Loss Of Responsibility Research Articles

The Ethical Challenges Faced by Nurses Providing Care to Patients with COVID-19: A Qualitative Content Analysis

Background: Nurses most frequently face ethical challenges due to their direct contact with patients. Accordingly, the present study aimed to investigate the ethical challenges faced by nurses who provided care to patients with COVID-19. Methods: This qualitative study was conducted using conventional content analysis. A total of 13 nurses who were selected through purposive sampling participated in the study. Data were collected via in-depth and semi-structured interviews until data saturation from June to late November 2021. Data were analyzed simultaneously with data collection using qualitative content analysis based on the steps proposed by Graneheim and Lundman. Besides, data accuracy and robustness were checked, and ethical standards were followed. Results: Data analysis led to the identification of two main themes including threatening adherence to professional obligations and experiencing moral distress in patient care. Conclusion: Based on the findings, nurses mentioned a large number of ethical challenges such as the risk of injustice and loss of responsibility in providing care, decision conflicts, weakening ethical concepts such as patience and kindness, conflict between professional obligations and personal commitments, and the lack of attention to metaphysical beliefs. The results of this study highlighted the importance of educational planning, psychological and economic support, gratitude and empathy shown by authorities, providing security in the workplace, and developing face-to-face psychological interventions based on nursing needs.

DAMPAK CERAI-GUGAT TKI/TKW TULUNGAGUNG PADA KESEHATAN MENTAL ANAK USIA DINI

Mental health is an educated thought of the individual's family and environmental factors. Individual circumstances that can not be separated from various forms of mental turbulence. Individuals can be declared to have mental health if they can adjust and solve problems with good stress management. The biggest influence on mental health is the family factor. Because, in the family the individual feels safe and loved. However, there are differences in the families of Indonesian migrant workers. TKI/TKW families actually have various problems in carrying out family life. Poor communication increases stress, resulting in decreased mental health. Poor mental health triggers various conflicts and leads to separation (divorce). Tulungagung district in the province of East Java, is one of the districts with the highest number of migrant workers, which is more than 1000 workers abroad per year. However, Tulungagung district also has the highest divorce rate, which is 200-400 filings for divorce per month. This study was conducted to determine the main factors for the decline in the mental health of the families of Indonesian migrant workers, as well as the motives for divorce that have been carried out by the families of migrant workers and to determine the impact of divorce The research method used is descriptive qualitative. Collecting data using literature study and using Alfred Schutz's phenomenological theory approach containing cause and purpose motives. The decline in mental health for migrant workers' families is due to several factors, namely: 1) lifestyle changes, 2) a sense of loneliness from both parties, 3) lack of communication, 4) lack of sexual desire, 5) loss of responsibility.

Between risk and autonomy: producing subjects in group homes and supervised workshops for people with intellectual disabilities

This study focusses on the question of how the values of autonomy, self-determination, and independence influence people with intellectual disabilities who live in a social world of institutionalized care. It analyses policies and practices – everyday activities. Data collection took place during 240 h of participant observation in three group homes and one workshop for adults with intellectual disabilities in Austria. The analysis demonstrates that these organizations attempt to enhance the status of people cared for to that of an autonomous subject. But this project is failing, as these people do not have the practical knowledge required to fulfil the social demands of reason, responsibility for their actions and their physical integrity, and also to manage household tasks efficiently. Consequently, they assimilate to being dependent subjects. Two risk management strategies support this: everybody should be treated equally, plus the loss of responsibility outside the social world and in medical practices. Points of interest This article compares written guidelines and everyday activities in group homes and supervised workshops for people with intellectual disabilities in Austria. It wants to clarify the connections between everyday activities, disability, society, and personal aims. The written guidelines of institutions for people with intellectual disabilities support the idea that people should become more self-determined and independent. However, everyday activities reveal that in real life, it is more important to keep people safe and well-cared for. This mismatch also becomes visible in a conflict between the ideal that people in group homes should be autonomous and the demand that the caregivers minimize possible health risks. This study recommends accepting that all people are somehow dependent. Further, the aim of belonging to others should receive more attention in group homes and supervised workshops.

The national strategy for Roma inclusion in Italy: between contradictions and loss of responsibilities

ABSTRACT After decades of emergency initiatives and a widespread institutional disengagement, in 2012, Italy adopted the National Strategy for the inclusion of Roma, Sinti and Caminanti communities, which opts for a unifying approach to dealing with the Roma presence. Even though in its formal objectives, the Strategy aims at overcoming the fragmentation of the policies focused on the Roma, seven years after its implementation only disconnected, often inconsistent, interventions have followed. The article examines whether and to what extent the implementation of this document has represented a break with the ambiguities and contradictions that characterised the structure of the relevant policies aimed at Roma integration in Italy before 2012. The analysis highlights a failed activation of the beneficiaries of the strategy in terms of both empowerment and participation in the decision-making arena. Although the strategy represents an unavoidable step – at least from a formal point of view – towards a coordinated approach to a controversial issue, it has failed to trigger virtuous circles able to affect the life conditions of the Roma, which remain alarming.

Werewolf in Kakania. Moosbrugger: an Analysis of His Subjectivity

We are held responsible for our deeds – even if we did not act according to our will. From a third-person perspective, to be deemed ‘mad’ is to be held not responsible for one’s actions. From a first-person perspective, to be mad is to feel that one’s deeds are not one’s own, thus not responsible for them – or vice versa to feel responsible for deeds that are not one’s own. The vulnerability to madness, the cypher of condicio humana, imbues responsibility: loss of responsibility (alienation) and excess of responsibility (guilt) are the extreme polarities of the dialectics of answerability in human existence. To be human is to be at odds with responsibility, that is, with the involuntary dimension of our being. Responsibility is at the same time a presupposition and a task since society expects a person to feel responsible for her deeds; yet responsibility is not an a priori, rather an achievement to be obtained through education. As Ricouer puts it: ‘Education is education to responsibility’. It is very difficult to disentangle responsibility from non-responsibility and standard assessment procedures are not always helpful for this. Taking the literary case of Musil’s serial murderer Moosbrugger, I sketch an alternative view based on the reconstruction of the life-world in which a given action takes place – rather than on the assessment of isolated symptoms. ‘To the judge –Musil writes – Moosbrugger was a universe, and it was very hard to say something convincing about a universe”. The judicial assessment of accountability is an ‘anaemic concept‘ if it does not takes into account the person‘s ‘universe’, that is, the ontological framework in which she is posited.

Redefinition of professional roles: if we re-started again from patients?

Redefining professional roles: should we re-start from patients? The redefinition of nursing competences is a need determined by the progressive changes of the health system and health professions. If on one side the definition of what nurses can or cannot do helps to render more visible the nursing profession, on the other also the WHO agrees that a rigid definition is not realistic. The constantly evolution of technologies and systems reshapes the boundaries between health professions. The actual debate is strikingly centered on professions (what each profession gains or looses, increase or loss of responsibility or power) and only rarely from patients' needs.

Changing Institutions Through Effective Communication

“There is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things.” (Niccolo Machiavelli)Public institutions are rigid organizations, characterized by a hierarchical structure, often slow in reacting. Changes are mostly induced by outside forces, either political opinions or international organizations that set structural standards the institutions must comply with. But when it comes to changing people – their mentality, the way they act/react – all bets are off, as there are social and psychological factors that enter the equation. This study investigates how could public managers use communication to ease the transition for the civil servants and to create adaptive mechanisms in their institutions.Whenever change is being implemented, the fear factor can set in. This can be the fear of change itself and its consequences such as the possible loss of job security or loss of responsibility or control. Continuous, honest and open communication is essential in such cases, because change can take people out of their “comfort zone” and raise their stress levels. The challenge is to communicate the right message – that the “new zone” is even more comfortable and secure, or at least it will be once the initial short-term discomfort of implementing change has been overcome. The study concludes that knowing how, what, when, to whom and how much to communicate is essential for institutions going through change processes and it can help motivate the employees and gain understanding and support from the community.

RESTRICTION OF DUTY HOURS FOR RESIDENTS IN INTERNAL MEDICINE: A QUESTION OF QUALITY OF LIFE BUT WHAT ABOUT EDUCATION AND PATIENT SAFETY?

Like in other medical specialities, training in internal medicine is confronted with the duty hours regulation. A reduction to a maximum of 48 duty hours has been introduced in Belgium in 1999 for all residents and is still under debate in the European Communities. A reduction of duty hours to a maximum of 80 hours per week was recently adopted in the USA. Several surveys were conducted in this country before and after the introduction of the new system to evaluate its impact on training and patient care. A reduction of duty hours appears to improve the mental health and the security and the quality of life of the trainees. On the other hand, it is suspected that reducing training hours can have a negative effect not only on education but also on patient safety and satisfaction giving the fragmentation of care. This appears to be a key problem, particularly in internal medicine, as it implies more frequent transfers of medical information, a source of medical errors and a loss of responsibility.

Clinical Holistic Medicine: Mental Disorders in a Holistic Perspective

From a holistic perspective, psychiatric diseases are caused by the patients unwillingness to assume responsibility for his life, existence, and personal relations. The loss of responsibility arises from the repression of the fundamental existential dimensions of the patients. Repression of love and purpose causes depersonalization (i.e., a lack of responsibility for being yourself and for the contact with others, loss of direction and purpose in life). Repression of strength in mind and emotions leads to derealization (the breakdown of the reality testing, often with mental delusions and hallucinations). The repression of joy and gender leads to devitalization (emotional emptiness, loss of joy, personal energy, sexuality, and pleasure in life).The losses of existential dimensions are invariably connected to traumas with life-denying decisions. Healing the wounds of the soul by holding and processing will lead to the recovery of the person's character, purpose of life, and existential responsibility. It can be very difficult to help a psychotic patient. The physician must first love his patient unconditionally and then fully understand the patient in order to meet and support the patient to initiate the holistic process of healing. It takes motivation and willingness to suffer on behalf of the patients in order to heal, as the existential and emotional pain of the traumas resulting in insanity is often overwhelming. We believe that most psychiatric diseases can be alleviated or cured by the loving and caring physician who masters the holistic toolbox. Further research is needed to document the effect of holistic medicine in psychiatry.

Self‐Knowledge, Responsibility, and the Third Person

Richard Moran's Authority and Estrangement offers a subtle and tantalizing exploration of asymmetries that arise between first‐person and third‐person self‐knowledge. According to Moran's central claim, the distinction of first‐person self‐knowledge is to engage the responsibility of the person. I will focus my remarks on this issue. I wish to raise some questions about the nature of the third‐person perspective, and about how assuming it affects the responsibility of the person. In this connection, I examine in some detail Moran's main examples of third‐person loss of responsibility. Moran's discussions are rich and provocative, and the questions I sketch out all too briefly here are primarily pleas for clarification.

An Icelandic Study of Five Parental Life Styles

An Icelandic family study1 of a nationwide random sample of 846 responding parents is presented. It consists of (a) a comparative group of married/cohabiting parents and four groups of single parent families, i.e., (b) widowed parents, (c) parents never in cohabitation, (d) divorced parents with custody (mainly women) and finally (e) divorced parents without custody (mainly men). Fathers without custody is a special group of single parent, families in Iceland (that relates to the social family profile, legislation, divorce rate and proportion of children born out of marriage). The main results of the fathers' situations, their complaints and wishes are presented. The fathers express more discontent with the custody arrangements than their visiting rights. For the other (single parent) groups family interaction is frequent and makes up a strong network of (social and emotional) support. The divorced fathers' marginal position in the family is reflected, i.e., in their restricted pattern of family interaction. The children of divorced parents lose more contact with their grandparents and other relatives in their fathers' family than with their mothers' family. The divorced fathers without custody have longer working hours and less good housing than the other groups. They express their unhappiness over loss of responsibility of their children, They suffer more than the other groups from sleep disturbances and sad thoughts.

Longitude and temporal variations of energetic electron precipitation near the trapping boundary

Electron precipitation occurring at latitudes near the midnight trapping boundary was measured remotely with a satellite‐borne x ray imager (>21 keV). This investigation has demonstrated for the first time the repetitive mapping of precipitation at the trapping boundary with x rays. The satellite spin motion (5.5 second period) provided repeated scans of each scene during a single pass of the satellite. When the in situ electron precipitation, measured directly with a spectrometer (>68 keV) on the same satellite, was limited to a narrow region at the trapping boundary the precipitation inferred from the x rays was generally fairly uniform over a median longitude interval of at least 45°. Significant decreases of x rays at longitudes away from the satellite crossing seldom occurred, but significant increases at certain longitudes were sometimes observed. The widespread arc patterns of the precipitation have important implications for both understanding the nature of the responsible loss mechanisms and for assessing the atmospheric effects.

Performance Budgeting in Los Angeles

> Probably no major administrative technique has won so wide an interest and acceptance in a short time as has performance budgeting. Its advocates have foreseen such happy consequences as more rational legislative-executive relations, administrative decentralization without loss of responsibility, more sharply drawn alternatives for program selection, and a clearer picture of costs which can spotlight inefficiency and point out cheaper routes to stated goals. Here, the predictions about performance budgeting are examined alongside its achievements in Los Angeles, New York State, the U. S. Department of Agriculture, and Cincinnati.