Physical Spheres Research Articles

People living with HTLV: meanings of the illness, experience of illness and its relationship with work

It is estimated that 2.5 million people are infected with the human T-cell lymphotropic virus (HTLV) in Brazil, mainly among afro-descendant populations with low socioeconomic status. The article presents results of the research that aimed to understand the illness experience of people living with HTLV, the ways of going about life and the relationships with work. Thirty-one semi-structured interviews were conducted with frequenters of an infectious diseases research institute. The oral narratives constituted the corpus that was analyzed using Sketch Engine software. Discourse analysis used references from Social Sciences, with emphasis on the health-work relationship. The manifestations of HTLV cause functional impairment and affect living standards, with repercussions on formal, informal, and domestic work. The narratives revealed complaints of physical symptoms and other health-related problems, in addition to prejudice, lack of family support and significant repercussions on work, namely issues aggravated by the absence of public policies aimed at people living with HTLV. The material, symbolic and subjective conditions caused by the progressive loss of physical capacity and early retirement affect not only the physical sphere, but also the psychic and social areas.

AStudy on Selected Aspects of the Quality of Life of People in Remission after Cancer Treatment with the use of the Individual in-depth Interview Technique

Background: Acharacteristic feature of cancer is, among other things, that even after successful oncological treatment, the patient cannot close this chapter of life and the experience of being acancer patient. In oncology there is no unambiguous definition of apatient as ahealthy person. Methods: The study covered agroup of 20 people. In the con- ducted tests the diagnostic survey method was introduced. The technique of individual in-depth interviews was used. The re- spondent could fully express his or her own feelings, emotions, thoughts and experiences. Results. The respondents stated that positive emotions ap- peared with the completion of treatment, but indicated that the feelings were not related to the sense of healing but only to the completion of tiring therapeutic procedures. Some respondents complained about the feeling of chronic fatigue. Fatigue was not only related to the physical sphere, although everyone con- firmed that the side effects of the therapy persisted for some time. The respondents paid more attention to mental fatigue, which had various forms, e.g.: anxiety about possible relapse; functional losses; feeling of loss caused by radical treatment. Out of 20 respondents, 4 persons indicated aloss of health, es- pecially the sense of joy and happiness, self-esteem, self-con- fidence, social contacts, family and time. Conclusions: The research group consisted of 20 respondents, which limits the possibility of formulating generalized con- clusions, but indicates various directions of possible improve- ment and, most importantly, shows how the thinking about can- cer can be changed.

Resilience and coping in difficult social situations among children from low socioeconomic families.

The study aimed to compare factors influencing social adaptation of children from families at risk of social exclusion versus their peers with higher socioeconomic status. The analysis applied to coping strategies in difficult social situations as well as intrapersonal and interpersonal attitudes, and attitudes towards the world. The study involved 169 children (girls n = 85, boys n = 84) aged 13-14 years. Children were included in the criterion group based on a statutory minimum subsistence level applicable for a given year in Poland. Children with higher levels of resilience scored high in cognitive-intellectual and physical spheres as well as in personality, pro-social, socio-moral and support spheres and the sense of efficacy. Factors such as socioeconomic status and family structure were found to differentiate children in terms of coping mechanisms and attitudes towards themselves, other people and the world. The study revealed that the child's psychological resilience is of particular importance for social adaptation.

Structure of somatic diseases among youth in the Republic of Tajikistan and their range by sex

Aim. To study the structure of the morbidity of young people with somatic diseases according to the data on admittance.Material and methods. The research materials are based on data from the Republican Center for Medical Statistics and Information of the Ministry of Health and Social Protection of the Republic of Tajikistan and reports of the youth medico-advisory departments of the Health Centers.Results and discussion. In total, 58103 people contacted YMAD in all regions of Tajikistan over two years (2018- 2019), including 18070 boys (31,1%) and 40033 girls (68,9%). Somatic diseases were revealed in 1030 cases among boys (55,1%) and in 840 cases - among girls (44,9%). Among the main somatic diseases among young people, the most common are diseases of the urinary tract (35,3%; endocrine diseases (24,1%); anemia (17,6%); helminthic invasions (14,4%); diseases of the gastrointestinal tract (10,2%). The combination of two or more of the listed diseases was observed in young men in 71,4% of cases, and in young women in 28,6 cases.Conclusions. Thus, the data shows a low level of the somatic health index of young people, which undoubtedly affects the quality of life and creates an unfavorable background for the realization of reproductive function in the future. Chronic somatic diseases contribute to the discussion of the quality of life of young people in the physical and emotional spheres.

Concept of Fallenness and Patriarchy in Anuradha Sharma Pujari’s Novel “Kanchan”

Patriarchy places women in a marginalised position. Women always bare same feeling and same status of their lives in patriarchal oppression and exploitation. Men often speak about virtues and vices of women and on the basis of that categorise them as chaste or unchaste. Women in patriarchal society should be pure to get societal honour. The society decides what a woman should do, how a woman should behave and these views are the cultural determinant of a society or a community. If a woman challenges these lessons of morality, she will get the identity of fallen woman in a patriarchal society. The novelist Sharma Pujari through the portrayal of Kanchan as a fallen woman does not want to condemn her fundamental disorder but attempts to expose the exploitation and oppression that exist in sexual practices and thereby wants to challenge it. A patriarchal society mirrors some cultural views and attitudes of sexuality. On the basis of these norms a woman is relegated to the rank of fallen woman. The man being the superior section of the society proves his male power in the emotional, physical and material sphere of a woman’s life. This power of patriarchal authority determines the fallenness of a woman and thereby deprives her from availing the pleasures and securities which are only permissible for a wife. The culturally constructed feminine myth looks at her as an exception. People’s psyche is moulded by this cultural affinities constructed by patriarchal system. The novel Kanchan describes the discrimination on gender relation and sexual responses between two genders that exists in a patriarchy. Anuradha Sharma Pujari narrates the complexities in the life of the woman character who tries to come out of her destitute situation by using her body. Adopting a feminist perspective this research article attempts to discuss the construction of the idea “fallen women” by patriarchy and the experiences and struggles of the marginalised protagonist Kanchan in the novel Kanchan.

Assessment of the Psychophysical Sphere and Functional Status of Women Aged 75-90 Living Alone and in Nursing Homes.

Aim: To assess the psychophysical sphere and functional status of women aged 75–90 living alone and in nursing homes. Methods: 23 women living in nursing homes (NH) and 20 living alone (HOME) underwent the following tests: Up and Go Test, Chair Stand Test, assessment of daily physical activity levels using pedometers, Mini-Mental State Examination, Groningen Activity Restriction Scale, Geriatric Depression Scale, and WHOQOL-Bref. Results: It was shown that the subjects living by themselves performed a greater amount of daily physical activity, although there was not significant difference between the two groups in the Up and Go Test result. There were not statistically significant differences in the self-assessment of the mental sphere, but significant differences were found in the self-evaluation of the physical sphere. In the NH group, subjects with and without depression did not differ in terms of the amount of daily physical activity and functional test results. Women with depression from the HOME group were less physically active and had worse functional fitness. Conclusions: Women living alone performed a greater amount of daily physical activity, but the functional status of women in both groups did not differ in a statistically significant way. The groups didn’t differ statistically significantly in terms of psychological self-assessment.

ТЕРАПИЯ ОБИЛЬНЫХ МЕНСТРУАЛЬНЫХ КРОВОТЕЧЕНИЙ У ПАЦИЕНТКИ РЕПРОДУКТИВНОГО ВОЗРАСТА

Women's lack of awareness of the problem (OMC) and lack of understanding of the importance of discussing this problem with an obstetrician – gynecologist may limit women's access to specialized medical care. Currently, there is no accurate data on the reliable number of women with heavy menstrual bleeding. OMK significantly reduces the quality of life of a woman, both in the physical and emotional sphere, so the goals of OMK therapy are to reduce blood loss during menstruation, normalize and stabilize iron (in some situations - ferritin) and clinically significant improvement in the quality of life. The described clinical case of the management of a patient with copious menstrual bleeding without organic causes allowed us to demonstrate a positive effect on OMC of a combined oral contraceptive (COC) containing estradiol valerate in combination with dienogest with a dynamic dosage regimen (Clair's drug). This was confirmed both by the improvement of hematological parameters, such as hemoglobin, hematocrit and ferritin, and the quality of life of the patient. This drug can be recommended for use in women with this pathological process – heavy menstrual bleeding without organic causes. Multicenter randomized clinical trials, as well as real clinical practice studies, have proven the effectiveness of Clyra in women with OMC. The long-term use of Clyra has also been proven to be safe in relation to the risks of venous thromboembolism. An analysis of the published data showed that the use of the Claira combination for up to 5.5 years (on average for 2.1 years) was accompanied by the same or even lower risk of VTE compared to other COC and EE/LNG.

English

BACKGROUND Chronic kidney disease (CKD) is a major health issue around the globe. The illness and its treatment affect both the patients and care givers life. Care giving can have varying effects on the caregiver’s life. It can disrupt the family routines, can contribute to occupational and financial problems and can affect the physical and psychological health of the carer. The purpose of this study was to assess the caregiver burden and resilience of the caregivers of patients undergoing maintenance haemodialysis. METHODS This is a cross-sectional study. The sample of the study consisted of caregivers of 180 patients with chronic kidney disease undergoing maintenance haemodialysis. Specially designed pro-forma, Burden Scale for Family Caregivers (BSFC), Brief Resilience Scale (BRS) are the tools used for the study. RESULTS The mean age of patients in bystanders with significant caregiver burden was 47.36 years and those with low burden was 48.12 years respectively. Among the 180 care givers, 8.9 % had low burden and 91.1 % had significant burden. Resilience was low in 27.2 % of caregivers, medium in 72.2 % and high in 0.6 % of caregivers. The mean BRS score was 3.81 + 0.473 in low burden group against a BRS score of 3.15 + 0.543 in significant burden group. There was a significant association between caregiver resilience and caregiver burden. CONCLUSIONS Chronic kidney disease, due to its long course and prolonged treatment, affects the physical, psychological and social spheres of patient and family. This may result in the feeling of burden among caregivers and affects the various aspects of carer’s life. Burden was high and resilience was low among the caregivers of patients with CKD. Attention should be given to the strategies to support the caregivers. KEYWORDS Care Giver Burden, Resilience, Chronic Kidney Disease

Selected school solutions in the field of a healthy lifestyle among children and adolescents

Introduction and aim: Lifestyle is the daily behaviors, habits and activities adopted by people. It is one of the factors that largely determines the state of human health. It is important to pay attention to what habits and activities we implement in our lives. The source of behaviors are usually attitudes and values acquired in the family and the nearest social environment. The basic categories of pro-health behaviours are related to physical health, psychosocial health, health prevention and avoiding harmful behaviours, preventing an illness and supporting recovery. Anti-health behaviors contribute to health disorders, negative impacts in emotional, physical and psychosocial sphere. The aim of the study was to present selected school solutions in the field of pro-healthy lifestyle among children and adolescents, the influence of pro-healthy lifestyle and assessment of the implementation of health education at schools. Material and method: 85 children and adolescents in the age range of 10-19+ years participated in the study. Twenty-three students in the age range of 10-12 years, 27 students in the age range of 13-16 years and 35 students in the age range of 17-19+ years were surveyed. Twenty-eight males and 57 females took the survey. Results: Respondents most often engage in physical activity 2-3 times per week. The vast majority of respondents actively participate in physical education classes at school as well as undertake extracurricular physical activity. The most popular activities are cycling and team games. The main source of knowledge about pro-healthy lifestyle among children and adolescents is the Internet and the least popular is the press. Conclusions: The majority of students know what a pro-healthy lifestyle is, while less than half of the respondents have no such knowledge. The researched gain knowledge about the way of promoting pro-healthy lifestyle by school, most often through the organization of "Health Day". The majority of children and adolescents participate in extracurricular physical activity, while the rest of the respondents do not undertake such activity.

Coincident play: temporal and spatial overlaps of play activities

ABSTRACT Previous research successfully addresses how digital play fits into the social relations of urban space, often disrupting or enriching them (e.g., Montola [2005]. ‘Exploring de Edge of the Magic Circle: Defining Pervasive Games’. Proceedings of the Digital Arts and Culture 2005 Conference. Copenhagen: IT University of Copenhagen) and the seamless transitions between digital and physical spheres (e.g., de Souza e Silva [2006]. ‘From Cyber to Hybrid: Mobile Technologies as Interfaces of Hybrid Spaces’. Space and Culture 9:3, 261–78). Considering the social, temporal and spatial context of a play activity, it typically exists parallel to other forms of play. Be it an insider or an outsider, it is further important for people to be able to recognise activities of play as they take place. This article applies Huizinga’s idea of play demarcation to build an analytical frame ‘coincident play’ to aid in understanding contexts of play, especially in urban space. A single park in Hong Kong serves as a case and provides around 20 parallel play activities to study. The proposed approach allows us to identify and analyse socially, temporally and spatially coexisting play and playful activities and to recognise the richness that ensues in specific physical spaces.

Measuring enzymatic degradation of degradable starch microspheres using confocal laser scanning microscopy

Degradable starch microspheres (DSM) have long been used for topical haemostasis, temporary vascular occlusion and as drug delivery systems. When used for the latter, exact degradation rates of DSM have high importance, as this ensures a controlled and timed drug delivery. Current methods of analysing degradation rates are based on whole batch measurements, which does not yield information regarding individual times of degradation nor does it provide direct correlation measurements between sphere diameter and specific degradation time.In this paper we present an alternative method for measuring degradation rates of biodegradable starch microspheres using confocal laser scanning microscopy (CLSM). We succeeded in visualizing the degradation by staining the DSM and then following the spheres over time in a confocal microscope, after the addition of α-amylase.Individual degradation rates of single spheres could be followed, allowing a precise correlation measure between sphere size and degradation time. Furthermore, physical abnormalities such as internal cavities were detected within some spheres. These physical differences also had a measurable effect on the rate of degradation. Finally, complete degradation rates could be determined very accurately.To our knowledge, this is the first paper in which DSM degradation is visualized and measured using CLSM. Statement of significanceUsing degradable starch microspheres as a drug delivery system, is a continuously evolving field which shows promise in several different areas of illnesses. This paper presents a new method which visualizes enzymatic degradation of starch microspheres in real-time using confocal microscopy. The method is simple, yet the versatility of it suggests that it could be broadly applied within the field of biodegradation. Here, it illuminates a previously uninvestigated parameter: the effect of physical sphere deformities on the rate of degradation. It also provides precise correlation measures between initial sphere size and time of complete degradation.

N11 Complementary and alternative methods to improve quality of life in patients with inflammatory bowel diseases: a systematic literature review

Abstract Background Inflammatory Bowel Diseases (IBD) shoved an increasing incidence in the last decade. They can occur at any age, but especially between 15 and 30. They have multifactorial aetiology, including genetic, intestinal bacterial, immunological and environmental causes. These diseases present invasive and often disabling symptoms. Typically, patients complained of abdominal pain, diarrhoea and rectal bleeding, and frequently they present complications such as malabsorption, malnutrition, water and electrolyte imbalances accompanied by nausea and vomiting, and intestinal obstruction or stricture. Moreover, the effects of IBD extend to the systemic level, with extraintestinal manifestations generally located at the musculoskeletal apparatus, skin or eyes, as well as psychiatric complications, including depression and anxiety. There is no definitive cure for IBD, and the severity of symptoms affect patients’ well-being, compromising their quality of life (QoL) which is, in fact, generally lower as compared to healthy population. This leads patients to search for self-care methods that allow them to achieve greater control and management of the disease, i.e., complementary and alternative methods (CAMs). Methods The purpose of the paper is to investigate the efficacy of mind-body CAMs in improving the QoL of patients suffering from IBD. Therefore, we focused on CAMs’ impact on the psychological and physical spheres of the subjects, considering outcomes such as anxiety, depression, stress, gastrointestinal symptoms and QoL. A systematic literature review was performed consulting the online databases PubMed, Cinahl, Cochrane, and Google Scholar regarding interventional studies performed in the last twenty years. Results 312 papers were identified and 21 of them were selected according to inclusion criteria applied to title and abstract. 8 of them were then excluded after full-text assessment according to exclusion criteria. The interventions described in the 13 papers included fell within the dimension of mind-body techniques in the sphere of mindfulness and relaxation. A quantitative synthesis was not performed because, among the identified evidence, the treatment effect is never reported for more than two studies. Overall, time-correlated positive developments were recorded in all the outcomes considered in patients with a greater degree of psychological stressors at the initial assessment, guaranteed an increase in the QoL or an avoidance of impairment of QoL during flare-ups. Conclusion Mind-body CAMs have the potential to allow patients suffering from IBD to improve their compromised QoL. However, this area needs further investigation, carrying out more homogeneous studies, with larger samples and longer intervention and follow-up periods.

The Suffering of Advanced Chronic Renal Patients and Their Relationship with Symptoms in Loja, Ecuador.

Advanced Chronic Kidney Disease (ACKD) supposes a public health problem in Ecuador that requires a comprehensive approach. In view of the scarcity of studies on the subject in this country, the objective of this research was to determine the signs and symptoms associated with the patients’ physical, social and psychological spheres that allow properly developing palliative care. A longitudinal, prospective and observational study was conducted with ACKD patients. In order to assess the symptomatic burden and suffering of these patients, the Edmonton Symptom Assessment System Revised: renal (ESAS-r) for renal patients and the Distress Thermometer (DT) were used. The sample consisted of a total of 246 patients. The most common symptoms that affect them, causing them suffering in their daily lives, are those related to well-being, difficulty falling asleep and itching. It is necessary that health professionals adapt care measures and help patients undergoing renal treatment, especially those who have suffered the disease for a longer period of time, in order to alleviate the patients’ suffering and therefore improve their daily lives. To such an end, a care plan could be designed that includes early palliative care.

Recent Developments on the Synthetic and Biological Applications of Chalcones-A Review

Chalcones are precursors of the biosynthesis of flavonoids present in plants. These motifs serve a wide range of applications, from synthetic to pharmacological to physical spheres. Chalcone derivatives attracted the scientific community all over the world in recent times due to their diversified applications. The presence of reactive α,β-unsaturated carbonyl moiety in chalcones makes them a versatile intermediate in synthesizing various classes of compounds of biological and physical interest. More importantly, the chalcones themselves have been known to possess enormous biological activities and physical properties like semiconductor, non-linear optical, fluorescence, and electronic properties. In this context, the present review summarises the overall developments in the synthetic, pharmacological, and physical applications of chalcones in recent fast. The critical discussion was attempted on the synthetic applications and biological potencies as anti-cancer, antidiabetic, antimicrobial, antioxidant, and anti-inflammatory.

Challenges experienced by post coronary artery bypass grafting patients: A qualitative study from Peshawar, Khyber Pakhtunkhwa, Pakistan.

To explore the experiences of post-coronary artery bypass grafting patients in Pakistan. The qualitative, descriptive, phenomenological study was conducted at the Lady Reading Hospital, Peshawar, Pakistan, from May 2018 to April 2019, and comprised patients having undergone coronary artery bypass grafting. Data was collected through semi-structured interviews that included probing questions. Codes, categories and themes were framed through extensive thematic analysis. Of the 14 patients, 11(78.6%) were male with a mean age of 50.81±5.61 years and 3(21.4%) were female with a mean age of 63.33±6.02 years. Four main themes were generated; challenges, perceptions about coronary artery bypass grafting, coping with the challenges, and perceptions about nurses and doctors. The subjects were of the view that they were affected with certain types of physical, psychological and financial challenges. These encounters affected the patients post-procedure in almost every aspect of their lives and made it difficult for them to carry out activities on a daily basis. Further, coping strategies varied from individual to individual. Patients after coronary artery bypass grafting were found to encounter issues related to physical, psychological and social spheres. Care for such patients must be planned in a way to avoid such challenges.

Thermoelastic medium in the context of four theories subjected to gravity field and laser pulse

The paper aims at studying the impact of gravity and laser pulse on the overall structure of the generalized thermoelasticity equations concerning a standardized elastic isotropic half-space. Using four generalized thermoelasticity theories, i.e. the Green-Naghdi (GN) theory, Green-Lindsay (GL) theory, Lord-Schulman (LS) theory, and Coupled Theory (CT), the authors applied the formulation. In the physical sphere, they attained the analytical expressions for the (Mechanical and Maxwell’s) stresses distribution, displacement components, and temperature through utilizing the normal mode analysis. Moreover, they calculated these expressions numerically and plotted the conforming graphs to demonstrate and make comparisons between theoretical findings. The paper concludes that the impact of gravity and laser pulse field is highly significant.

Weight stigma and health – Repercussions on the health of adolescents and adults: integrative review of the literature

ABSTRACT Objective To conduct an integrative review in order to understand the repercussions of the social stigma of overweight on the health of adults and adolescents. Methods The international protocol for systematic review and meta-analysis studies PRISMA was adopted to guide the writing of this review. The databases used were PubMed, Psycinfo, SciELO, Medline, Lilacs and Pepsic, considering studies published in the period from 2000 to 2020. Sixty-seven (67) articles were analyzed, and 4 categories emerged: repercussions on physical well-being; repercussions on social well-being; repercussions on mental well-being; and mixed category (physical and psychological impact). Results In the vast majority of studies analyzed, weight stigma had a negative impact on the different spheres that make up the health construct, that is, the physical, social and mental spheres. Conclusions The consequences of weight stigma are a source of intense suffering, with an impact that reduces the quality of life of individuals who experience stigmatization, involving physical, emotional and social aspects.

Railway cyber safety: An intelligent threat perspective

Cybersecurity threats to railways are increasing, both due to improvements in the techniques of hackers and the increasing merger of cyber and physical spheres. Accepted approaches to safety can be extended to consider the risks from cyber, however the nature of railways as complex cyber-physical systems of systems may require a broader approach beyond functional safety. This paper explores some of the cybersecurity hazards using a war gaming approach. The authors find that, while standard engineering approaches are effective in building new rail control system components, a broader and more creative consideration of attacks has benefits. In particular they identify the ability to cause mass disruption by targeting the fail-safes designed to ensure safety or auxiliary systems that are not directly classified within the scope of the ICS.

The medical nurses: the factors of professional burning-out

Nowadays, the professional burnout of paramedical personnel becomes a serious health care problem, resulting in productivity loss and medical care costs increase. The most effective mean to prevent the mentioned burnout is elimination of risk factors. The study purpose is to identify such factors (both positive or negative ones) and to quantify their contribution into development of professional burnout as exemplified by paramedical personnel in the Tomsk Oblast of Russia. The study sampling included 2,486 paramedicals as respondents. The sociological survey was carried out using questionnaire that included the Maslach Burnout Inventory tool and questions to assess corresponding factors of social, professional, economic and physical spheres of life. The study established high prevalence of high degree (29.57%) and extremely high degree (37.01%) of professional burnout in respondents. The following factors were associated with decrease in likelihood of burnout: advanced age (r = -0.089), married status (OR = 0.7; 95% CI 0.6-0, 9), higher number of children in family (r = -0.088), adequate sleep (r = -0.046), amount of time spent on sports per day (r = -0.167). The following factors were associated with increase in the likelihood of burnout: self-reported lack of sleep (OR = 2.1; 95% CI 1.8-2.5), frequent night shift work (r=0.082). The multiple linear regression analysis was applied with selection of model using the Akaike criterion: two mathematical models were formed for the integral value of professional burnout and its "Emotional exhaustion" sub-scale. The models described 15% and 20% of dispersion, respectively. The models allow both to quantify particular contributing factors to development of this syndrome and to develop programs of strengthening positive factors and mitigate negative ones. This will prevent development of professional burnout in paramedical personnel in the Tomsk Oblast.

Integrity at end of life in the intensive care unit: a qualitative study of nurses\u2019 views

BackgroundIntegrity is a core value for delivering ethical health care. However, there is a lack of precision in defining what integrity is and how nurses understand it. In the setting of nurses caring for critically ill and dying patients in intensive care units (ICUs), integrity has not received much attention. Therefore, the aim of this study was to explore how nurses perceive and maintain the integrity of patients during end-of-life care in the ICU setting.MethodsThis study had a qualitative descriptive design. Data were collected using individual semi-structured interviews with 16 intensive care nurses working at ICUs in four Swedish hospitals. The data were analysed by applying qualitative content analysis.ResultsFive overall categories were explored: seeing the unique individual; sensitive to patient vulnerability; observant of patients’ physical and mental sphere; perceptive of patients’ religion and culture; and being respectful during patient encounters. Many nurses found it difficult to define integrity and to explain what respecting integrity entails in the daily care of dying patients. They often used notions associated with respect and patient-centred attitudes, such as listening and being sensitive or by trying to describe good care. Integrity was nonetheless seen as a central value for their clinical work and a precondition for ethical nursing practice. Some nurses were concerned about patient integrity, which is at risk of being “wiped out” due to the patient’s illness/injury, unfamiliarity with the ICU environment and utter dependence on others for care. Protecting patients from harm and reducing patient vulnerability were also seen as important and a way to maintain the integrity of patients.ConclusionsThe study results show that even though integrity is a fundamental ethical concept and a core value in nursing, ethical codes and guidelines are not always helpful in clinical situations in the end-of-life care of ICU patients. Hence, opportunities must regularly be made available for ICU nurses to reflect on and discuss ethical issues in terms of their decision-making and behaviour.