Professional Boundary Ethics Attitudes and Awareness Among Nurses and Physicians in a University Hospital in the Kingdom of Saudi Arabia

This study sought to gauge ethical attitudes about professional boundary issues of physicians and nurses in the Kingdom of Saudi Arabia. Respondents scored 10 relevant boundary vignettes as to their ethical acceptability. The group as a whole proved “aware/ ethically conservative,” but with the physicians' score falling on the “less ethically conservative” part of the spectrum compared to nurses. The degree of ethicality was more related to profession than to gender, with nurses being more “ethical” than physicians.     

Book Review: Managing Mental Health in the Community: Chaos and Containment

Abstract

The British Association of Counselling first introduced a Code of Ethics and Practice for Counsellors in 1984. It has subse-quendy been revised three times. The codes have to be sufficiently broad to be accepted by the membership of BAC, who come from a wide range of theoretical backgrounds. Inevitably this means that the codes do not satisfy everyone nor do they resolve all ethical dilemmas. This paper focuses on sections of the codes which are unsatisfactory, or inadequate for psychodynamic counsellors. It also looks at the influence of psychodynamic counsellors in changes to the clauses on sexual exploitation. Finally the absence of any mention of dual and multiple relationships is discussed.     

A Draft Model Aggregated Code of Ethics for Bioethicists

Bioethicists function in an environment in which their peers—healthcare executives, lawyers, nurses, physicians—assert the integrity of their fields through codes of professional ethics. Is it time for bioethics to assert its integrity by developing a code of ethics? Answering in the affirmative, this paper lays out a case by reviewing the historical nature and function of professional codes of ethics. Arguing that professional codes are aggregative enterprises growing in response to a field's historical experiences, it asserts that bioethics now needs to assert its integrity and independence and has already developed a body of formal statements that could be aggregated to create a comprehensive code of ethics for bioethics. A Draft Model Aggregated Code of Ethics for Bioethicists is offered in the hope that analysis and criticism of this draft code will promote further discussion of the nature and content of a code of ethics for bioethicists.     

The Use of Metaphors with African-American Couples

SUMMARY

There is a dearth of data in the literature on African-American couples. This omission probably reflects the assumption that interventions that are effective with one race are effective with others. This paper explores the use of metaphor as a tool for working with an underserved and neglected population. Since the African-American culture is extensive in its use of metaphor, this medium provides a fertile channel for therapeutic communication.     

The Future of the Church as a Primary Health Place

ABSTRACT

There is a critical need for change in America's Health System, and religious organizations can facilitate not only the redefining of what health is but also the shaping of what the primary health services of the future should look like, function as, and be. The vision presented here is that the local parish or some extension of it be seen by the average citizen as a primary health place. The model proposed is that faith based living in community become the core health concept, defining what it means to be human and healthy become the core teaching, and that healing such that no illness need dominate become the goal. Within that context, health information, education, prayer, care, and support for most chronic illness, lifestyle change, and end of life concerns would begin at one's community of faith and only within that context to specially trained persons. This health system will compliment the sophisticated and complex acute medical care system that now exists.     

Sources of influence on the professional development of psychologists and psychiatrists in Norway and Germany

Background: There are many professional psychotherapists, but no psychotherapy profession. The psychotherapists’ professions vary between countries, the most frequent being psychiatry and clinical psychology.

Aim: As these professions have different basic training and also may be impacted differently by other factors, we wanted to study potential differences as to perceived influences on their development as psychotherapists across career level, theoretical orientation, and gender.

Methods: More than 2500 Norwegian and German psychiatrists and psychologists reported data on their professional development in the DPCCQ/2000, a lengthy multi-part survey instrument developed within the ‘Collaborative Research Network’ of the Society for Psychotherapy Research. The four groups were compared for differences, and a series of multiple regression analyses were conducted to examine the impact of profession on a variety of aspects of therapist experiences.

Results: Although a few therapist experiences (e.g. teaching, treating patients, institutional conditions) had a significantly different impact between the two professions, as a main effect, they only accounted for less than 1% or the variance.

Conclusion: Profession seems to have little influence on perceived development as a psychotherapist, and it is reasonable to conclude that other therapist qualities, often personal qualities, are more important for therapeutic processes and outcomes.     

Narrative counselling with a young engineer

This case study applied a narrative approach to develop the sense of self as a career resource for a young male engineer in his first working year. The participant client attended eight sessions lasting 60 to 90 minutes each over a period of five months. The case sessional data were thematically analysed. Following the intervention, the participant displayed career strengths of willingness to deal with challenges, enhanced adaptability strategies and volition to elect preferred work setting. He also displayed an enhanced future orientation. Narrative counselling appeared to support career adaptability development.     

The lived experiences of single mothers in Swaziland of their son's aggressive behaviour

The study explored and described the lived experiences of single mothers and described guidelines for psychiatric nurses to facilitate the mental health of single mothers subjected to aggression by their adolescent sons. Participants were a purposive sample of 8 (single mothers, aged between 40 and 50 years, 7 mothers were employed and 3 were professionally trained, 4 mothers were domestic workers and 1 earned living by selling vegetables). The mothers attended the outpatient department at the National Psychiatric Hospital in Swaziland because of being exposed to aggression by their adolescent sons and had adolescent sons living with them 6 months prior to as well as during the study. Data were collected using individual in-depth phenomenological interviews, direct observation and field notes. Analyses used thematic coding. Results reflected that single mothers experienced their adolescent sons as disrespectful and violent, they had negative experiences about their adolescent sons which resulted in anxiety related symptoms, they had negative experiences of self and experienced poor relationships with their neighbours. Guidelines concerning intra- and interpersonal challenges were formulated for the psychiatric nurse to facilitate the mental health of these mothers.     

Psychoanalysis is becoming an impossible profession within the public welfare system in Sweden

Abstract

The preconditions for psychoanalytic practice within the Swedish public welfare system are analyzed in this article. Psychoanalysis remains a one-to-one treatment and relies on the analyst's capacity to use his or her own subjective response. The development of the psychoanalytic process is dependent on unconscious reality, making it impossible to work with a model that has a strict relation between diagnosis, treatment method, and result. Objectivity and the desire to predict treatment outcomes characterize the immanent logic in the complex system of laws and recommendations that affects most practices within the field of medicine. As a consequence of this development, psychoanalysis and psychodynamic therapy are marginalized, since our treatment methods are not adapted to the present industrialization and economization of the medical health sector, with the result that the preconditions for psychoanalytic training have changed dramatically. The exclusion of psychoanalysis from the national health insurance scheme is a demanding challenge at a time when the Swedish welfare model is undergoing fundamental changes.     

Diagnosis and treatment of respiratory tract infections in primary health care by the nurse versus the physician: Efficacy and patient attitudes

Abstract

Five district physicians and one registered nurse were compared regarding their effectiveness in diagnosing and treating acute upper respiratory tract infections in patients (n=186) at a Swedish community health centre. Attitudes and views of the patient, or of the accompanying adult when the patient was a child, regarding the consultation itself, as well as more general aspects of health care were investigated (n=99) using a questionnaire. The questionnaire included 42 propositions of a “fuzzy” type to be judged on a 100-point truth-value scale, 18 of them concerning the consultation and 24 the more general aspects. No differences between the physicians and the nurse were found in their efficacy of diagosis and treatment. Subjects' overall attitudes were found to be positive toward both the physicians and the nurse. Results of multivariate analyses of variance performed for the consultation and general aspects of health care items separately and concerning type of persons providing health care (physician/nurse), treatment (antibiotics/no antibiotics) and patient age (child/adult), revealed overall differences in questionnaire response as regards patient age in relation to the consultation items.