical ideas in the “No-Fish Dietary” story featured in Wild Wise Weird, this commentary explores the untapped potential of home gardens as spaces for healing. As the world grapples with climate change and environmental degradation, reconnecting with the healing power of nature—starting with our own home gardens—offers a sustainable path forward.

The nursing profession must address climate change to protect and promote human health. Climate change activities as corporate social responsibility provide a promising avenue to both scale successful organizational initiatives and to generate hope, transformative improvements, and renewed professional commitments for nursing. Addressing climate change through corporate social responsibility is urgent and timely in the COVID-19 disaster recovery period for the nursing profession.

In classroom sessions, various student-centered learning approaches, such as collaborative and problem-based learning, are used. Today, incorporating Information and Communication Technologies (ICT) into nursing education promotes self-directed and personalized learning among students.

In this editorial, we argue that midwives should focus on climate change, a link which has been underexplored.

Among all aspects, the unmet needs of healthcare information from the healthcare and illness-related domains have the potency to predict the unmet needs of emotional support from the emotional and relational domains in this population. The current study aims to examine the predictors of the needs for emotional support among FCGs of cancer patients by analyzing the demanded healthcare information, i.e., cancer-specific information, caregiver-specific information, therapy-specific information, information on cancer physical needs, information on alternative therapies, and information on support services.

Our society is undergoing digital change. Dealing with digital technologies has become a daily practice. Many healthcare facilities are implementing digital technologies. Nurses are placed in a strategic position to be the leader of the digital healthcare workforce. Nursing students are more exposed to this technological advancement as they are future professional nurses. This study aimed to examine how information-processing and exchanging skills in digital spaces affect digital problem-solving skills among nursing students. The Bayesian mindsponge framework (BMF) was used as (...) a conceptual framework. This quantitative study utilized a cross-sectional design. The population was all nursing students in two private nursing institutions located in Bangkok, Thailand (n=476) and Surabaya, Indonesia (n=179). Samples were the total population. Self-developed instrument was used in data collection. Data analysis used BMF analytics. The majority were females aged 20-22 years old who use smartphones and tablets daily. The information-processing and information-exchanging skills in digital spaces were positively associated with digital problem-solving skills among nursing students (MInformationProcess=0.30 and SDInformationProcess=0.05; MInformationExchange=0.37, and SDInformationExchange=0.05). More efforts are needed to improve nursing students’ problem-solving skills by using digital content, for instance, by modifying the information-processing and information-exchanging skills in digital spaces. Collaborative learning methods should be promoted in order to support the creation of conducive environment for supporting knowledge or information-exchanging behavior among nursing students by using digital technology. (shrink)

Individual attributes, such as educational background, may influence the degree of health consideration in food consumption. The local social norms may affect the same consideration in the collective level. Represented by education level and the custom rules adherence in food choosing behavior, this study aimed to examine how knowledge influences health consideration in food consumption and how the local social norms moderate this association in a multicultural enriched society. By utilizing the Bayesian Mindsponge Framework (BMF) as a conceptual framework, this (...) study analyzed a dataset of 710 urban residents in Indonesia. There was a negative association between education level and health consideration in food consumption in which the custom rules adherence in food choosing behavior moderated against this negative association. For those with a low level of custom-based food consumption, their health consideration is lower as they have higher education level. However, the opposite trend which is a more intuitive positive association was found in those who consume more custom-based food. Socio-cultural factors have a complex impact on food choosing behavior among Indonesian urban residents. Therefore, governmental policies in the health promotion campaign of healthy-nutritious food should incorporate socio-cultural aspects with a deeper understanding of the human mind’s information processing. (shrink)

Background: The most common hematological abnormality among people infected with Human Immunodeficiency Virus (HIV) is anemia. This is also related to high mortality risk among patients receiving Antiretroviral Therapy (ART). Purpose: This study aimed to identify predictors of anemia among HIV patients taking ART using a regimen of the single-tablet drug contain tenofovir, lamivudine, and efavirenz in Jayapura, Papua. Methods: This was a cross-sectional study conducted at Jayapura regional hospital from June to September 2017. A total of 80 HIV patients (...) were eligible for analysis. Data collection was conducted through an interview, medical record, measurement, and laboratory assay. The significance of differences among categorical variables was analyzed using Fisher’s exact test. The variables with p < 0.25 were then analyzed using binary logistic regression to determine predictors associated with anemia. A threshold of p < 0.05 indicates statistical significance. Results: This study showed that Body Mass Index (BMI) <18.50 (p = 0.01; OR = 5.63; 95% CI = 1.43 < OR < 22.19), length on ART ≤12 months (p = 0.00; OR = 4.90; 95% CI = 1.65 < OR < 14.53), and Cluster of Differentiation 4 (CD4+) percentage out of normal (p = 0.02; OR = 0.19; 95% CI = 0.05 < OR <0.77) had a significant association with anemia. Conclusion: BMI, length on ART, and CD4+ percentage were predictors of anemia among HIV patients taking antiretroviral therapy containing tenofovir, lamivudine, and efavirenz regimen in Jayapura. (shrink)

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over half (...) (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly. (shrink)

Given this bitter reality, the “near-suicide” term is coined to describe the phenomenon in which poor patients with serious illnesses or injuries choose to end their treatment, which is highly likely to result in mortality, to avoid making their families destitute.

The current study aims to examine how types of demanded healthcare information affect the FCG’s role in reducing the fear of female cancer patients (i.e., cancer-specific information, caregiver-specific information, therapy-specific information, information on cancer physical needs, information on alternative therapies, and information on support services).

The current study aims to examine how types of demanded healthcare information affect the FCG’s role in catalyzing the adaptation of female cancer patients (i.e., cancer-specific information, caregiver-specific information, therapy-specific information, information on cancer physical needs, information on alternative therapies, and information on support services).

Background: The time before surgery is a traumatic period for patients. Despite this fact, no research has been conducted on nurses’ preoperative patient education in Ethiopia. This study aimed to assess preoperative patient education practices and associated factors among nurses working in East Amhara comprehensive specialized hospitals, Ethiopia, 2022. Methods: A hospital-based cross-sectional study was conducted with 416 nurses. Pretested, structured questionnaires were used to collect the data. Bivariable analysis was performed for each independent variable with a P-value < 0.25 (...) on the data imported to multivariate logistic regression analysis. AOR with a 95% CI and a P-value < 0.05 at a 5% level of significance were considered. Results: Only 38.5% of nurses were found to have good practices for preoperative patient education, with a response rate of 98%. Nurses with 6 years of work experience (AOR = 3.15, 95% CI: 1.692– 5.874), adequate time (AOR = 2.33, 95% CI: 1.119– 4.889), training (AOR = 4.27, 95% CI: 1.548– 11.796), age 25– 29 (AOR = 0.15, 95% CI: 0.070– 0.331), age 30– 34 (AOR = 0.25, 95% CI: 0.137– 0.479), and knowledge (AOR = 3.73, 95% CI: 2.222– 6.273) were significantly associated. Conclusion: Preoperative patient education practices among nurses were poor. Work experience, knowledge, training, and adequate time were found to be significant. Organize preoperative patient education programs for nurses that share experiences and provide ongoing training. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and the other pillars (...) of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

Phenomenology has been adapted for use in qualitative health research, where it’s often used as a method for conducting interviews and analyzing interview data. But how can phenomenologists study subjects who cannot accurately reflect upon or report their own experiences, for instance, because of a psychiatric or neurological disorder? For conditions like these, qualitative researchers may gain more insight by conducting observational studies in lieu of, or in conjunction with, interviews. In this article, we introduce a phenomenological approach to conducting (...) this kind of observational research. The approach relies on conceptual grounding to focus a study on specific aspects of the participants’ experiences. Moreover, the approach maintains the openness to novel discoveries that qualitative research requires while also providing a structured framework for data collection and analysis. To illustrate its practical application, we use examples of hemispatial neglect—a neurologic disorder in which patients characteristically lack awareness of their own illness and bodily capacities. However, the approach that we describe can be applied more broadly to the study of complex illness experiences and other experiential alterations. (shrink)

- First book to describe what pain means in vulnerable or special groups of people - Clinical applications described in each chapter - Provides insight into the nature of pain experience across the lifespan -/- This book, the third and final volume in the Meaning of Pain series, describes what pain means to people with pain in “vulnerable” groups, and how meaning changes pain – and them – over time. -/- Immediate pain warns of harm or injury to the person (...) with pain. If pain persists over time, more complex meanings can become interwoven with this primitive meaning of threat. These cognitive meanings include thoughts and anxiety about the adverse consequences of pain. Such meanings can nourish existential sufferings, which are more about the person than the pain, such as loss, loneliness, or despair. -/- Although chronic pain can affect anyone, there are some groups of people for whom particular clinical support and understanding is urgently needed. This applies to “vulnerable” or “special” groups of people, and to the question of what pain means to them. These groups include children, women, older adults, veterans, addicts, people with mental health problems, homeless people, or people in rural or indigenous communities. Several chapters in the book focus on the lived experience of pain in vulnerable adults, including black older adults in the US, rural Nigerians, US veterans, and adults with acquired brain injury. The question of what pain experience could mean in the defenceless fetus, neonate, pre-term baby, and child, is examined in depth across three contributions. -/- This book series aspires to create a vocabulary on the “meanings of pain” and a clinical framework with which to use it. It is hoped that the series stimulates self-reflection about the role of meaning in optimal pain management. -/- Meanings of Pain is intended for people with pain, family members or caregivers of people with pain, clinicians, researchers, advocates, and policy makers. Volume I was published in 2016; Volume II in 2019. (shrink)

Aims and Objectives The purpose of this paper was to clarify the concept of ethical conflict in nursing and highlight the importance of tackling this issue. -/- Background Ethical conflict is on the rise in the nursing context. It is associated with the compromise of nurses' well-being and patient care. However, there is no thorough conceptual understanding of this concept. -/- Design Concept analysis. -/- Methods Databases (PubMed, PsycINFO, CINAHL, Scopus, Embase, Web of Science and SocINDEX) were searched for studies (...) between 1984 and 2021. Both quantitative and qualitative studies related to ethical conflict in nursing were included. Walker and Avant's method of concept analysis was used to identify the defining attributes, antecedents and consequences of the concept of ethical conflict in nursing. We followed the PRISMA-ScR checklist to report the study. -/- Results Thirty studies were included for conceptualization. Defining attributes were divided into four categories: (1) emotional responses, (2) incompatible values, (3) competing interests and (4) ambiguous obligations. The antecedents were (1) ethical sensitivity, (2) negative ethical climate, (3) insufficient authority, (4) unrealistic expectations, (5) poor collaboration and (6) inadequate resources. The consequences were identified as (1) moral residue, (2) loss of identity, (3) professional burnout and (4) poor patient care. -/- Conclusions A unified conceptual model of ethical conflict in nursing shed light on the ethical issues nurses might come across in practice. Despite the fact that ethical conflict is inherently negative, we conceptualised this concept as a neutral fact and an opportunity for nursing action. The construct identification provides basis for both the development of practice and the development of staff support and education. (shrink)

Introduction: Agricultural workers perform intense labor outside in direct sunlight and in humid environmental conditions exposing them to a high risk of heat-related illness (HRI). To implement effective cooling interventions in occupational settings, it is important to consider workers’ perceptions. To date, an analysis of agricultural workers’ experience and perception of cooling devices used in the field while working has not been published. -/- Methods: Qualitatively data from 61 agricultural workers provided details of their perceptions and experiences with cooling interventions. (...) -/- Results: The participants in the bandana group reported the bandana was practical to use at work and did not interfere with their work routine. Cooling vest group participants agreed that the vest was effective at cooling them, but the practicality of using the vest at work was met with mixed reviews. -/- Conclusion: The findings of this qualitative study support and extend existing research regarding personal cooling and heat prevention research interventions with vulnerable occupational groups. Personal cooling gear was well received and utilized by the agricultural workers. Sustainable heat prevention studies and governmental protection strategies for occupational heat stress are urgently needed to reduce the risk of heat-related morbidity, mortality, and projected climate change health impacts on outdoor workers. (shrink)

This short peer-reviewed text is a concise overview of neurodiversity, the natural diversity of human brain functioning including ways that are currently pathologized as disorders. The concept is essential to understanding humans and societies.

In this paper, I bring together Jewish and Buddhist philosophical resources to develop a notion of radical responsibility that can confront a complicity within nursing and health care between empathy and (neo)liberal white supremacist hegemony. My inspiration comes from Angela Davis's call for building coalitions to advance struggles for peace and justice. I proceed as follows. First, I note ways phenomenology clarifies empathy's seeming foundational role in nursing care, and how such a formulation can be complicit with assumptions about private (...) individualism. Second, I turn to the Jewish philosophies of Martin Buber and Emmanuel Levinas, and their advocacy for a kind of responsibility that precedes the constitution of individuality as this can provide a resource for action and practice circumventing liberal influenced empathy. I note critical reservations about direct and practical application of Levinasian ethics in nursing care, and turn to engaged Buddhist philosophies of interdependence—such as in Thich Nhat Hanh and the Dalai Lama—as a corrective. Third, I conclude by indicating ways interreligious radical responsibility can reorient us toward housekeeping habits of character and away from exceptional crisis management, noting specific examples and actions in health care, nursing education and nursing scholarship. (shrink)

Today, many philosophers write on topics of contemporary interest, such as emerging technologies, scientific advancements, or major political events. However, many of these reflections, while philosophically valuable, fail to contribute to those who may benefit the most from them. In this article, we discuss our own experience of engaging with nursing researchers and practicing nurses. By drawing on the field of philosophical phenomenology, we intervene in a longstanding debate over the meaning of “empathy” in nursing, which has important implications for (...) nursing research, training, and practice. However, our intention is not only to introduce and discuss this philosophical intervention. Rather, we present this intervention as a model for how philosophers might successfully engage with the field of nursing, and perhaps with other fields as well, with the aim of effecting positive change in research or practice. The article proceeds in five parts. First, we introduce the problem of conceptual clarity in nursing and explain why many nursing concepts are still in need of refinement. Second, we discuss the origins of the concept of empathy in nursing and outline the challenges associated with borrowing theory from other fields. Third, we explain how nurses tend to conceptualize empathy today, drawing upon the psychological distinction between cognitive and emotional empathy. Fourth, we discuss our intervention in this debate and explain how we attempt to resolve existing conceptual confusions by developing the concept of empathy from the ground up. Fifth, we conclude by briefly reflecting upon some of the challenges of interdisciplinary engagement and providing some recommendations based upon our own experience. (shrink)

Is it possible to train empathy? We suggest a new way, based on insights from phenomenology.

Highlights: -/- • Breastfeeding and breastfeeding support can contribute to mitigating climate change. • Achieving global nutrition targets will save more emissions than fuel-switching. • Breastfeeding support programmes support a just transition. • This work can support the expansion of mitigation options in energy system models. -/- Abstract: -/- Renewable gas has been proposed as a solution to decarbonise industrial processes, specifically heat demand. As part of this effort, the breast-milk substitutes industry is proposing to use renewable gas as a (...) substitute for fossil natural gas. However, decarbonising the industrial processing of breast-milk substitutes can increase social license for these products, potentially undermining breastfeeding. World Health Organisation nutrition targets aim to increase exclusive breastfeeding to at least 50% globally by 2025 to improve maternal, infant, and young child health and nutrition. This target will have implications for the energy transition. A weakness of existing energy models is that demands for end-use products such as breast-milk substitutes are typically not considered explicitly. This paper develops an analytical framework for explicitly representing infant feeding methods in energy systems models. We compare the emissions saved in Ireland from decarbonising the industrial processing of breast-milk substitutes with renewable gas with the emissions saved by an increase in exclusive breastfeeding to 50% in both Ireland and a key export market, China. We demonstrate that the emissions saved from achieving the minimum global breastfeeding target are greater than when renewable gas is used to displace natural gas in the production of breast-milk substitutes in Ireland. We discuss the decarbonisation of breast-milk substitutes in relation to the principle of justice as non-maleficence, a principle based on the commitment to avoid harm, a novel application of a principle of justice. We conclude that breastfeeding support can be considered a demand-side measure for mitigating climate change by reducing the demand for energy services to produce breast-milk substitutes. A key recommendation is to position breastfeeding support as both a public health and a climate justice issue that is relevant for a just transition. The framework developed for this paper could be applied to support the inclusion of a wider range of mitigation options with social justice outcomes in energy system models. [Open access]. (shrink)

When decisionally incapable patients need a surrogate to make medical decisions for them, sometimes the patient has not appointed a healthcare agent and there is intractable disagreement among potential surrogates of equal priority, legal rank, or relation to the patient (e.g., child vs. child, sibling vs. sibling). There is no ethical, legal, or professional consensus about how to identify the appropriate surrogate in such circumstances. This article presents a case study involving an elderly female patient whose four children disagree about (...) whether to continue life-sustaining treatment for their mother, along with an ethical analysis of various strategies for selecting the appropriate surrogate in cases of conflicting equal-rank family members. It critically examines three different strategies—chance, majority rules, and quality of relationship with the patient—and defends the third approach. (shrink)

Taiwan and Vietnam have taken successful measures to combat the spread of COVID-19 at the early stages. Many authors attributed the successful policies to the lessons learned by these countries during the severe acute respiratory syndrome (SARS) pandemic in 2002.(Ohara, 2004) This manuscript provides a summary of recent early-stage policies that were successful in mitigating the spread and creating resilience against the negative consequences of COVID-19 in Taiwan and Vietnam. Crucially, these policies go beyond and complement social isolation. As social (...) isolation is expected to have a negative socio-economic impact on the population and adherence is likely to decrease with time(Armitage and Nellums, 2020; Weems et al., 2020), it is important to consider a broad range of policies to promote a steady control of the COVID-19 spread. Initially, we provide a brief introduction to some general concepts related to COVID-19. Thereafter, we introduce a concise review of policies and their dates relative to the first detection case in Taiwan and Vietnam as well as doing a comparative analysis. (shrink)

The COVID -19 is one of the most contagious and fatal diseases known today, which had spread in communities very fast. This deadly virus affecting the lives of many people and causing fatalities. Besides the strong practice of praying and putting trust in Allah for the cure of disease, Islam also recommends taking medications and adopt sufficient precautions for the safety and well-being of the community. Before 1400 years ago, the Prophet Muhammad (peace be upon Him) introduced the quarantining and (...) hygiene practice, at a time there was very little known to combat the contagious diseases. Currently, modern societies are emphasizing on hand hygiene, social distancing, quarantining, and social isolation to combat COVOD-19. Islam has superseded modern societies by establishing the idea of quarantines and hygienic practice for contagious and fatal diseases. The commandments to prevent the spread of COVID-19 by worldwide public health organizations are almost in line with the teachings of Islam. (shrink)

L’épidémie de Covid-19 aurait pu y faire des ravages. Pourtant, ce 11 avril, le Vietnam ne comptait que 258 cas déclarés et aucun décès selon l’université américaine Johns Hopkins. Des chiffres observés avec moins de méfiance que ceux du voisin chinois, avec qui il partage 1 280 kilomètres de frontière. Le résultat est surprenant pour ce pays de 96 millions d’habitants, qui ne consacre que peu de moyens à la santé. À Hô-Chi-Minh-Ville, seuls 900 lits d’hôpitaux sont équipés pour les (...) soins intensifs, soit 1 pour près de 9 000 habitants. (shrink)

Background The purpose of this systematic review is to examine cooling intervention research in outdoor occupations, evaluate the effectiveness of such interventions, and offer recommendations for future studies. This review focuses on outdoor occupational studies conducted at worksites or simulated occupational tasks in climatic chambers. -/- Methods This systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched to identify original research on intervention studies published (...) in peer‐reviewed journals that aimed at reducing heat stress or heat‐related illness from January 2000 to August 2020. -/- Results A systematic search yielded a total of 1042 articles, of which 21 met the inclusion criteria. Occupations with cooling intervention studies included agriculture (n = 5), construction (n = 5), industrial workers (n = 4), and firefighters (n = 7). The studies focused on multiple types of cooling interventions cooling gear (vest, bandanas, cooling shirts, or head‐cooling gel pack), enhanced heat dissipation clothing, forearm or lower body immersion in cold water, water dousing, ingestion of a crushed ice slush drink, electrolyte liquid hydration, and modified Occupational Safety and Health Administration recommendations of drinking water and resting in the shade. -/- Conclusion Current evidence indicates that using multiple cooling gears along with rest cycles may be the most effective method to reduce heat‐related illness. Occupational heat‐related illnesses and death may be mitigated by targeted cooling intervention and workplace controls among workers of vulnerable occupational groups and industries. (shrink)

This book offers a philosophically-based, yet clinically-oriented perspective on current medical reasoning aiming at 1) identifying important forms of uncertainty permeating current clinical reasoning and practice 2) promoting the application of an abductive methodology in the health context in order to deal with those clinical uncertainties 3) bridging the gap between biomedical knowledge, clinical practice, and research and values in both clinical and philosophical literature. With a clear philosophical emphasis, the book investigates themes lying at the border between several disciplines, (...) such as medicine, nursing, logic, epistemology, and philosophy of science; but also ethics, epidemiology, and statistics. At the same time, it critically discusses and compares several professional approaches to clinical practice such as the one of medical doctors, nurses and other clinical practitioners, showing the need for developing a unified framework of reasoning, which merges methods and resources from many different clinical but also non-clinical disciplines. In particular, this book shows how to leverage nursing knowledge and practice, which has been considerably neglected so far, to further shape the interdisciplinary nature of clinical reasoning. Furthermore, a thorough philosophical investigation on the values involved in health care is provided, based on both the clinical and philosophical literature. The book concludes by proposing an integrative approach to health and disease going beyond the so-called “classical biomedical model of care”. (shrink)

Since the “last day” of 2019, a new virus emerged in Asia, which in Feb./2020 was called by the World Health Organization (WHO, 2020) as Coronavirus disease (Covid-19). Due to its fast transmission, after eight months since the first global official case, at 23:59 (GMT) on August 31, 2020, the world has accounted for about 25,620,737 new confirmed cases with 854,222 deaths and 17,921,063 recovered cases (WORLDOMETERS, 2020). The pandemic is the newest challenge for all nations, most of them eager (...) to learn from countries that are successful against the virus. However, until now, no methodology was developed to identify them by taking into account a holistic approach with international rankings concerned to health, innovation, sustainability, image, and competitiveness, as well as the estimated real number of fatal cases by one million population during the first 180 days of facing the pandemic. Thus, the main objective is to develop a holistic methodology to identify twenty benchmark countries that are saving people's lives against Covid-19. The research is applied, as its results and recommendations are useful for academy, government policymakers and authorities. It is descriptive, with a qualitative and quantitative approach, based on bibliographic and documentary research, involving the study of official sites, articles, reports, manuals, and other technical documents related to 13 international rankings. As a result, the fifteen phases of the methodology, far from perfect, shows that among 108 well-evaluated countries, the top six benchmark countries are from Asia (1) Vietnam; 2) Taiwan; 3) Thailand; 4) China; 5) Malaysia; 6) Singapore), which suffered from fatal cases from first SARS-CoV in 2002/2003, followed by 7) South Korea; 8) New Zealand; 9) Australia; 10) Japan; 11) Hong Kong; 12) Cyprus; 13) Greece; 14) Latvia; 15) Iceland; 16) the United Arab Emirates; 17) Czech; 18) Lithuania; 19) Norway, and 20) Estonia. (shrink)

Aims and Objectives. This article uses the concept of embodiment to demonstrate a conceptual approach to applied phenomenology. -/- Background. Traditionally, qualitative researchers and healthcare professionals have been taught phenomenological methods, such as the epoché, reduction, or bracketing. These methods are typically construed as a way of avoiding biases so that one may attend to the phenomena in an open and unprejudiced way. However, it has also been argued that qualitative researchers and healthcare professionals can benefit from phenomenology’s well-articulated theoretical (...) framework, which consists of core concepts, such as selfhood, empathy, temporality, spatiality, affectivity, and embodiment. -/- Design. This is a discursive article that demonstrates a conceptual approach to applied phenomenology. -/- Method. To outline and explain this approach to applied phenomenology, the Discussion section walks the reader through four stages of phenomenology, which progress incrementally from the most theoretical to the most practical. -/- Discussion. Part one introduces the philosophical concept of embodiment, which can be applied broadly to any human subject. Part two shows how philosophically trained phenomenologists use the concept of embodiment to describe general features of illness and disability. Part three illustrates how the phenomenological concept of embodiment can inform empirical qualitative studies and reflects on the challenges of integrating philosophy and qualitative research. Part four turns to phenomenology’s application in clinical practice and outlines a workshop model that guides clinicians through the process of using phenomenological concepts to better understand patient experience. -/- Conclusion and Relevance to Clinical Practice. A conceptual approach to applied phenomenology provides a valuable alternative to traditional methodological approaches. Phenomenological concepts provide a foundation for better understanding patient experience in both qualitative health research and clinical practice, and therefore provide resources for enhancing patient care. (shrink)

Empathy is a topic of continuous debate in the nursing literature. Many argue that empathy is indispensable to effective nursing practice. Yet others argue that nurses should rather rely on sympathy, compassion, or consolation. However, a more troubling disagreement underlies these debates: There’s no consensus on how to define empathy. This lack of consensus is the primary obstacle to a constructive debate over the role and import of empathy in nursing practice. The solution to this problem seems obvious: Nurses need (...) to reach a consensus on the meaning and definition of empathy. But this is easier said than done. Concept analyses, for instance, reveal a profound ambiguity and heterogeneity of the concept of empathy across the nursing literature. Since the term “empathy” is used to refer to a range of perceptual, cognitive, emotional, and behavioral phenomena, the presence of a conceptual ambiguity and heterogeneity is hardly surprising. Our proposal is simple. To move forward, we need to return to the basics. We should develop the concept from the ground up. That is, we should begin by identifying and describing the most fundamental form of empathic experience. Once we identify the most fundamental form of empathy, we will be able to distinguish among the more derivative experiences and behaviors that are addressed by the same name and, ideally, determine the place of these phenomena in the field of nursing. The aim of this article is, consequently, to lay the groundwork for a more coherent concept of empathy and thereby for a more fruitful debate over the role of empathy in nursing. In Part 1, we outline the history of the concept of empathy within nursing, explain why nurses are sometimes warry of adapting concepts from other disciplines, and argue that nurses should distinguish between adapting concepts from applied disciplines and from more theoretical disciplines. In Part 2, we show that the distinction between emotional and cognitive empathy—borrowed from theoretical psychology—has been a major factor in nurses’ negative attitudes toward emotional empathy. We argue, however, that both concepts fail to capture the most fundamental form of empathy. In Part 3, we draw on and present some of the seminal studies of empathy that can be found in the work of phenomenological philosophers including Max Scheler, Edmund Husserl, and Edith Stein. In Part 4, we outline how their understanding of empathy may facilitate current debates about empathy’s role in nursing. (shrink)

Being a parent advocate of the rights of children with autism, I have witnessed how the Vietnamese news media perpetuate misrepresentation, misinformation and disinformation about autism. As the first media study of its kind in Vietnam, this thesis set out to describe, interpret and explain the issue of misrepresentation, misinformation and disinformation about autism in the Vietnamese online news media between 2006 and 2016.

An Islamic approach from its theological sources to address the spiritual pain related to palliative care of terminally ill patients can be established on attaining a spiritual stage of soul or spirit termed as reassured soul. The attainment of such stage is based on hope of the patient to receive mercy and forgiveness of God. And the way of attainment of hope is possible by doing the repentance, praying, and patience. In combating the pain and suffering, the patient is supposed (...) to understand that the life in its reality is a test and facing such a test is possible by two ways, one is patient centric by building patience within to endure the suffering and second is seeking help from God by praying. For the spiritual wellbeing, the patient should understand that his suffering is in fact expiation for his sins. On the other hand, the visitors and caregivers of patients have certain responsibilities that contribute to enhancing of the spiritual well-being of the patient, including comforting them by giving hope to the patients and at the same time praying for their recovery. These all elements enhance the spiritual well-being of patients and help in prevention of suffering by spiritual means. (shrink)

When we talk about child sexual abuse, we can understand culture as one of the most important determinants of child health. As a public health problem, sexual abuse has different causes, from which we can distinguish the silence and secrecy maintained by third parties. In each case of abuse, there is a person or persons who are present at the moment of the abuse, or who, without being present, know that the abuse is taking place, or who even help the (...) perpetrator in some way to commit the abuse. In order to work consistently on this type of abuse of children, we need to work on adding values to a culture that helps to talk freely and openly about sexuality and to teach how to achieve transparency in communities that could help to disclose sexual abuse. (shrink)

Objectives The study aims to evaluate the impact of the Revised Health Insurance Law 2014 on the utilisation of outpatient and inpatient care services, healthcare services utilisation at different levels of providers, types of providers and types of visits across different entitlement groups. Design/setting Secondary data from two waves of the Vietnam Household Living Standard Survey (VHLSS) 2016, VHLSS 2014 were used. A cross-sectional study applying propensity score matching was conducted. Participants A total of 4900 individuals who reported using healthcare (...) services are analysed. Outcomes measure Numbers of outpatient and inpatient visits, frequency of healthcare service utilisation at commune health stations, district hospitals, provincial hospitals, public and private health facilities, number of visits at health facility for medical treatment and health checks per year. Results The result indicates that health insurance (HI) policy increased the number of outpatient visits for the enrolled between 0.87 and 1.29. The greatest impact was found on participants of heavily subsidised health insurance (HSHI) programmes with 1.29 visits per person per year. Similarly, an increase between 0.08 and 0.16 in the number of inpatient admissions was because of participation in HI. With regard to type of healthcare providers, the study found that participation in HI has the most effect on the use of healthcare services at district hospitals. However, the study demonstrated that the impacts of HI on the increase in the frequency of visiting commune health stations, number of visits at the provincial hospital for HSHI groups, and number of visits at health facilities for health check and consultation were sensitive to unobserved characteristics. Conclusion Our findings imply that policy-makers in Vietnam could continue expanding health insurance coverage to increase access to healthcare services for citizens, especially vulnerable groups. In addition, the government should draw more attention to primary healthcare level. (shrink)

The poet speaks in a particular way that can “bring things to nearness”. This particular way of bringing things to nearness may have some useful implications for understanding human well-being. Sometimes I have noticed that, when I read a poem that really “speaks to me”, the poetic language puts me in touch with well-being in a very palpable way, and this has brought me to wonder about this question: What is it that is taking place in a much loved poem (...) that can bring me close to a felt sense of well-being? This paper will draw upon some philosophical insights from the writings of Heidegger and Gendlin to explore what poetry opens up and holds in order to speak of well-being. What is it about poetry that is adequate to hold the deepest roots of hearing with the fullness of what is speaking? Heidegger’s later ideas about the essence of language and its non-representational power held within the unity of “the fourfold” may be helpful here. And what is it about poetry that can open up worlds, open us to sensation, and carry us beyond the literal words into the experience of well-being? Gendlin’s ideas concerning “thinking beyond patterns” and “carrying forward” may illuminate how poetry holds open what other language cuts off for us. The paper will conclude by pointing to poetry as a crucial form of adequate human discourse that is up to the task of understanding well-being and is therefore highly relevant to health and social care. (shrink)