In this study, we examined the perception of actual and ideal ethical climate type among 95 nurses working in the internal medicine wards of one central hospital in the state of Israel. We also examined whether nurses' demographic characteristics influence that perception and if a relationship between perceptions of an actual and an ideal ethical climate type influences nurses' job satisfaction. A questionnaire composed of three subquestionnaires was administered and the responses analyzed using multiple linear regressions, analysis of variance and Pearson's correlation coefficient. The results demonstrated that demographic characteristics (such as: gender, job tenure and level of education) partially influence the perception of an ideal ethical climate. Incongruence in perceptions of 'caring' and 'independence' climate types indicated a decline in nurses' job satisfaction, while perception of actual 'caring' and 'service' climates positively influenced all aspects of job satisfaction. We recommend constructing training programs emphasizing the ethics of nursing practice and also to help lead nurses to clarify an ethical framework and guide nursing staff in dealing with ethical dilemmas.

The authors explored the hypothesis that the relationship between need for structure and cognitive structuring behavior is moderated by the ability to achieve cognitive structure (AACS). Need for structure is defined as the preference to use cognitive structuring as a means to achieve certainty. AACS refers to the extent to which individuals are able to use information-processing processes (cognitive structuring or piecemeal) consistent with ihe level of their need for structure. The authors suggested that only under high AACS would there be a positive correlation between need for structure and cognitive structuring behavior. In contrast, under low AACS the correlation would be negative. To examine this hypothesis, the authors used different operationalizations of the need for structure, AACS, and cognitive structuring behavior. The results of the 5 studies in which this was done confirmed the hypothesis.

Both nurses and physicians should be made more aware of the conflicts between them and better trained to understand how they can be constructively resolved.

The subject of sexuality among elderly patients with dementia was examined, focusing on two main aspects: the sexual behaviour of institutionalized elderly people with dementia; and the reactions of other patients, staff and family members to this behaviour. The behaviour was found to be mostly heterosexual and ranged from love and caring to romance and outright eroticism. Reactions varied, being accepting of love and care but often objecting to erotic behaviour. Understanding of the sexual needs of elderly people should become an integral part of the training and continued education of health care staff, thus helping to resolve conflicts and clarify common misconceptions.

The subject of sexuality among elderly patients with dementia was examined, focusing on two main aspects: the sexual behaviour of institutionalized elderly people with dementia; and the reactions of other patients, staff and family members to this behaviour. The behaviour was found to be mostly heterosexual and ranged from love and caring to romance and outright eroticism. Reactions varied, being accepting of love and care but often objecting to erotic behaviour. Understanding of the sexual needs of elderly people should become an integral part of the training and continued education of health care staff, thus helping to resolve conflicts and clarify common misconceptions.

This study endeavoured to clarify the ethical dilemmas concerning sexuality encountered by nurses caring for elderly patients suffering from dementia, and to assist the decision-making process of the nurses and staff who handle dilemmas of this nature. Many of the staff in geriatric institutions report difficulties, confusion, embarrassment and helplessness as well as negative responses and rejection when encountering sexual situations between patients of the same or different sex, patients and staff members or between patients and visitors. Embarrassment over sexuality is felt by staff members, visitors and family. This embarrassment may result in elderly patients being treated like children, and being separated from their partners. A response of this nature can provoke anger in the patients, sometimes leading to violence. The central dilemma on the subject of sexuality in a geriatric institution is the fact that staff are in conflict between the desire to protect the elderly patients and maintain their dignity and the patients' desire to fulfil their sexual needs. Since no single, definitive prescription can be provided for conduct acceptable to the staff, the patients and their families, it was decided to work with the staff on the basis of case studies to help them in selecting ways of coping.

The solution to non-compliance with the duty to report must be a targeted investment in training and education. Relevance to clinical practice. Finding the reasons for compliance and non-compliance with the duty to report needlestick injuries will help in designing educational programmes for hospital staff and in determining a strategy for improving health behaviour.

In this study the importance of the concept of autonomy among residents in geriatric institutions was investigated. By granting the residents more autonomy, their satisfaction increased, their daily routine changed, and their participation in social activity increased. Correlation was found between the degree of autonomy and the degree of the participation in different activities within the ward. The conclusion reached is that the residents' quality of life improves with more autonomy within the institution's framework.