Nursing

Background: School meal programs are not only government initiatives but also community-driven efforts. Aiming to combat food insecurity among school-aged children effectively, these programs are executed in conjunction with food bank initiatives. Various community groups play a crucial role in the success of both food security initiatives. There is a need to improve community engagement to successfully link school meal programs with food banks to build program synergy, combating food insecurity through a two-sided approach. Aim: This study aims to examine (...) community engagement in school meals program by analyzing its purposeful focus on creating jobs and income-generating opportunities for different community groups, i.e., youths, women, and others. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: Findings showed that the school meals program’s purposeful focus on creating jobs and income-generating opportunities for women in the community was positively associated with community engagement, thereby supporting the linkage between the programs and food banks. In contrast, providing jobs and income-generating opportunities for youths and other community groups had an ambiguous association with community engagement in school meal programs. Conclusions: Findings underscore the importance of creating jobs and income-generating opportunities for women to improve community engagement in school meal programs. Formulating strategies that empower woman’s entrepreneurship may foster their involvement and engagement in school meal programs, promising to successfully link these programs with food bank initiatives among implementing countries. (shrink)

I evaluate Professor Nancy Munn’s criticism in her 1994 review of Dame Professor Marilyn Strathern’s 1991 book Partial Connections that Strathern does not refer to “classic sources.” For one end (getting included in collections of important articles on a topic), I suppose that the material would be better presented with reference to classic sources. More specifically, it would be better for Strathern to refer to the rationale presented by E. Evans-Pritchard for focusing on primitive societies: that it is best to (...) start with simple and move towards more complex. Strathern implies a rejection of this rationale, but it seems her work would benefit from being recast in a more traditional academic format. (shrink)

I notice that quite a few philosophers die younger than I expect, given the affluent social groups they are from or connected to, such as Robert Nozick (63 years), G.A. Cohen (68 years), Bernard Williams (73 years), and Derek Parfit (74 years). Perhaps others suffer from mental health problems, beyond the quite mild problems I suffered from writing a lot in 2023, which led to quite a heavy-handed response by the NHS, I think. In this paper, I explain how to (...) talk with a psychiatrist or mental health nurse, in a way which draws upon our skills as analytic philosophers. I refer to David Lewis when doing so, suspecting he is a bad influence! (shrink)

Background: The feeding modalities used in school meal programs—such as breakfast, lunch, dinner, snacks, and take-home rations—are influenced by various factors, including supply chain constraints and technical challenges in food distribution. The methods of supply sourcing, whether through domestic or foreign food reserves via in-kind donations or purchases, play a critical role in shaping the feeding options provided. Aim: This study aims to examine the association between supply-sourcing strategies, i.e., domestic and foreign in-kind donations and national-international purchases, with the feeding (...) modalities applied in school meal programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of government representatives who manage large-scale school meal programs across 126 countries. Results: The findings revealed that sourcing supplies through in-kind donations from neighboring or distant countries showed a highly reliable negative association with the feeding modalities of school meal programs, while those from the national bodies showed an ambiguous relationship. The purchasing methods—whether domestic or foreign—tended to exhibit positive associations with feeding modalities, though these associations were only weakly reliable. Conclusions: The findings reveal substantial rooms to improve the effectiveness of supply purchasing strategies in enhancing school meal program feeding modalities. Further research is needed to examine the impact of sourcing supplies through domestic in-kind donations on feeding outcomes. Additionally, developing strategic plans to optimize the use of in-kind donations from international organizations is strongly recommended to avoid its negative consequences and further enhance program effectiveness. (shrink)

Background: The feeding modalities applied in countries with school meal programs are varied because these are shaped not only by the national commitments to alleviate food insecurity among children but also by resource availability from national and international agencies. In terms of financial resources, the USA plays a consistent role in providing donations, grants, loans, and loan guarantee programs to support global school feeding. The U.S. Department of Agriculture (USDA) oversees these funding sources for international school meal programs. Aim: This (...) study aims to examine the moderating effect of USDA funding on the relationship between supply purchasing methods and feeding modalities among countries implementing school meal programs. Methods: The Bayesian Mindsponge Framework, combining the reasoning strengths of Mindsponge Theory and inference advantages of Bayesian analysis, was employed on a dataset of 126 government representatives who manage large-scale school meal programs in 126 different countries. Results: The findings indicated that USDA funding has the potential to positively moderate the relationship between foreign supply purchases and the feeding modalities of school meal programs. However, the direct association between foreign purchases and feeding modalities was unclear. Conversely, while USDA funding was found to have a negative moderation effect on the relationship between domestic supply purchases and feeding modalities, it is these domestic purchases that show potential for positively influencing the feeding modalities. Conclusions: Findings underscore the importance of supporting the World Bank and World Food Programme’s recommendation to rely more on local resources and capacities for developing long-term and sustainable school meal programs. Further exploration of the impact of foreign supply purchases on feeding modalities is needed. Formulating strategic plans to better leverage USDA funding for enhancing domestic supply purchases is highly recommended. (shrink)

Healthy eating has long been a focus of professionals and researchers, both to evaluate strategies for improvement and to gain a deeper understanding of its dynamics in order to develop effective promotion methods. This study aims to examine the roles of individuals’ information-seeking abilities and e-health literacy in fostering a healthy eating intention among Iranians. Employing Bayesian Mindsponge Framework analytics on a dataset of 9,755 Iranian participants, the study found positive associations between healthy eating information-seeking ability, e-health literacy, and healthy (...) eating intention among Iranian adults. However, the moderating effect of e-health literacy on the relationship between information-seeking ability and healthy eating intention remains ambiguous. We suggest that enhancing individuals' healthy eating information-seeking abilities and e-health literacy, alongside improving the availability, affordability, and accessibility of reliable healthy eating information, is essential for fostering healthy eating intentions. (shrink)

Coastal engagement activities have been explored for their measurable health benefits, including both physical and mental health outcomes. These activities may foster a deeper sense of connection to nature following every visit to the coast, such as watching the sunset, beach walking, spending time on the beach, wildlife spotting, shell collecting, engaging in beach and water sports, mountain biking, and participating in seagoing activities. However, limited research has examined the moderating effect of nature connectedness on the relationship between these activities (...) and health outcomes, both physically and mentally. This study aimed to analyse how the relationships between coastal activities and perceived mental and general health conditions in the previous year are moderated by the level of nature connectedness among adult visitors. By analyzing the dataset of 1,939 Flemish individuals engaged in the Belgian coast, under the Bayesian Mindsponge Framework (BMF), this study found a crucial moderating role of coastal nature connectedness. Findings showed that coastal activities are negatively associated with mental and general health scores, but with the moderating effect of nature connectedness, this negative association may shift. In each level of nature connectedness, coastal activities showed different effects on mental and general health conditions, with higher improvement found in mental health scores. Findings indicate that, beyond the type of coastal activities, nature connectedness is an essential subjective sense that determines therapeutic benefits. This study highlights the complex interplay of environmental factors, subjective perceptions, and biophysical-psychological interactions in shaping individual health outcomes. There is a need for targeted coastal management strategies to facilitate nature-based activities that promote nature-connectedness and, subsequently, coastal healing capabilities. (shrink)

The COVID-19 pandemic put immense pressure on healthcare systems globally, including those of highly developed countries like the United States and United Kingdom. During the pandemic, professional nursing organizations were the first to call attention to the disproportionate pandemic-related deaths among Filipino nurses. These organizations played a central role in addressing the various crises Filipino nurses faced due to their vulnerabilities as frontliners, ethnic minorities, and migrants in their host countries. Using the Volatile, Uncertain, Complexity, and Ambiguous (VUCA) framework, this (...) monograph assesses the pandemic-response actions and strategies of PNAA and PNAUK, two Filipino nursing associations in the US and UK. The major themes suggest that the two organizations are multifunctional entities with the capacity to act as lobbyists, research organizations, and decision-makers when adapting, strategizing, and coping with VUCA conditions. These findings corroborate previous findings on the potentiality of diasporic nursing organizations in addressing the gaps in government support for migrant workers in the healthcare industry. (shrink)

Artificial intelligence is now widely accessible and already being used by healthcare researchers throughout various stages in the research process, such as assisting with systematic reviews, supporting data collection, facilitating data analysis and drafting manuscripts for publication. The most common AI tools used are forms of generative AI such as ChatGPT, Claude and Gemini. Generative AI is a type of AI that can generate human-like text, audio, videos, code and images based on text-based prompts inputted by a human user. Generative (...) AI is trained on large amounts of data, and the outputs are sophisticated and can be indistinguishable from a response from a skilled human. In this article, we outline several AI applications that can be used in healthcare research, examining their benefits, limitations and outline best practices for maintaining research integrity and ethical standards. (shrink)

Here we abstract the LC oscillation circuit of the physical world into a mathematical axiomatic system, aiming to establish a logical language based on "duality, periodicity, and energy conservation." Traditional mathematics is built on "static points," while this system is built on "dynamic waves." In this world, "zero" is not empty, but the perfect balance of electromagnetic energy. You will find it very suitable for describing the following fields: -/- • Macroeconomics: Treating as production inertia and as market capacity; periodic (...) economic crises are a type of "oscillation." -/- • Biological Rhythms: Fluctuations in the concentration of chemicals within cells. -/- • Logic Circuits: Providing a mathematical description for quantum computing based on phase rather than binary bits. -/- • More: Sociology, politics, physiology, psychology, cognitive science, quantum theory, environmental governance, etc. (shrink)

This article constitutes a Patient Perspective, grounded in lived experience, its primary aim is to enhance awareness of anti- depressant-induced anhedonia by providing experience-based insights, relevant to clinicians, researchers, and caregivers. My own experiences with treatment-resistant depression-anxiety have been significant and long-lasting. In my 22-year-plus jour- ney of illness experience—and having taken over 23 antidepressant medications—emotional-blunting, anhedonia, and mania have all, at times, been side-effect-related factors. This work explores the conundrum of antidepressant-induced anhedonia, developing an in-depth patient perspective useful for (...) mental health practitioners, psychiatrists, psychologists, and for wider formal professional and informal nonprofessional caring actors. I write this via a reflexive lens as a long-term mental health patient, while also recognizing my dual-positionality as a Chartered Psychologist and an academic with a PhD working in the field of mental health. Thus, my dual-perspective provides a unique lens useful for translating the patient experience to a wider caregiving audience: fostering understanding and deepened awareness of the anhedonia experience. Implications for patient care are discussed. (shrink)

Illness and injury are often accompanied by experiences of bodily objectification. Medical treatments intended to restore the structure or function of the body may amplify these experiences of objectification by recasting the patient’s body as a biomedical object—something to be examined, measured, and manipulated. In this article, we contribute to the phenomenology of embodiment in illness and medicine by reexamining the results of a qualitative study of the experiences of nurses and patients isolated in an intensive care unit during the (...) first wave of COVID-19. Drawing upon the phenomenological concept of embodiment—as developed in the work of Edmund Husserl, Maurice Merleau-Ponty, Jean-Paul Sartre, and Emmanuel Levinas—we reconsider how bodily objectification manifests in complex clinical encounters. We show that, in these settings, objectification is not simply the unilateral act of a clinician objectifying a patient. Rather, both clinicians and patients reported a variety of objectifying experiences influenced by their interactions, the immediate context of the intensive care milieu, and the broader atmosphere of a global pandemic. In light of these findings, we argue that bodily objectification in illness and medicine can often be more complicated than typically presented in the phenomenological literature. (shrink)

Purpose. This article aims to theoretically substantiate and empirically investigate the impact of emotional service on customer loyalty in the beauty industry. It identifies key emotional interaction factors that enhance customer satisfaction and the competitive advantage of beauty service providers. Design / Method / Approach. The study employs an empirical approach based on a survey conducted at the “Women Place” beauty salon in Odesa, Ukraine. Forty regular clients participated, evaluating the significance of emotional and personalized service components. Data was analyzed (...) using descriptive statistics and visualized through percentage-based charts. Findings. The research reveals that personalized communication, staff politeness, cleanliness, interior design, music, and aromatherapy influence customer loyalty. Emotional service plays a critical role in shaping positive client experiences and strengthening brand affiliation. Clients value not only service quality but also the emotional atmosphere and individual approach. Theoretical Implications. This study contributes to understanding emotional service as a strategic tool for loyalty development in the Ukrainian beauty industry. It broadens the theoretical framework by integrating emotional labor, non-verbal communication, and personalization into customer behavior analysis. Practical Implications. The findings offer practical recommendations for beauty business managers to improve emotional interaction processes, implement CRM systems, and develop customer-oriented strategies to retain clientele and reduce churn. Originality / Value. This is one of the first comprehensive empirical studies in Ukraine examining emotional service in loyalty formation, considering sensory, behavioral, and personalized dimensions. Research Limitations / Future Research. The study is limited to one beauty salon. Future research may compare other market segments and explore demographic factors influencing emotional service perception. Article Type. Applied Research. (shrink)

[Editorial] We argue that midwives should focus on climate change, a link which has been underexplored.

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over half (...) (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly. (shrink)

In this article, we explicate evidence-based nursing (EBN), critically appraise its framework and respond to nurses’ concern that EBN sidelines the caring elements of nursing practice. We use resources from care ethics, especially Vrinda Dalmiya’s work that considers care as crucial for both epistemology and ethics, to show how EBN is compatible with, and indeed can be enhanced by, the caring aspects of nursing practice. We demonstrate that caring can act as a bridge between ‘external’ evidence and the other pillars (...) of the EBN framework: clinical expertise; patient preferences and values. Drawing on an influential EBN handbook, section 1 presents the aims and features of EBN, including the normative principle that EBN should take place within a ‘context of caring’. We aim to understand this context and whether it can be neatly detached from the EBN framework, as the handbook seems to suggest. In section 2, we highlight the grounds for resistance to EBN from the nursing community, before mounting the argument that nursing practices can be understood fruitfully through feminist care ethics and/or virtue ethics lenses. In section 3, we deepen that analysis using Dalmiya’s concepts of care-knowing and care as a hybrid ethico-epistemic virtue, which are ideally suited to the complex practices of nursing. In section 4, we bring this rich understanding of care into conversation with EBN, showing that its framework cannot be adequately theorised without paying proper attention to care. Caring can be neither an innocuous background assumption of nor an afterthought to the EBN framework. (shrink)

Phenomenology has been adapted for use in qualitative health research, where it’s often used as a method for conducting interviews and analyzing interview data. But how can phenomenologists study subjects who cannot accurately reflect upon or report their own experiences, for instance, because of a psychiatric or neurological disorder? For conditions like these, qualitative researchers may gain more insight by conducting observational studies in lieu of, or in conjunction with, interviews. In this article, we introduce a phenomenological approach to conducting (...) this kind of observational research. The approach relies on conceptual grounding to focus a study on specific aspects of the participants’ experiences. Moreover, the approach maintains the openness to novel discoveries that qualitative research requires while also providing a structured framework for data collection and analysis. To illustrate its practical application, we use examples of hemispatial neglect—a neurologic disorder in which patients characteristically lack awareness of their own illness and bodily capacities. However, the approach that we describe can be applied more broadly to the study of complex illness experiences and other experiential alterations. (shrink)

- First book to describe what pain means in vulnerable or special groups of people - Clinical applications described in each chapter - Provides insight into the nature of pain experience across the lifespan -/- This book, the third and final volume in the Meaning of Pain series, describes what pain means to people with pain in “vulnerable” groups, and how meaning changes pain – and them – over time. -/- Immediate pain warns of harm or injury to the person (...) with pain. If pain persists over time, more complex meanings can become interwoven with this primitive meaning of threat. These cognitive meanings include thoughts and anxiety about the adverse consequences of pain. Such meanings can nourish existential sufferings, which are more about the person than the pain, such as loss, loneliness, or despair. -/- Although chronic pain can affect anyone, there are some groups of people for whom particular clinical support and understanding is urgently needed. This applies to “vulnerable” or “special” groups of people, and to the question of what pain means to them. These groups include children, women, older adults, veterans, addicts, people with mental health problems, homeless people, or people in rural or indigenous communities. Several chapters in the book focus on the lived experience of pain in vulnerable adults, including black older adults in the US, rural Nigerians, US veterans, and adults with acquired brain injury. The question of what pain experience could mean in the defenceless fetus, neonate, pre-term baby, and child, is examined in depth across three contributions. -/- This book series aspires to create a vocabulary on the “meanings of pain” and a clinical framework with which to use it. It is hoped that the series stimulates self-reflection about the role of meaning in optimal pain management. -/- Meanings of Pain is intended for people with pain, family members or caregivers of people with pain, clinicians, researchers, advocates, and policy makers. Volume I was published in 2016; Volume II in 2019. (shrink)

Aims and Objectives The purpose of this paper was to clarify the concept of ethical conflict in nursing and highlight the importance of tackling this issue. -/- Background Ethical conflict is on the rise in the nursing context. It is associated with the compromise of nurses' well-being and patient care. However, there is no thorough conceptual understanding of this concept. -/- Design Concept analysis. -/- Methods Databases (PubMed, PsycINFO, CINAHL, Scopus, Embase, Web of Science and SocINDEX) were searched for studies (...) between 1984 and 2021. Both quantitative and qualitative studies related to ethical conflict in nursing were included. Walker and Avant's method of concept analysis was used to identify the defining attributes, antecedents and consequences of the concept of ethical conflict in nursing. We followed the PRISMA-ScR checklist to report the study. -/- Results Thirty studies were included for conceptualization. Defining attributes were divided into four categories: (1) emotional responses, (2) incompatible values, (3) competing interests and (4) ambiguous obligations. The antecedents were (1) ethical sensitivity, (2) negative ethical climate, (3) insufficient authority, (4) unrealistic expectations, (5) poor collaboration and (6) inadequate resources. The consequences were identified as (1) moral residue, (2) loss of identity, (3) professional burnout and (4) poor patient care. -/- Conclusions A unified conceptual model of ethical conflict in nursing shed light on the ethical issues nurses might come across in practice. Despite the fact that ethical conflict is inherently negative, we conceptualised this concept as a neutral fact and an opportunity for nursing action. The construct identification provides basis for both the development of practice and the development of staff support and education. (shrink)

This short peer-reviewed text is a concise overview of neurodiversity, the natural diversity of human brain functioning including ways that are currently pathologized as disorders. The concept is essential to understanding humans and societies.

Today, many philosophers write on topics of contemporary interest, such as emerging technologies, scientific advancements, or major political events. However, many of these reflections, while philosophically valuable, fail to contribute to those who may benefit the most from them. In this article, we discuss our own experience of engaging with nursing researchers and practicing nurses. By drawing on the field of philosophical phenomenology, we intervene in a longstanding debate over the meaning of “empathy” in nursing, which has important implications for (...) nursing research, training, and practice. However, our intention is not only to introduce and discuss this philosophical intervention. Rather, we present this intervention as a model for how philosophers might successfully engage with the field of nursing, and perhaps with other fields as well, with the aim of effecting positive change in research or practice. The article proceeds in five parts. First, we introduce the problem of conceptual clarity in nursing and explain why many nursing concepts are still in need of refinement. Second, we discuss the origins of the concept of empathy in nursing and outline the challenges associated with borrowing theory from other fields. Third, we explain how nurses tend to conceptualize empathy today, drawing upon the psychological distinction between cognitive and emotional empathy. Fourth, we discuss our intervention in this debate and explain how we attempt to resolve existing conceptual confusions by developing the concept of empathy from the ground up. Fifth, we conclude by briefly reflecting upon some of the challenges of interdisciplinary engagement and providing some recommendations based upon our own experience. (shrink)

Is it possible to train empathy? We suggest a new way, based on insights from phenomenology.

Highlights: -/- • Breastfeeding and breastfeeding support can contribute to mitigating climate change. • Achieving global nutrition targets will save more emissions than fuel-switching. • Breastfeeding support programmes support a just transition. • This work can support the expansion of mitigation options in energy system models. -/- Abstract: -/- Renewable gas has been proposed as a solution to decarbonise industrial processes, specifically heat demand. As part of this effort, the breast-milk substitutes industry is proposing to use renewable gas as a (...) substitute for fossil natural gas. However, decarbonising the industrial processing of breast-milk substitutes can increase social license for these products, potentially undermining breastfeeding. World Health Organisation nutrition targets aim to increase exclusive breastfeeding to at least 50% globally by 2025 to improve maternal, infant, and young child health and nutrition. This target will have implications for the energy transition. A weakness of existing energy models is that demands for end-use products such as breast-milk substitutes are typically not considered explicitly. This paper develops an analytical framework for explicitly representing infant feeding methods in energy systems models. We compare the emissions saved in Ireland from decarbonising the industrial processing of breast-milk substitutes with renewable gas with the emissions saved by an increase in exclusive breastfeeding to 50% in both Ireland and a key export market, China. We demonstrate that the emissions saved from achieving the minimum global breastfeeding target are greater than when renewable gas is used to displace natural gas in the production of breast-milk substitutes in Ireland. We discuss the decarbonisation of breast-milk substitutes in relation to the principle of justice as non-maleficence, a principle based on the commitment to avoid harm, a novel application of a principle of justice. We conclude that breastfeeding support can be considered a demand-side measure for mitigating climate change by reducing the demand for energy services to produce breast-milk substitutes. A key recommendation is to position breastfeeding support as both a public health and a climate justice issue that is relevant for a just transition. The framework developed for this paper could be applied to support the inclusion of a wider range of mitigation options with social justice outcomes in energy system models. [Open access]. (shrink)

Aims and Objectives. This article uses the concept of embodiment to demonstrate a conceptual approach to applied phenomenology. -/- Background. Traditionally, qualitative researchers and healthcare professionals have been taught phenomenological methods, such as the epoché, reduction, or bracketing. These methods are typically construed as a way of avoiding biases so that one may attend to the phenomena in an open and unprejudiced way. However, it has also been argued that qualitative researchers and healthcare professionals can benefit from phenomenology’s well-articulated theoretical (...) framework, which consists of core concepts, such as selfhood, empathy, temporality, spatiality, affectivity, and embodiment. -/- Design. This is a discursive article that demonstrates a conceptual approach to applied phenomenology. -/- Method. To outline and explain this approach to applied phenomenology, the Discussion section walks the reader through four stages of phenomenology, which progress incrementally from the most theoretical to the most practical. -/- Discussion. Part one introduces the philosophical concept of embodiment, which can be applied broadly to any human subject. Part two shows how philosophically trained phenomenologists use the concept of embodiment to describe general features of illness and disability. Part three illustrates how the phenomenological concept of embodiment can inform empirical qualitative studies and reflects on the challenges of integrating philosophy and qualitative research. Part four turns to phenomenology’s application in clinical practice and outlines a workshop model that guides clinicians through the process of using phenomenological concepts to better understand patient experience. -/- Conclusion and Relevance to Clinical Practice. A conceptual approach to applied phenomenology provides a valuable alternative to traditional methodological approaches. Phenomenological concepts provide a foundation for better understanding patient experience in both qualitative health research and clinical practice, and therefore provide resources for enhancing patient care. (shrink)

Empathy is a topic of continuous debate in the nursing literature. Many argue that empathy is indispensable to effective nursing practice. Yet others argue that nurses should rather rely on sympathy, compassion, or consolation. However, a more troubling disagreement underlies these debates: There’s no consensus on how to define empathy. This lack of consensus is the primary obstacle to a constructive debate over the role and import of empathy in nursing practice. The solution to this problem seems obvious: Nurses need (...) to reach a consensus on the meaning and definition of empathy. But this is easier said than done. Concept analyses, for instance, reveal a profound ambiguity and heterogeneity of the concept of empathy across the nursing literature. Since the term “empathy” is used to refer to a range of perceptual, cognitive, emotional, and behavioral phenomena, the presence of a conceptual ambiguity and heterogeneity is hardly surprising. Our proposal is simple. To move forward, we need to return to the basics. We should develop the concept from the ground up. That is, we should begin by identifying and describing the most fundamental form of empathic experience. Once we identify the most fundamental form of empathy, we will be able to distinguish among the more derivative experiences and behaviors that are addressed by the same name and, ideally, determine the place of these phenomena in the field of nursing. The aim of this article is, consequently, to lay the groundwork for a more coherent concept of empathy and thereby for a more fruitful debate over the role of empathy in nursing. In Part 1, we outline the history of the concept of empathy within nursing, explain why nurses are sometimes warry of adapting concepts from other disciplines, and argue that nurses should distinguish between adapting concepts from applied disciplines and from more theoretical disciplines. In Part 2, we show that the distinction between emotional and cognitive empathy—borrowed from theoretical psychology—has been a major factor in nurses’ negative attitudes toward emotional empathy. We argue, however, that both concepts fail to capture the most fundamental form of empathy. In Part 3, we draw on and present some of the seminal studies of empathy that can be found in the work of phenomenological philosophers including Max Scheler, Edmund Husserl, and Edith Stein. In Part 4, we outline how their understanding of empathy may facilitate current debates about empathy’s role in nursing. (shrink)

An Islamic approach from its theological sources to address the spiritual pain related to palliative care of terminally ill patients can be established on attaining a spiritual stage of soul or spirit termed as reassured soul. The attainment of such stage is based on hope of the patient to receive mercy and forgiveness of God. And the way of attainment of hope is possible by doing the repentance, praying, and patience. In combating the pain and suffering, the patient is supposed (...) to understand that the life in its reality is a test and facing such a test is possible by two ways, one is patient centric by building patience within to endure the suffering and second is seeking help from God by praying. For the spiritual wellbeing, the patient should understand that his suffering is in fact expiation for his sins. On the other hand, the visitors and caregivers of patients have certain responsibilities that contribute to enhancing of the spiritual well-being of the patient, including comforting them by giving hope to the patients and at the same time praying for their recovery. These all elements enhance the spiritual well-being of patients and help in prevention of suffering by spiritual means. (shrink)

When we talk about child sexual abuse, we can understand culture as one of the most important determinants of child health. As a public health problem, sexual abuse has different causes, from which we can distinguish the silence and secrecy maintained by third parties. In each case of abuse, there is a person or persons who are present at the moment of the abuse, or who, without being present, know that the abuse is taking place, or who even help the (...) perpetrator in some way to commit the abuse. In order to work consistently on this type of abuse of children, we need to work on adding values to a culture that helps to talk freely and openly about sexuality and to teach how to achieve transparency in communities that could help to disclose sexual abuse. (shrink)

In the United States, information about a person’s criminal history is accessible with a name and date of birth. Ruth Crampton has studied nurses’ care for prisoner-patients in hospital settings and found care to be perfunctory and reactive. This article examines whether it is morally permissible for nurses in hospital settings to access information about prisoner-patients’ criminal histories. Nurses may argue for a right to such information based on the right to personal safety at work or the obligation to provide (...) prisoner-patients with the care that they deserve. These two arguments are considered and rejected. It is further argued that accessing information about a prisoner-patient’s criminal history violates nurses’ duty to care. Care, understood through Sarah Ruddick’s account as work and relationship, requires nurses to be open and unbiased in order to do their part in forming a caring relationship with patients. Knowledge of a prisoner-patient’s criminal history inhibits the formation of this relationship and thus violates nurses’ duty to care. (shrink)

Counselling y cuidados paliativos es el título del libro escrito por la doctora Esperanza Santos y el profesor José Carlos Bermejo. En esta obra, de fácil lectura y con consejos muy prácticos y útiles, se presentan elementos fundamentales para brindar un acompañamiento de óptima calidad en el cuidado paliativo, así como la posibilidad de hacer un autoexamen de cómo los cuidadores de los pacientes prestan sus servicios e incluso para no caer en burnout. Este libro es de gran utilidad, tanto (...) para los profesionales de la salud que trabajan en las unidades de cuidados paliativos, como para personas que dedican gran parte de su tiempo al cuidado de familiares con enfermedades terminales, o que pasan por procesos prolongados de enfermedad. Con ejemplos de conversaciones de la vida real entre cuidadores y pacientes, la lectura del libro se hace, a la vez, agradable, divertida y profundamente reflexiva. (shrink)

This paper is a study about Philadelphia’s comprehensive user engagement sites (CUESs) as the authors address and examine issues related to the upcoming implementation of a CUES while seeking solutions for its disputed questions and plans. Beginning with the federal drug schedules, the authors visit some of the medical and public health issues vis-à-vis safe injection facilities (SIFs). Insite, a successful Canadian SIF, has been thoroughly researched as it represents a paradigm for which a Philadelphia CUES can expand upon. Also, (...) the existing criticisms against SIFs are revisited while critically unpackaged and responded to in favor of the establishment. In the main section, the authors propose the layout and services of the upcoming CUES, much of which would be in congruent to Vancouver’s Insite. On the other hand, the CUES would be distinct from Insite, as the authors emphasize, in that it will offer an information center run by individuals in recovery and place additional emphasis on early education for young healthcare professionals by providing them a platform to work at the site. The paper will also briefly investigate the implementation of a CUES site under an ethical scope of the Harm Reduction Theory. Lastly, the authors recommend some strategic plans that the Philadelphia City government may consider employing at this crucial stage. (shrink)

If health sciences are to be humanized, health professionals must first humanize themselves. This research deepens the paradigmatic aspects that enrich and form the basis of a compassionate attitude, a key element in this process of humanization. For this reason, emphasis has been placed on the sensitivity that underlies a compassionate attitude. It is proposed that this sensitivity includes wonder as a starting point that allows one to connect with reality and to encounter the reality of the human person, who (...) in turn discovers that she is called to communion with another like herself. In this way, compassion is considered as a movement of the heart, and the particularities and consequences of this movement are identified in order to respond to objections to compassion, especially those of the German philosopher Friedrich Nietzsche. It is noted that his criticism is directed against compassion understood as pity, while compassion understood as a movement of the heart distances itself from falling into the sentimentalization of pity and helps to affirm the positive dimension of compassion. -/- Si se quiere humanizar las ciencias de la salud, han de comenzar a humanizarse los profesionales de la salud. Por esta razón, en esta investigación se profundiza en aspectos paradigmáticos que fundamentan y enriquecen el ser compasivo, considerado como un elemento clave en dicho proceso de humanización. Para ello, se ha puesto énfasis en la sensibilidad que se encuentra al fondo de la actitud compasiva. Se ha planteado que dicha sensibilidad involucra el asombro como punto de partida, que conecta con la realidad y que permite encontrarse con la realidad de la persona humana, que a su vez se descubre llamada a la comunión con el otro semejante a ella. De esta manera, se llega a considerar la compasión como un movimiento del corazón, y a partir de allí, se determinan las particularidades y consecuencias de este movimiento para responder a las objeciones que se le hacen a la compasión, principalmente las del filósofo alemán Friedrich Nietzsche. Se ha determinado que sus críticas están dirigidas a una compasión entendida como lástima, mientras que la compasión entendida como movimiento del corazón, se aleja de caer en la sentimentalización de la lástima y da luces para retomar la dimensión positiva que posee la compasión. (shrink)

In society, human vulnerability is linked to many causes, such as poverty, injustice, discrimination and disease, among others. In the midst of this panorama of external factors that place people in situations of vulnerability, some see clearly - though others less so - a vulnerability that is inherent to the human person, simply because it exists. This approach to vulnerability is considered a conditio humana that affects everyone. Precisely because it is a human condition, vulnerability is closely related to autonomy. (...) For this reason, in this article we have tried to deepen the relationship between autonomy and vulnerability, focusing on an anthropological vulnerability and determining whether vulnerability is an obstacle to autonomy, since vulnerability and autonomy seem to be the representatives of polar opposites: one that is limited and can do nothing or very little, and the other that can do everything and has no limits. -/- La vulnerabilidad humana está asociada en la sociedad a múltiples causas, tales como la pobreza, la injusticia, la discriminación, las enfermedades, entre otras. En medio de este panorama de agentes externos que lleven a los seres humanos a situaciones vulnerables, se deja ver, para unos claramente, para otros no tanto, una vulnerabilidad propia a la persona humana por el simple hecho de existir. Uno de los enfoques de la vulnerabilidad es considerarla como una conditio humana que nos afecta a todos, asunto que ha sido insistentemente ratificado por el pensamiento contemporáneo. Justamente, por ser una conditio humana, la vulnerabilidad se encuentra en estrecha relación con la autonomía. Es así que en este trabajo nos hemos propuesto ahondar en ese entramado de autonomía y vulnerabilidad, tomando el enfoque de la vulnerabilidad antropológica con el fin de describir la interrelación entre dichos principios y determinando si la vulnerabilidad constituye un “freno” o no para la autonomía, pues vulnerabilidad y autonomía parecen ser los representantes de dos polos opuestos, el del que se encuentra limitado y no puede hacer nada o hace poco, y el del que puede hacerlo todo sin ningún límite. (shrink)

Paul Ricoeur argues that narration is lived life. Therefore, human experience has a narrative dimension, ie, it has a narrative structure and every effort you want to make for the human need to consider the narrative. For this reason, the text theory is converted to Ricoeur in a general model for the study of human action, since this is conceived as an open work to anyone who can read it. Given this general framework for discussion, we have deepened the notion (...) of the patient as “text”, and described their richness for reflection of bioethics and medical act, rescuing the value of listening, prudence, responsibility and rediscovering a place for the principle of autonomy and casuistry. -/- Paul Ricoeur sostiene que la narración es vida vivida. Por lo tanto, la experiencia humana posee una dimensión narrativa, es decir, tiene una estructura narrativa y todo esfuerzo que quiera dar cuenta de lo humano tendrá que contar con lo narrativo. Por esta razón, la teoría del texto se convierte para Ricoeur en un modelo general para el estudio de la acción humana, pues esta es concebida como una obra abierta a cualquiera que pueda leer. Teniendo en cuenta este marco general de reflexión, hemos profundizado en la noción del paciente como “texto”, y describimos su riqueza para la reflexión de la bioética y el actuar médico, rescatando el valor de la escucha, la prudencia, la responsabilidad y redescubriendo un lugar para el principio de autonomía y la casuística. (shrink)

In the early 2000s, it was already mentioned that one of the problems of bioethics was a lack of wonder or amazement (Thaumazein in Greek). Today we see that the patient, the weak, and the helpless have become clients or objects at the disposal of personal, communal, and corporate whims based on functionality or utility that can take on a life of its own. Accordingly, this article proposes wonder or amazement as an attitude that not only makes it possible to (...) place the human being at the center and starting point of bioethical reflection, but it is those who suffer the most, the weak and the defenceless, who are predominantly at that center or starting point. -/- A comienzos de la década del 2000 ya se mencionaba que una de las cuestiones que aquejaba la Bioética era la falta de asombro. En la actualidad vemos que el paciente, el débil y el indefenso han pasado a ser clientes u objetos puestos a disposición de caprichos personales, comunitarios o empresariales basados en la funcionalidad o utilidad que pueda tener una vida en particular. Es por eso que en este trabajo proponemos el asombro como una actitud que permite no solo situar a la persona humana como centro y punto de partida de la reflexión bioética, sino que en dicho centro esté de manera preponderante el que más sufre, el débil y el indefenso. (shrink)

We can say that it is necessary for every human being to walk towards the comprehension of the contingent and limited reality of the human person, starting with those whose work involves dealing with patients, as well as those who dedicate themselves to bioethical reflection, and even the patients themselves. In this way, at the time when these people face a situation of pain and suffering, they will be able to assume it with integrity and strength, always choosing to protect (...) the valuable gift of human life, and not simply looking for it. to make the pain disappear as it may, tearing it up at the root, often ending up with a human life, be it at the moment of conception, as an embryo, with disabilities, sick or aging. -/- Podemos decir que es necesario que todo ser humano camine hacia la comprensión de la realidad contingente y limitada de la persona humana, empezando por aquellos cuyo trabajo involucra el trato con pacientes, así como quienes se dedican a la reflexión bioética, e incluso los mismos pacientes. De esta manera, en el momento en que estas personas se enfrenten a una situación de dolor y sufrimiento, podrán asumirla con entere-za y fortaleza, optando siempre por proteger el valioso don de la vida humana, y no simplemente buscando hacer desaparecer el dolor a como dé lugar, arrancándolo de raíz, muchas veces terminando con una vida huma-na, sea en el momento de la concepción, como embrión, con discapacidades, enferma o envejecida. (shrink)

The professional situation is considered a major interface of practicum training, here conceived as a School of conjunction, a school where one learns to make links, a foundation for the engineering of professionalization. The notion of situation is here developed based on the study of a data corpus elaborated during an experience with a practicum training model centred on writing and the construction of the professional situation by a subject-actor-author of the situation, in interaction with others, in the context of (...) nurse training. The analysis and interpretation of data brings to light a complex and unique unit, constructed in the space-time of a professional practice, a process during which several states succeed one another. The critical moment in action characterizes this unit; it is central to the process, mobilizing reflection in action, internal deliberation, and action-related decision. La situation professionnelle est identifiée comme interface majeure de la formation en alternance conçue ici comme une Ecole de la conjonction, une école où l’on apprend à relier, fondement d’une ingénierie de professionnalisation. La notion de situation est approfondie à partir de l’étude d’un corpus de données constitué au fil de l’expérimentation d’un modèle de formation en alternance centrée sur l’écriture et la construction de la situation professionnelle par un sujet-acteur-auteur de la situation, en interaction avec autrui, dans le contexte de la formation en soins infirmiers. L’analyse et l’interprétation des données permettent de mettre en évidence une unité singulière complexe, construite dans l’espace-temps d’une pratique professionnelle, un processus au cours duquel plusieurs états se succèdent. Le moment critique dans l’action la caractérise ; il occupe la place centrale du processus, mobilisant réflexion dans l’action, délibération intérieure et décision d’action. (shrink)

One of the many proposals put forth recently in the revival of bioethics concerns solidarity, which is part of the agenda for the discipline in the twenty-first century. In this article, solidarity is proposed as a bioethical value, inasmuch as it cannot be achieved without considering the person towards whom one shows solidarity and without taking into account his or her environment. It is not possible to make bioethical judgments or to accomplish in-depth biological thinking when forgetting the person who (...) is at the source or heart of the matter. Based on a study of the experience of a group of health volunteers in Medellin (Colombia), this research found evidence of the existence of three elements that, together, serve as a hinge between solidarity and bioethics. -/- Entre las muchas propuestas que se han hecho recientemente en ese resurgir de la bioética se encuentra la solidaridad, consti­tuyéndose parte de la agenda del siglo XXI sobre esta disciplina. Proponemos la solidaridad como un valor bioético puesto que así como no se puede ser solidario sin tener en cuenta a la persona con quien soy solidario y su entorno, no se pueden emitir juicios bioéticos o hacer una reflexión bioética de fondo olvidando a quien se tiene en frente. A partir de un estudio de la expe­riencia de una población de voluntarios del sector salud en Medellín, Colombia, se logró evidenciar que existen tres elementos que, en conjunto, sirven de bisagra entre la solidaridad y la bioética. (shrink)

The article considers the relevance of research on the problem of gender in oncology. The existing views on gender differences are given. The directions of further research / within the framework of gender psychology are determined.

Tradução do livro: Sociologias da alimentação: os comedores e o espaço social alimentar. Florianópolis, Editora da UFSC, 2004, 311 páginas. Obra traduzida juntamente com Rossana Pacheco da Costa Proença e Carmen Silvia Rial. ISBN 85.328.0290-7. [Título original: Sociologies de l'alimentation: Les mangeurs et l'espace social alimentair. Obra publicada originalmente pela PUF, Paris, 2002. Edição original 288 páginas. ISBN: 213050643. Janeiro 2003, 2e édition. Etnologia-Antropologia].

Seit wenigen Jahren erfreuen sich in den Lebenswissenschaften mehrere Theorien eines immer weitergehenden Einflusses, die unter Etikettierungen wie Systembiologie, Netzwerktheorie oder Signalomics nur scheinbar unabhängige Herangehensweisen an komplexe Zusammenhänge darstellen. Navigation ist der übergreifende Gedanke, der so unterschiedliche Gebiete wie Regelungstheorie, Entscheidungstheorie und Systemwissenschaft verbindet. Navigation als Lage- und Kursbestimmung nebst den zugehörigen Signalverarbeitungsprozessen und Steuerkommandos ist die Grundlage dessen, was lebende Organismen von der blo§en Ansammlung materieller Ingredienzien unterscheidet – von der molekularen Ebene bis zum Sozialverhalten. Denn stets stellen (...) sich Prozesse des Lebens als solche des Suchens, Kommunizierens, Disponierens und Vervollkommnens dar, ob es sich nun um die Regulation der Sauerstoffspannung im Blut oder die Organisation eines Ameisenvolkes handelt. Navigationsaufgaben sind damit schließlich auch Fragestellungen ärztlicher Entscheidungsfindung, die sich in einem komplexen Raum aus individuellen, sozialen und ethischen Anforderungen entfalten. (shrink)

Adaptation and stress are two main concepts useful for better understanding the phases of illness and health-related human behavior. The two faces of adaptation, adaptation as a process and adaptation as a product, have raised the question of how long the adaptation process will take in cancer trajectories. The care setting transition from clinical-based into home-based cancer care has stressed the role of family caregivers (FCG) in cancer management. This study examines how types of demanded healthcare information affect the FCG’s (...) role in catalyzing the adaptation of female cancer patients. The mindsponge theory was used in conceptual development and results interpretation. Bayesian Mindsponge Framework (BMF) analytics was used for statistical analysis on a dataset of 48 spouses (husbands) and 12 other family members in five congested communities of Surabaya, Indonesia. Results showed that among the six types of demanded healthcare information, FCGs with a higher tendency to demand cancer-specific information are more likely to need support in catalyzing the adaptation of female cancer patients. Meanwhile, FCGs with a higher demand for information on alternative therapies are less likely to need support in catalyzing cancer adaptation. Other types of healthcare information have ambiguous effects on the need for support in cancer adaptation assistance. This study reveals that the demanded cancer-specific information, e.g., cancer’s prognosis or likely outcome, must be prioritized to assist FCG’s role in catalyzing adaptation among female cancer patients. Cancer prognosis and outcomes reflect the future of cancer care results. (shrink)