Schopenhauer is widely recognized as the Western philosopher who has shown the greatest openness to Indian thought and whose own ideas approach most closely to it. This book examines his encounter with important schools of Hindu and Buddhist philosophy and subjects the principal apparent affinities to a careful analysis. Initial chapters describe Schopenhauer’s encounter with Indian thought in the context of the intellectual climate of early nineteenth-century Europe. For the first time, Indian texts and ideas were becoming available and the (...) belief that they could bring about a second Renaissance—an “Oriental Renaissance”—was widespread. Schopenhauer shared in this enthusiasm and for the rest of his life assiduously kept abreast of the new knowledge of India. Principal sections of the book consider the two main pillars of Schopenhauer’s system in relation to broadly comparable ideas found, in the case of Hindu thought, in Advaita Vedānta, and within Buddhism in the Mādhyamika and Yogācāra schools. Schopenhauer’s doctrine of the world as representation, or a flow of impressions appearing in the consciousness of living beings, is first considered. The convergence between this teaching and Indian idealism, especially the doctrine of illusory appearance, has long been recognized. Schopenhauer himself was aware of it, emphasizing that it was the result not of influence but of a remarkable convergence between Eastern and Western thought. This convergence is subjected to a much more detailed examination than has previously been carried out, undertaken in the light of twentieth-century Indology and recent studies of Schopenhauer. The second main pillar of Schopenhauer’s system, the doctrine of the world as will, is then examined and its relationship to Indian thought explored. This section of the work breaks new ground in the study of Schopenhauer, for although the similarity of his ethical and soteriological teaching to that of Indian religions has long been noted the underlying reasons for this have not been grasped. It is demonstrated that they are to be found in hitherto unrecognized affinities, of which Schopenhauer himself was largely unaware, between the metaphysics of the will and Indian ideas relating to karmic impressions, the store-consciousness, the causal body, and śakti as the “force” or “energy” that maintains the existence of the world. Final chapters discuss the controversial and difficult question of the relation of the will to final reality in Schopenhauer’s thought in the light of Indian conceptions, and suggest that the two central pillars of his philosophy may be seen, to a greater extent than previously supposed, as a bridge by which the Eastern and Western traditions of philosophical thought may be brought into a closer and more creative relationship. (shrink)

Schopenhauer is widely recognized as the Western philosopher who has shown the greatest openness to Indian thought and whose own ideas approach most closely to it. This book examines his encounter with important schools of Hindu and Buddhist philosophy and subjects the principal apparent affinities to a careful analysis. Initial chapters describe Schopenhauer’s encounter with Indian thought in the context of the intellectual climate of early nineteenth-century Europe. For the first time, Indian texts and ideas were becoming available and the (...) belief that they could bring about a second Renaissance—an “Oriental Renaissance”—was widespread. Schopenhauer shared in this enthusiasm and for the rest of his life assiduously kept abreast of the new knowledge of India. Principal sections of the book consider the two main pillars of Schopenhauer’s system in relation to broadly comparable ideas found, in the case of Hindu thought, in Advaita Vedānta, and within Buddhism in the Mādhyamika and Yogācāra schools. Schopenhauer’s doctrine of the world as representation, or a flow of impressions appearing in the consciousness of living beings, is first considered. The convergence between this teaching and Indian idealism, especially the doctrine of illusory appearance, has long been recognized. Schopenhauer himself was aware of it, emphasizing that it was the result not of influence but of a remarkable convergence between Eastern and Western thought. This convergence is subjected to a much more detailed examination than has previously been carried out, undertaken in the light of twentieth-century Indology and recent studies of Schopenhauer. The second main pillar of Schopenhauer’s system, the doctrine of the world as will, is then examined and its relationship to Indian thought explored. This section of the work breaks new ground in the study of Schopenhauer, for although the similarity of his ethical and soteriological teaching to that of Indian religions has long been noted the underlying reasons for this have not been grasped. It is demonstrated that they are to be found in hitherto unrecognized affinities, of which Schopenhauer himself was largely unaware, between the metaphysics of the will and Indian ideas relating to karmic impressions, the store-consciousness, the causal body, and śakti as the “force” or “energy” that maintains the existence of the world. Final chapters discuss the controversial and difficult question of the relation of the will to final reality in Schopenhauer’s thought in the light of Indian conceptions, and suggest that the two central pillars of his philosophy may be seen, to a greater extent than previously supposed, as a bridge by which the Eastern and Western traditions of philosophical thought may be brought into a closer and more creative relationship. (shrink)

Objectives—This study examined the issue of confidentiality in relation to i) undergraduate curriculum content in physiotherapy, and ii) the awareness, experiences and attitudes of clinical physiotherapists.Design—Postal survey of universities and focus group interviews with physiotherapists.Setting—Twenty-five universities in the UK and Ireland and 44 therapists in five hospitals in southern England.Results—The survey of universities indicated that legal and ethical aspects of confidentiality featured in virtually all preregistration courses that responded. However, whereas its inclusion was rated as extremely important, the degree (...) of coverage of confidentiality varied considerably between courses. Within the focus groups, 35 informants recollected coverage of confidentiality in their preregistration education, and 12 in postregistration in-service training; in neither case was this coverage in great detail. Informants identified environmental factors and working practices as barriers to preserving confidentiality. Disclosure to others also gave rise to difficulties. Informants were only aware in general terms of the relevant sections of the Chartered Society of Physiotherapy's Rules of Professional Conduct.Conclusions—Aspects of hospital-based physiotherapy practice were seen to create specific problems in relation to confidentiality. More detailed sources of education and guidance on this issue appear to be required. (shrink)

BackgroundBoosting the individual learning passion of medical students is a novel approach to improve their academic performance. It facilitates the medical education reform, motivating both policymakers and educators to focus on the function of positive psychology in the career development of medical students. Therefore, this study aimed to assess the status of two types of learning passion; to clarify the relationship between self-esteem and two types of learning passion among Chinese medical students; to examine the mediating role of psychological (...) capital in the relationship between self-esteem and two types of learning passion, respectively; and to identify the moderating role of professional identity in the relationship between PsyCap and two types of learning passion, respectively.MethodsA cross-sectional online survey was conducted from April to June 2016 in China. A total of 1,218 valid questionnaires were collected from four medical schools.ResultsSelf-esteem significantly and positively influenced medical students’ PsyCap.ConclusionTwo types of learning passion of medical students are positively influenced by self-esteem and PsyCap. Medical students with high-level self-esteem should possess strong PsyCap, which augments their harmonious as well as obsessive learning passion. Moreover, the positive effect of medical students’ PsyCap on harmonious learning passion is more notable among those with a lower professional identity. Finally, this study argues that strengths-based interventions of self-esteem and PsyCap are a beneficial approach for future enhancing learning passion in the domain of medical education. (shrink)

BackgroundHealthcare professionals are exposed to advertisements for prescription drugs in medical journals. Such advertisements may increase prescriptions of new drugs at the expense of older treatments even when they have no added benefits, are more harmful, and are more expensive. The publication of medical advertisements therefore raises ethical questions related to editorial integrity.MethodsWe conducted a descriptive cross-sectional study of all medical advertisements published in the Journal of the Danish Medical Association in 2015. Drugs advertised 6 times or (...) more were compared with older comparators: comparative evidence of added benefit; Defined Daily Dose cost; regulatory safety announcements; and completed and ongoing post-marketing studies 3 years after advertising.ResultsWe found 158 medical advertisements for 35 prescription drugs published in 24 issues during 2015, with a median of 7 advertisements per issue. Four drug groups and 5 single drugs were advertised 6 times or more, for a total of 10 indications, and we made 14 comparisons with older treatments. We found: ‘no added benefit’ in 4 of 14 comparisons, ‘uncertain benefits’ in 7, and ‘no evidence’ in 3 comparisons. In no comparison did we find evidence of ‘substantial added benefit’ for the new drug; advertised drugs were 2 to 196 times more expensive per Defined Daily Dose; 11 safety announcements for five advertised drugs were issued compared to one announcement for one comparator drug; 20 post-marketing studies were requested for the advertised drugs versus 10 studies for the comparator drugs, and 7 studies assessed both an advertised and a comparator drug at 3 year follow-up.Conclusions and relevanceIn this cross-sectional study of medical advertisements published in the Journal of the Danish Medical Association during 2015, the most advertised drugs did not have documented substantial added benefits over older treatments, whereas they were substantially more expensive. From January 2021, the Journal of the Danish Medical Association no longer publishes medical advertisements. (shrink)

We present a cross-sectional study of ethical decision-making correlated with spirituality and utilizing moral intensity as a moderator for workers in the Southeastern United States. This study presents spirituality as an individual variable and moral intensity as a situational variable along with ethical decision-making to examine the interaction of these factors in moral dilemmas. Utilizing previously validated instruments for ethical decision-making and individual spirituality, we find that workers with relatively high measured spirituality made less ethical decisions (...) compared to workers with relatively lower measures of spirituality. Further, we find that the introduction of high moral intensity as a situational variable does not moderate the observed correlation between spirituality and ethical decision-making. This research supports the conceptual nature of the Interactionist Theory by presenting in a single study both individual and situational variables in ethical decision-making. (shrink)

ObjectiveTo apply a socioecological approach to identify risk and protective factors across levels of the “sports-ecosystem,” which are associated with mental health outcomes among athletes in para-sports and non-para sports. A further aim is to determine whether para athletes have unique risks and protective factor profiles compared to non-para athletes.MethodsA cross-sectional, anonymous online-survey was provided to all categorized athletes aged 16 years and older, registered with the Australian Institute of Sport. Mental health outcomes included mental health symptoms, general (...) psychological distress, risky alcohol consumption and eating disorder risk. Risk and protective factors across multiple levels of the socioecological model, including individual, microsystem, exosystem and macrosystem level factors were assessed via self-report.ResultsA total of 427 elite athletes participated in the study. No significant differences in the rates of mental health problems were observed between para and non-para athletes. Both differences and similarities in risk and protective factor profiles were found across the multiple levels of the sports-ecosystem. Weak evidence was also found to support the hypothesis that certain risk factors, including experiencing two or more adverse life events in the past year, sports related concussion, high self-stigma, inadequate social support and low psychological safety conferred a greater risk for poorer mental health outcomes for para athletes in particular.ConclusionRisk factors occurring across various levels of the sports ecosystem, including individual, interpersonal and organizational level risk factors were found to be associated with a range of poorer mental health outcomes. The association between mental ill-health and certain risk factors, particularly those at the individual and microsystem level, appear to be greater for para athletes. These findings have important implications for policy and mental health service provision in elite sports settings, highlighting the need for more nuanced approaches to subpopulations, and the delivery of mental health interventions across all levels of the sports ecosystem. (shrink)

BackgroundInformed consent is a key element of ethical clinical research. Addicted population may be at risk for impaired consent capacity. However, very little research has focused on their comprehension of consent forms. The aim of this study is to assess the capacity of addicted individuals to provide consent to research.Methods53 subjects with DSM-5 diagnoses of a Substance Use Disorder and 50 non psychiatric comparison subjects participated in the survey from December 2014 to March 2015. This cross-sectional (...) class='Hi'>study was carried out at a community-based Outpatient Treatment Center and at an urban-located Health Centre in Spain. A binary judgment of capacity/incapacity was made guided by the MacArthur Competence Assessment Tool for Clinical Research and a clinical interview. Demographics and clinical characteristics were assessed by cases notes and the Mini-Mental State Examination, the Global Assessment Functional Scale and the Clinical Global Impression Scale.ResultsNPCs performed the best on the MacCAT–CR, and patients with SUD had the worst performance, particularly on the Understanding and Appreciation subscales. 32.7 % SUD people lacked research-related decisional capacity. There were no statistically significant differences between the groups in terms of capacity to consent to research.ConclusionsThe findings of our study provide evidence that a large proportion of individuals with SUD had decisional capacity for consent to research. It is therefore inappropriate to draw conclusions about capacity to make research decisions on the basis of a SUD diagnosis. In the absence of advanced cognitive impairment, acute withdrawal or intoxication, we should assume that addicted persons possess decision-making capacity. Thus, the view that people with SUD would ipso facto lose decision-making power for research consent is flawed and stigmatizing. (shrink)

BackgroundRespecting patients’ confidentiality is an ethical and legal responsibility for health professionals and the cornerstone of care excellence. This study aims to assess health professionals’ knowledge, attitudes, and associated factors towards patients’ confidentiality in a resource-limited setting.MethodsInstitutional based cross-sectional study was conducted among 423 health professionals. Stratified sampling methods were used to select the participants, and a structured self-administer questionnaire was used for data collection. The data was entered using Epi-data version 4.6 and analyzed using SPSS, (...) version 25. Bi-variable and multivariable binary logistic regression analyses were used to measure the association between the dependent and independent variables. Odds ratio with 95% confidence intervals and P value was calculated to determine the strength of association and to evaluate statistical significance.ResultOut of 410 participants, about 59.8% with [95% CI (54.8–68.8%)] and 49.5% with [95% CI (44.5–54.5%)] had good knowledge and favorable attitude towards patents confidentiality respectively. Being male (AOR = 1.63, 95% CI [1.03–2.59]), taking training on medical ethics (AOR = 1.73, 95% CI = [1.11–2.70]), facing ethical dilemmas (AOR = 3.07, 95% CI [1.07–8.79]) were significantly associated factors for health professional knowledge towards patients’ confidentiality. Likewise, taking training on medical ethics (AOR = 2.30, 95% CI [1.42–3.72]), having direct contact with the patients (AOR = 3.06, 95% CI [1.12–8.34]), visiting more patient (AOR = 4.38, 95% CI [2.46–7.80]), and facing ethical dilemma (AOR = 3.56, 95% CI [1.23–10.26]) were significant factors associated with attitude of health professionals towards patient confidentiality.ConclusionThe findings of this study revealed that health professionals have a limited attitude towards patient confidentiality but have relatively good knowledge. Providing a continuing medical ethics training package for health workers before joining the hospital and in between the working time could be recommended to enhance health professionals’ knowledge and attitude towards patient confidentiality. (shrink)

Background: High ethical sensitivity positively affects the quality of nursing care; nevertheless, Chinese nurses’ ethical sensitivity and the factors influencing it have not been described. Research objectives: The purpose of this study was to describe ethical sensitivity and to explore factors influencing it among Chinese-registered nurses, to help nursing administrators improve nurses’ ethical sensitivity, build harmony between nurses and patients, and promote the patients’ health. Research design: This was a descriptive, cross-sectional study. Participants and research context: (...) We recruited 500 nurses from several departments in three tertiary hospitals. The Chinese Moral Sensitivity Questionnaire–Revised version and the Jefferson Scale of Empathy-Health Professionals were used to assess the nurses’ ethical sensitivity and empathy ability, respectively. Fifteen sociodemographic variables were included in the questionnaires. Ethical considerations: Informed consent was obtained from the participants regarding participation and data storage and handling. This program has been examined and supported by the research center of medical ethics and professional ethics of Guilin Medical University. The Approval No. was 2016RWYB04. The whole research process is conducted strictly according to ethical requirements. Results: The valid response rate was 84.40%. The total score of Chinese Moral Sensitivity Questionnaire–Revised was 35.82 ± 8.17. The subscale scores of moral responsibility and strength and sense of moral burden were 21.50 ± 4.91 and 14.33 ± 3.98, respectively. Significant differences were found among age groups, gender, years of working, category of profession, and quality of family communication regarding nurses’ ethical sensitivity. Regression analysis showed that the main factors influencing nurses’ ethical sensitivity were gender, years of working, quality of family communication, career satisfaction, and empathic ability. Discussion: Our findings suggest that Chinese nurses’ ethical sensitivity in tertiary hospitals in Guilin is at a medium level. Conclusion: The director of nursing schools and hospitals in China should pay attention to nurses’ ethical sensitivity and should intensify education and training to improve nurses’ ethical sensitivity. Further studies should focus on interventions aimed at improving Chinese nurses’ ethical sensitivity. (shrink)

To determine the attitude of general practitioners towards continuing medical education and reasons motivating or hindering them from attending CME procedures, we conducted a cross-sectional survey from November 2013 to April 2014 in Karachi. Three hundred general practitioners who possessed a medical license for practice in Pakistan filled a pre-designed questionnaire consisting of questions pertaining to attitudes towards CME. Data was entered and analyzed using SPSS v16.0. 70.3% of the participants were males. Mean age was 47.75 ± 9.47 (...) years. Only 67.33% knew about CME and only 52% had attended a CME session. Reasons for attending CME procedures reported were: need for updating knowledge, skills and competencies, opportunity to meet colleagues and presenting scientific papers. Mean Likert score was 1.67 for those who thought CME is worthwhile and 1.44 for those who consider their clinical duties as the major hurdle in attending CME procedures. Most common cause for not attending CME was lack of knowledge followed by time constraint. Most physicians were not sufficiently informed about the potential benefits of CME and had never attended a CME session. Most common reason for attending CME procedures reported was need for updating knowledge, skills and competencies while reasons hindering physicians from attending CME were lack of knowledge and time constraint. (shrink)

Systemic therapy considers the complex dynamics of relational factors and resources contributing to psychological symptoms. Negative maintaining factors have been well researched for people suffering from Alcohol-use Disorders. However, we know little about the complex dynamics of these negative factors and resources. We interviewed fifty-five participants suffering or fully remitted from Alcohol-use disorders in this cross-sectional study. The interviews focused on relational factors referring to a Support Social Network and a Craving Social Network. The CSN included all (...) significant others who were associated with craving situations. We compared the network characteristics of the group suffering from Alcohol-use Disorders to a fully remitted control group. The abstinent group with full remission named on average fewer individuals in the CSNs. They had lower social negativity mean scores in the Support Social Network compared to the non-remitted group. In the CSN, the mean scores of social support were significantly higher than the median for both groups. These findings reveal the complex interplay of relational patterns contributing to the etiology, maintenance, and recovery from Alcohol-use disorders. A successful recovery can be linked to increased social resources and reduced relations associated with craving. However, craving-associated relations represent an important source of social support. Future research should investigate this ambivalence for the systemic perspective on the explanation and treatment of Alcohol-use disorders. (shrink)

Background Integrating artificial intelligence (AI) into healthcare has raised significant ethical concerns. In pharmacy practice, AI offers promising advances but also poses ethical challenges. Methods A cross-sectional study was conducted in countries from the Middle East and North Africa (MENA) region on 501 pharmacy professionals. A 12-item online questionnaire assessed ethical concerns related to the adoption of AI in pharmacy practice. Demographic factors associated with ethical concerns were analyzed via SPSS v.27 software using appropriate statistical tests. Results (...) Participants expressed concerns about patient data privacy (58.9%), cybersecurity threats (58.9%), potential job displacement (62.9%), and lack of legal regulation (67.0%). Tech-savviness and basic AI understanding were correlated with higher concern scores (p < 0.001). Ethical implications include the need for informed consent, beneficence, justice, and transparency in the use of AI. Conclusion The findings emphasize the importance of ethical guidelines, education, and patient autonomy in adopting AI. Collaboration, data privacy, and equitable access are crucial to the responsible use of AI in pharmacy practice. (shrink)

Background The integration of artificial intelligence (AI) in radiography presents transformative opportunities for diagnostic imaging and introduces complex ethical considerations. The aim of this cross-sectional study was to explore radiographers’ perspectives on the ethical implications of AI in their field and identify key concerns and potential strategies for addressing them. Methods A structured questionnaire was distributed to a diverse group of radiographers in Saudi Arabia. The questionnaire included items on ethical concerns related to AI, the perceived impact (...) on clinical practice, and suggestions for ethical AI integration in radiography. The data were analyzed using quantitative and qualitative methods to capture a broad range of perspectives. Results Three hundred eighty-eight radiographers responded and had varying levels of experience and specializations. Most (44.8%) participants were unfamiliar with the integration of AI into radiography. Approximately 32.9% of radiographers expressed uncertainty regarding the importance of transparency and explanatory capabilities in the AI systems used in radiology. Many (36.9%) participants indicated that they believed that AI systems used in radiology should be transparent and provide justifications for their decision-making procedures. A significant preponderance (44%) of respondents agreed that implementing AI in radiology may increase ethical dilemmas. However, 27.8%expressed uncertainty in recognizing and understanding the potential ethical issues that could arise from integrating AI in radiology. Of the respondents, 41.5% stated that the use of AI in radiology required establishing specific ethical guidelines. However, a significant percentage (28.9%) expressed the opposite opinion, arguing that utilizing AI in radiology does not require adherence to ethical standards. In contrast to the 46.6% of respondents voicing concerns about patient privacy over AI implementation, 41.5% of respondents did not have any such apprehensions. Conclusions This study revealed a complex ethical landscape in the integration of AI in radiography, characterized by enthusiasm and apprehension among professionals. It underscores the necessity for ethical frameworks, education, and policy development to guide the implementation of AI in radiography. These findings contribute to the ongoing discourse on AI in medical imaging and provide insights that can inform policymakers, educators, and practitioners in navigating the ethical challenges of AI adoption in healthcare. (shrink)

BackgroundThe concept of career identity is integral to nursing practices and forms the basis of the nursing professions. Positive career identity is essential for providing high-quality care, optimizing patient outcomes, and enhancing the retention of health professionals. Therefore, there is a need to explore potential influencing variables, thereby developing effective interventions to improve career identity.ObjectivesTo investigate the relationship between moral distress, moral courage, and career identity, and explore the mediating role of moral courage between moral distress and career identity among (...) nurses.DesignA quantitative, cross-sectional study.MethodsA convenient sample of 800 nurses was recruited from two tertiary care hospitals between February and March 2022. Participants were assessed using the Moral Distress Scale-revised, Nurses’ Moral Courage Scale, and Nursing Career Identity Scale. This study was described in accordance with the STROBE statement.Ethical considerationResearch ethics approval was obtained from the researcher’s university and hospital where this study was conducted prior to data collection.FindingsMoral distress is negatively associated while moral courage is positively associated with career identity among nurses. Moral courage partially mediates the relationship between moral distress and career identity ( β = −0.230 to −0.163, p < 0.01).DiscussionThe findings reveal a relationship between moral distress, moral courage, and career identity among nurses.ConclusionBy paying attention to nurses’ moral distress and courage, healthcare providers can contribute to the development of effective interventions to improve career identity, and subsequently performance, among nurses. (shrink)

The purpose of this study is to investigate the current state of post-traumatic growth and identify its influencing factors in discharged COVID-19 patients. PTG refers to individual experiences of significant positive change arising from the struggle with a major life crisis. This descriptive cross-sectional study used the convenient sampling method to recruit 140 discharged COVID-19 patients in Hunan, China. The results show that the PTG of the discharged COVID-19 patients was positively correlated with self-esteem, post-traumatic stress (...) disorder, coping style tendency, and social support, but negatively correlated with the time from onset to diagnosis. Our findings could provide guidance on improving the psychological state and well-being of discharged COVID-19 patients. (shrink)

A high level of professional integrity is expected from healthcare professionals, and literature suggests a relationship between unethical behavior of healthcare professionals and poor academic integrity behavior at medical school. While academic integrity is well researched in western countries, it is not so in the Middle East, which is characterized by different cultural values that may influence students’ academic integrity conduct. We conducted a cross-sectional study among health-professions students at a university in the Middle East to assess (...) perceptual differences on various cheating behaviors, as well as to explore the reasons underlying the cheating behavior. A validated survey instrument disseminated among first and second-year undergraduate students resulted in 211 complete responses and this data was analyzed using descriptive and inferential statistics. Pearson’s Chi-square/ Fischer’s exact test was applied to test the association of various factors with academic misconduct. The major determinants of academic misconduct were investigated using Binary Logistic regression model. The conducted analysis and the results showed that preceding cheating behavior was the only factor significantly associated with cheating in the university (p. (shrink)

Objective Moral distress is a complex phenomenon experienced by healthcare professionals. This study examined the relationships between key dimensions of Organizational Culture in Healthcare (OCHC)—perceived psychological safety, ethical climate, patient safety—and healthcare professionals’ perception of moral distress.Design Cross-sectional surveySetting Pediatric and adult critical care medicine, and adult hospital medicine healthcare professionals in the United States.Participants Physicians (n = 260), nurses (n = 256), and advanced practice providers (n = 110) participated in the study.Main outcome measures Three (...) dimensions of OCHC were measured using validated questionnaires: Olson’s Hospital Ethical Climate Survey, Agency for Healthcare Research and Quality’s Patient Safety Culture Survey, and Edmondson’s Team Psychological Safety Survey. The perception of moral distress was measured using the Moral Distress Amidst a Pandemic Survey. The hypothesized relationships between various dimensions were tested with structural equation modeling (SEM).Results Adequate model fit was achieved in the SEM: a root-mean-square error of approximation =0.072 (90% CI 0.069 to 0.075), standardized root mean square residual = 0.056, and comparative fit index =0.926. Perceived psychological safety (β= −0.357, p <.001) and patient safety culture (β = −0.428, p<.001) were negatively related to moral distress experience. There was no significant association between ethical climate and moral distress (β = 0.106, p = 0.319). Ethical Climate, however, was highly correlated with Patient Safety Culture (factor correlation= 0.82).Conclusions We used structural equation model to test a theoretical model of multi-dimensional organizational culture and healthcare climate (OCHC) and moral distress.Significant associations were found, supporting mitigating strategies to optimize psychological safety and patient safety culture to address moral distress among healthcare professionals. Future initiatives and studies should account for key dimensions of OCHC with multi-pronged targets to preserve the moral well-being of individuals, teams, and organizations. (shrink)

Background: The rapid pace of progress in medical research, the consequent need for the timely transfer of new knowledge into practice, and the increasing need for ethics support, is making the work of Ethics Committees (ECs) ever more complex and demanding. As a response, ECs in many countries exhibit large variation in number, mandate, organization and member competences. This cross-sectional study aims to give an overview of the different types of activities of Italian ECs and favour discussion (...) at a European level.Methods: A questionnaire was emailed to all Italian Ethics Committees contained in the national Registry of the Ministry of Health, enquiring whether the EC was conducting, or planning to conduct, 4 specific activities. A telephone interview was conducted to determine reasons for failure to respond.Results: Response rate was 53% (101 respondents out of 191). 20% of ECs restrict their responsibilities to research protocol review, 25% also offer ethical consultation to institutions, support on individual health care decisions and promotes educational initiatives, while the remaining 50% conduct a few of the examined activities to varying degrees. Large variation was observed across different types of hosting institutions and geographical locations.Conclusions: A common European model should be developed, defining EC functions, member selection modalities, necessary member competences, decision-making criteria and measures for work verification. In the absence of sound empirical evidence, it would be interesting to study the effectiveness and efficiency of the different existing models. (shrink)

As the practice of medicine inevitably raises both ethical and legal issues, it had been recommended since 1999 that medical ethics and human rights be taught at every medical school. Most Nigerian medical schools still lack a formal undergraduate medical ethics curriculum. Medical education remains largely focused on traditional medical science components, leaving the medical students to develop medical ethical decision-making skills and moral attitudes passively within institutions noted for relatively strong paternalistic traditions. In conducting a needs assessment for developing (...) a curriculum germane to the Nigerian society, and by extension most of Sub-Saharan Africa, this study determined the views of Nigerian medical students on medical ethics education, ethical issues related to the doctor-patient relationship and the ethical/professional dilemmas they are confronted with. Using self-administered 63-item structured questionnaires, a cross-sectional survey of the final year medical students of the University of Nigeria was conducted in July 2015.Using the Statistical Package for the Social Sciences software (SPSS Version 17), frequency counts and percentages were generated. The sample included 100 males (71.4%) and 40 females (28.6%), with the respective mean (SD) age being 24.6(5.61) and 21.8 (6.38) years. Only 35.7% were satisfied with their medical ethics knowledge, and 97.9% indicated that medical ethics should be taught formally. Only 8.6% had never witnessed a medical teacher act unethically. The dilemmas of poor communication between physicians and patients, and the provision of sub-standard care were reported highest for being encountered ‘often’. A majority (60.7%) indicated that “a doctor should do his best always, irrespective of the patient’s wishes”. No significant difference in responses across gender was noted. There is a strong desire by the contemporary Nigerian medical student for medical ethics education. Their lack of exposure in medical ethics in an ethically challenging environment suggest a dire need for the development of an appropriate medical ethics curriculum for them and the provision of an ethically conducive learning environment. (shrink)

AimsTo examine attitudes towards physician-assisted suicide (PAS) among physicians in Sweden and compare these with the results from a similar cross-sectional study performed in 2007.ParticipantsA random selection of 250 physicians from each of six specialties (general practice, geriatrics, internal medicine, oncology, surgery and psychiatry) and all 127 palliative care physicians in Sweden were invited to participate in this study.SettingA postal questionnaire commissioned by the Swedish Medical Society in collaboration with Karolinska Institute in Stockholm. ResultsThe total response (...) rate was 59.2%. Slightly fewer than half [47.1% (95% CI 43.7–50.5)] of the respondents from the six specialties accepted PAS, which is significantly more than accepted PAS in the 2007 study [34.9% (95% CI 31.5–38.3)]. Thirty-three percent of respondents were prepared to prescribe the needed drugs. When asked what would happen to the respondent’s own trust in healthcare, a majority [67.1% (95% CI 63.9–70.3)] stated that legalizing PAS would either not influence their own trust in healthcare, or that their trust would increase. This number is an increase compared to the 2007 survey, when just over half [51.9% (95% CI 48.0–55.2)] indicated that their own trust would either not be influenced, or would increase.ConclusionsThe study reveals a shift towards a more accepting attitude concerning PAS among physicians in Sweden. Only a minority of the respondents stated that they were against PAS, and a considerable proportion reported being prepared to prescribe the needed drugs for patient self-administration if PAS were legalized. (shrink)

BackgroundThe Mental Capacity Act was enacted in 2007 in England and Wales, but the assessment of mental capacity still remains an area of professional concern. Doctors’ compliance with legal and professional standards is inconsistent, but the reasons for poor compliance are not well understood. This preliminary study investigates doctors’ experiences of and attitudes toward mental capacity assessment.MethodsThis is a descriptive, cross-sectional study where a two-domain, study-specific structured questionnaire was developed, piloted and digitally disseminated to doctors (...) at differing career stages employed in a large, multi-site National Health Service Trust in London over 4 months in 2018. Descriptive statistics and frequency tables adjusted for missing data were generated and secondary analysis was conducted.ResultsParticipants were predominantly UK trained, female and between the ages of 30 and 44 years. Less than half of the participants reported receiving formal MCAx training. Only one-third of the participants self-rated themselves as very competent or extremely competent. Self-reported MCA confidence was significantly affected by career stage with Consultants with over 10 years of experience reporting lowest confidence.ConclusionsThis study describes significant variation in practice by doctors and low self-confidence in the practice of MCAx. These results raise concerns that MCAx continues to be inconsistently performed by doctors despite appropriate awareness of the law and professional guidance on best practice. (shrink)

ObjectiveWe aimed to provide an overview of the psychological status and behavioral consequences of the lockdown during the COVID-19 pandemic in Libya.MethodsA cross-sectional study was conducted among the Libyan population through May and June 2020 in more than 20 cities. The survey comprised basic demographic data of the participants and anxiety symptoms measured using the seven-item Generalized Anxiety Disorder scale with ≥15 as the cut-off score for clinically significant anxiety symptoms. Additionally, a survey regarding the lockdown effect (...) was administered, which consisted of several parts, to measure the lockdown status.ResultsA total of 8084 responses were recorded, of which, 5090 were women and 2994 were men. The mean age for study participants was 27.2 years. Among the participants, 1145 reached the cut-off score to detect anxiety symptoms; however, of the study variables, only five were predictors of clinically significant anxiety: age, gender, marital status, work status, being a financial supporter for the family, and being infected with COVID-19. Women had 1.19 times higher odds to exhibit anxiety symptoms than men. Increasing age was significantly associated with reduced likelihood of exhibiting anxiety symptoms, whereas being married was significantly associated with higher likelihood of anxiety symptoms, compared to not being married. Being suspended from work was associated with an increase in the likelihood of anxiety symptoms. However, we found that being infected with COVID-19 was associated with a 9.59 times higher risk of exhibiting severe anxiety symptoms. Among the study participants, 1451 reported a physical and/or verbal abuse episode from family members, 958 reported abuse outside the family, and 641 reported abuse from enforcers, during the lockdown.ConclusionOur study provided an overview of the psychological and behavioral status, among those who resided in Libya during the civil war and COVID-19 pandemic. The study demonstrates a concerningly high level of clinically significant anxiety during lockdown among the Libyan population during Libya’s lockdown period. (shrink)

This cross-sectional study aimed to assess the applicability of social cognitive determinants among the Chinese adolescents and examine whether the predictability of the social cognitive theory model on physical activity differs across gender and urbanization. A total of 3,000 Chinese adolescents ranging between the ages of 12–15 years were randomly selected to complete a set of questionnaires. Structural equation modeling was applied to investigate the relationships between social cognitive variables and PA in the urbanization and gender subgroups. (...) The overall model explained 38.9% of the variance in PA. Fit indices indicated that the structural model of SCT was good: root mean square error of approximation = 0.047, RMR = 0.028, goodness of fit index = 0.974, adjusted goodness of fit index = 0.960, Tucker–Lewis coefficient = 0.971, and comparative fit index = 0.978. Regarding the subgroup analysis, social support had a more substantial impact on the PA of adolescents in suburban areas than that in urban areas, whereas self-regulation had a more substantial impact on the PA of adolescents in urban areas than in suburban areas. The results indicate that the SCT model predicts the PA of Chinese adolescents substantially. An SCT model could apply over a range of subgroups to predict the PA behavior and should be considered comprehensively when designing interventions. These findings would benefit PA among the Chinese adolescents, especially across genders and urbanization. (shrink)

BackgroundDecisions about limitations of life sustaining treatments are made for end-of-life patients in intensive care units. The aim of this research was to explore the professional and ethical attitudes and experiences of medical professionals on treatment of end-of-life patients in ICUs in the Republic of Croatia.MethodsA cross-sectional study was conducted among physicians and nurses working in surgical, medical, neurological, and multidisciplinary ICUs in the total of 9 hospitals throughout Croatia using a questionnaire with closed and open type (...) questions. Exploratory factor analysis was conducted to reduce data to a smaller set of summary variables. Mann–Whitney U test was used to analyse the differences between two groups and Kruskal–Wallis tests were used to analyse the differences between more than two groups.ResultsLess than third of participants stated they were included in the decision-making process, and physicians are much more included than nurses. Sixty two percent of participants stated that the decision-making process took place between physicians. Eighteen percent of participants stated that ‘do-not-attempt cardiopulmonary resuscitations’ orders were frequently made in their ICUs. A decision to withdraw inotropes and antibiotics was frequently made as stated by 22.4% and 19.9% of participants, respectively. Withholding/withdrawing of LST were ethically acceptable to 64.2% of participants. Thirty seven percent of participants thought there was a significant difference between withholding and withdrawing LST from an ethical standpoint. Seventy-nine percent of participants stated that a verbal or written decision made by a capable patient should be respected. Physicians were more inclined to respect patient’s wishes then nurses with high school education. Nurses were more included in the decision-making process in neurological than in surgical, medical, or multidisciplinary ICUs. Male participants in comparison to female, and physicians in comparison to nurses with high school and college education displayed more liberal attitudes about LST limitation.ConclusionsDNACPR orders are not commonly made in Croatian ICUs, even though limitations of LST were found ethically acceptable by most of the participants. Attitudes of paternalistic and conservative nature were expected considering Croatia’s geographical location in Southern Europe. (shrink)

Higher education institutions are expected to produce quality and competitive graduates for the job market and nation-building. In realizing this role, Bukidnon State University needs to ensure that graduates may land a job-relevant and align with their education and training. With this, a tracer study was conducted to verify whether the three batches of graduates are employed and are employable. It ascertained their employability based on their work experience from graduation to the present job. It employed a cross- (...) class='Hi'>sectional method and data mining for the information of 326 graduates. The results revealed that the majority of graduates had jobs relevant to their education and training; yet, there was a significant difference in the employability of graduates across batches, except in terms of gender. Biological Science, Social Studies, and Math graduates were employable within the first six and twelve months compared to graduates from other curricula. It was claimed that the BukSU had prepared BSE graduates for employment. However, these results have implications for strategic options in improving the programs. The study made some recommendations for future tracer initiatives. (shrink)

The aim of the present study was to corroborate or undermine a previously presented conjecture that physicians’ estimations of others’ opinions are influenced by their own opinions. We used questionnaire based cross-sectional design and described a situation where an imminently dying patient was provided with alleviating drugs which also shortened life and, additionally, were intended to do so. We asked what would happen to physicians’ own trust if they took the action described, and also what the physician (...) estimated would happen to the general publics’ trust in health services. Decrease of trust was used as surrogate for an undesirable action. The results are presented as proportions with a 95 % Confidence Interval. Statistical analysis was based on inter-rater agreement -test as well as χ2 test and Odds Ratio with 95 % CI. We found a moderate inter-rater agreement between what would happen with the physicians’ own trust in healthcare and their estimations of what would happen with the general population’s trust. We identified a significant difference between being pro et contra the treatment with double intentions and the estimation of the general population’s trust. Focusing on either decreasing or increasing own trust and being pro or contra the action we identified a strong association [OR 79 ]. Although the inter-rater agreement in the present study was somewhat weaker compared to a study about the explicit use of the term ‘physicians assisted suicide’ we found that our hypothesis—physicians’ estimations of others’ opinions are influenced by their own opinions—was corroborated. This might have implications in research as well as in clinical decision-making. We suggest that Merton’s ideal of disinterestedness should be highlighted. (shrink)

ObjectiveTo investigate the characteristics of sleep disorders and anxiety in patients with tinnitus, their influencing factors, and the role of sleep disorders as mediators.MethodsThe general conditions and disease characteristics of 393 patients with tinnitus presented to the Changzheng Hospital of the Naval Medical University from 2018 to 2021 were collected. All patients accepted questionnaires such as Tinnitus Handicap Inventory, Pittsburgh Sleep Quality Index and Self-rating Anxiety Scale, and then the characteristics and the influencing factors of sleep disorders and anxiety were (...) analyzed.ResultsAmong the 393 tinnitus patients, 213 cases were diagnosed with sleep disorders, and 78 cases were diagnosed with anxiety, including 25 men and 53 women. Binary regression showed that gender, hearing loss, tinnitus severity, and sleep disorders severity were positively associated with anxiety. Multiple logistic regression analysis showed that female gender, hearing loss and sleep disorders were the independent risk factors of anxiety. The mediating effect of sleep disorders between tinnitus severity and anxiety accounted for 27.88% of the total effect size.ConclusionFemales patients with hearing loss, moderate to severe tinnitus, and sleep disorders were at greater risk for anxiety, with sleep disorders partially mediating the anxiety associated with tinnitus. (shrink)

Objective: Previous research suggests a positive association between pain, depression and sleep. In this study, we investigate how sleep correlates with varying levels of pain and depression in nursing home patients with dementia.Materials and methods: Cross-sectional study with sleep-related data, derived from two multicenter studies conducted in Norway. We included NH patients with dementia according to the Mini-Mental State Examination from the COSMOS trial and the DEP.PAIN.DEM trial whose sleep was objectively measured with actigraphy. In the (...) COSMOS trial, NH patients were included if they were ≥65 years of age and with life expectancy >6 months. In the DEP.PAIN.DEM trial, patients were included if they were ≥60 years and if they had depression according to the Cornell Scale for Depression in Dementia. In both studies, pain was assessed with the Mobilization-Observation-Behavior-Intensity-Dementia-2 Pain Scale, and depression with CSDD. Sleep parameters were total sleep time, sleep efficiency, sleep onset latency, wake after sleep onset, early morning awakening, daytime total sleep time and time in bed. We registered use of sedatives, analgesics, opioids and antidepressants from patient health records and adjusted for these medications in the analyses.Results: Mean age was 86.2 years and 76.3% were female. Hierarchical regressions showed that pain was associated with higher TST and SE, less WASO and more DTS. More severe dementia was associated with more WASO and TiB. More severe depression was associated with less TST, less DTS and less TiB. Use of sedative medications was associated with less TiB.Conclusion: When sleep was measured with actigraphy, NH patients with dementia and pain slept more than patients without pain, in terms of higher total sleep time. Furthermore, their sleep efficiency was higher, indicating that the patients had more sleep within the time they spent in bed. Patients with more severe dementia spent more time awake during the time spent in bed. Furthermore, people with more severe depression slept less at daytime and had less total sleep time Controlling for concomitant medication use did not affect the obtained results. (shrink)

Background Protecting a person’s right to privacy and confidentiality is important in healthcare services. As future health professionals, nursing students should bear the same responsibility as qualified health professionals in protecting patient privacy. Objectives To investigate nursing students’ practices of patient privacy protection and to identify factors associated with their practices. Research design A cross-sectional study design was adopted. A two-part survey was used to collect two types of data on nursing students: (1) personal characteristics, including demographics, (...) clinical experience and use of information and communication technology and social media and (2) practice of patient privacy protection, collected using the Patient Privacy Scale. Participants and research context: A total of 319 nursing students aged 18 or above, studying pre-registration nursing programmes and who had attended at least one block of clinical placement, were recruited from a university in Hong Kong. Ethical considerations The study received ethical approval from the Survey and Behavioural Research Ethics Committee of the Chinese University of Hong Kong. The participants were informed of the study aim and written consent was obtained before completing the survey. Findings: The mean total score on the Patient Privacy Scale was 119.7 out of 135. Nursing students who were regular users of Instagram and those who had never taken photographs with patients and hence did not need to obtain patient consent were associated with better practices of patient privacy protection (higher total scores on the Patient Privacy Scale). Conclusions The findings improve our understanding of nursing students’ practice of patient privacy protection and the associated factors. This will inform the development and revision of current strategies to enhance nursing students’ practice of patient privacy protection, especially their use of social media. (shrink)

Objectives To determine the role played by law in medical specialists9 decision-making about withholding and withdrawing life-sustaining treatment from adults who lack capacity, and the extent to which legal knowledge affects whether law is followed. Design Cross-sectional postal survey of medical specialists. Setting The two largest Australian states by population. Participants 649 medical specialists from seven specialties most likely to be involved in end-of-life decision-making in the acute setting. Main outcome measures Compliance with law and the impact of (...) legal knowledge on compliance. Results 649 medical specialists (of 2104 potential participants) completed the survey (response rate 31%). Responses to a hypothetical scenario found a potential low rate of legal compliance, 32% (95% CI 28% to 36%). Knowledge of the law and legal compliance were associated: within compliers, 86% (95% CI 83% to 91%) had specific knowledge of the relevant aspect of the law, compared with 60% (95% CI 55% to 65%) within non-compliers. However, the reasons medical specialists gave for making decisions did not vary according to legal knowledge. Conclusions Medical specialists prioritise patient-related clinical factors over law when confronted with a scenario where legal compliance is inconsistent with what they believe is clinically indicated. Although legally knowledgeable specialists were more likely to comply with the law, compliance in the scenario was not motivated by an intention to follow law. Ethical considerations (which are different from, but often align with, law) are suggested as a more important influence in clinical decision-making. More education and training of doctors is needed to demonstrate the role, relevance and utility of law in end-of-life care. (shrink)

Background Professional values create a basis for successful collaboration and person-centred care in integrated care and services. Little is known about how different health and social care workers assess their professional values. Research aim To describe and compare professional value orientation among different health and social care workers in Finland. Research design A quantitative cross-sectional study. Participants and research context We carried out an online survey of health and social care workers from 8 March to 31 May (...) 2022, using the Finnish version of the Nurses’ Professional Values Scale-3. The data were analysed using descriptive and advanced statistics. Ethical considerations Permission was received from all participating organizations and those who completed the survey provided informed consent. Results A total of 1823 health and social care workers, representing seven professional groups and students, took part. The overall level of professional values among the participants was relatively high. Commitment to providing patients and clients with equal care was more important than engaging with society and professional responsibilities in the work environment. Professional values were strongest among professionals with higher educational degrees and training in professional ethics. The same was true for workers who received organizational support for ethical practice, were satisfied with their work and had shorter work experience. Discussion Our results showed shared professional values among different health and social care workers and students. These results are meaningful for integrated care and services. At the same time, a clear need for strengthening engagement with society and professional responsibilities for developing work environments were identified. Conclusions Health and social care workers and students need training in professional ethics and organizational support for ethical practice and work satisfaction to maintain their professional values at different stages of their career. (shrink)

We assessed students’ and employees’ perception of ethical climate at a university school of medicine compared to that of social sciences and humanities, as well as temporal changes in the employees’ perception of ethical climate. We also explored potential predictors of ethical climate, including moral foundations. This cross-sectional questionnaire study was conducted at the University of Split School of Medicine and the Faculty of Humanities and Social Sciences, in Croatia, from April to September 2019. We used 36-item (...) Ethical Climate Questionnaire and 22-item Moral Foundation Questionnaire to survey employees, senior and doctoral students. We collected responses using ballot boxes as well as online survey. We collected 449 complete responses. The dominant ethical climates at two schools were “Company rules and procedures” and “Laws and professional codes”. We compared our results with a study conducted in 2012 and found that the perception of ethical climate had not changed dramatically in last 8 years. Ethical climate, or shared social and work-related behaviours, does not seem to change in these institutions even when students and staff are included with faculty in surveys. We provide further discussion of why this seems to be the case. (shrink)

IntroductionNew nurses struggled with time management, which was a prominent theme in safety care for patients. However, the transition training of time management for new nurses was complicated and ignored by clinical managers. The purpose of this study was to understand the level of new nurses’ TMD from a nationwide perspective and detect the influencing factors of the TMD.Materials and methodsA cross-sectional study design with a stratified sampling method was sampled in China. Six hundred and seventy (...) new nurses within the first year of employment were recruited. New nurses’ time management disposition, job stressors, self-efficacy, clinical communication competence, and safety behavior were measured by corresponding scales.ResultsNew nurses showed the best sense of time’s value, followed by the sense of time efficacy and time monitoring view for time management disposition. The related factors of time management disposition were communication skills, safety behavior, job stressors, and being without a preceptor. New nurses’ time management disposition was at a moderate level and they performed worse in time allocation. The highest education, with or without a preceptor, the experience of part-time jobs, and class cadre were significantly influencing the time management disposition of new nurses.ConclusionNursing managers should pay attention to new nurses’ time management disposition. Reducing the job stressors, improving communication ability, and safe behavior were important measures to improve the time management disposition. (shrink)

ContextPeople with mental disorders can acquire long-term disabilities, which could impair their functioning and quality of life (QoL), requiring permanent care and social support. Systematic data on QoL and functioning, which could support a better management of these people, were not available.ObjectiveTo analyze the QoL, level of functioning and their association with sociodemographic and clinical factors of people with mental disorders who underwent deinstitutionalization using assisted living facilities.MethodsA Cross-sectional study was conducted between July 2018 and July 2019, (...) through interviews using the World Health Organization Quality of Life (WHOQOL-BREF) to determine the QoL scores, and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to determine the level of functioning. All adults (≥18 years old) with mental disorders, who underwent deinstitutionalization, users of assisted living facilities and assisted by the Psychosocial Assistance Centers III, in a city in the state of São Paulo, Brazil, were selected. For statistical analysis of the associated factors, Student’st-test was used for dichotomous variables and ANOVA for polynomial variables. Pearson correlation coefficient was used to measure the association between QoL and functioning scores.ResultsOut of 359 people who underwent deinstitutionalization with mental disorders, 147 met the eligibility criteria. The mean total score for the WHOQOL-BREF was 66.5 ± 13.4 and the mean score for WHODAS 2.0 was 10.4 ± 7.6. An association was found between people who were studying (n= 65.8; 95%CI, 63.5–68.1vs. n= 73.9; 95%CI, 67.5–80.3;p= 0.04) and better WHOQOL-BREF QoL scores or WHODAS 2.0 levels of functioning (n= 10.9; 95%CI, 9.6–12.2vs. n= 5.1; 95%CI, 2.5–7.7;p= 0.01). A weak negative correlation (r= 0.41) emerged between higher QoL scores and functioning improvement.ConclusionThis study indicates that the QoL of the sample is associated by their functioning levels, which, in turn, may reflect on their social interactions. Public policies that favor interventions increasing socialization of this population can result in better health outcomes. The QoL and functioning scores provide valuable insights to develop public policies more suited to this population profile. (shrink)

BackgroundOrgan donation has become one of the most effective ways to save lives and improve the quality of life for patients with end-stage organ failure. No previous studies have investigated the preferences for the different consenting options for organ donation in Egypt. This study aims to assess Egyptians’ preferences regarding consenting options for posthumous organ donation, and measure their awareness and acceptance of the Egyptian law articles regulating organ donation.MethodsA cross sectional study was conducted among 2743 (...) participants over two years. Each participant was required to rank eleven consenting options from 1 to 11, and to report his awareness and acceptance of the seven articles of the Egyptian law of organ donation.Results47% of the participants expressed willingness to donate their organs after death. This percentage increased to 78% when consenting options were explained to participants. “Informed consent by donor only” was the most preferred type of consent for one third of respondents. Awareness of the law articles regulating organ donation was relatively low ranging from 56% to 23%.ConclusionCurrently, around half of the Egyptian population agree to posthumous organ donation. This percentage could be increased significantly by raising the awareness about how the process of donation could be regulated and how the patient’s right of decision could be protected. (shrink)

Physical literacy has received considerable attention in the field of physical education and physical activity worldwide. According to recent studies, the level of physical fitness among Chinese university students is gradually decreasing. This study aims to examine the impact of the PF level on PA and PL, as well as the relationships among PF, PA, and PL, in Chinese university students. Participants comprised 798 university students in Chongqing, China. Participants completed the tests of vital capacity, cardiorespiratory fitness, muscular strength, (...) and flexibility, according to the National Physical Fitness Measurement Standards Manual, as well as questionnaires on PA and PL. The independent t-tests were conducted to examine sex differences in the evaluated variables, and the Pearson’s correlation between each PF test and PL attributes and PA was calculated according to sex. In addition, the independent t-tests were conducted to determine whether the PF level had an effect on PL attributes and PA at various intensities. Significant sex differences were found in the PF domains of vital capacity, muscular strength, and aerobic fitness, with higher scores in men than in women, but not in the PF domain of flexibility and total PL score. Furthermore, the PF domains of muscular strength and aerobic fitness were significantly and positively correlated with the PL attributes of confidence and physical competence in both men and women, while the PF domains of vital capacity and aerobic fitness were significantly and positively correlated with the PL attribute of motivation in men. In addition, PL was significantly and positively associated with cardiorespiratory fitness, vital capacity, muscular strength, and flexibility among participants in the fit group. These findings support advocating for increased participation in PA in university students and using PL as a tool to improve PF components. (shrink)

Background: Dignity is a multidimensional construct that includes perception, knowledge, and emotions related to competence or respect. Attitudes to aging are a comprehensive personal view of the experience of aging over the course of life, which can be influenced by various factors, such as the levels of health and self-sufficiency and social, psychological, or demographic factors. Aim: The purpose of this study was to explore the attitudes to aging of home-dwelling and inpatient older adults, and whether dignity and other (...) selected factors belong among the predictors influencing attitudes to aging in these two different groups of older adults. Research design: Cross-sectional study using a set of questionnaires: Patient Dignity Inventory, Attitudes to Aging Questionnaire, and Barthel Index. Pearson and Spearman correlation analyses and multivariable linear regression were used for statistical processing. Participants and research context: 233 inpatients and 237 home-dwelling older adults participated in the research in two regions of the Czech Republic. Ethical considerations: Institutional Review Board approval was received from the authors’ university. Findings: The inpatients had more negative attitudes to aging. The predictors of their attitudes to aging were gender and dignity. Women and inpatients with poor dignity ratings had more negative attitudes to aging. The predictors for home-dwelling older adults were education, living arrangement, and dignity. More negative attitudes to aging were found in older adults with lower levels of education who lived alone and rated their dignity as low. Discussion and Conclusions: The results of this study add to the understanding that a sense of dignity is an important predictor of attitudes to aging for both home-dwelling older adults and inpatients. (shrink)

BackgroundNowadays, social media have become central in the daily lives of people, including healthcare professionals. Fears arise that the accelerated growth of these social platforms was not accompanied by the appropriate training of the healthcare students and workers on the professional use of social media. This study primarily aimed to assess the awareness of the healthcare students at Beirut Arab University, Lebanon on the professional standards of social media. It also aimed to assess the presence of differences in the (...) practices and attitudes of healthcare students according to gender and major.MethodsA cross-sectional study was designed, and a paper-based questionnaire was distributed to healthcare students. Chi-Square test was used to analyse certain findings.ResultsOut of 1800 students approached, 496 participated in the questionnaire. All participants used social media. Only 19.5% (96/496) of them had received a structured education on the professional use of social media during their university study. The majority of students (349/488, 71.5%) thought that the professional standards on social media are distinct from those established in face-to-face interactions. Female students were more likely to get adequate answers in accordance with international guidelines. There were statistically significant differences in the practices and attitudes of students belonging to different majors (p value < 0.05).ConclusionThe line between what is professional on social media, and what is not, remains blurred for healthcare students. This study uncovered the need for clear and updated evidence-based guidelines assisting students in making the most appropriate decisions in the various online scenarios faced in healthcare practice. (shrink)

Background:Personal values influence nursing students’ development of professional values, which affect professional outcomes, and how nursing students react to different situations. Personal values can be shaped by different factors, including culture, gender, and age.Aims:To explore personal values held by nursing students, and to verify if and how gender and year of study affect nursing students’ personal values.Research design:A multicenter, cross-sectional study was used.Participants and research context:The whole population of nursing undergraduate students available at the time was (...) recruited from eight centers of two Universities, composing a sample of 947 students. Demographic data were collected and it was administered the Portrait Values Questionnaire.Ethical considerations:Ethical approval was obtained from the Institutional Review Boards of the University of the participating centers.Findings:The study sample was mainly composed of young (92.6%, n = 877), female (77.3%, n = 732), Italian (95.8%, n = 907), and unmarried (98.6%, n = 934) nursing students. The most important value for nursing students, consistently through the years of nursing school, was Self-transcendence, which has the motivational emphasis on helping others and selflessness. Then, we found that male students had higher levels of Power (p < 0.001) and Achievement (p = 0.031), while female students outscored male students in Benevolence (p = 0.005) and Security (p = 0.006). Year of study showed no statistically significant difference.Discussion:Nursing students express high levels in hetero-directed values. Male nursing students, although they choose a stereotypically feminine profession, outscored females in stereotypical masculine values such as dominance and success. This is the first study that describes the personal value profile of undergraduate nursing students, according to the Theory of Basic Human Values, and it is a starting point for future research.Conclusion:Nursing educators might want to consider the findings from this study while guiding students in developing awareness for their personal values. (shrink)

ObjectiveThe level of health literacy is one of the important factors affecting health outcomes. Family is an important place to shape personality traits, and people with different personalities will adopt different lifestyles, which will lead to variations in health outcomes. Therefore, this article aims to explore the relationship between health literacy and personality and its influencing factors in different family structures.MethodsThis was a cross-sectional study with 1,406 individuals. A questionnaire was utilized to measure health literacy, personality and (...) demographic variables, including family structure. Canonical correlation analysis and hierarchical multiple regression analysis were used to examine the relation between health literacy and personality traits between two types of family structure.ResultsCCA showed that the canonical correlation coefficients were 0.309 and 0.347, in two-parent family and single-parent family, respectively. The openness of personality traits exhibited the highest correlation with health literacy. Compared with the remaining personality traits, openness yielded the strongest effect in two types of family structure, respectively. Education and monthly income were significantly associated with health literacy.ConclusionOur results support the relation between health literacy and personality traits in two types of family structure. (shrink)

We have investigated attitudes towards the use of health data among the Swedish population by analyzing data from a survey answered by 1645 persons. Health data are potentially useful for a variety of purposes. Yet information about health remains sensitive. A balance therefore has to be struck between these opposing considerations in a number of contexts. The attitudes among those whose data is concerned will influence the perceived legitimacy of policies regulating health data use. We aimed to investigate what views (...) are held by the general public, and what aspects matter for the willingness to let one’s data be used not only for one’s own care but also for other purposes. We found that while there is a broad willingness to let one’s data be used, the possibility to influence that use is considered important. The study also indicated that when respondents are required to balance different interests, priority is typically given to compulsory schemes ensuring that data are available where needed, rather than voluntary participation and data protection. The policy implications to be drawn from this are not self-evident, however, since the fact that a majority has a certain attitude does not by itself determine the most adequate policy. (shrink)