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PubMed2006

[Effects of individual reminiscence therapy on older adults' depression, morale and quality of life].

PURPOSE: This study examined the effects of individual reminiscence therapy on older adults' depression, morale, and the quality of life. METHODS: The design was a single-group pre-test and post-test study. Subjects consisted of 31 older adults from two senior centers and a welfare center in Seoul. Individual reminiscence therapy was applied to study subjects four times, once a week for an hour at each time. Measurement tools were the Geriatric Depression Scale Short Form Korea (GDSSF-K) for depression, Mun Ae-ri's (1996) scale for morale, and Medical Outcomes Study Short Form 36 (SF-36) for the quality of life. Data was analyzed using descriptive statistics, paired t-test, and pearson correlation. RESULTS: The application of individual reminiscence therapy reduced older adults' depression (t=-5.65, p=.000), and enhanced older adults' morale (t=4.65, p=.000). The application of individual reminiscence therapy improved older adults' quality of life (t=5.00, p=.000). CONCLUSION: Findings of the study suggest that individual reminiscence therapy may be applied as a nursing intervention that contributes to the improvement of older adults' quality of life, reduces their depression, and enhances their morale.

Aged↗
PubMed1989

Moral treatment: contexts considered.

Many scholars associate the 19th-century practice of moral treatment with occupational therapy practice. A more thorough understanding of moral treatment is therefore relevant for occupational therapists. This article considers moral treatment within the contexts that shaped both its characteristics and the course of its practice--the medical community and 19th-century society. This consideration may provide therapists with a broader understanding of moral treatment and enable them to address the question of a relationship between the two practices.

Commitment of Persons with Psychiatric Disorders↗
PubMed1994

Moral treatment: how a caring practice lost its rationale.

The 19th-century practices of moral treatment and phrenology serve as historical examples of a narrowing focus in health care and reveal the manner in which theories can shape practice. The story of moral treatment, as it is told in connection with phrenology, emphasizes the push for success and right solutions. The push followed several shifts in the conceptualization of mental illness, the last of which proved moral therapy unreasonable. If practitioners in this century hope to ensure that the heart of moral treatment will withstand the effects of ever-changing theories, they must hold caring attitudes, words, and actions at the center of their practice.

Attitude to Health↗
PubMedDate not supplied

The morale-productivity relationship: how close?

Is there a direct relationship between morale and productivity? According to Robert H. Garin, professor of secondary and higher education at East Texas State University and John F. Cooper, dean of instruction at Patrick Henry Community College, the traditional view that the individual whose morale is high will be highly productive, or vice versa, is not a necessarily valid one. The authors analyzed the historical development of the major representative research studies and concepts concerning the morale-productivity relationship and found that the relationship evolved from one of simple direct correlation to the present viewpoint that a variety of factors--such as the environment, motivation, job levels, and so on--must be taken into consideration before any positive conclusion can be drawn. Because of the national concern over the decline in American productivity standards, Garin and Cooper believe that the morale-productivity relationship is an area ripe for further experimental research.

Efficiency↗
PubMed1987

Joint ventures: a risk to the ministry's moral capital?

When Catholic health care providers become involved in a joint venture, they put at risk not only their financial and legal resources but also their "moral capital," that is, their tradition of healing in Jesus Christ's name. Since collaborative arrangements may offer the only way to respond to persons in need, organizations that are contemplating joint ventures must assess in moral terms the "return" on such arrangements. The joint ventures fraught with the greatest moral risk are those between hospitals and physicians. In such arrangements, the patient's best interests may be compromised by the economic interests of both the physicians and the provider. Although both the law and the American Medical Association seem reluctant to prohibit entrepreneurial activity that places physicians in conflict-of-interest situations, they have established disclosure requirements to help safeguard patient interests. Moral tensions also are inherent in managed care plans such as health maintenance organizations and preferred provider organizations. The emphasis on gatekeeping to avoid unnecessary medical procedures and the potential for excluding persons in need who cannot afford to participate in such plans are two serious concerns. The patient's right to confidentiality also may be threatened in capitated systems, which rely on complex utilization review procedures that expose the patient's records to a wide circle of people. Each ethical issue will not arise in every potential joint venture. The sooner an organization can name the key values it wants to protect, however, the easier it will be for potential partners to work together and to build into the joint venture safeguards for these values.

Catholicism↗
PubMed2000

Ethical decision making in nurses. Relationships among moral reasoning, coping style, and ethics stress.

Stress related to ethical decision-making is a serious consequence of frequent encounters with ethical dilemmas for oncology nurses. A descriptive, correlational design using survey techniques was used as a study design with a nationwide sample of 229 oncology nurses. The results indicated nurses experienced an average of 32 different types of ethical dilemmas within the past year on a daily basis. Pain management is the most frequently cited ethical dilemma, followed by cost containment issues and making quality of life and other decisions in the patient's best interest. Approximately 80% of respondents rated their ethics stress level as a 6 or above on a scale of 0 to 10. Forty-three percent of the sample indicated they use an independent or "sovereign" style of moral reasoning, 23% rely on or accommodate to the judgment of others, and 34% use characteristics of both moral reasoning styles. Understanding the relationships among style of moral reasoning, coping style, and ethics stress can assist nurses and administrators to deal more effectively with the increased moral distress found in many oncology practice settings today. Findings suggest specific interventions for reducing ethics stress in this population of nurses.

Adaptation, Psychological↗
PubMedDate not supplied

The demands and limits of care--ethical reflections on the moral dilemma of neonatal intensive care.

Decisions regarding the care of deformed and retarded infants pose difficult ethical and moral dilemmas for both physicians and parents. Ethical inquiry regarding such questions must be concerned with how we see and understand the dilemma for conceptualization of the problem often shapes the decisions that are made. The fundamental issue that provides the background for the kind and amount of care defective newborns should receive is the obligation parents have to care for their children. New medical technology has so extended the limits of care that the extent of parental (and societal) obligation is unclear. In dealing with the problem of defective newborns, the action of both physicians and parents is determined in part by concern to act in a manner congruent with assumed roles and identity. With no moral consensus regarding the care of defective newborns, the doctor is put in a precarious position. What is revealed is how dependent medicine is on its underlying moral community to give it moral direction in instances of ambiguity and uncertainty.

Congenital Abnormalities↗
PubMed2000

Kohlberg's theory of moral development: insights into rights reasoning.

Kohlberg's theory of moral development was based on extensive research done on the reactions of people of all ages to specific moral situational dilemmas. Kohlberg was specifically interested in reasoning processes involved in decision-making. The way in which children perceive their rights is also based on reasoning processes that are inextricably linked to their level of development and more specifically to their level of moral development since the area of human rights can be considered essentially moral. Since Kohlberg's theory is primarily concerned with development, a great deal of insight can be gained into the developmental shift that occurs in children's reasoning about the rights to which they feel they should be entitled. This article focuses on Kohlberg's six-stage theory, specifically as it pertains to reasoning processes similar to those that would be used in rights reasoning. At each stage the authors propose a potential view of how children at each developmental stage might perceive their rights based on the description Kohlberg gives of the developmental trends associated with each stage. A critical assessment of Kohlberg's work is also given in order to highlight certain considerations about the limitations of this theory that need to be considered for future research.

Adolescent↗
PubMed2001

The relationship of education and moral reasoning to ethical practice: a meta-analysis of quantitative studies.

This meta-analytic article of quantitative studies is aimed at summarizing knowledge gained on ethical practice for the period of 1987 to 1997 and at suggesting directions for future research. It specifically investigated the relationships of education and moral reasoning to ethical practice, with ethical practice as the dependent variable. The sample consisted of eight studies that investigated the relationship between education and ethical practice, and five studies that addressed the relationship between moral reasoning and ethical practice. A small to medium relationship between education and ethical practice was found, with an overall mean for effect sizes, d = .44, p = .000. To test the relationship between moral reasoning and ethical practice the Pearson product moment coefficient r was used as the effect size estimate, as each of the studies in this group reported correlation analyses. A small but significant relationship was found between moral reasoning and ethical practice (overall r of .2, p = .000). These results are evaluated in comparison to those of a decade earlier and overall trends are identified. As before, the majority of the studies are in the form of dissertations, and few of their authors have published their work in the general scientific literature. Similarly, clarity has not yet been achieved with regard to the conceptual and operational definitions of ethical practice. Theoretical, measurement, and policy issues are discussed in highlighting the implications of the study.

Education, Nursing↗
PubMed1976

The influence of moral reasoning on behavioral choices.

This study examined the ways in which exposure to moral reasoning statements affected the subsequent behavioral choices of 144 seventh-, eighth-, and ninth-grade boys at different stages of moral judgment. The subjects were divided among 4 experimental conditions, each of which attempted to isolate and relate behavioral choice and reasoning in specific ways. The presentation of reasoning had different effects on the behavioral choices of subjects at 2 different stages. The findings were considered in terms of their implications for developmental change as well as for a developmental analysis of the relationship between moral reasoning and moral behavior.

Adolescent↗
PubMed1976

Moral and cognitive development of moderately retarded, mildly retarded, and nonretarded individuals.

The relationships of moral maturity, cognitive reasoning, MA, and CA were investigated with three IQ groups. The subjects were 20 moderately retarded, 20 mildly retarded, and 20 nonretarded individuals matched for MA. The findings indicated that moderately retarded individuals are at lower levels of cognitive reasoning and moral maturity than MA-matched mildly retarded and nonretarded individuals. The findings also indicated a stronger relationship between moral maturity and cognitive reasoning than between MA and moral maturity or MA and cognitive reasoning. The findings were discussed in terms of the positions of Kohlberg and Gilligan (1971) and Taylor and Achenback (1975).

Adolescent↗
PubMed2004

Death, dignity, and moral nonsense.

Although the concept of human dignity is widely invoked in discussions regarding end-of-life decision making, the content of the notion is ambiguous. Such ambiguity has led some to conclude that human dignity is a redundant or even useless concept that we would be better off without. This paper argues, to the contrary, that the concept of human dignity is indispensable to moral discourse. Far from dispensing with human dignity, we must work to clarify the concept. The paper outlines two distinct but related conceptions of dignity that are often conflated in contemporary moral discourse. These conceptions are labelled "basic dignity" and "personal dignity", respectively. It is argued that basic dignity functions as a universal meaning constraint on moral discourse in general. Hence, to dispense with the notion could reduce us to speaking moral nonsense. Throughout the discussion, some implications for our understanding of end-of-life decision making are explored.

Conflict, Psychological↗
PubMed2006

Culture, moral experience and medicine.

No one can doubt any longer that culture is crucial to medicine. The evidence for health disparities across ethnic and racial groups as well as for cultural influences on health care practices is too impressive to overlook. Yet the concept of culture and how it is employed in medicine today is quite different from the way culture is now regarded in anthropology, the discipline that originated and popularized the concept. Rather than understand culture as a "timeless" ethnic stereotype applied to patients-which is a common but dangerous practice-physicians need to understand how culture influences doctors as much as patients. And physicians need to understand that culture is not only about differences in dress, etiquette and diet, but also and most profoundly, about what really matters to people. That is, culture is about the changing moral experiences of patients, families, and practitioners, and how those moral experiences powerfully affect the doctor-patient relationship. This article suggests that there is a moral crisis in today's medicine that reflects global cultural transitions. This crisis must be addressed if practitioners are to provide care at the highest moral and human level.

Culture↗
PubMed1991

Sexual and moral development of Israeli female adolescents from city and kibbutz: perspectives of Kohlberg and Gilligan.

This paper analyzes real-life moral dilemmas of Israeli city and kibbutz adolescents. The contribution of Gilligan's theory to our knowledge of adolescent moral development as originally conceived by Kohlberg is emphasized. It is suggested that Kohlberg's view of the adolescent as a moral philosopher limits the understanding of the moral development of female adolescents, who use both care and justice in their self-descriptions within existing relationships.

Adolescent↗
PubMed1990

Décalage in moral judgement as a measure of deactualisation weakness of schizophrenic adolescents.

12 schizophrenic, 11 borderline and 20 neurotic adolescents were examined with the procedure, according to Kohlberg, to moral development. In addition, existence techniques, themes and formal personality attributes according to Thomae were assessed. In schizophrenic adolescents a very distinct discrepancy between average and the highest stage values of the moral judgement were the main result (décalage value). This distinct décalage corresponds with the previously discussed distinct ambiguity tolerance of schizophrenics that comes into being on the basis of a deactualisation weakness towards situatively stimulated representative pieces of existence. In connection with this décalage and with the other values for moral judgement are findings on life style and theme that can be interpreted in the sense of an introversion and a cry for help connected with increased resistance and present a form of illness mastering. A detachment from the parents only appears possible at the cost of an increased lability (in the area of moral and ego-identity as décalage).

Adolescent↗
PubMed1987

Moral obligations to the not-yet born: the fetus as patient.

The fetus destined to be born rather than aborted has become increasingly an object of medical and moral concern. With considerable justification, women view this concern--which they share to a great degree--with suspicion that it will serve as a pretext for denying them social and economic equality with men. This article attempts to show that practical moral judgments about our obligations to not-yet-born children can be made without falling into the abyss of controversy surrounding abortion. By stressing the similarities in fathers' duties to their born children, we can also counter a measure of our historical propensity to view women's moral duties to their not-yet-born children as the overwhelmingly important feature of their moral lives, and resist the temptation to impose coercive public policies.

Abortion, Induced↗
PubMed1984

Improving nursing morale in a climate of cost containment. Part 1. Organizational assessment.

Faced with declining resources for health care and greater pressures to improve productivity of nursing staff, nursing administrators must act now to develop organizational responses to morale problems among nursing staff. As part of a two-part series for JONA, the authors describe low-cost organizational approaches that address nursing morale. Presented in Part 1 is a low-cost diagnostic process for assessing needs of staff and appraising organizational dimensions contributing to morale. Assessment findings provide clear direction for developing organizational approaches for improving morale.

Cost Control↗
PubMedDate not supplied

Freud reconsidered: bisexuality, homosexuality, and moral judgement.

This article examines methodological problems and unacknowledged moral judgements in Freud's theory of homosexuality. Freud raises the issue of bisexuality in connection with the origins of homosexuality. When critically examined, the theory of bisexuality reduces to a theory of the capacity to be attracted to either females or males, and in that sense explains little about the origin of exclusive homosexual orientation. Freud's further investigations into the origin of homosexuality, strictly speaking, do not provide a clear explanation of sexual exclusivity. Finally, it is argued that Freud's moral assumptions color the nature of his conclusions. At the very least, without morally justifying his procedure, he transforms the course of psychosexual development as determined by psychoanalysis into a moral imperative against which homosexuality is judged a fixated and immature state.

Female↗