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PubMed1975

Common themes among morale and depression scales.

This paper reports on the intra- and interbattery scaling of three morale and depression batteries comprised of self-reported items: PGC, G-H, and ZUNG. Responses to the three scales were sought from a sample of long-term residents of a state mental hospital. First, the batteries were factor analyzed separately to identify the intrabattery scales; then the resultant scales were compared using canonical correlation and super matrix factor analysis to identify the interbattery themes. These analyses resulted in the identification of a Clinical Depression domain across all three batteries and single independent themes in both the Zung and PGC batteries.

Adult↗
PubMed1977

Correlations of life satisfaction, morale and adjustment measures.

Pearson Product Moment correlation coefficients were computed for seven frequently used measures of life satisfaction, adjustment, and morale. Data on the seven instruments were collected from 259 subjects over the age of 60 representing three clusters: institutionalized older people, those with limited ambulation, and "community" aged. Intercorrelations among the measures indicate a high level of interrelationship.

Aged↗
PubMed1977

Changes in individual attitudes toward traditional morality: a 24-year follow-up study.

Changes in individual attitudes toward traditional morality are charted by focusing on a sample of 1950 persons from rural Pennsylvania surveyed as high school sophomores in 1947 and again 24 years later when they were in their early 40s. A series of 12 Likert-type items were used to assess traditionalism. In general, the subjects' attitudes changes toward a more permissive stance in regard to questions concerned with adult behavior. Liberalization of attitudes toward the behavior of young people was less pronounced. The direction and degree of change differed markedly among individuals. Frequency of church attendance was closely associated with the amount of change. Those attending church once a week or more were decidedly less likely to change toward a liberal or permissive position than were those who attended less often. Other factors related to amount of liberalization included residence, education, and income.

Adolescent↗
PubMed1980

Alternative models of person-environment fit: prediction of morale in three homes for the aged.

The notion of congruence or P-E fit has been suggested as a fruitful theoretical scheme for the understanding of the impact of environments on the well-being of older people (French et al., 1974; Kahana, 1975). Alternative models have been proposed for understanding the type of congruence which results in the most positive outcomes. Such models have differential implications for intervention to enhance well-being of the aged. This paper represents an initial effort to put these alternative theoretical models to an empirical test. Data for this study came from 124 interviews at three homes for the aged. In order to overcome methodological problems posed by conventional approaches, a procedure which measures incongruence in terms of non-linear transformations of difference scores was used. Congruence models examined included non-directional, one-directional, and two-directional models. The findings point to the importance of P-E fit in the arenas of congregation, impulse control, and segregation. In contrast, personal and/or environmental characteristics rather than fit were found to be more important along the dimensions of affective expression and institutional control in explaning morale.

Adaptation, Psychological↗
PubMed1985

Sex differences in the structure of the Philadelphia Geriatric Center Morale Scale.

This research examined sex differences in the factorial structure of the Philadelphia Geriatric Center Morale Scale. In particular, we view the covariance structure of the scale items as a function of several parameter matrices. We analyzed the factorial invariance by testing hypotheses involving the equivalence constraints of one or more parameter matrices in the male and female populations. Data for this research came from the 1968 National Senior Citizens Survey. Analysis of covariance structures (or LISREL) was used to assess the factorial invariance of the scale. We found some statistically significant sex differences in the first-order factor loadings and measurement error variances. Substantively, however, these differences are less important.

Aged↗
PubMed1987

Economic competition in health care: a moral assessment.

Economic competition threatens equity in the delivery of health care. This essay examines four of the various ways in which it does that: the reduction of charity care, increased patient cost-sharing, "cream-skimming" of healthy subscribers, and lack of information to patients about rationed care that is not prescribed. In all four cases, society must guard against distinct inequities and injustices, but also in all four, either the particular problem is not inherent in competition or, though inherent, it is not irremediable. Competition therefore cannot be finally morally accepted or rejected as an economic structure for delivering health care without knowing what among a wide range of supplementary things our society is actually going to do with it.

Cost Allocation↗
PubMed1991

Moral absolutism and the double-effect exception: reflections on Joseph Boyle's Who is entitled to double effect?

Joseph Boyle raises important questions about the place of the double-effect exception in absolutist moral theories. His own absolutist theory (held by many, but not all, Catholic moralists), which derives from the principles that fundamental human goods may not be intentionally violated, cannot dispense with such exceptions, although he rightly rejects some widely held views about what they are. By contrast, Kantian absolutist theory, which derives from the principle that lawful freedom must not be violated, has a corollary--that it is a duty, where possible, to coerce those who try to violate lawful freedom--which makes superfluous many of the double-effect exceptions Boyle allows. Other implications of the two theories are contrasted. Inter alia, it is argued that, in Boyle's theory, that a violation of a fundamental human good can be viewed as a cost proportionate to a benefit obtained, cannot yield a double-effect exception to the prohibition of intentionally violating that good, because paying a cost cannot be unintentional.

Bioethical Issues↗
PubMed1991

Conceptions of morality and the doctrine of double effect.

Whether one should accept a principle like DDE cannot be settled independent of one's more general moral theory. In this, I take it, I agree with Professor Boyle, though I do not think he has shown that DDE has a role only in his particular form of absolutism. Still, since his theory does require DDE, an important question is what the alternatives are--whether we must choose between this absolutism and either utilitarianism or intuitionism. A form of contractualism, the requirements of which derive to a large extent from institutionally or conventionally established rights, is sketched here as an attractive alternative. It does not lead, so far as I can see, to DDE.

Bioethical Issues↗
PubMed1992

Justice and the moral acceptability of rationing medical care: the Oregon experiment.

The Oregon Basic Health Services Act of 1989 seeks to establish universal access to basic medical care for all currently uninsured Oregon residents. To control the increasing cost of medical care, the Oregon plan will restrict funding according to a priority list of medical interventions. The basic level of medical care provided to residents with incomes below the federal poverty line will vary according to the funds made available by the Oregon legislature. A rationing plan such as Oregon's which potentially excludes medically necessary procedures from the basic level of health care may be just, for the right to publically-sponsored medical care is restricted by opposing rights of private property. However, the moral acceptability of the Oregon plan cannot be determined in the absence of knowing the level of resources to be provided. Finally, Oregon to date has failed to include the individuals being rationed in discussions as to how the scarce resources are to be distributed.

Adult↗
PubMed1995

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↗
PubMed1993

Euthanasia in The Netherlands: facts and moral arguments.

Some facts about euthanasia practices in The Netherlands are given. It is shown that there are several possible courses of action at the end of life, of which active euthanasia is the most problematic. Euthanasia is related to respect for the patient and the patient's right to refuse medical treatment. Some moral arguments against and in favour of euthanasia are discussed.

Beneficence↗
PubMed1978

Who should make moral policy decisions in health care?

Physical therapists are not always involved in the formulation of moral policy that significantly affects their professional practice as clinicians, researchers, and educators. This paper analyzes five major positions being taken regarding what the physical therapist's role ought to be, and suggests possibilities for increased involvement in the policy-making process.

Decision Making↗
PubMed1997

The social worker as moral citizen: ethics in action.

Social workers today face some of the most complex ethical dilemmas in the history of the profession. This article presents a framework of moral citizenship to guide ethical social work practice. The framework includes the action philosophies of philosopher Hannah Arendt and Lutheran theologian Paul Tillich integrated with concepts of professional responsibility and the unique contributions of social work pioneer Charlotte Towle. Social conscience and social consciousness, including awareness, thinking, feeling, and action, are major components of the framework.

Ethics, Professional↗
PubMed1992

Issues of child custody and our moral values in the era of new medical technology.

A series of ethical, moral, and legal dilemmas are presented along with the related landmark case law. The definition of motherhood and the types of mothers, such as genetic, gestational, and surrogate, have become a confusing matter, not only for a growing child but for lawmakers and mental health professionals as well. Pregnancy through artificial insemination gives certain rights to women who are not married to the father, even when these women have contracted to surrender the baby after birth. The law has recognized that biological mothers have a potential right to custody or at least visitation. Such a right, however, is not established on behalf of a father whose only relationship with a child is through his genetic component unless a strong emotional bond exists, and the mother is not married to and cohabiting with her husband. The author argues that the principle of "the child's best interest" must prevail in all custody disputes, regardless of who the biological parent is.

Child↗
PubMed1998

Reasoning about moral aspects of illness and treatment by preschoolers who are healthy or who have a chronic illness.

Our study evaluates the moral reasoning skills of healthy and chronically ill 3 and 4 year olds with respect to illness and treatment, by use of an interview technique that reduces verbal demands on the child. We presented children with pairs of scenarios comparing ill characters with characters acting immorally and characters being punished, as well as with pairs of scenarios comparing treated characters with characters acting immorally and characters being punished. We asked children to point to the character who did something "naughty." With the exception of the chronically ill 3 year olds, the children performed consistently above chance and did not confuse illness and immorality. Older and healthy children performed better than younger and chronically ill ones (differences were the result of differing receptive vocabulary skill levels). This research has implications for evaluating young children's reasoning abilities and suggests that medical professionals should use tools that reduce demands on children's verbal proficiency.

Attitude to Health↗
PubMed1995

Peer social support: a key to care giver morale and satisfaction.

Social support is a group dynamic, but studies have not identified specific strategies for managers to use as direct environmental resources. The authors discuss a study that explored group social support as a component of job morale for bedside care givers. Specific unit-based factors are identified for managers to develop focused staff social support activities. These include means of universal recognition, use of common space, methods to develop team culture and styles, and methods of communication.

Academic Medical Centers↗
PubMedDate not supplied

Do student preceptorships affect moral reasoning?

The author examines the effects of a senior preceptorship course on the moral reasoning of senior nursing students. The findings suggest a broadening gap between education and practice resulting from changes in the health care industry, more specifically, in the acute care facility and a compromise of professional role enactment in the hospital. The author suggests we reconsider the following questions: Is the patient still the first priority in nursing? Is the hospital setting an appropriate placement for nursing students?

Adult↗
PubMed1983

Moral development: a differential evaluation of dominant models.

This article examines and evaluates the supporting evidence from the prevailing models of moral development. Using the criteria of empirical relevance, intersubjectivity, and usefulness, the classical model from psychoanalytic theory, Kohlberg's and Gilligan's models from cognitive developmental theory, and the social learning theory model are reviewed. Additional considerations such as the theoretical congruency and sex role bias of certain models are briefly discussed before concluding with the current use of the models by nursing.

Cognition↗