Prior studies have shown that powerful individuals are more unethical than powerless individuals. In real life, power is unstable, and multiple social interactions may cause loss of power. However, extant research has assumed the power structure to be stable and thus overlooked the potential interaction of power and stability in affecting unethicality. Using the approach-inhibition theory of power, we predicted that stability of power moderates power’s effect on unethical behavior. Results from four studies revealed that powerful individuals showed more unethical (...) behavior than powerless individuals only when power was stable, but not when it was unstable. The higher level of unethical behavior under the condition of stable power was explained by attitude toward risk. Our results highlight that the link between power and unethicality is broken when power is unstable. Powerful individuals are no more unethical than powerless individuals when they face a greater possibility of losing their power. (shrink)

The emphasis on evidence based medicine (EBM) has placed increased focus on finding timely answers to clinical questions in presence of patients. Using a combination of natural language processing for the generation of clinical excerpts and information theoretic distance based clustering, we evaluated multiple approaches for the efficient presentation of context-sensitive EBM excerpts.

Generalized anxiety disorder can cause significant socioeconomic burden and daily life dysfunction; hence, therapeutic intervention through early detection is important. This study was the final stage of a 3-year anxiety screening tool development project that evaluated the psychometric properties and diagnostic screening utility of the Mental Health Screening Tool for Anxiety Disorders, which measures GAD. A total of 527 Koreans completed online and offline versions of the MHS: A, Beck Anxiety Inventory, Generalized Anxiety Disorder-7, and Penn State Worry Questionnaire. The (...) participants had an average age of 38.6 years and included 340 females. Participants were also administered the Mini-International Neuropsychiatric Interview. Internal consistency, convergent/criterion validity, item characteristics, and test information were assessed based on the item response theory, and a factor analysis and cut-off score analyses were conducted. The MHS: A had good internal consistency and good convergent validity with other anxiety scales. The two versions of the MHS: A were nearly identical. It had a one-factor structure and showed better diagnostic accuracy for GAD detection than the GAD-7 and BAI. The IRT analysis indicated that the MHS: A was most informative as a screening tool for GAD. The MHS: A can serve as a clinically useful screening tool for GAD in Korea. Furthermore, it can be administered both online and offline and can be flexibly used as a brief mental health screener, especially with the current rise in telehealth. (shrink)

We used functional magnetic resonance imaging to examine the interactive effects of perceived competence and task interest on the cognitive and affective responses to negative feedback. Twenty-four undergraduates performed both interesting and uninteresting tasks and received failure feedback. The participants’ perceived competence in the task was manipulated between subjects prior to scanning with bogus feedback. The results showed that negative feedback processing was contingent upon both perceived competence and task interest. The most adaptive coping mechanism, indicated by activation in the (...) cognitive control network and attenuation in the negative affect region, was identified for the high-competence and high-interest combination. When either competence or interest was low, signals in the cognitive control network were weaker. The most detrimental activation patterns were observed for the combination of low-competence and high interest. Our results reveal the combination of task and learner characteristics that best harnesses the potential benefits of negative feedback and illustrate the neuroscientific mechanisms underlying this observation. (shrink)

Green consumers are those who seek to fulfill economic responsibility with their choices of environment-friendly products. Previous research found that it is not easy to identify green consumers by using traditional demographic or psychographic measurements due to the instability of moral attitude and actual behavior. The frontal theta brain waves of 19 right-handed respondents were recorded and analyzed in a choice task between an environment-friendly (green) product and a conventional product. Product information, which was provided to the respondents, included written (...) descriptions as well as the price of each product without visual depiction. Based on the respondents’ choice, they were classified into two groups: green (GR) consumers who chose an environment-friendly product option and non-green (Non-GR) consumers who chose the option of a conventional product. While processing the green product message, we discovered that frontal theta activations were significantly higher among GR consumers than Non-GR consumers. On the contrary, the frontal theta waves of GR consumers were not differentiated from Non-GR consumers while processing the price information. Therefore, theta activations in the frontal area may potentially be a unique neural indicator of GR consumers’ cognitive engagement with environment-friendly product messages. (shrink)

We examine the effects of taxes on Corporate Social Responsibility (CSR). Employing a tax reform in Korea that imposed a new tax on cash retention, we find that treated firms improved CSR performance after the tax reform was enacted. This result is driven by improvement in environmental and social performance. Moreover, the observed improvement is more pronounced in treated firms that face less severe financial constraints, are afforded fewer investment opportunities, feature large foreign ownership stakes, and employ stronger corporate governance (...) mechanisms. The results suggest that tax increases lead to an increase in CSR investment and the magnitude of the increase depends on firm-level characteristics. As such, our results support the tax-strategic view of CSR in a country that has been a latecomer in incorporating CSR practices into business operations. (shrink)

So far researchers have regarded performance appraisal feedback as desirable and have examined feed back issues assuming that feedback is actually provided. The purpose of this article is to investigate whether there is any positive effect of offering no performance appraisal feedback. We studied if the inflated expec tation of employees' own performance appraisal affects the performance of the employee positively when the feedback is held back. The empirical results indicated that expectation was positively inflated and it made significant contributions (...) to compliance with supervisor, job satisfaction and organizational commit ment. The results also showed that expectation of their supervisors' rating is a more significant indicator than the real appraisal rating itself in reviewing some employee attitudes like compliance with supervisor and organizational commitment. Several theoretical and managerial implications of the findings, including the importance of cultural difference, were also discussed. (shrink)

Sleep quality, personality, and cognitive load potentially increase second language writing anxiety and subsequently affect SLW achievement. This study investigates the predictions of sleep quality, personality, and cognitive load toward SLW anxiety and achievement in a computer-based test. Participants included 172 voluntary undergraduates majoring in English as foreign language. SLW anxiety in a computer-based test, sleep disturbance, personality and cognitive load was assessed with the SLW Anxiety Inventory, Pittsburg Sleep Quality Index, Type-D Personality, and cognitive load questionnaires. A structural equation (...) modeling approach was applied to examine the interdependence among the observed variables. An adequate-fit SLW anxiety model was built. The structural model showed that sleep disturbance, social inhibition personality, and computer-induced cognitive load were significant predictors of SLW anxiety in a computer-based test. Subsequently, SLW anxiety in a computer-based test and computer-induced cognitive load were significant negative predictors of computer-based SLW achievement. (shrink)

Drawing on conservation of resources theory, this study examined the moderating role of ethical leader behavior in the effects of daily perceived job insecurity on work outcomes the next day (i.e., work engagement and customer-directed helping) through occupational regret the next morning among frontline service employees working in adverse work situations (i.e., the coronavirus disease pandemic). Using experience sampling method, data were collected from 135 frontline service employees across five consecutive workdays. The results showed that daily perceived job insecurity had (...) a negative indirect effect on work engagement and customer-directed helping the next day through (increased) occupational regret the next day in the morning. In addition, ethical leader behavior moderated the negative indirect effect of daily perceived job insecurity on next-day work engagement and customer-directed helping through next-morning occupational regret. Specifically, these negative effects were especially stronger among employees who had observed low levels of ethical leader behavior the previous day. The theoretical implications of the present findings for researchers and their practical implications for managers are discussed. (shrink)

In an emerging field such as social enterprise, it is important for an organization to secure legitimacy to obtain resources and sustain its business. Specifically, when a government distributing subsidies does not have adequate information to decide which organization is trustworthy, it is the legitimacy-seeking activities of social enterprise that decides who receives a subsidy; this, in turn, decides which organization will survive. One of the most effective ways to gain legitimacy is to explicitly emphasize in the public promotion that (...) the organization devotes to its social mission. In the case of Work Integration Social Enterprises (WISEs), an organization emphasizes its social employment of the disadvantaged individuals. However, we argue that social enterprises’ public promotion that emphasizes social employment can lower the expected wage, job satisfaction, and organizational commitment of the employees who are hired due to their disadvantaged social status. This is because such obvious promotional messages makes the employees more keenly aware of their disadvantaged status; as a result, this reinforces their self-prejudice that they are not competitive enough in the labor market. We test our hypotheses in the context of South Korean WISEs and found general support for our arguments. (shrink)

Design ethics has been offered as a course in undergraduate design programs in Taiwan for over a decade, but research on teaching design ethics and the results of teaching these courses is scant. We conducted two tests to examine the effect of an ethics course, and the differences among the effects of design department, gender, and study year on student opinions regarding ethical design standards at the National Yunlin University of Science and Technology in Taiwan. The participants comprised 934 undergraduates (...) from the five design departments at YunTech’s College of Design from Years 1–4. The results confirmed the effect of an ethics course on student EDS opinions. In addition, we observed significant variations among students according to design departments, suggesting that the characteristics of the design departments also affected students’ EDS opinions. The results indicated that gender did not significantly affect design students’ EDS opinions; however, students in their early years of study produced higher scores than those in their advanced years of study did, based on the six EDS opinions. The implications of these results for teaching design ethics and future research are discussed in this paper. (shrink)

BackgroundThe COVID-19 pandemic has highlighted prosocial behavior as a professional healthcare core competency. Although medical students are expected to work in the best interests of their patients, in the pandemic context, there is a greater need for ethical attention to be paid to the way medical students deal with moral dilemmas that may conflict with their obligations.MethodsThis study was conducted in the spring semester of 2019 on 271 students majoring in health professions: medicine, dentistry, and veterinary medicine. All participants provided (...) informed consent and completed measures that assessed utilitarian moral views, cognitive reflections, cognitive reappraisal, and moral judgment.ResultsThe healthcare-affiliated students who scored higher on the instrumental harm subscale in the measurement of utilitarian moral views were more likely to endorse not only other-sacrificial actions but also self-sacrificial ones for the greater good in moral dilemma scenarios. In particular, those engaged in deliberative processes tended to make more self-sacrificial judgments. The mediation analysis also revealed that the effect of deliberative processes on self-sacrificial judgments was mediated by cognitive reappraisal.ConclusionsThese findings suggested that cognitive reappraisal through deliberative processes is involved when the students with utilitarian inclination make prosocial decisions, that it is necessary to consider both moral views and emotional regulation when admitting candidates, and that moral education programs are needed in the healthcare field. (shrink)

The population of international students in South Korea is growing. During the career development phase, international students face unique challenges related to their bicultural identity and acculturation experiences. The present study examined the role of bicultural self-efficacy on mediating the relationship between acculturation and career decision-making self-efficacy for international students in South Korea. Responses from 120 international students in South Korea were analyzed using structural equation modeling. The results showed that bicultural self-efficacy fully mediated the relationship between acculturation to mainstream (...) culture and career decision-making self-efficacy but did not mediate the relationship between acculturation to heritage culture and career decision-making self-efficacy. The implications for effective educational intervention for international college students’ career development were discussed based on the results. (shrink)

Aim: Explore nurses’ values and perceptions regarding the practice of medical aid in dying. Background: Medical aid in dying is becoming increasing legal in the United States. The laws and American Nurses Association documents limit nursing involvement in this practice. Nurses’ values regarding this controversial topic are poorly understood. Methodology: Cross-sectional electronic survey design sent to nurse members of the American Nurses Association. Inductive thematic content analysis was applied to open-ended comments. Ethical Considerations: Approved by the institutional review board (#191046). (...) Participants: 1213 nurses provided 3639 open-ended comments. More than 80% of participants self-identified as white 58% held a graduate degree; and half were of Christian faith. Results: Values ranged on a continuum expressed through four themes: “Honoring Patient Autonomy without Judgment,” “Honoring with Limitations,” “Not until...,” and “Adamantly against.” Some felt it was a duty to honor the patients’ wishes, set aside own beliefs, and respect patients’ choices often with a spiritual connotation. Nurses held concerns about the process, policy, potential psychological harm, legal risk, and the need to learn more about MAID. Nurse who were adamantly against MAID associated the practice with murder/suicide and against religious beliefs. Disparate values were expressed about changing the MAID legislation to allow patient support with taking MAID medications and allowing MAID via advance directive. Conclusions: Nurses desire more education on MAID. There is not one universally held position on the nurse’s role during MAID. Healthcare policy/standards need to accommodate the wide variation in nurses’ values. Implications: Nurses desire education regarding their role in MAID. Nurses are encouraged to participate in policy discussions as the practice becomes increasingly legal. Managers need to expect that nurses, patients, and families will need psychological support to participate in MAID. Careful construction of policy/standards is needed to minimize conflict, moral distress, and psychological harm amongst nurses. Further research is needed. (shrink)

Over the past two decades, Victor and Cullen's (Adm Sci Q 33:101-125, 1988) typology of ethical climates has been employed by many academics in research on issues of ethical climates. However, little is known about how managerial practices such as communication and empowerment influence ethical climates, especially from a functional perspective. The current study used a survey of employees from Taiwan's top 100 patent-owning companies to examine how communication and empowerment affect organizational ethical climates. The results confirm the relationship between (...) these two managerial practices and organizational ethical climates. We discuss our results and their implications for both future academic research and practice. (shrink)

This study investigated the usefulness of the six-item Stress and Anxiety to Viral Epidemics scale and the Coronavirus Anxiety Scale as tools to assess anxiety related to coronavirus disease in cancer patients. A total of 221 patients with cancer responded to an anonymous online questionnaire between 15 July and 15 August 2020. The functional impairment of the patients was assessed using the Work and Social Adjustment Scale, and the SAVE-6 and CAS were also applied. Among these 221 cancer patients, 110 (...) had SAVE-6 scores ≥ 15 and 21 had CAS scores ≥ 5. Within the study population, 104 and 29 patients had WSAS scores ≥ 11 and ≥ 21, respectively. The correlations between the SAVE-6 and WSAS and CAS scores were statistically significant. The cut-off for the SAVE-6 was 15 points, while that for the WSAS was 11. Our results suggested that the SAVE-6 and CAS could be used to evaluate moderate and severe degrees of functional impairment related to mental health, respectively, in cancer patients during viral epidemics. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

In this article, we develop a measure of complete well-being. The framework is derived from the theoretical model of human flourishing understood as a state in which all aspects of a human life are favorable. The approach extends beyond psychological well-being and reflects the World Health Organization definition of health that not only considers the health of body and mind but also embraces the wholeness of the person. The Well-Being Assessment is a comprehensive instrument designed to assess holistic well-being in (...) six domains: emotional health, physical health, meaning and purpose, character strengths, social connectedness, and financial security. Although each of these domains is distinct, all of them are nearly universally desired, and all but financial security constitute ends in themselves. Data were collected from a representative sample of working adults. A sample of 276 employees participated in the pilot, 2,370 participated in the first wave and 1,209 in the second wave of the survey. The WBA showed a good fitting, satisfactory reliability, test–retest correlation, and convergent/discriminant validity in relation to stability over time and relevant health measures, as well as a good fit to the data that were invariant over time, gender, age, education, and marital status. The instrument can be of use for scientists, practitioners, clinicians, public health officials, and patients. Adoption of more holistic measures of well-being that go beyond psychological well-being may help to shift the focus from health deficiencies to health and well-being promotion. (shrink)

ObjectivesWorking-age cancer patients face barriers to resuming work after treatment completion. Those resuming work contend with reduced productivity arising from persisting residual symptoms. Existing studies of return to work after cancer diagnosis were done predominantly in Western countries. Given that employment and RTW in cancer survivors likely vary regionally due to healthcare provision and social security differences, we documented rates and correlates of RTW, work productivity, and activity impairment among Chinese cancer survivors in Hong Kong at one-year post-treatment.MethodsOf 1,106 cancer (...) patients assessed at six-months post-cancer treatment, 593 previously worked; detailed work status, psychological distress, physical symptom distress, supportive care needs, health-related quality of life, and illness perception were assessed. Six months later, work productivity and activity impairment were assessed. Descriptive analyses examined RTW rate. Fully adjusted regressions determined RTW, work productivity, and activity impairment predictors.ResultsAt baseline, 39% were working, 26% on sick leave, and 35% were unemployed. Compared to patients returning to work, unemployed participants were older, likely manual/service-oriented workers, and had lower family income, chemotherapy, fewer unmet health system and information needs, poorer physical functioning, and negative illness perceptions. Sick leave participants were likely service-oriented workers, who had head and neck cancer, chemotherapy, and poor physical functioning. At FU, baseline depressive symptoms, physical symptom distress, and negative illness perceptions predicted presenteeism and work productivity loss; gynecological cancer, fewer unmet health system and information needs, and greater unmet sexuality needs predicted absenteeism; physical symptom distress, negative illness perception, and poor physical functioning predicted activity impairment.ConclusionCancer survivors who had more physically demanding jobs and poorer physical functioning delayed RTW. Unmanaged physical symptom and psychological distress hindered work productivity. (shrink)

This study assessed the knowledge and perception of human biological materials (HBM) and biorepositories among three study groups in South Korea. The relationship between the knowledge and the perception among different groups was also examined by using factor and regression analyses. In a self‐reporting survey of 440 respondents, the expert group was found more likely to be knowledgeable and positively perceived than the others. Four factors emerged: Sale and Consent, Flexible Use, Self‐Confidence, and Korean Bioethics and Biosafety Action restriction perception. (...) The results indicate that those who are well aware of the existence of biobanks were more positively inclined to receive the Sale and Consent perception. As a result of the need for high quality HBMs and the use of appropriate sampling procedures for every aspect of the collection and use process, the biorepository community should pay attention to ethical, legal, and policy issues. (shrink)

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

BackgroundAttention deficit hyperactivity disorder is clinically diagnosed; however, quantitative analysis to statistically analyze the symptom severity of children with ADHD via the measurement of head movement is still in progress. Studies focusing on the cues that may influence the attention of children with ADHD in classroom settings, where children spend a considerable amount of time, are relatively scarce. Virtual reality allows real-life simulation of classroom environments and thus provides an opportunity to test a range of theories in a naturalistic and (...) controlled manner. The objective of this study was to investigate the correlation between participants’ head movements and their reports of inattention and hyperactivity, and to investigate how their head movements are affected by different social cues of different sensory modalities.MethodsThirty-seven children and adolescents with and without ADHD were recruited for this study. All participants were assessed for diagnoses, clinical symptoms, and self-reported symptoms. A virtual reality-continuous performance test was conducted under four conditions: control, no-cue, visual cue, and visual/audio cue. A quantitativecomparison of the participants’ head movements was conducted in three dimensions using a head-mounted display in a VR classroom environment. Task-irrelevant head movements were analyzed separately, considering the dimension of movement needed to perform the VR-CPT.ResultsThe magnitude of head movement, especially task-irrelevant head movement, significantly correlated with the current standard of clinical assessment in the ADHD group. Regarding the four conditions, head movement showed changes according to the complexity of social cues in both the ADHD and healthy control groups.ConclusionChildren and adolescents with ADHD showed decreasing task-irrelevant movements in the presence of social stimuli toward the intended orientation. As a proof-of-concept study, this study preliminarily identifies the potential of VR as a tool to understand and investigate the classroom behavior of children with ADHD in a controlled, systematic manner. (shrink)

The fluctuation-dissipation theorem is a central theorem in nonequilibrium statistical mechanics by which the evolution of velocity fluctuations of the Brownian particle under a fluctuating environment is intimately related to its dissipative behavior. This can be illuminated in particular by an example of Brownian motion in an ohmic environment where the dissipative effect can be accounted for by the first-order time derivative of the position. Here we explore the dynamics of the Brownian particle coupled to a supraohmic environment by considering (...) the motion of a charged particle interacting with the electromagnetic fluctuations at finite temperature. We also derive particle’s equation of motion, the Langevin equation, by minimizing the corresponding stochastic effective action, which is obtained with the method of Feynman-Vernon influence functional. The fluctuation-dissipation theorem is established from first principles. The backreaction on the charge is known in terms of electromagnetic self-force given by a third-order time derivative of the position, leading to the supraohmic dynamics. This self-force can be argued to be insignificant throughout the evolution when the charge barely moves. The stochastic force arising from the supraohmic environment is found to have both positive and negative correlations, and it drives the charge into a fluctuating motion. Although positive force correlations give rise to the growth of the velocity dispersion initially, its growth slows down when correlation turns negative, and finally halts, thus leading to the saturation of the velocity dispersion. The saturation mechanism in a supraohmic environment is found to be distinctly different from that in an ohmic environment. The comparison is discussed. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

This study aims to disclose how the magnetic resonance imaging neuroimaging approach has been applied in education studies, and what kind of learning themes has been investigated in the reviewed MRI neuroimaging research. Based on the keywords “brain or neuroimaging or neuroscience” and “MRI or diffusion tensor imaging or white matter or gray matter or resting-state,” a total of 25 papers were selected from the subject areas “Educational Psychology” and “Education and Educational Research” from the Web of Science and Scopus (...) from 2000 to 2019. Content analysis showed that MRI neuroimaging and learning were studied under the following three major topics and nine subtopics: cognitive function, science education, and brain development. As for the type of MRI neuroimaging research, the most frequently used approaches were functional MRI, followed by structural MRI and DTI, although the choice of approach was often motivated by the specific research question. Research development trends show that the neural plasticity theme has become more prominent recently. This study concludes that in educational research, the MRI neuroimaging approach provides objective and empirical evidence to connect learning processes, outcomes, and brain mechanisms. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)