Nursing students' ethical perpectives on assisting patients with eating and drinking.

IntroductionFaecal incontinence (FI) is the involuntary loss of liquid or solid stool that is a social or hygienic problem. The prevalence of FI in residents of care homes is high,...

Mental health nurses advocate for patients through a person-centered approach because they care for people experiencing mental distress who tend to be limited to exercising their human rights and autonomy through interpersonal relationships. Therefore, it is necessary to provide high-quality person-centered care for these patients by identifying the influencing factors. This study aims to identify the factors affecting mental health nurses in performing person-centered care for patients. This study had a cross-sectional, descriptive-correlational survey design. Nurses (N = 166) working at psychiatric wards in Korea completed an online questionnaire on moral sensitivity, attitudes toward people with mental illness, and person-centered care. The t-test and stepwise multiple regression analysis were used. Ethical approval for the study was obtained from the relevant ethics committee. Moral sensitivity was a significant factor correlating with the provision and perception of person-centered care. Attitudes toward patients had no effect on person-centered care. The predictor variables for the provision of person-centered care (R2 = 0.247) were moral sensitivity (β = 0.33), having a professional qualification (β = 0.19), marital status (β = 0.18), and closed ward (β = -0.15). The predictor variables for the perception of person-centered (R2 = 0.150) care were closed ward (β = -0.25), moral sensitivity (β = 0.23), and marital status (β = 0.18). Mental health nurses can strengthen person-centered care by improving moral sensitivity related to the ethical aspect of nursing and professional competence to address the complex needs of patients. Person-centered care needs to be applied more carefully in closed wards where human rights issues may arise. Through these efforts, the dignity of patients can be protected.

In recent years, patient advocacy has emerged as a prominent concept within healthcare. How nursing students decide what is best for their patients is not well understood. The objective is to examine nursing students' views on doing what is best for patients during their clinical experiences and how they seek to establish patient interests when providing care. Research questions guiding the interview were as follows: (1) What are nursing students' perceptions of patient interests? (2) What factors influence nursing students' perceptions of advocating for patient's interests? Qualitative descriptive research using thematic analysis. Data was collected through individual online interviews with nine nursing students with clinical experience. The study was approved by the University Research Ethics Committee. Participants provided digital informed consent. The students asserted that they are able to understand the patients' interests by placing emphasis on the patients' needs. They believe that it is crucial to adopt a collaborative strategy for the provision of care to meet these requirements. In addition, some of them expressed concern over the most effective methods of advocating for the interests of patients. Three themes were identified. (1) Focussing on patient needs first, (2) taking a collective approach, and (3) learning how to advocate. Students understand and value the ethical commitments associated with advocating for the patient's best interest by considering factors such as prioritising the patient's needs, adopting a strategy that involves everyone, and acquiring the ability to undertake the advocacy role. Additionally, nursing education strategies in clinical contexts require additional study to inspire students to do what is in their patient's best interests.

American Dietetic Association: Standards of Practice and Standards of Professional Performance for Registered Dietitians (Competent, Proficient, and Expert) in Extended Care Settings

While ethical norms for conducting academic research in the United Kingdom are relatively clear, there is little empirical understanding of how university research ethics committees (RECs) themselves operate and whether they are seen to operate well. In this article, we offer insights from a project focused on the Scottish university context. We deployed a three-sided qualitative approach: (i) document analysis; (ii) interviews with REC members, administrators, and managers; and (iii) direct observation of REC meetings. We found that RECs have diverse operation and vary in terms of what members understand to be the remit of their REC and what should constitute the content of ethics review. Overall, though, most participants perceive university RECs as operating well. When asked what they consider to be areas for further improvement, most commented on: implementation of an online system; more experience with how to evaluate various kinds of research projects; best practice exchange and training opportunities; more accurate reflection of the REC role as part of the university’s workload allocation model; and greater recognition of the importance of research ethics governance in the university’s research environment, and, for the members themselves, their career advancement. Based on our findings and subsequent discussions during an end-of-project roundtable with stakeholders, we propose a model of collaboration that can address some of the identified areas that could benefit from further improvement. This model would facilitate a heightened awareness of the importance of supporting REC members in their own effort in assisting students and staff alike in undertaking as ethically robust research as possible.

Research ethics approval procedures and research ethics committees (RECs) are now well-established in most Western Universities. RECs base their judgements on an ethics code that has been developed by the health and biomedical sciences research community and that is widely considered to be universally valid regardless of discipline. On the other hand, a sizeable body of literature has emerged criticising the work of RECs, as, among other things, overly bureaucratic and unresponsive to the needs of disciplines outside the biomedical sciences. This article adopts the format of a debate between a Chair of a university REC and a social science researcher as a vehicle for contrasting different perspectives on research ethics. The fictional debate allows for a productive discussion between the two sides, incorporating key insights from the recent literature and concludes with a synthesis that sketches out some ideas about how university RECs can be made more responsive and accountable.

Women who live in humanitarian settings are three times more likely to die than those who live in peaceful environments. Person-centred maternity care (PCMC) is a fundamental human right for every woman, yet it is often overlooked in humanitarian contexts. This scoping review aims to summarise person-centred maternity healthcare in fragile and humanitarian contexts. A scoping review of quantitative and/or qualitative approach was conducted to assess person-centred maternity care in humanitarian settings. Research that assessed dimensions of PCMC such as autonomy, dignity, privacy, communication, confidentiality and supportive care was included. Electronic database searches of PubMed, MEDLINE, EMBASE, PsycINFO, Scopus and generic web searches (Google Scholar) were used to search for available evidence. We used the Preferred Reporting Items for Systematic Review and Meta-Analyses criteria for scoping review statement. The data from the final selected articles were extracted into an Excel spreadsheet. Finally, we described the study characteristics and summarised the concept of person-centred care. A total of 889 articles were identified. After exclusion by title and abstract, 71 articles were eligible for full-text review, and finally 16 articles were eligible for data extraction. Our findings revealed low respect and supportive care, poor communication and autonomy, and breach of privacy. Resource constraints, protracted insecurity, cultural and language barriers were attributed to poor person-centred sexual and reproductive health. The review identified several implemented interventions, including training for healthcare providers, access to language translators, social and cultural support programmes, free healthcare services and community engagement initiatives. There are significantly more reports of negative experiences of maternity healthcare services than positive ones. Prioritising culturally appropriate approach, simulation-based training for healthcare providers on person-centred care, community engagement and the integration of PCMC domains into existing health services are essential to improve quality maternal health.

As society becomes more aware of the rights of individuals, ethical issues become of increasing importance. Many research funders, including the research councils, increasingly emphasise research governance and ethical review in their consideration of submitted proposals. Little is known, however, about what universities do over ethical scrutiny and in order to find out the authors undertook a national study of all universities in the United Kingdom. The focus of the study was on human volunteers for research outside the remit of the National Health Service. The key questions being: to what extent do universities undertake ethical scrutiny of research and, if so, how? The broad conclusion is that when this survey was carried out in the autumn of 2003, the majority of universities were aware of the need for the ethical scrutiny of research on human subjects although in many of those universities the scrutiny system was being developed at the time of completion of the questionnaire. In some cases practice appeared to lag behind awareness and whilst there were some very good examples there were also some which were below an ‘acceptable’ standard. Recommendations are made concerning structures, coverage and membership for systems of ethical scrutiny within the university sector.

In this paper, we outline an online survey-based study seeking to understand academic attitudes towards social media research ethics (SMRE). As the exploratory phase of a wider research project, findings are discussed in relation to the responses of 30 participants, spanning multiple faculties and locations at one international university. The paper presents an empirical measure of attitudes towards social media research ethics, reflecting core issues outlined throughout the nascent Internet-mediated research (IMR) literature, in addition to survey questions relating to familiarity with SMRE guidance, and experience of reviewing SMRE proposals from students and/or as part of the university's research ethics committees (RECs). Findings indicate notable variance in academic attitudes towards the ethical challenges of social media research, reflecting the complexity of decision-making within this context and further emphasising the need to understand influencing factors. Future directions are discussed in relation to the tentative findings presented by the current study.

BackgroundStudying global health problems requires international multidisciplinary teams. Such multidisciplinarity and multiculturalism create challenges in adhering to a set of ethical principles across different country contexts. Our group on health system responses to violence against women (VAW) included two universities in a European high-income country (HIC) and four universities in low-and middle-income countries (LMICs). This study aimed to investigate professional and policy perspectives on the types, causes of, and solutions to ethical challenges specific to the ethics approval stage of the global research projects on health system responses to VAW.MethodsWe used the Network of Ethical Relationships model, framework method, and READ approach to analyse qualitative semi-structured interviews (n = 18) and policy documents (n = 27). In March-July 2021, we recruited a purposive sample of researchers and members of Research Ethics Committees (RECs) from the five partner countries. Interviewees signposted policies and guidelines on research ethics, including VAW.ResultsWe developed three themes with eight subthemes summarising ethical challenges across three contextual factors. The global nature of the group contributed towards power and resource imbalance between HIC and LMICs and differing RECs’ rules. Location of the primary studies within health services highlighted differing rules between university RECs and health authorities. There were diverse conceptualisations of VAW and vulnerability of research participants between countries and limited methodological and topic expertise in some LMIC RECs. These factors threatened the timely delivery of studies and had a negative impact on researchers and their relationships with RECs and HIC funders. Most researchers felt frustrated and demotivated by the bureaucratised, uncoordinated, and lengthy approval process. Participants suggested redistributing power and resources between HICs and LMICs, involving LMIC representatives in developing funding agendas, better coordination between RECs and health authorities and capacity strengthening on ethics in VAW research.ConclusionsThe process of ethics approval for global research on health system responses to VAW should be more coordinated across partners, with equal power distribution between HICs and LMICs, researchers and RECs. While some of these objectives can be achieved through education for RECs and researchers, the power imbalance and differing rules should be addressed at the institutional, national, and international levels. Three of the authors were also research participants, which had potential to introduce bias into the findings. However, rigorous reflexivity practices mitigated against this. This insider perspective was also a strength, as it allowed us to access and contribute to more nuanced understandings to enhance the credibility of the findings. It also helped to mitigate against unequal power dynamics.

Introduction Pregnancy‐related anaemia is associated with high maternal, foetal, and infant morbidity and mortality in rural communities where access to resources for healthcare may be limited. Comprehending the perceptions of rural women concerning the contributing factors to anaemia is essential. The aim was to explore women’s perspectives regarding factors associated with anaemia during pregnancy in a rural village in Mpumalanga Province, South Africa. Methods Qualitative, exploratory and descriptive designs were used. The study targeted pregnant women aged 20–35 years who presented with anaemia in late pregnancy (34–38 weeks of gestation) at the selected clinic in rural villages. Twenty (20) participants were recruited from the clinic register and followed up at their homes using nonprobability purposive sampling. Permission to access the village was obtained from the Chief, and ethical clearance from the University Research Ethics Committee was obtained. Data were collected through unstructured in‐depth interviews and analysed using open‐coding analysis. Trustworthiness was ensured through dependability, confirmability, transferability and credibility. Results The associated factors were found to be low socioeconomic status, late antenatal care booking, poor adherence to iron supplements, dietary myths, restricting a nutritious and balanced diet, and a preference for attending traditional healers rather than skilled attendants, resulting in adverse health outcomes. Conclusion Creation of awareness on utilisation of preconception care services and encouragement to initiate ANC during the first trimester for the provision of comprehensive assessment, early detection, referral and management. Provide contextual health education, including the WHO’s four anaemia‐preventive strategies.

This review discusses three pieces of work, that is, a conference panel and two books, that deal with the role of research ethics committees (RECs) in regulating biomedical research and medical anthropological research. We summarise the papers and conversations of a panel we convened on this topic during the 2020 European Association for Social Anthropologists (EASA) conference. We review two relatively recent books which discuss the role of RECs in biomedical research: Adam Hedgecoe’s (2020) Trust in the System: Research Ethics Committees and the Regulation of Biomedical Research, and Salla Sariola and Bob Simpson’s (2019) Research as Development: Biomedical Research, Ethics, and Collaboration in Sri Lanka. Finally, we consider how the review that RECs outside academic institutions perform is inadequate for ethnographic research, including that involving prospective participants who may lack capacity to consent. We conclude that undertaking the research ethics review internally (i.e., under university RECs) would be a first step forward in reclaiming ethnographic research ethical conversations.

PROFESSORS WHO INCLUDE THEIR STUDENTS as subjects in classroom-based research projects typically must submit to a review by their university's research ethics committee (REC) even in cases which present only minimal risks, and when the investigation is intended for evaluation of teaching approaches only, and not for publication. Results of a web-based survey with 378 respondents indicate that the perceived costs of the review process may outweigh the perceived benefits to subjects. A logistic regression analysis identifies the time it takes to complete the review application, the time it takes to receive a response, and the necessity of revising a project as significant factors in respondents viewing the REC process as a barrier to research. Instituting policies of expedited review for minimal-risk classroom research and exempting evaluations that are not to be published, both of which are permitted under the current regulations, would decrease burdens on both researchers and REC members, and foster improvement of teaching.

TNF-Like Weak Inducer of Apoptosis Promotes Angiogenesis, Thereby Exacerbating Cutaneous Psoriatic Disease

Midwifery students in South Africa place great value on the clinical support they receive from midwifery practitioners. Adequate clinical support should help midwifery students to practice procedures safely and independently, allowing them to be competent upon degree completion. To describe the clinical support and perceived competency levels of midwifery students. Public hospitals in KwaZulu-Natal. The researcher chose a quantitative research method using a descriptive design. An all-inclusive purposive and convenience sampling method was undertaken to recruit midwifery students from an undergraduate nursing programme at a university in KwaZulu-Natal. Gatekeepers permission and ethics approval was obtained from the university's registrar and research ethics committee. A self-evaluation questionnaire describing the clinical support and perceived competency levels was completed by 60 respondents. Data were analysed using International Business Machines Corporation Statistical Package for Social Sciences (IBM-SPSS) Version 27. The results highlighted that the clinical support midwifery students received, was beneficial to their clinical learning outcomes. Eighty per cent of clinical support offered to midwifery students was obtained through clinical supervision. Ninety-three per cent of respondents revealed that the clinical support they received were from midwifery practitioners (without a speciality qualification). Although students rated themselves as competent in 88.6% of midwifery procedures, poor outcomes were identified in 11.4% procedures. Midwifery practitioners play a significant role in supporting midwifery students during clinical placement. Advancing the roles of midwifery practitioners through mentorship training is likely to strengthen the quality of clinical support provided and thus improve the competence levels of midwifery students. The findings in this paper are valuable in developing clinical support training guidelines for midwifery practitioners.