Background Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context (...) of medical decisions of adults. Objective The present study targeted the existing knowledge of what and how relational factors impact individuals making medical decisions using the theoretical framework of relational autonomy. Methods A meta-synthesis study was utilized. Four electronic databases, including Embase, OVID Medline, CINAHL, and PubMed, were searched, along with gray literature and reference lists, to identify relevant studies. Results 23 studies reporting 21 qualitative and two mixed-method studies were reviewed. Four themes emerged from the qualitative findings: (1) supportive relationships facilitate an individual’s relational autonomy; (2) obtaining comprehensive information from broader sources helps individuals exercise relational autonomy; (3) undue family pressure impedes the exercising of patient relational autonomy; and (4) healthcare providers’ dominant voice hampers the demonstration of relational autonomy. Conclusions Applying relational autonomy to assist adults in making well-considered decisions is essential. The meta-synthesis suggests establishing a supportive relationship between individuals, healthcare providers, and family. A supportive relationship will allow healthcare providers to make judgments in line with an individual’s values and wishes with the aim of promoting relational autonomy. Advance care planning was proposed as the effective solution to obtain a consensus between individuals and their families while respecting an individual’s values and preferences. Furthermore, it is considered crucial for healthcare providers to appreciate an individual's values and incorporate their preferences into recommendations. (shrink)

Recent studies on the effects of mandatory online teaching, resulting from the COVID-19 pandemic, have widely reported low levels of satisfaction, unwillingness to continue online teaching, and negative impacts on the psychological well-being of teachers. Emerging research has highlighted the potential role of psychological need thwarting, in terms of autonomy, competence, and relatedness thwarting, resulting from online teaching. The aim of this study was to evaluate the immediate and delayed effects of PNT of online teaching on teachers’ well-being, intention to (...) continue online teaching, and job satisfaction. Moreover, data collected from both cross-sectional and longitudinal surveys allowed for a systematic validation of an important instrument in the field of teacher psychology, the Psychological Need Thwarting Scale of Online Teaching, in terms of longitudinal reliability and validity. The data reveal the usefulness of the construct of PNT in terms predicting and explaining teachers’ willingness to continue using online teaching as well as the degree of burnout after a period of 2 months, such that PNT is positively associated with burnout and negatively associated with willingness to continue online teaching. As such, the PNTSOT is recommended for future research evaluating the long-term psychological, affective, and intentional outcomes stemming from teachers’ PNT. Moreover, based on our findings that the impact from PNT of online teaching is persistent and long-term, we suggest that school leaders provide flexible and sustained professional development, model respectful and adaptive leadership, and create opportunities for mastery for the development of community of practice that can mitigate the thwarting of teachers’ autonomy, competence, and relatedness during times of uncertainty. Additionally, in terms of the psychometric properties of the PNTSOT instrument, our empirical findings demonstrate internal reliability, test–retest reliability, measurement invariance, and criterion validity based on cross-sectional and longitudinal data. (shrink)

Background: Healthcare workers in the front line of diagnosis, treatment, and care of patients with coronavirus disease 2019 are at great risk of both infection and developing mental health symptoms. This study aimed to investigate the following: whether healthcare workers in general hospitals experience higher mental distress than those in psychiatric hospitals; the role played by religion and alexithymic trait in influencing the mental health condition and perceived level of happiness of healthcare workers amidst the stress of the COVID-19 pandemic; (...) and factors that influence the resilience of healthcare workers at 6 weeks' follow-up.Methods: Four-hundred and fifty-eight healthcare workers were recruited from general and psychiatric hospitals, and 419 were followed-up after 6 weeks. All participants filled out the 20-item Toronto Alexithymia Scale, five-item Brief-Symptom Rating Scale, and the Chinese Oxford Happiness Questionnaire.Results: Under the stress of the COVID-19 pandemic, 12.3% of frontline healthcare workers in general hospitals reported having mental distress and perceived lower social adaptation status compared with those working in psychiatric hospitals. Christians/Catholics perceived better psychological well-being, and Buddhists/Taoists were less likely to experience mental distress. The results at 6 weeks of follow-up showed that the perceived lower social adaptation status of general hospital healthcare workers was temporary and improved with time. Christian/Catholic religion and time had independent positive effects on psychological well-being; however, the interaction of Christian/Catholic religion and time had a negative effect.Conclusions: Collectivism and individualism in the cultural context are discussed with regard to alexithymic trait and Buddhist/Taoist and Christian/Catholic religious faiths. Early identification of mental distress and interventions should be implemented to ensure a healthy and robust clinical workforce for the treatment and control of the COVID-19 pandemic. (shrink)

Online music sharing, deemed illegal for invading intellectual property rights under current laws, has become a crucial issue for the music industry in the modern digital age, but few have investigated the potential costs and utilities for individuals involved in such online misbehavior. This study aimed to fill in this gap to predict consumers' intentions to engage in online music sharing and further consider consumers' online music sharing knowledge as a moderator in the research model. The results of repeated measures (...) analysis of variance of costs and utilities of online music sharing not only give more detailed information to grasp empirical implications but also provide some suggestions to the music industry in Taiwan. (shrink)

In order to usurp the Party, seize power and restore capitalism, the Wang-Chang-Chiang-Yao anti-Party clique has turned out counterrevolutionary opinions in the ideological realm. They have tried in every way to distort and revise history and have fabricated the "struggle between the Confucianists and the Legalists" in history. They have confounded different social contradictions and have replaced the class struggle with the "struggle between the Confucianists and the Legalists" and the antagonism within the landlord class with the "line struggle." To (...) them, Legalists were always "progressive" and "innovative" while Confucianists always "represented the forces of restoration." They have tried their best to glorify emperors, kings, generals and ministers in history, to praise Legalists as "saviors," to cover up the Legalists' nature as an exploiting class, to call for metaphysics and the idealist viewpoint of history, and to turn out revisionist fallacies. Because important changes took place in the Confucian and Legalist schools during the periods of the Western and Eastern Han dynasties, the "Gang of Four" and the writers in its service have showed a great interest in histories of the dynasties and have published a series of articles on the so-called "struggle between the Confucianists and the Legalists." In the current struggle against the "Gang of Four," it is of great practical significance to review the changes in the Confucian and Legalist schools and their roles and class nature during the Han dynasties, to criticize and expose the criminal clique's counterrevolutionary political intrigues and plots, and to clarify the historical facts confused by the "Gang of Four.". (shrink)

The main purpose of this study is to explore and map the intellectual structure of business ethics studies during 1997–2006 by analyzing 85,000 cited references of 3,059 articles from three business ethics related journals in SSCI and SCI databases. In this article, co-citation analysis and social network analysis techniques are used to research intellectual structure of the business ethics literature. We are able to identify the important publications and the influential scholars as well as the correlations among these publications by (...) analyzing citation and co-citation. Three factors emerged in this study are: (1) ethical/unethical decision making, (2) corporate governance and firm performance, and (3) ethical principles and code of conduct. (shrink)

Ben shu dui Luling Wang xue de yan jiu, zhu yao cong yi xia liang fang mian zhan kai: shou xian, zhong dian jie shao le ti chu Luling Wang xue de li lun yi ju he Luling Wang xue fa zhan de ge ge jie duan de jie ding, te dian ji qi zhu yao de dai biao ren wu. Qi ci, ju ti lun shu le Luling Wang xue fa zhan de ge ge jie duan de zui (...) zhu yao dai biao ren wu de zhi xue li lu, xin xue si xiang, jing xue te dian. Tong guo dui Luling Wang xue zong ti shang de yan jiu, gai kuo he zheng li yi ji dui ge ge fa zhan jie duan zhu yao de dai biao ren wu Wang xue si xiang de bu tong shi jiao de tan tao chan fa, cong zong ti shang rang shi ren jiao wei xi tong de liao jie Luling Wang xue de gai mao ji qi cao chuang, fa zhan, ding sheng ji shi wei de li shi guo cheng he zhong yao dai biao ren wu de Wang xue si xiang. Tong shi, zai qian mian yan jiu de ji chu shang, dui Luling Wang xue zai Jiang you Wang xue nai zhi Yangming hou xue fa zhan guo cheng zhong de zhong yao di wei yi ji dui zhong wan Ming ru xue si xiang fa zhan de ying xiang zuo le zong jie. (shrink)

Background: Upper limb functional exercise has a positive effect on promoting the rehabilitation of upper limb function. However, little is known, about what drives postoperative patients to engage in and even maintain the advised exercises. This study integrated the health action process approach and the theory of planned behavior theory to investigate the psychosocial determinants on the initiation and maintenance of ULFE in breast cancer patients. In addition, this study also tests key hypotheses relating to reasoned and implicit pathways to (...) ULFE and its maintenance among postoperative patients with breast cancer.Methods: Purposive sampling was used to recruit patients from two breast cancer wards in a provincial hospital in Jiangsu, China. Patients completed self-reported questionnaire about constructs from integrated theories concerning ULFE at an initial time point : task self-efficacy, positive outcome expectations, negative outcome expectations, risk perception, attitude behavior, subjective norm, perceived behavioral control, behavioral intention, and ULFE-in hospital. Three months later, patients self-reported: maintenance self-efficacy, action planning, coping planning, recovery self-efficacy, and ULFE-maintenance.Results: The model has a good fit. For behavioral intention of ULFE, subjective norm and perceived behavioral control were positively directly related to behavioral intention. Regarding the initiation of ULFE, perceived behavioral control and behavioral intention had a direct positive relation to ULFE-IH. In the maintenance of ULFE, action planning, coping planning, maintenance self-efficacy, and recovery self-efficacy all had significant positive relation on ULFE-M. In addition, maintenance self-efficacy had a significant positive association on action planning, coping planning, and recovery self-efficacy. Coping planning was significantly predicted by behavioral intention. Additionally, behavioral intention is a mediator of subjective norm and perceived behavioral control to ULFE-IH. Action planning, coping planning, and recovery self-efficacy are mediators of maintaining self-efficacy to ULFE-M.Conclusions: This study presents the first attempt to integrate the health behavior model in ULFE in postoperative patients with breast cancer. The study has shown that the HAPA-TPB integrated model has good applicability and effectiveness to explain and predict ULFE initiation and maintenance. Future work can be considered to develop appropriate intervention strategies based on this integrated behavioral theory. (shrink)

The main purpose of this study is to explore and map the intellectual structure of business ethics studies during 1997–2006 by analyzing 85,000 cited references of 3,059 articles from three business ethics related journals in SSCI and SCI databases. In this article, co-citation analysis and social network analysis techniques are used to research intellectual structure of the business ethics literature. We are able to identify the important publications and the influential scholars as well as the correlations among these publications by (...) analyzing citation and co-citation. Three factors emerged in this study are: (1) ethical/unethical decision making, (2) corporate governance and firm performance, and (3) ethical principles and code of conduct. (shrink)

The twenty-first century is arguably the century of computing. In such a world saturated by computing, Computational Thinking is now recognized as a foundational competency for being an informed citizen and being successful in STEM work. Nevertheless, how to effectively import different types of teaching methods in university courses is subjected to further evaluation. Currently, the arguments in favor of tangible robots including high interaction, great practicality, and specific operation results make themselves to be often used as a teaching medium (...) and tool for teaching activities between teachers and students. Hence, in addition to cultivating students with computational thinking ability, this paper discussed how to integrate tangible robots into project-based learning courses of thinking skills training to improve the learning performance of the computational thinking ability. This study conducted in one semester on the 105 students from three classes. Experimental results show that the project-based learning method integrated with the teaching material of robotic visual programs approach had significantly better effectiveness in improving students' learning achievements than the traditional teaching method integrated with paper practice teaching materials approach. Analysis of the questionnaire results showed that the proposed learning approach did not increase the students' cognitive burden. In sum, the proposed approach helps students' learning achievement and cognitive load. (shrink)

Some of the authors of the essays on Chinese philosophers prefer the pin yin system of romanization for Chinese names and words, while others prefer the Wade‐Giles system. Given that both systems are in wide use today, important names and words are given in both their pin yin and Wade‐Giles formulations. The author's preference is printed first, followed by the alternative romanization within brackets.