Moral Distress in Rehabilitation Professionals: Results From a Hospital Ethics Survey

Mukherjee, Debjani; Brashler, Rebecca; Savage, Teresa A.; Kirschner, Kristi L.

doi:10.1016/j.pmrj.2009.03.004

Cited by 15 publications

(13 citation statements)

References 19 publications

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“…Selon Foye, Kirschner, Wagner, Stocking et Siegler (2002), la première étude à les avoir documentés remonterait à 1984, lorsque Hansen (1984) 3) Depuis Hansen, les recherches inductives sur le sujet ont été en majorité réalisées aux États-Unis (Caplan et al, 1987;Foye et al, 2002;Lohman, Mu, & Scheirton, 2004;Mu, Lohman, & Scheirton, 2006;Mukherjee, Brashler, Savage, & Kirschner, 2009;Penny, Ewing, Hamid, Shutt, & Walter, 2014;Walker, 2001) et en Angleterre (Atwal & Caldwell, 2003;Barnitt, 1998;Kolehmainen, Francis, McKee, & Duncan, 2011). Deux études menées au Canada se sont intéressées aux enjeux éthiques rencontrés par des étudiants en ergothérapie (Kinsella et al, 2008;Kinsella, Phelan, Lala, & Mom, 2015).…”

Section: Problématiqueunclassified

Les enjeux éthiques de la pratique de l’ergothérapie : perceptions d’ergothérapeutes

Drolet

Maclure

2016

approchesind

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Peu d’études ont documenté les enjeux éthiques de la pratique de l’ergothérapie, c’est-à-dire les situations susceptibles de compromettre une valeur éthique. Pour combler cette lacune, une recherche inductive a été menée. À cette fin, un devis phénoménologique a été utilisé, soit la phénoménologie descriptive et transcendantale de Husserl. Des entretiens qualitatifs ont été réalisés auprès de 26 ergothérapeutes francophones du Québec ayant des caractéristiques variées. L’analyse des verbatim montre que plusieurs valeurs sont compromises en pratique, soit : l’autonomie des patients, l’autonomie professionnelle des ergothérapeutes, la dignité humaine, l’engagement occupationnel, l’holisme et l’écologisme, la justice sociale, le partenariat et le professionnalisme. Ces résultats révèlent qu’il est parfois difficile d’actualiser une pratique respectueuse des valeurs estimées importantes pour des ergothérapeutes. En général, les résultats de la recherche sont comparables à ceux des écrits sur le sujet.

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Section: Problématiqueunclassified

Les enjeux éthiques de la pratique de l’ergothérapie : perceptions d’ergothérapeutes

Drolet

Maclure

2016

approchesind

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“…Studies with RPE indicate that patients undergoing inpatient rehabilitation tend to desire recovery pathways that are different from those desired by rehabilitation professionals [23,88–90]. Through enhanced insight and communication, results may help reduce conflicts around goal setting and discharge planning [91]. …”

Section: The Biopsycho-ecological Modelmentioning

confidence: 99%

The Biopsycho‐ecological Paradigm: A Foundational Theory for Medicine

Stineman

Streim

2010

PM&R

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The current biomedical and psychosocial frameworks that form the conceptual basis of medicine today are insufficient to address the needs of the medically complex and environmentally challenged populations of patients often cared for by physical medicine and rehabilitation specialists. The expanded biopsycho-ecological model of health, illness, injury, and disability operating through mechanisms of Health Environmental Integration (HEI) encourages a more complete understanding of illness, injury, activity limitation, and participation restriction as arising at the interface between the person and the environment. HEI recognizes complex interacting multilevel functional hierarchies beginning at the cellular level and ending at the individual’s experience of the environment. Although the foci of illness and injury are within the body and mind, the physical and social environments contain elements that can cause or exacerbate disease and barriers that interact in ways that lead to injuries and disabilities. Furthermore, these environments hold the elements from which treating agents, facilitators, and social supports must be fashioned. The highly integrative biopsycho-ecological framework provides an expanded basis for understanding the objective causes and subjective meanings of disabilities. Disabilities are reduced through HEI by seeking to maximally integrate the body and mind (the self) with both the surrounding physical environment and other people in society. HEI offers mechanisms for interdisciplinary research, an expanded framework for education and empowerment, and a blueprint for optimizing day-to-day clinical care at both the individual patient and treatment population levels in the ever-changing scientific, political, and policy environments.

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“…Patient-centered care has influenced the PCEAM-R in at least three ways. Questions and prompts included in the model (1) emphasize a shared involvement (partnership) of patients and health professionals in managing patients' health care; (2) imply an understanding of the patient as a whole person and social being, embedded in a range of relationships of care and interdependence, and having preferences that are informed by his/ her social context; and (3) were written (as much as the authors were able) with jargon-free, simple language that takes a neutral perspective on who the users of the model are (perhaps the patient, the health professional[s], or both). These influences of patient-centered care may be particularly relevant in a rehabilitation context, in which patients transition between community and institutional contexts and in which relationships of www.ajpmr.com Patient-Centered Care Ethics caregiving are often long-term and include both professional and informal carers.…”

Section: Theoretical Grounding In Patient-centered Carementioning

confidence: 99%

A Patient-Centered Care Ethics Analysis Model for Rehabilitation

Hunt

Ells

2013

American Journal of Physical Medicine &Amp; Rehabilitation

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There exists a paucity of ethics resources tailored to rehabilitation. To help fill this ethics resource gap, the authors developed an ethics analysis model specifically for use in rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a process model to guide careful moral reasoning for particularly complex or challenging matters in rehabilitation. The Patient-Centered Care Ethics Analysis Model for Rehabilitation was developed over several iterations, with feedback at different stages from rehabilitation professionals and bioethics experts. Development of the model was explicitly informed by the theoretical grounding of patient-centered care and the context of rehabilitation, including the International Classification of Functioning, Disability and Health. Being patient centered, the model encourages (1) shared control of consultations, decisions about interventions, and management of the health problems with the patient and (2) understanding the patient as a whole person who has individual preferences situated within social contexts. Although the major process headings of the Patient-Centered Care Ethics Analysis Model for Rehabilitation resemble typical ethical decision-making and problem-solving models, the probes under those headings direct attention to considerations relevant to rehabilitation care. The Patient-Centered Care Ethics Analysis Model for Rehabilitation is a suitable tool for rehabilitation professionals to use (in real time, for retrospective review, and for training purposes) to help arrive at ethical outcomes.

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Moral Distress in Rehabilitation Professionals: Results From a Hospital Ethics Survey

Cited by 15 publications

References 19 publications

Les enjeux éthiques de la pratique de l’ergothérapie : perceptions d’ergothérapeutes

Les enjeux éthiques de la pratique de l’ergothérapie : perceptions d’ergothérapeutes

The Biopsycho‐ecological Paradigm: A Foundational Theory for Medicine

A Patient-Centered Care Ethics Analysis Model for Rehabilitation

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