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Children's fearfulness as a moderator of parenting in early socialization: Two longitudinal studies.

Findings from 2 longitudinal studies replicate and considerably extend past work on child temperament as a moderating link between parenting and successful socialization outcomes. In Study 1 (N = 106 mothers and children), child fearfulness, mother-child positive relationship, and maternal power assertion were assessed at 22 and 33 months; the outcome--children's moral self--was assessed at 56 months. In Study 2 (N = 102 mothers, fathers, and children), child fearfulness and parent-child positive relationship were assessed at 7 and 15 months; parents' power assertion was assessed at 15 months. The outcomes were children's receptive, willing stance toward the parent at 25 months, and rule-compatible conduct without supervision at 38 months. Child fearfulness significantly moderated the impact of parenting: In both studies, for relatively fearless children, mother-child positive relationship predicted future successful socialization outcomes in mother-child dyads. There was no analogous moderation effect in father-child dyads in Study 2. For relatively fearful children, fathers' power assertion in Study 2 predicted poor socialization outcomes. All Temperament x Parenting interactions appeared limited to measures obtained in the 2nd year.

Child, Preschool↗

Underpinnings of ethical reasoning in nursing.

Nursing is a manifestation of a value according to which it is morally good to promote physical and psychological well-being. Such a moral obligation involves making judgements. Ethical judgements are the decisions a person makes on whether a particular act is right or wrong. Ethical principles serve as the basis for ethical rules and as a framework for decision-making. Ethical theory provides a rationale that explains the principles and rules in order to provide a structured approach to ethical reasoning. Although ethics is not a science with verifiable answers, a knowledge of ethical theory enables nurses to make decisions in a manner that is more comprehensive and well reasoned than is opinion or intuition. In this paper, an overview of ethical theories, ethical principles and influences on ethical or moral reasoning is presented as well as the ethical decision-making process.

Beneficence↗

Intensive care: situations of ethical difficulty.

Twenty enrolled nurses (ENs), 20 registered nurses (RNs) and 20 physicians working in intensive care in northern Sweden narrated 255 stories about their experience of being in ethically difficult care situations. The ENs' stories mainly concerned problems relating to relationship ethics, the stories narrated by the physicians mainly concerned problems relating to action ethics, while the RNs' stories gave equal attention to both kinds of problems. The most common theme of both the RNs' and the physicians' stories was that of too much treatment. An obvious similarity between the ENs, RNs and physicians was that they saw themselves as equally lacking in influence in ethically difficult care situations. The only apparent difference between the three groups, however, was that the ENs brought up relationship problems more often than the others. Thus, the differences between the RNs and the physicians were fewer than usually reported in the literature. This might be related to the specialization of intensive care.

Adult↗

Registered nurses' and physicians' reflections on their narratives about ethically difficult care episodes.

Thirteen registered nurses and eight physicians in medical and oncological care reflected on their previous narratives about ethically difficult care situations. Although the interviewees had narrated different kinds of stories there were more similarities than differences in their reflections. Common themes were: meeting death, balancing between being open to one's own and others' reactions and being sheltered, handling advanced medical technology and grasping care as a whole. The two groups, however, disclosed different cognitive styles and types of rationality. The nurses referred to their personal experience of giving care and also receiving care very much within a praxis perspective, while physicians referred to science and proven experience within a poiesis perspective.

Adult↗

Being a palliative care nurse in an academic hospital: a qualitative study about nurses' perceptions of palliative care nursing.

The original philosophy of palliative care emphasizes the importance of the integration of compassion and medical science. The meaning palliative care nurses assign to their relationships with patients has been described in several studies. This qualitative research was undertaken in order to elicit the way nurses working on a palliative care ward in an academic hospital perceive their role and gain insight into the problems they encounter. The findings present two different perceptions held by nurses about the nature of their work. The first, the more prominent, is 'striving to adopt a well-organized and purposeful approach as a nurse on an academic ward'; the second is 'striving to enhance the well-being of the patient'. Nurses should be supported in the development of their palliative care approach and be assisted in reflecting on their practice in terms of a model of 'reflective practice' and in the development of 'moral imagination'.

Academic Medical Centers↗

Children's understanding of the mitigating function of disclaimers.

Despite earlier work indicating young children's competence in the use and understanding of retrospective "facework strategies" such as apologies, justifications, and excuses, it was hypothesized that an understanding of the disclaimer, a prospective strategy, would be relatively late appearing. An experiment is reported in which 144 British children between the ages of 5 and 11 years were presented with stories concerning an actor who had brought about certain negative consequences, having either previously issued, or not, a disclaimer. Children were asked to indicate and justify whether they felt the actor should be punished. Broadly consistent with the hypothesis guiding the present study, significant reductions in punishment recommendations following the provision of a disclaimer were found only among the 11-year-old subjects. However, from subjects' justifications for the decision not to punish, it was noted that nearly 50% of the 8-year-olds and 25% of the 5-year-olds provided evidence of understanding the mitigating function of disclaimers.

Child↗

Explaining the self-conception of perceived conduct using indicators of moral functioning in physical education.

The purpose of this study was to determine whether four indicators of moral functioning in physical education (moral judgment, moral reason, moral intention, and prosocial behavior) predicted the self-conception of perceived conduct. Participants were 204 male (n = 87) and female (n = 117) physical education students in fourth, fifth, and sixth grades. For the male students, the four indicators of moral functioning were found to be highly related, and, so, no subsequent analyses were conducted. For the female students, a standard multiple regression analysis revealed that the indicators of moral functioning accounted for 21% of the variance in perceived conduct. Discussion of the results highlights the value of considering in combination the moral functioning and self-concept literatures.

Analysis of Variance↗

Separating care and cure: an analysis of historical and contemporary images of nursing and medicine.

This paper provides a philosophical critique of professional stereotypes in medicine. In the course of this critique, we also offer a detailed analysis of the concept of care in health care. The paper first considers possible explanations for the traditional stereotype that caring is a province of nurses and women, while curing is an arena suited for physicians and men. It then dispels this stereotype and fine tunes the concept of care. A distinction between 'caring for' and 'caring about' is made, and concomitant notions of parentalism are elaborated. Finally, the paper illustrates, through the use of cases, diverse models of caring. Our discussion reveals the complexity of care and the alternative modes of caring in health care.

Career Choice↗

Back to the basics: reflections on moral discourse in a contemporary Hindu community.

Instead of searching through Hindu sources for appropriate insights into the questions related to "playing God" in biomedicine, the author seeks rather to understand why some Hindus at least are not inclined to ask such questions. Using examples from the Srĩvaisnava sect of south India, the author shows how Srĩvaisnava Hindus focus primarily on character formation and the practice of the virtues encoded in the classical texts, thereafter leaving it to the individual to "act as he or she will" in the world outside the community-a world which is neutral vis à vis religious values, neither governed by such values nor able to instigate the adjustment of religious values to fit changing times. The question then becomes, "What do modern ethicists have to learn from the moral discourse of the Srĩvaisnava community."

Ethical Analysis↗

Storytelling as a method for teaching values and attitudes.

Storytelling is not widely accepted as a teaching method in medical education, sometimes for valid reasons that are explained by the authors. Yet clinician-teachers who choose and tell stories appropriately--especially if these are stories of their own clinical experiences--can stimulate their students to examine their values and attitudes in ways that would be hard or impossible to achieve by other methods. The present article, which contains a story of the type advocated, shows how storytelling can help students and residents discuss and overcome their crises of professionalization and come to grips with the troubling aspects of the doctor-patient relationship. The authors maintain that storytelling allows educators to bring the discussion of values and attitudes to where students are most likely to appreciate and understand the message--the clinical encounter.

Attitude↗