uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Developing ethical competence in health care organizations
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. (Social Medicine)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Social Medicine)ORCID iD: 0000-0001-7173-4333
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (Centre for bioethics)
Show others and affiliations
2007 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 6, 825-837 p.Article in journal (Refereed) Published
Abstract [en]

Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy.

Place, publisher, year, edition, pages
2007. Vol. 14, no 6, 825-837 p.
Keyword [en]
clinical practice, ethics rounds, moral distress, pharmacy practice
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-11717DOI: 10.1177/0969733007082142ISI: 000250961600012PubMedID: 17901191OAI: oai:DiVA.org:uu-11717DiVA: diva2:39486
Available from: 2007-10-15 Created: 2007-10-15 Last updated: 2017-12-11Bibliographically approved
In thesis
1. Ethical Competence and Moral Distress in the Health Care Sector: A Prospective Evaluation of Ethics Rounds
Open this publication in new window or tab >>Ethical Competence and Moral Distress in the Health Care Sector: A Prospective Evaluation of Ethics Rounds
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Ongoing structural and financial changes in the health care sector have resulted in increased risks for ethical dilemmas and moral distress. It is purported that increased ethical competence will help staff manage ethical dilemmas and hence decrease moral distress. To enhance ethical competence several approaches may be used – theoretical education, and methods focusing on reflection and decision-making abilities.

Ethics rounds are a widespread systematic method hypothesized to improve ethical competence, nurture a reflective climate, and help in ethical decision-making. Despite its popularity, its effects on moral distress have hitherto never been evaluated in a controlled study.

The purpose of this thesis was to evaluate the impact of an intervention, including ethics rounds; the hypothesis being that the intervention would decrease perceived moral distress. An additional aim was exploring the concept of moral distress in various health care establishments, including pharmacies.

Focus groups were conducted to explore the concept of moral distress. To evaluate the intervention a scale assessing staff-perceived moral distress was designed, validated, and implemented.

Results showed that moral distress is evident in diverse health care settings. Some factors associated with this were lack of resources, conflicts of interest, and rules that are incompatible with practice. An expanded definition of moral distress was presented.

The training program was much appreciated by participants. However, no significant effects on perceived moral distress were found. Reasons could be that the intervention was too short or otherwise ineffective, there is no association between ethical competence and moral distress, the assessment scale was not sensitive enough, or management was not sufficiently involved.

There is a need to further refine the various aspects of ethical dilemmas in clinical settings, and to evaluate the most efficient means to enhance skills for dealing with ethical dilemmas, for the benefit of staff, patients, institutions, and society.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 67 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 224
Keyword
Social medicine, Moral distress, Ethics rounds, Ethical competence, Professional ethics, Clinical practice, Pharmacy practice, Work organization, Sweden, Socialmedicin
Identifiers
urn:nbn:se:uu:diva-7493 (URN)978-91-554-6797-5 (ISBN)
Public defence
2007-03-09, Minus, Gustavianum, Akademigatan 3, Uppsala, 09:15
Opponent
Supervisors
Available from: 2007-02-16 Created: 2007-02-16 Last updated: 2013-09-25Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Authority records BETA

Kälvemark Sporrong, SofiaArnetz, BengtHansson, Mats G.Höglund, Anna T.

Search in DiVA

By author/editor
Kälvemark Sporrong, SofiaArnetz, BengtHansson, Mats G.Höglund, Anna T.
By organisation
Department of Public Health and Caring SciencesDepartment of Pharmacy
In the same journal
Nursing Ethics
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 795 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf