"Parental Burnout" is a specific syndrome resulting from an imbalance between continuous exposure to chronic parenting stress and available protective resources. Mothers of children with special ...needs have an increased risk of Parental Burnout due to dealing with various difficulties from carrying out long-term childcare.
To examine difficulties, coping strategies, and PB (risk factors and protective resources), among ultra-Orthodox and non-Orthodox Jewish mothers of children with special needs with high or low levels of Parental Burnout.
A qualitative study. Twelve mothers of children with special needs identified with high or low Parental Burnout via a quantitative study were interviewed. The constant-comparative analysis method was used to analyze the findings.
Three themes and twelve categories emerged: 1. Difficulties involved in motherhood with six categories: (a) caregiver burden, (b) task overload, (c) physical and mental self-neglect, (d) environmental, couple-hood, family and social neglect, (e) recognizing the gap between their child with special needs and other children of the same age, (f) the environment's contradictory expectations from the mother; 2. Coping strategies with four categories: (a) practical, (b) spiritual, (c) social and (d) emotional; and 3. Parental Burnout, consequences and coping with two categories: (a) personal and environmental risk factors (e.g., fear of the future, difficulty in trusting others in taking care of their child), and (b) personal and environmental protective resources (e.g., sharing similar circumstances with other mothers, a belief in God).
The findings contribute to understanding the unique difficulties, coping strategies and differences in risk factors and protective resources of Parental Burnout among ultra-Orthodox and non-Orthodox Jewish mothers of children with special needs. In order to alleviate the difficulties experienced by mothers and thus also reduce Parental Burnout risk factors and provide effective protective resources, it is recommended to develop empirically based professional guidance for policymakers, child development specialists, nurses, physiotherapists, and informal caregivers.
Developments in genetics enable detection of fetal genetic abnormalities. The decision whether to abort is affected by culture, perceived severity of abnormality, and legal regulations. The study ...aimed to assess the cultural differences in women’s intention to abort if their fetus is diagnosed with a genetic disease. A cross-sectional study was conducted in Israel, Germany, and Cyprus. A questionnaire presented six scenarios where the fetus of a pregnant woman is diagnosed with a mild, moderate, or severe genetic disease. For each scenario, the participating women were asked to rate their perceived severity of having a child with the disease, sense of control over performing an abortion, and intention to undergo an abortion. 141 Israeli, 121 German, and 96 Cypriot women participated in the study. The results revealed that Israeli women were more inclined to perform an abortion (Israel: Mild-Disease M ± SD = 3.20 ± 1.37; Moderate-Disease 2.90 ± 1.39; Severe-Disease 4.08 ± 1.51) compared to Cyprus (Mild-Disease SD = 2.74 ± 1.52; Moderate-Disease 2.53 ± 1.27; Severe-Disease 3.41 ± 1.70) and Germany (Mild Disease, M ± SD = 2.38 ± 1.42; Moderate Disease 2.23 ± 1.44; Severe-Disease 2.98 ± 1.51). In all cases, Israeli women reported a higher sense of control over performing an abortion and Cypriot women expressed the highest perceived severity. Sense of control, perceived severity, being Israeli, and increased age explained 31% of the variance in the intention to abort (F = 54.39). Intention to abort following the diagnosis of a fetus with a genetic disease varies by country. There is a greater intention to abort when women feel more control, and have a higher perceived severity, regardless of the severity of the disease.
As in other areas of medical practice, relatives accompany patients to genetic consultations. However, unlike in other areas, the consultations may be relevant to the relatives’ health because they ...may be at risk of developing the same genetic condition as the patient. The presence of relatives in genetic consultation may affect the decision‐making process and it raises questions about the perception of patient autonomy and the way it is practiced in genetics. However, these issues have not been examined in previous empirical studies. This article aims to fill this gap by reporting findings from a qualitative study with clinicians working in the area of inherited breast cancer. The findings indicate that family presence has an impact on the patient's decisions to undergo genetic testing and preventative operations when she is diagnosed as a carrier. The findings further indicate that, unlike in other areas of medical practice, blood relatives who are present in consultations are perceived by clinicians as patients or potential patients, and this in turn increases their involvement in discussions in the consultation room. Finally, the findings indicate that in genetics, a relational approach to autonomy is applied. Decisions are made in a social context, where the relatives’ views are heard and taken into account. The findings suggest that the conventional bioethical approach to autonomy, which perceives the decision‐making unit as comprising a clinician and an individual patient, is challenged in genetics. The findings thus suggest that bioethicists, lawyers and policy‐makers should consider whether this individualistic approach is still valid and applicable.
Leading research projects are evidence of the growing public interest in genetic diagnosis and treatment. In this context, disclosure of genetic information to relatives has become a prominent issue. ...However, this involves patient confidentiality, which is grounded in law and conflicts with disclosure to relatives. When conducting a legal and bioethical discussion in this context, it is first necessary to examine how clinicians perceive the role of law in their practice and how they interpret it. A qualitative study was therefore conducted among clinicians in Israel. The findings indicate that the clinicians' approach is more relational than that of the law, in view of their pro-active steps to ensure that familial information reaches the relatives when the patient is reluctant to convey this information themselves. In light of these findings the authors argue that the law can resolve situations of explicit and implicit refusal to inform relatives.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background:
Nurses engaging in research are held to research ethics standards.
Research aim:
Examine experiences, behaviors, and perceptions of nurses in Israel regarding research ethics and explore ...possible related factors.
Research design:
An original investigator-designed self-administered questionnaire measured five variables: (a) ethics in research, (b) encountered research misconduct during the course of one’s studies, (c) the inclination to fabricate data, (d) the inclination to select or omit data, and (e) knowledge of research misconduct in the workplace. Additionally, demographic data were collected.
Participants and research context:
The questionnaire was completed by 151 Israeli registered nurses. 10.2% hold a PhD, 34 % hold an MA, 42.2% hold a BA, and 13.6% with no academic degree.
Ethical considerations:
The study was approved by the University’s ethics committee; anonymity and consent of the respondents were respected.
Findings:
Registered nurses’ level of studies achieved was significantly associated with a lower inclination to fabricate data, with one exception—PhD nurses were more inclined to fabricate data than nurses with a Master’s degree. A trend was found in which a higher level of studies is associated with higher knowledge of research misconduct in the workplace.
Discussion:
Results indicate that nurses’ perceptions of research ethics change throughout their academic studies, indicating a positive influence of level of studies, research experience, and work experience on ethics perceptions. Nevertheless, PhD nurses showed a greater inclination to actually select, omit, or even fabricate data than MA nurses. This may be related to pressure to publish.
Conclusion:
PhD nursing programs should include ethics training. Academic faculty members should serve as role models regarding research integrity. Research ethics deserves further emphasis on all levels of nurse education in Israel, as well as in the nurses’ code of ethics and related documents. This may positively impact ethical research practices.
Patients commonly search for e-health information about their illnesses which may be drawn from sites with varying reliability, and might contradict treatment recommendations. The present study was ...an early phase study that examined nurses’ and patients’ feelings and perceptions after an encounter with patients who present e-health information. Altogether 87 nurses and 118 patients answered a scenario-based questionnaire, in which patients presented nurses with e-health information of varying reliability that contradicted the nurse’s own treatment recommendations. Respondents were asked to appraise their own feelings (control, comfort and knowledge expertise) in such a situation and how they thought their role-partner would feel in such a situation (nurses about patients; patients about nurses). The results show that regardless of the information reliability, the nurses thought that they would feel more positive than the patients, while patients thought they would feel less positive than the nurse. Positive correlations were found between nurses’ feelings and their expectations of patients feelings. The same was not true for patients. In conclusion, both parties agreed that the nurse’s response would be more positive than the patients. However, when appraising patient’s reactions and feelings, nurses expressed an egocentric bias.
Hereditary breast and ovarian cancer and Lynch syndrome are associated with increased lifetime risk for common cancers. Offering cascade genetic testing to cancer-free relatives of individuals with ...HBOC or LS is a public health intervention for cancer prevention. Yet, little is known about the utility and value of information gained from cascade testing. This paper discusses ELSI encountered during the implementation of cascade testing in three countries with national healthcare systems: Switzerland, Korea, and Israel.
A workshop presented at the 5th International ELSI Congress discussed implementation of cascade testing in the three countries based on exchange of data and experiences from the international CASCADE cohort.
Analyses focused on models of accessing genetic services (clinic-based versus population-based screening), and models of initiating cascade testing (patient-mediated dissemination versus provider-mediated dissemination of testing results to relatives). The legal framework of each country, organization of the healthcare system, and socio-cultural norms determined the utility and value of genetic information gained from cascade testing.
The juxtaposition of individual versus public health interests generates significant ELSI controversies associated with cascade testing, which compromise access to genetic services and the utility and value of genetic information, despite national healthcare/universal coverage.
Efforts are needed across disciplines to close disparities in genomic healthcare. Nurses are the most numerous trained healthcare professionals worldwide and can play a key role in addressing ...disparities across the continuum of care. ACCESS is an empirically-based theoretical framework to guide clinical practice in order to ameliorate genomic disparities.
The framework was developed by the International Nursing CASCADE Consortium based on evidence collected between 2005 and 2023 from individuals and families of various ethnic backgrounds, with diverse hereditary conditions, and in different healthcare systems, i.e., Israel, Korea, Switzerland, and several U.S. States. The components of the framework were validated against published scientific literature.
ACCESS stands for Advocating, Coping, Communication, cascadE Screening, and Surveillance. Each component is demonstrated in concrete examples of clinical practice within the scope of the nursing profession related to genomic healthcare. Key outcomes include advocacy, active coping, intrafamilial communication, cascade screening, and lifelong surveillance. Advocacy entails timely identification of at-risk individuals, facilitating referrals to specialized services, and informed decision-making for testing. Active coping enhances lifelong adaptation and management of disease risk. Effective intrafamilial communication of predisposition to hereditary disease supports cascade testing of unaffected at-risk relatives. Lifelong surveillance is essential for identifying recurrence, changes in health status, and disease trajectory for life-threatening and for life-altering conditions.
ACCESS provides a standardized, systematic, situational, and unifying guide to practice and is applicable for nursing and for other healthcare professions. When appropriately enacted it will contribute towards equitable access to genomic resources and services.
Mobile health applications (mHealth apps) have now gained global popularity. However, evaluating the level of their use over time still remains a pertinent challenge. According to the Technology ...Acceptance Model (TAM), perceived ease of use and usefulness predict attitudes toward technology utilization. Together, these factors serve as determinants of behavioral intention to use the technology, which in turn predicts actual use.
We sought to elucidate factors affecting behavioral intention to use mHealth apps in an Israeli adult population sample.
A modified TAM Likert Scale questionnaire-based survey was offered to 200 participants, with 168 respondents.
Sixty one percent of participants reported using mHealth apps on their smartphones, 81% of whom used mHealth apps from health maintenance organization providers. Generation Y participants displayed more confidence with the use of mHealth apps, and were less concerned about compromising the confidentiality of their health records. Furthermore, answers to TAM-related questions among mHealth apps users were significantly more positive, compared with nonuser TAM components that accounted for 51% of the total variance in the intention to use mHealth apps.
TAM constructs were related to the behavioral intention to continue to use mHealth apps. Health organizations as providers of mHealth apps were strong determinants of their acceptance and utilization. Generational differences in user competence were observed; however, whether user experience or interface design represents the underlying differentials remains to be elucidated, and developers of health care-related mobile technologies will need to address this question.
Purpose
To investigate the association between patient safety culture (PSC) and the incidence and reporting rate of medical errors by Israeli nurses.
Design
Self‐administered structured ...questionnaires were distributed to a convenience sample of 247 registered nurses enrolled in training programs at Tel Aviv University (response rate = 91%).
Methods
The questionnaire's three sections examined the incidence of medication mistakes in clinical practice, the reporting rate for these errors, and the participants’ views and perceptions of the safety culture in their workplace at three levels (organizational, departmental, and individual performance). Pearson correlation coefficients, t tests, and multiple regression analysis were used to analyze the data.
Findings
Most nurses encountered medical errors from a daily to a weekly basis. Six percent of the sample never reported their own errors, while half reported their own errors “rarely or sometimes.” The level of PSC was positively and significantly correlated with the error reporting rate. PSC, place of birth, error incidence, and not having an academic nursing degree were significant predictors of error reporting, together explaining 28% of variance.
Conclusions
This study confirms the influence of an organizational safety climate on readiness to report errors. Senior healthcare executives and managers can make a major impact on safety culture development by creating and promoting a vision and strategy for quality and safety and fostering their employees’ motivation to implement improvement programs at the departmental and individual level.
Clinical Relevance
A positive, carefully designed organizational safety culture can encourage error reporting by staff and so improve patient safety.
