Ajob Primary Research 

About: Ajob Primary Research is an academic journal. The journal publishes majorly in the area(s): Informed consent & Health care. It has an ISSN identifier of 2150-7724. Over the lifetime, 111 publications have been published receiving 1604 citations.

Development and Testing of an Instrument to Measure Moral Distress in Healthcare Professionals

Abstract: Background: Although moral distress is increasingly recognized as an important problem that threatens the integrity of health care providers and health care systems, few reliable and valid measures of moral distress are currently in use in research or clinical practice. This article describes the development and testing of a revised measure of moral distress, the Moral Distress Scale–Revised (MDS-R), designed for use in multiple health care settings and with multiple disciplines. Methods: After instrument development and content validity testing, a survey methodology was used to assess reliability and construct validity of the MDS-R. Registered nurses (n = 169) and physicians (n = 37) in eight intensive care units (ICUs) at an academic medical center in the southeastern United States participated; the survey was administered during a 2-week period in January 2011. Results: Adequate reliability and evidence of construct validity were demonstrated. Moral distress was significantly higher for nurses than phy...

Research Participants’ Understanding of and Reactions to Certificates of Confidentiality

Abstract: Background: Certificates of Confidentiality are intended to facilitate participation in critical public health research by protecting against forced disclosure of identifying data in legal proceedings, but little is known about the effect of Certificate descriptions in consent forms. Methods: To gain preliminary insights, we conducted qualitative interviews with 50 HIV-positive individuals in Durham, NC, to explore their subjective understanding of Certificate descriptions and whether their reactions differed based on receiving a standard versus simplified description. Results: Most interviewees were neither reassured nor alarmed by Certificate information, and most said it would not influence their willingness to participate or to provide truthful information. However, compared with those receiving the simplified description, more who read the standard description said it raised new concerns, that their likelihood of participating would be lower, and that they might be less forthcoming. Most interviewees...

Developing a Model of the Benefits and Burdens of Research Participation in Cancer Clinical Trials.

Abstract: Background: Recruiting and retaining human participants in cancer clinical trials is challenging for many investigators. Although we expect participants to identify and weigh the benefits and burdens of research participation for themselves, it is not clear what burdens adult cancer participants perceive in relation to benefits. We identify key attributes and develop an initial conceptual framework of benefit and burden based on interviews with individuals enrolled in cancer clinical research. Methods: Semistructured interviews were conducted with a purposive sample of 32 patients enrolled in cancer clinical trials at a large northeastern cancer center. Krueger's guidelines for qualitative methodology were followed. Results: Respondents reported a range of benefits and burdens associated with research participation. Benefits such as access to needed medications that subjects otherwise might not be able to afford, early detection and monitoring of the disease, potential for remission or cure, and the abili...

Conflicts in Care for Obstetric Complications in Catholic Hospitals

Abstract: Background: A recent national survey revealed that over half of obstetrician-gynecologists working in Catholic hospitals have conflicts with religious policies, but the survey did not elucidate the nature of the conflicts. Our qualitative study examines the nature of physician conflicts with religious policies governing obstetrician-gynecologist (ob-gyn) care. Results related to restrictions on the management of obstetric complications are reported here. Methods: In-depth interviews lasting about one hour were conducted with obstetrician-gynecologists throughout the United States. Questions focused on physicians’ general satisfaction with their hospital work settings and specific experiences with religious doctrine-based ob-gyn policies in the various hospitals where they have worked. Results: Conflicts reported here include cases in which Catholic hospital religious policy (Ethical and Religious Directives for Catholic Health Care Services) impacted physicians’ abilities to offer treatment to women exper...

Ethics in Humanitarian Aid Work: Learning From the Narratives of Humanitarian Health Workers

Abstract: Little analysis has been made of ethical challenges encountered by health care professionals (HCPs) participating in humanitarian aid work This is a qualitative study drawing on Grounded Theory analysis of 20 interviews with health care professionals who have provided humanitarian assistance We collected the stories of ethical challenges reported by expatriate HCPs who participated in humanitarian and development work Analysis of the stories revealed that ethical challenges emerged from four main sources: (a) resource scarcity and the need to allocate them, (b) historical, political, social and commercial structures, (c) aid agency policies and agendas, and (d) perceived norms around health professionals’ roles and interactions We discuss each of these sources, illustrating with quotes from the respondents the consequences of the ethical challenges for their personal and professional identities The ethical challenges described by the respondents are both familiar and distinct for bioethics The findi