Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting, Nepal

Abstract

BackgroundHealthcare ethics is neglected in clinical practice in LMICs (Low and Middle Income Countries) such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal.MethodsThis was a cross sectional study conducted among resident doctors (n = 118) and ward nurses (n = 86) in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer’s V value was assessed to ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05.ResultsOur study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcare ethics: Hippocratic Oath (33 % of doctors and 51 % of nurses were unaware), Nuremberg code (90 % of both groups were unaware) and Helsinki Declaration (85 % of doctors and 88 % of nurses were unaware). A high percentage of respondents said that their major source of information on healthcare ethics were lectures (67.5 % doctors versus 56.6 % nurses), books (62.4 % doctors versus 89.2 % nurses), and journals (59 % doctors versus 89.2 % nurses). Attitude of doctors and nurses were significantly different (p < 0.05) in 9 out of 22 questions pertaining to different aspects of healthcare ethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcare ethics except for need of integration of medical ethics in ungraduate curricula (97.4 % doctors versus 81.3 % nurses),paternalistic attitude of doctor was disagreed more by doctors (20.3 % doctors versus 9.3 % nurses). Notably, only few (9.3 % doctors versus 14.0 % nurses) doctors stood in support of physician-assisted dying.ConclusionsSignificant proportion of doctors and nurses were unaware of three major documents on healthcare ethics which are the core principles in clinical practice. Provided that a high percentage of respondents had motivation for learning medical ethics and asked for inclusion of medical ethics in the curriculum, it is imperative to avail information on medical ethics through subscription of journals and books on ethics in medical libraries in addition to lectures and training at workplace on medical ethics which can significantly improve the current paucity of knowledge on medical ethics.Electronic supplementary materialThe online version of this article (doi:10.1186/s12910-016-0154-9) contains supplementary material, which is available to authorized users.

Effect of educational intervention on knowledge and attitude towards research, research ethics, and biobanks among paramedical and administrative teams in the National Liver Institute, Egypt

“…Also, most of the study participants (92.9% of paramedical and 86.1% of administrative teams) agreed that the Ethics Committee of Scientific Research is useful. This was in agreement with Adhikari et al study where 98.8% nurses (85 out of 86) agreed that ethics course should be taught in every medical/nursing teaching institution [11].…”

“…Regarding research ethics knowledge of the study participants, more than 90% of the paramedical team and two thirds of the administrative team knew about research ethics and knew that doing a research on patient or use their data without their permission is not ethical or permissible. This result was in agreement with Adhikari et al's study where 96.5% of nurses knew the importance of confidentiality and patient data security [11] and also in Aliyu et al's study where the majority of the nurse participants (82.6%, 114 out of 138 ) possess good knowledge of ethical dilemma [12].…”

Knowledge, Attitudes and Practices of Medical Residents towards Healthcare Ethics in the Islamic Hospital, Jordan

“…Several items and sections of this questionnaire were used by other studies. (20,24,27) This questionnaire was pilot-tested on 15 medical residents to identify ambiguous or difficult questions, acceptability of questions and the time needed to complete the questionnaire. Respondents were asked to give their feedback and their comments on an external sheet, and minor changes were made accordingly.…”

“…(15)(16)(17)(18)(19) Several studies revealed that medical residents face many ethical challenges, sometimes on a daily basis, in addition to their negative attitudes and low level of knowledge. (20)(21)(22)(23)(24)(25)(26)(27)(28)(29) Therefore, the present study aimed to assess the baseline knowledge, attitudes and practices (KAPs) of medical residents in the Islamic Hospital in Amman (2017) towards healthcare ethics.…”

Ethical challenges in mental health research with focus in Nepal

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