Journal of Medical Ethics and History of Medicine最新文献_第8页

Clinical commitment and competence: a qualitative study. 临床承诺与胜任力:一项质性研究。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-09-28 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i14.4390

Somaye Zamanian Jahromi, Narges Shafaroodi, Laleh Lajevardi

{"title":"Clinical commitment and competence: a qualitative study.","authors":"Somaye Zamanian Jahromi, Narges Shafaroodi, Laleh Lajevardi","doi":"10.18502/jmehm.v13i14.4390","DOIUrl":"https://doi.org/10.18502/jmehm.v13i14.4390","url":null,"abstract":"Commitment, a component of clinical competence, includes accountability and responsibility for professional roles and tasks; and, it has a positive correlation with job satisfaction and performance. This study aimed to elaborate on the concept of commitment in the field of occupational therapy using qualitative content analysis. The data was collected through interviewing 13 occupational therapists both in a focus group interview (including four participants) and in one-to-one interviews (nine other participants). The collected data was analyzed based on the Grenheim method, and commitment concept was defined under three main themes: (i) commitment to patient (five subthemes), (ii) commitment to self (three subthemes), and (iii) commitment to profession (three subthemes). This study's findings indicated that to acquire clinical competence, therapists should be committed to their patients, to themselves, and to their profession. Future research is needed to further examine how and to what extent these commitment themes affect clinical competence as well as the interaction among them.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"13 ","pages":"14"},"PeriodicalIF":1.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/e6/JMEHM-13-14.PMC7816542.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25325623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Rate and causes of discharge against medical advice from a university hospital emergency department in Iran: an ethical perspective. 伊朗一所大学医院急诊科不遵医嘱出院的比率和原因:伦理观点。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-09-28 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i15.4391

Sanaz Rouhbakhsh Halvaei, Hojat Sheikh Motahar Vahedi, Ayat Ahmadi, Maryam Sadat Mousavi, Alireza Parsapoor, Ali Reza Sima, Amir Ahmad Shojaei, Ehsan Shamsi-Gooshki

{"title":"Rate and causes of discharge against medical advice from a university hospital emergency department in Iran: an ethical perspective.","authors":"Sanaz Rouhbakhsh Halvaei, Hojat Sheikh Motahar Vahedi, Ayat Ahmadi, Maryam Sadat Mousavi, Alireza Parsapoor, Ali Reza Sima, Amir Ahmad Shojaei, Ehsan Shamsi-Gooshki","doi":"10.18502/jmehm.v13i15.4391","DOIUrl":"https://doi.org/10.18502/jmehm.v13i15.4391","url":null,"abstract":"Discharge against medical advice (DAMA) is a common problem in the health-care system. It imposes risks to both patients and medical staff and could be the subject of ethical deliberation. This cross-sectional study was conducted in 2017 on 400 patients who were discharged against medical advice from the emergency ward of Shariati Hospital, Tehran, Iran. Patients' information was collected using clinical records and telephone calls. The collected data were analyzed using STATA software. DAMA rate was 12% in the emergency department of Shariati Hospital. Male gender was found to be a risk factor for DAMA (OR: 1.90; CI (95%): 1.44 - 2.52; P < 0.0001). In addition, younger patients were more likely to leave hospital against medical advice (p-value: 0.04). The more common reasons for DAMA were feeling better, long delay in diagnostic and therapeutic procedures and the hectic ambience of the emergency ward. Patients' self-discharge is a multi-dimensional phenomenon that is affected by patients' characteristics, medical conditions and hospital circumstances. It raises some ethical concerns, mainly due to a conflict between patients' autonomy and beneficence. It is helpful for the medical staff to create an effective relationship with patients who are at higher risk of DAMA, in order to increase their compliance and prevent the consequences of leaving hospital against medical advice.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"13 ","pages":"15"},"PeriodicalIF":1.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c7/19/JMEHM-13-15.PMC7816543.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25325625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Investigation of moral intelligence's predictive components in students of Shahid Beheshti university of medical sciences (SBMU). 沙希德·贝赫什蒂医科大学学生道德智力预测成分的调查。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-09-20 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i13.4389

Maryam Mohammadi, Shabnam Mohammadi, Ali Mehri, Fatemeh Bagheri Mazraeh

{"title":"Investigation of moral intelligence's predictive components in students of Shahid Beheshti university of medical sciences (SBMU).","authors":"Maryam Mohammadi, Shabnam Mohammadi, Ali Mehri, Fatemeh Bagheri Mazraeh","doi":"10.18502/jmehm.v13i13.4389","DOIUrl":"https://doi.org/10.18502/jmehm.v13i13.4389","url":null,"abstract":"This study aimed to investigate dominant predictor components of moral intelligence (MI) based on the Lennick and Kiel's model in students of Shahid Beheshti University of Medical Sciences (SBMU). In this descriptive-analytical study, 322 students of SBMU were chosen through cluster sampling. To collect data, a 40-item questionnaire, whose validity and reliability was confirmed in previous studies, based on the Lennick and Kiel's model was used. The collected data were analyzed by SPSS 21 software using appropriate descriptive and analytical statistics. Of 322 participants, 180 and 142 were female and male, respectively. The mean age of the participants was 22.30±2.69 years. The study's regression analysis revealed that the most and the least direct effects were related to the forgiveness (R2=0.320) and compassion (R2=0.284) components, respectively. Among the inspected components, the responsibility component with an overall effect of R2=0.655 was shown to be the strongest predictor component of MI. Universities play a significant role in students' moral development and enhancement. The present study's findings suggest that developing strategic plans and interventions can enhance MI level (e.g., incentive systems for individuals maintaining high moral responsibility). Since today's students will be tomorrow's medical and healthcare professionals, upgrading of MI level in students studying in various divisions of medical sciences enhances their moral responsibility through setting out strong ethics principles to follow and the quality of care that they will provide to patients, thereby improving health.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"13 ","pages":"13"},"PeriodicalIF":1.0,"publicationDate":"2020-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38614404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Human resources and patient rights during COVID-19 pandemic in Iran. 伊朗COVID-19大流行期间的人力资源和患者权利。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-09-16 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i10.4384

Seyedhassan Adeli, Morteza Heidari, Akram Heidari

{"title":"Human resources and patient rights during COVID-19 pandemic in Iran.","authors":"Seyedhassan Adeli, Morteza Heidari, Akram Heidari","doi":"10.18502/jmehm.v13i10.4384","DOIUrl":"https://doi.org/10.18502/jmehm.v13i10.4384","url":null,"abstract":"On February 19, 2020, first cases of COVID-19 positive were reported in Iran. When COVID-19 declared pandemic by the World Health Organization (WHO) in March 2020, Iran was among the most affected countries (1). Iran was ranked 11th among pandemic-affected countries with more than 328,844 laboratory-confirmed cases as of August 11, 2020 (2). The rapid spread of the pandemic disease and not knowing about COVID19-affected areas necessitated making immediate decisions and adopting appropriate control measures. The burden of the pandemic, added to that of the common diseases, imposed additional pressures on hospitals and healthcare centers, with various consequences such as patient’s rights disregard. COVID19 patients as well as other inpatients during the pandemic deserved their legitimate rights of being treated with the highest possible care and attention. In patient's rights charter (3), various aspects of patient's rights include providing appropriate healthcare service, necessary information, freedom of choice in therapeutic services, and ethical considerations (e.g., privacy and confidentiality). Fulfilling these rights was challenged by shortcomings in hospital capacity, equipment, financial resources, and even necessary knowledge regarding effective treatment. Inadequacy and lack of human resources (4) was a major challenge because healthcare staff count could not be increased to comply with the continuously increasing patient count (4). *Corresponding Author","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"13 ","pages":"10"},"PeriodicalIF":1.0,"publicationDate":"2020-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38614401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Thoughts about "other" patients' rights during COVID-19 pandemic. 关于COVID-19大流行期间“其他”患者权利的思考。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-09-16 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i11.4386

Dimosthenis Chrysikos, Constantinos G Zografos, George C Zografos

引用次数: 2

Turning unprofessional behaviors around using Holmes' reflection approach: a randomized controlled study. 利用霍姆斯的反思方法扭转非专业行为：随机对照研究。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-09-16 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i12.4388

Leila Naeimi, Fariba Asghari, Saharnaz Nedjat, Azim Mirzazadeh, Mahsa Abbaszadeh, Ali Reza Sima, Sara Mortaz Hejri

{"title":"Turning unprofessional behaviors around using Holmes' reflection approach: a randomized controlled study.","authors":"Leila Naeimi, Fariba Asghari, Saharnaz Nedjat, Azim Mirzazadeh, Mahsa Abbaszadeh, Ali Reza Sima, Sara Mortaz Hejri","doi":"10.18502/jmehm.v13i12.4388","DOIUrl":"10.18502/jmehm.v13i12.4388","url":null,"abstract":"Many medical schools around the world have included professionalism training in their formal curriculum. However, these efforts may not be adequate; given the exposure of students to unprofessional behaviors in the clinical settings. In the present study, we aimed to design, implement, and evaluate a longitudinal program to improve professionalism among medical students upon their transition to clinical settings. A total of 75 medical students were enrolled in the study and randomly assigned to two groups. The control group did not receive any training, while for the intervention group; a 10-hour program through 16 weeks was organized based on the Holmes' reflection approach. The effectiveness of the program was evaluated by measuring three outcomes in both groups. Data analysis was performed using paired t-test and Multiple Linear Regression. Scores of judgment of professionalism increased in the intervention group (from 7.56 to 10.17; P< 0.001), while there was no significant improvement in the control group's scores. Students' attitudes towards professionalism and their professional behaviors did not change significantly. Based on our findings, the Holmes reflection approach helps students improve their cognitive base of professionalism. Long-term follow-up and further qualitative studies will help us better understand the effects of this approach on other desirable outcomes.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"13 ","pages":"12"},"PeriodicalIF":1.0,"publicationDate":"2020-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38614403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ebola, quarantine, and the need for a new ethical framework. 埃博拉，隔离，以及对新道德框架的需求。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-08-26 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i9.4078

Corey Benjamin Moore

引用次数: 2

A brief historical overview of the anatomy of fascia in medieval Persian medicine. 中世纪波斯医学中筋膜解剖的简要历史概述。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-08-25 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i7.4073

Mohsen Bahrami, Saeed Shokri, Reza Mastery Farahani, Majid Dadmehr

引用次数: 2

Policy considerations to achieve practical ethics: closing the gap between ethical theory and practic. 实现实践伦理的政策考量:缩小伦理理论与实践之间的差距。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-08-25 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i8.4075

Mansure Madani, Nazafarin Ghasemzadeh, Ali Dizani, Ahad Faramarz Gharamaleki, Bagher Larijani

{"title":"Policy considerations to achieve practical ethics: closing the gap between ethical theory and practic.","authors":"Mansure Madani, Nazafarin Ghasemzadeh, Ali Dizani, Ahad Faramarz Gharamaleki, Bagher Larijani","doi":"10.18502/jmehm.v13i8.4075","DOIUrl":"https://doi.org/10.18502/jmehm.v13i8.4075","url":null,"abstract":"Social and professional behaviors are driven by extrinsic as well as intrinsic factors including executive rules and regulations enacted by extrinsic agents through coercion, police force and penalties. Despite their effectiveness, these mechanisms undermine the fact that ethics is an intrinsic human quality. The present study seeks strategies to apply extrinsic coercion as an incentive to direct ethics as an intrinsic value. Ethical behaviors driven by intrinsic motivations are more permanent and less costly. Legal force can either strengthen or weaken intrinsic requirements. Extrinsic conditions such as considering the interests, attitudes and preferences of others, involving people in the regulation and execution of law, justification of law, avoiding excessive punishment or rewards, and indirect support of ethics by establishing the appropriate social context can help boost intrinsic requirements in individuals. Ethics will not be practically established unless we harness individuals' 'willingness to act' as an essential determinant for ethical behavior. This requires adoption of a more psychological approach to ethics. If this aspect of ethical behavior is considered in regulations and executive processes, extrinsic forces can strengthen intrinsic requirements and spread ethics.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"13 ","pages":"8"},"PeriodicalIF":1.0,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7575913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38635838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Medical students' knowledge and attitudes toward history of medicine. 医学生对医学史的认识与态度。

IF 1

Journal of Medical Ethics and History of Medicine Pub Date : 2020-08-25 eCollection Date: 2020-01-01 DOI: 10.18502/jmehm.v13i6.4071

Alireza Salehi, Hourieh Afsharipur, Hossein Molavi Vardanjani, Mina Vojoud, Leila Bazrafkan, Mohammad Hossein Sharifi

{"title":"Medical students' knowledge and attitudes toward history of medicine.","authors":"Alireza Salehi, Hourieh Afsharipur, Hossein Molavi Vardanjani, Mina Vojoud, Leila Bazrafkan, Mohammad Hossein Sharifi","doi":"10.18502/jmehm.v13i6.4071","DOIUrl":"https://doi.org/10.18502/jmehm.v13i6.4071","url":null,"abstract":"Attention to the history of medicine (HM) has been increasing enormously among the scientific community. History of Culture and Civilization of Iran and Islam (HCCII) is taught in medical schools as a required course. However, data on medical students' level of knowledge and attitude about HM is limited. This is a cross-sectional survey conducted between 2016 and 2017. A multi-stage random cluster sampling was done in which 230 medical students were asked to fill a standardized self-administered questionnaire. Univariate statistical tests and ordinary multivariable linear regression were applied. Medical students' knowledge level was 50.8%, which is considered fair and weak. Interestingly, the knowledge score of those who attended only in HCCII course did not differ significantly from those who did not attend this course (P = 0.163). The results showed that knowledge scores were considerably greater in those who participated in related volunteer workshops than those who did not (P = 0.0001). The mean score of attitude toward HM was significantly higher in female subjects than male subjects (P = 0.028). Moreover, data indicated that attendance at the HCCII course and workshops was not associated with improvement in attitude. According to the outcomes, the authors recommend revising the content, teaching method and structure of the HCCII course curriculum.","PeriodicalId":45276,"journal":{"name":"Journal of Medical Ethics and History of Medicine","volume":"13 ","pages":"6"},"PeriodicalIF":1.0,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7575911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38635836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0