Background: Old age–based discrimination is observed as the most tolerated prejudice in society and has also been witnessed in healthcare institutions. Aims: The aim of this study is to explore age-based discrimination in healthcare institutions as perceived by seniors and students of Medicine and Nursing. Research design: A multi-method study design, by involving a triangulation design. Participants and research context: A purposeful sample of individuals aged 65+ (n = 80) and medical and nursing students (n = 100) in the eastern region of Poland. Ethical considerations: Ethical approval of the research protocol was received from the Ethics Committee at the Medical University of Lublin. Findings: ‘Old age’ was perceived by groups of participants based on three themes: (a) positive, (b) negative and (c) neutral connotations. The negative connotations predominated. The beginning of old age was defined by the metric of age and described by showing the complexity of the ageing process involving subjective, objective and societal aspects. Experience of age discrimination in healthcare institutions was reported by 24 (30%) seniors and witnessed by 47 (47%) students surveyed and for both groups occurred mainly at the hospital level and by physicians. Only 48 students (48%) declared a willingness to work with the older people in the future, and barriers were reported at the personal and professional levels, and also in some visions of older people. Conclusion: The conceptualization of old age as reported by seniors and students mainly carried negative connotations, reflecting the profoundly based stereotypes within society regarding the older people. Seniors have reported being exposed to ageism and have witnessed ageism episodes in HCIs; also, students have faced ageism episodes during their clinical education. There is a need for ethical education within medical and nursing courses to shape positive attitudes towards the older people. A positive vision of ageing should be promoted not only among young people but also among adults and older people to avoid self-stereotyping of older people and seeing old age from negative perspective.
The aim of this study was to map and summarize the published research findings on hospital ethical climate and its relationship with nursing staff job satisfaction as well as strategies proposed in the literature for the improvement of hospital ethical climate and job satisfaction through the actions of nursing staff in leadership positions. A scoping review has been performed in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension scoping reviews statement (PRISMA-ScR). Three electronic bibliographic databases were searched: the SCOPUS, Medline, and CINHAL Complete using a combination of keywords with the range of years 1994–2021. A total of 15 papers out of 235 records identified were eligible for the analysis. The literature review confirmed a significant relationship between ethical climate and job satisfaction of nurses. Furthermore, the interdependence of ethical climate and job satisfaction of nursing staff affects many different aspects including patients, co-workers, an organization and research. Identifying factors that influence ethical climate and job satisfaction as well as the relationship between these variables may help to reduce the dropout concerning a change of profession among nursing staff.
Background: This study aimed to map and summarise the state of the research regarding doctoral programs in nursing, as well as the issues debated in the context of nursing doctoral education. A Scoping Review in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension scoping reviews statement (PRISMA-ScR) was conducted. Three electronic bibliographic data bases were searched: Cumulative Index to Nursing and Allied Health Literature Complete, Medline (on EBSCO Host) and SCOPUS to identify empirical studies published between January 2009 and December 2019. The review process was based on framework identified by Arksey and O’Malley and further revised by Levac and colleagues. Analysis was performed with the use of the Donabedian framework regarding the structure of the doctorate programmes, the process, and the outcomes. Results: The review included 41 articles, mostly originating in the United States (n=26) and Europe (n=8), mainly by collecting the perceptions of students and faculty members with descriptive studies. The following issues were investigated at the (a) structure level: Prerequisite for doctoral candidates, Qualifications of faculty members, Mission of doctoral programs; (b) process level: Doctoral programs contents, Doctoral programs resources and quality, Mentoring and supervision, Doing doctorate abroad; and (c) outcome level: Academic performance outcomes in doctoral programs, Doctoral graduates’ competences, Doctoral students/graduates’ satisfaction, Doctoral graduates’ challenges. Conclusions: Doctoral programs have mainly been investigated to date with descriptive studies, suggesting more robust research investigating the effectiveness of strategies to prepare future scientists in the nursing discipline. Doctorates are different across countries, and there is no visible cooperation of scholars internationally; their structure and processes have been reported to be stable over the years, thus not following the research development in nursing, discipline and practice expectations. Moreover, no clear framework of outcomes in the short- and long-term have been established to date to measure the quality and effectiveness of doctorate education. National and global strategies might establish common structure, process and outcome frameworks, as well as promote robust studies that are capable of assessing the effectiveness of this field of education.
The problem of early motherhood is still a serious medical and social problem in many countries around the world. The aim of this study was to analyze the attitudes of teenage mothers towards pregnancy and childbirth. A retrospective cross-sectional study was conducted with the use of an original questionnaire containing a test to measure attitudes on a five-point Likert scale and a Life Orientation Test-Revised (LOT-R) to assess dispositional optimism. The study involved 308 teenage mothers between 13 and 19 years of age. Attitudes of teenage mothers towards pregnancy and childbirth were more often positive (90.6%) than negative (9.4%). Sociodemographic features determining the attitudes of teenage mothers towards both their pregnancy and childbirth included their age, marital status, current occupation, and main source of income. The type of attitude adopted by teenage mothers towards pregnancy and childbirth was significantly related to the level of their dispositional optimism.
Background: The concept of conscientious objection is well described; however, because of its nature, little is known about real experiences of nursing professionals who apply objections in their practice. Extended roles in nursing indicate that clinical and value-based dilemmas are becoming increasingly common. In addition, the migration trends of the nursing workforce have increased the need for the mutual understanding of culturally based assumptions on aspects of health care delivery. Aim: To present (a) the arguments for and against conscientious objection in nursing practice, (b) a description of current regulations and practice regarding conscientious objection in nursing in Poland and the United Kingdom, and (c) to offer a balanced view regarding the application of conscientious objection in clinical nursing practice. Design: Discussion paper. Ethical considerations: Ethical guidelines has been followed at each stage of this study. Findings: Strong arguments exist both for and against conscientious objection in nursing which are underpinned by empirical research from across Europe. Arguments against conscientious objection relate less to it as a concept, but rather in regard to organisational aspects of its application and different mechanisms which could be introduced in order to reach the balance between professional and patient’s rights. Discussion and conclusion: Debate regarding conscientious objection is vivid, and there is consensus that the right to objection among nurses is an important, acknowledged part of nursing practice. Regulation in the United Kingdom is limited to reproductive health, while in Poland, there are no specific procedures to which nurses can apply an objection. The same obligations of those who express conscientious objection apply in both countries, including the requirement to share information with a line manager, the patient, documentation of the objection and necessity to indicate the possibility of receiving care from other nurses. Using Poland and the United Kingdom as case study countries, this article offers a balanced view regarding the application of conscientious objection in clinical nursing practice.