Survey highlights the need for specific interventions to reduce frequent conflicts between healthcare professionals providing paediatric end‐of‐life care

Archambault-Grenier, Marie-Anne; Roy-Gagnon, Marie-Hélène; Doucet, Hubert; Humbert, Nago; Stojanović, Sanja; Payot, Antoine; Fortin, Sylvie; Janvier, Annie; Duval, Michel

doi:10.1111/apa.14013

Cited by 18 publications

(14 citation statements)

References 28 publications

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“…The value of precision is revealed insofar as education and discussion focused on real issues and scenarios can help healthcare personnel to better identify, distinguish and manage emotional burdens and difficult situations, as expressed in the following quote: "Some of the contributing factors that were identified were inherent to the conflict situation and could not be tackled by direct intervention, such as emotional load, critical or precipitated situations and uncertain prognosis, although healthcare professionals can be prepared to cope with them through discussions and education" (48).…”

Section: Axiological Associationsmentioning

confidence: 99%

Appealing to Tacit Knowledge and Axiology to Enhance Medical Practice in the COVID-19 Pandemic: A Systematic Review and Hermeneutic Bioethical Analysis

Serrano-Zamago

Altamirano-Bustamante

2021

Front. Public Health

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Background: The pressure of coronavirus disease 2019 (COVID-19) pandemic, epidemiological and demographic changes, personnel-patient relationship in healthcare, and the development of biotechnologies do not go unnoticed by the healthcare professional. Changes are so wide and at a high rate that guidelines and mere scientific knowledge, which are represented by evidence-based medicine, are not sufficient to lead actions, thus the experiential aspects in the configuration of an ethos present as a fundamental part of the resources to deal with critical scenarios, such as a pandemic. In this regard, the recognition of tacit knowledge as a way of teaching and learning skills related to ethical aspects such as principles, virtues, and values, revealed as a fundamental part of the clinical field. The challenge is to strengthen binomial evidence-based medicine and values-based in order to achieve excellence in the health care of the patients and the well-being of the clinical personnel.Method: A 2-fold analysis was conducted taking pediatric endocrinology as an example. First, a systematic review was carried out in electronic databases BIREME, PubMed, and PhilPapers following PEO and PRISMA approaches. A total of 132 articles were garnered. After reading their title and abstract, 30 articles were obtained. Quantitative information was arranged in an Excel database according to three themes: ethics, axiology, and tacit knowledge. A quality criterion that meets our research question was assigned to each article and those which had a quality criterion of 3 (9) were taken to carry out the hermeneutic bioethical analysis, which consisted of three stages, namely naïve reading, codification, and interpretation. The results were analyzed in Atlas.ti. to elucidate the relations between the three main themes in accordance with the objective.Results: Although there was no difference in the frequency of tacit knowledge skills, including cognitive, social, and technical, for medical practice, there is an intrinsic relationship between epistemic and ethical values with cognitive skills, this means that professionals who practice honesty, authenticity and self-control are capable of seeing patients as persons and thus respect their dignity. This suggested that there is a strong partnership between evidence-based medicine and value-based medicine, which reinforced this binomial as the two feet on which medical practice decisions rested. With regard to tacit knowledge in terms of the context of the COVID-19 pandemic, the challenges refer to (1) adapting and learning a new way of establishing trust with the patient and (2) how to capitalize on the new knowledge that new experiences have posed.Discussion: The analysis of ethical-tacit knowledge in medicine is a recent phenomenon and is in full development. Although no references were found that dealt with any of the main topics in pediatric endocrinology, there is an interest in pediatrics to explore and discuss educational strategies in ethics related to its tacit dimension as a vector of enhancement in the clinical practice. Educational strategies ought to take into consideration the development of skills that promote reflection and discussion of experiences, even more vigorously in the context of the COVID-19 pandemic.

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Section: Axiological Associationsmentioning

confidence: 99%

Appealing to Tacit Knowledge and Axiology to Enhance Medical Practice in the COVID-19 Pandemic: A Systematic Review and Hermeneutic Bioethical Analysis

Serrano-Zamago

Altamirano-Bustamante

2021

Front. Public Health

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“…Archambault‐Grenier et al. publish their findings on conflicts in paediatric end‐of‐life care , with Verhagen commenting on the findings. Another study by Assaad et al.…”

Section: End‐of‐life Care and Decisionsmentioning

confidence: 99%

Highlights in this issue

Käll¹,

Lagercrantz²

2018

Acta Paediatrica

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“…The conflict arises at all levels within the hospital as a social organization, and has been identified as a global problem (1)(2)(3)(4)(5)(6)(7). It is determined both by internal reasonsorganizational management, sociopsychological, personal and external (economic, political, socio-cultural), which are interrelated and change over time (1,5,8,9,10).…”

Section: Introductionmentioning

confidence: 99%

Sources of conflict in public hospitals

Raykova¹,

Semerjieva²,

Bakova³

2018

TJS

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PURPOSE: The aim of this research is to identify the sources of conflicts at workplace in publichospitals in Bulgaria. METHODS: By means of direct individual poll was studied the opinion of 302 medical employees at four general hospitals. Of all respondents, 223 (73.8±2.53%) were medical professionals and 79 (26.2±2.53%) were рhysicians. We used a set of questions that determine sources of conflicts in hospitals. The data were analysed using descriptive statistics and non-parametric analysis at a significance level for the null hypothesis p<0.05.The statistical analysis was performed using SPSS v. 16. RESULTS: Conflicts in hospitals are determined by the conditions and factors of the socioeconomic environment, the particularities of the organizational and management structure, the nature of the interpersonal relationships within the team, mediated by the joint work activities and the personal characteristics of the employees in the organization. CONCLUSIONS: Conflicts in hospitals arises due to a variety of factors. The systematic study of the sources of conflicts in the hospital allows to identify the problem areas and to prevent a negative impact on the work of medical staff.

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Survey highlights the need for specific interventions to reduce frequent conflicts between healthcare professionals providing paediatric end‐of‐life care

Abstract: End-of-life conflicts were frequent and predominantly occurred between healthcare professionals. Specific interventions could target most of the contributing factors.

Cited by 18 publications

References 28 publications

Appealing to Tacit Knowledge and Axiology to Enhance Medical Practice in the COVID-19 Pandemic: A Systematic Review and Hermeneutic Bioethical Analysis

Appealing to Tacit Knowledge and Axiology to Enhance Medical Practice in the COVID-19 Pandemic: A Systematic Review and Hermeneutic Bioethical Analysis

Highlights in this issue

Sources of conflict in public hospitals

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