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Biomedical subjects

M Walden

Publications and source records attributed to M Walden.

42 records · Page 3Linked to original sources
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Influence of practice environment and nurse characteristics on perinatal nurses' responses to ethical dilemmas.

BACKGROUND: Previous research on nurses' responses to ethical dilemmas has focused either on nurse characteristics or on practice environment characteristics, but has not examined both influences concurrently. OBJECTIVE: To explore the relative contributions of practice environment characteristics and nurse personal and professional characteristics to perinatal nurses' willingness to be involved in activities to resolve clinical ethical dilemmas. METHODS: A descriptive correlational design and hierarchical multiple regression were used to examine responses of 127 perinatal nurses to three instruments: the Nursing Ethical Involvement Scales (NEIS), Perinatal Values Questionnaire (PVQ), and Demographic Data Sheet (DDS). RESULTS: The organizational variable, nursing influence, accounted for the greatest amount of variance in nurses' reported resolution actions, with nurses' concern about ethics and consequentialist values also contributing significantly. The three predictors together accounted for 31% (24% adjusted) of the variance in actions to resolve clinical ethical dilemmas. Level of nursing education was not a statistically significant influence. CONCLUSIONS: These results suggest that nurses are more likely to be involved in dilemma resolution activities when they perceive themselves to have higher levels of influence in their practice environments and higher levels of concern about the ethical aspects of clinical situations. Nurses who emphasize consideration of morally relevant aspects of individual patient situations (consequentialist value orientation) and deemphasize adherence to abstract standards, rules, and policies also are more likely to be involved in dilemma resolution.

Adult↗
PubMedDate not supplied

Prenatal hemoglobinopathy screening: receptivity of Southeast Asian refugees.

Because of the availability of safe, accurate prenatal diagnosis for hemoglobinopathies, we wanted to know if pregnant women identified as carriers of a hemoglobinopathy by prenatal screening use this information to determine whether their fetus is at risk. Blood from all pregnant women served by a 40 percent sample of prenatal care providers in Rochester, New York, over 51 months underwent Hb electrophoresis and MCV +/- Hb A2 determination. The frequency of positive was 33/229 (14 percent) for Southeast Asians versus 567/15,824 (3.6 percent) for non-Southeast Asians. Of the positives, 29 (88 percent) Southeast Asians came for counseling versus 348 (61 percent) others. Of those counseled, 26 (90 percent) Southeast Asians had their partners tested, as did 211 (61 percent) others. Of the partners tested, 17 (65 percent) Southeast Asians were also positive compared to 44 (21 percent) others. Of couples offered prenatal diagnosis, 50 percent of each group (4/8 and 17/34) accepted. Of those accepting, all Southeast Asians actually underwent the procedure, while seven (41 percent) others miscarried or failed to keep their appointment. Thus, in our pregnant population, Southeast Asians are four times more likely to be hemoglobinopathy carries than non-Southeast Asians, and Southeast Asian carriers are four times more likely to warrant, want, and undergo prenatal diagnosis for a hemoglobinopathy than non-Southeast Asian carriers.

Adult↗