Impact of Dying Neonates on Doctors' and Nurses' Personhood: A Systematic Scoping Review

Huang, Huixin; Toh, Rachelle Qi En; Chiang, Christine Li Ling; Thenpandiyan, Ashiley Annushri; Vig, Prachi Simran; Lee, Randal Wei Liang; Chiam, Min; Lee, Alexia Sze Inn; Baral, Vijayendra Ranjan; Krishna, Lalit Kumar Radha

doi:10.1016/j.jpainsymman.2021.07.002

Cited by 18 publications

(25 citation statements)

References 99 publications

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“…The RToP offers both a reflexive, longitudinal, holistic and evidence-based approach to capture evolving concepts of dignity [12,[32][33][34][35][36][37][38][39]. Using the lens of the RToP it is possible to understand how the Individual Ring and its associated concept of Individual Identity balance sometimes competing preferences, biases, beliefs, mores, norms, values and principles, in a variety of psycho-emotional, experiential, perceptual, and contextual considerations; and prevailing professional, sociocultural, legal, ethical, and personal considerations [16,17,[40][41][42][43][44].…”

Section: Theoretical Lensmentioning

confidence: 99%

A systematic scoping review on patients’ perceptions of dignity

et al. 2022

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Background A socioculturally appropriate appreciation of dignity is pivotal to the effective provision of care for dying patients. Yet concepts of dignity remain poorly defined. To address this gap in understanding and enhance dignity conserving end-of-life care, a review of current concepts of dignity is proposed. Methods To address its primary research question “How do patients conceive the concept of dignity at the end of life?”, this review appraises regnant concepts and influences of dignity, and evaluates current dignity conserving practices. To enhance accountability, transparency and reproducibility, this review employs the Ring Theory of Personhood (RToP) as its theoretical lens to guide a Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) of patient perspectives of dignity. Three independent teams of reviewers independently analysed included articles from a structured search of PubMed, Embase, PsycINFO, Scopus, CINAHL and Cochrane Databases using thematic and content analyses. The themes and categories identified were compared and combined using the Funnelling Process to create domains that guide the discussion that follows. Results Seventy-eight thousand five hundred seventy-five abstracts were identified, 645 articles were reviewed, and 127 articles were included. The three domains identified were definitions of dignity, influences upon perceptions of dignity, and dignity conserving care. Conclusions This SSR in SEBA affirms the notion that dignity is intimately entwined with self-concepts of personhood and that effective dignity conserving measures at the end of life must be guided by the patient’s concept of dignity. This SSR in SEBA posits that such personalised culturally sensitive, and timely support of patients, their family and loved ones may be possible through the early and longitudinal application of a RToP based tool.

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Section: Theoretical Lensmentioning

confidence: 99%

A systematic scoping review on patients’ perceptions of dignity

et al. 2022

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“…The Ring Theory of Personhood (RToP) Kuek, Ngiam [29] Kuek, Ngiam [29] Ho, Kow [34] Ngiam, Ong [38]Chan, Chia [35] Ngiam, Ong [38]Chan, Chia [35] Huang, Toh [23,[41][42][43] Kuek, Ngiam [29] Radha Krishna and Alsuwaigh [31]Kuek, Ngiam [25] suggests Radha Krishna and Alsuwaigh [28]'s Ring Theory of Personhood (RToP), [41][42][43]could help identify medical students facing or at risk of MD and direct timely, holistic, personalised, and appropriate support that will attenuate the risk of burnout, attrition in the profession and compromised patient care [12][13][14]22].…”

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confidence: 99%

“…At the core of the Ring Theory is the Innate Ring. Krishna and Alsuwaigh defined the Innate Ring as containing the rights and privileges bestowed to all persons by virtue of their being living humans, conceived due to their connections with the Divine or their genetic makeup [23,28,29]. Innate Ring also houses the individual's spiritual, religious and/or theist beliefs and values which are shaped by the individual's demographical and historical features such as the ethnicity, culture, religion, family unit, gender, society, country, and the social group they were born into [23,28,29].…”

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confidence: 99%

“…Krishna and Alsuwaigh defined the Innate Ring as containing the rights and privileges bestowed to all persons by virtue of their being living humans, conceived due to their connections with the Divine or their genetic makeup [23,28,29]. Innate Ring also houses the individual's spiritual, religious and/or theist beliefs and values which are shaped by the individual's demographical and historical features such as the ethnicity, culture, religion, family unit, gender, society, country, and the social group they were born into [23,28,29]. These individualized beliefs, values, moral ideals, and ethical principles influence the individual's thinking, goals, motivations, and actions, which are expressed through the Individual Ring [23,28,29].…”

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confidence: 99%

“…The Individual Ring encompasses and builds upon the Innate Ring and represents a conscious function which includes the ability to think, feel, communicate, carry out actions, and interact with the environment [23,28,29]. The Individual Ring confers a sense of individuality shaped by the individual's values, beliefs, principles, biases, preferences, thoughts, emotions, experiences, decision making and personality drawn from the values, beliefs and principles contained in the other three rings [23,28,29].…”

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confidence: 99%

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A systematic scoping review moral distress amongst medical students

et al. 2022

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Background Characterised by feelings of helplessness in the face of clinical, organization and societal demands, medical students are especially prone to moral distress (MD). Despite risks of disillusionment and burnout, efforts to support them have been limited by a dearth of data and understanding of MD in medical students. Yet, new data on how healthcare professionals confront difficult care situations suggest that MD could be better understood through the lens of the Ring Theory of Personhood (RToP). A systematic scoping review (SSR) guided by the RToP is proposed to evaluate the present understanding of MD amongst medical students. Methods The Systematic Evidence-Based Approach (SEBA) is adopted to map prevailing accounts of MD in medical students. To enhance the transparency and reproducibility, the SEBA methodology employs a structured search approach, concurrent and independent thematic analysis and directed content analysis (Split Approach), the Jigsaw Perspective that combines complementary themes and categories, and the Funnelling Process that compares the results of the Jigsaw Perspective with tabulated summaries to ensure the accountability of these findings. The domains created guide the discussion. Results Two thousand six hundred seventy-one abstracts were identified from eight databases, 316 articles were reviewed, and 20 articles were included. The four domains identified include definitions, sources, recognition and, interventions for MD. Conclusions MD in medical students may be explained as conflicts between the values, duties, and principles contained within the different aspects of their identity. These conflicts which are characterised as disharmony (within) and dyssynchrony (between) the rings of RToP underline the need for personalised and longitudinal evaluations and support of medical students throughout their training. This longitudinal oversight and support should be supported by the host organization that must also ensure access to trained faculty, a nurturing and safe environment for medical students to facilitate speak-up culture, anonymous reporting, feedback opportunities and supplementing positive role modelling and mentoring within the training program.

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