Reflecting on the nature of Confucian ethics

Mental Health Nurses’ Tacit Knowledge of Strategies for Improving Medication Adherence for Schizophrenia: A Qualitative Study

Non-adherence to medication among patients with schizophrenia is an important clinical issue with very complex reasons. Since medication administration is an essential nursing responsibility, improving strategies for patient medication compliance must be fully understood. This study aimed to explore the strategies mental health nurses (MHNs) implement in clinically improving patients with schizophrenia and to describe the nurses’ tacit knowledge of application strategies. A qualitative study with purposeful sampling was used. Twenty-five experienced MHNs in a psychiatric hospital in central Taiwan were given an in-depth interview. The texts were content-analyzed using NVivo 12 Pro software. MHNs promote medication adherence among patients with schizophrenia using the following strategies: establishing a conversational relationship, overall assessment of non-adherence to medication, understanding the disease and adjusting the concept of medication, incorporating interpersonal connection feedback, and building supportive resources. This study explored the strategies of MHNs that incorporated knowledge in managing treatment adherence in patients with schizophrenia. The findings add knowledge to clinical nursing practice about medication adherence among patients with schizophrenia.

Avoiding Cultural Imperialism in the Human Right to Health

As political instruments, human rights can be challenged in two important ways: first, by undermining the claim to universality by appealing to a kind of cultural relativism, and second, by accusing human rights of unjustifiably imposing values that are not genuinely universal (which I dub the problem of parochialism). The human right to health is no exception. If a human right to health is to be a useful instrument in mobilizing action for global health justice, then we need to take seriously the ways that health intersects with culture. Universal applicability is essential to both the legitimacy and efficacy of human rights. But without cultural sensitivity, additional injustices and imperialistic harms may be perpetuated. There are two goals within this paper-(1) to show that cultural imperialism is a moral and practical hazard, both in general and for the human right to health in particular and (2) to articulate a way of thinking about the human right to health that can minimize these hazards and arm it with moral credibility and political weight.

Will Confucian Values Help or Hinder the Crisis of Elder Care in Modern Singapore?

The unique mix of modern Western and traditional Confucian values in Singapore presents young people with contradictory views on duties to aging parents. It remains to be seen whether the changing demands of modern life will result in new generations giving up Confucian family ethics or whether the Confucian dynamic will find a way to adapt to the new pressures. It is the opinion of this author that the Confucian family structure has mixed potential for the growing crisis of elder care. Alone, both Confucian traditions and typical Western institutional approaches toward elder care fall short of what is necessary for intergenerational social justice, yet a hybrid of the two has great potential for the growing aging crisis. To demonstrate this, I first give a brief account of the history of filial piety in Confucianism as well as the social environment from which it originated. Then I turn my attention to the present issues of an aging population and elder care that face much of the developed world in the twenty-first century. Finally, I show how adherence to Confucian filial traditions can both help to address many of these issues and how it can potentially leave unjust gaps in elder care. Ultimately, I conclude that the crisis of elder care may be best dealt with through a hybrid of Confucian values and Western approaches.

Patients' perceptions and expectations of family participation in the informed consent process of elective surgery in taiwan

PURPOSE

This study investigated patients' perceptions and expectations of their families' participation in the informed consent process of elective surgery.

METHODS

This is a survey study. Anonymous questionnaires that were mailed to potential participants included a demographic data sheet and a scale, measuring patients' perceptions of themselves and their families' participation level in the informed consent process. A convenience sample of patients who had undergone surgery and had been discharged within 4 months from a medical center in southern Taiwan (n = 1,737) were recruited.

RESULTS

One hundred and forty-five recipients replied, gaining a response rate of 10.0%, and 120 provided complete data. The mean age of the participants was 56.0 years (range 20-85, SD = 14.98), and more than half were female (54.2%). Twenty-one participants (17.5%) perceived having less family participation than their own participation in the surgery informed consent process, and 40% expected more family participation in the process. The mean scores of the self-rated participation level was significantly higher than that of the families (p < .001). Patients' expectations of family participation were significantly higher than their perceptions of family participation (p < .001). Eleven patients (9.2%) reported having more family participation than they expected. Participants received the most information about the disease during the informed consent process and the least information about alternatives to surgery. Age, gender, number of previous surgeries and admissions influenced the study participants' perceived level of participation in the informed consent process.

CONCLUSION

This preliminary study demonstrates that patients' perceptions and expectations for family participation in the surgical informed consent process vary. Healthcare providers should be aware of patients' expectation to appropriately invite their family into the informed consent process.