Biomedical subjects

Nili Tabak

Publications and source records attributed to Nili Tabak.

12 recordsLinked to original sources

PubMed2006

Healthy participants in phase I clinical trials: the quality of their decision to take part.

AIMS AND OBJECTIVE: This study was set out to test the quality of the decision-making process of healthy volunteers in clinical trials. BACKGROUND: Researchers fear that the decision to volunteer for clinical trials is taken inadequately and that the signature on the consent forms, meant to affirm that consent was 'informed', is actually insubstantial. DESIGN: The study design was quasi-experimental, using a convenience quota sample. METHODS: Over a period of a year, candidates were approached during their screening process for a proposed clinical trial, after concluding the required 'Informed Consent' procedure. In all, 100 participants in phase I trials filled out questionnaires based ultimately on the Janis and Mann model of vigilant information processing, during their stay in the research centre. RESULTS: Only 35% of the participants reached a 'quality decision'. There is a definite correlation between information processing and quality decision-making. However, many of the healthy research volunteers (58%) do not seek out information nor check alternatives before making a decision. CONCLUSIONS: Full disclosure is essential to a valid informed consent procedure but not sufficient; emphasis must be put on having the information understood and assimilated. Research nurses play a central role in achieving this objective.

Attitude to Health↗

PubMed2006

The health beliefs of hospital staff and the reporting of needlestick injury.

AIM: The aim of this study is to examine the connection between the health beliefs of hospital staff (doctors, nurses and auxiliary staff) and their failure to report needlestick injuries. BACKGROUND: Needlestick injury to hospital staff is quite frequent and can result in infections and disease, but staff frequently do not report the injury despite their awareness of the risk of blood-borne pathogens. METHODS: Five questionnaires were constructed based on three existing research tools and were tested for validity and reliability. Two hundred and forty questionnaires were distributed to eight randomly chosen departments of a single Israeli hospital. Seventy-six percent of the questionnaires were anonymously completed and returned. RESULTS: Nurses had the highest rate of needlestick injury, followed by auxiliary staff and doctors. Auxiliary staff showed the highest rate of compliance with the duty to report such injuries, while doctors showed the lowest. Perceived severity of contractable disease, the perceived efficacy of reporting injuries and overall motivation to maintain health were the best predictors of reporting compliance. Non-compliers emphasized the negative aspects of reporting the injuries, primarily that it took up too much time. CONCLUSIONS: The solution to non-compliance with the duty to report must be a targeted investment in training and education. Relevance to clinical practice. Finding the reasons for compliance and non-compliance with the duty to report needlestick injuries will help in designing educational programmes for hospital staff and in determining a strategy for improving health behaviour.

Accidents, Occupational↗

PubMed2005

Sexual harassment--abuse or flirtation.

Sexual harassment is a continuum of expression of human behavior ranging from attraction and flirtation at one extreme through to violence at the other. Four main models have been proposed to account for the phenomenon. These include the biological, organizational, sociocultural and the spill-over models. In this article, the term spill-over is used to explain the appearance and characteristics of harassment in the health care environment of the hospital. With the introduction of two new laws in Israel, the Law of Equal Opportunity and the Law for Prevention of Sexual Harassment, greater awareness of the rights of victims of harassment and their remedies are now on the Statute Book. Some of the salient features of the two laws are emphasized. Changes in the attitude of the courts based on this legislation are now occurring and greater prominence given to violent behavior is a feature of the change in public awareness of sexual harassment.

Female↗

PubMed2004

The influence of nurses' attitudes, subjective norms and perceived behavioral control on maintaining patients' privacy in a hospital setting.

The research reported in this article examined the influence of nurses' attitudes, subjective norms and perceived behavioral control on maintaining patients' privacy during hospitalization. The data were gathered from 109 nurses in six internal medicine wards at an Israeli hospital. The research was based on the theories of reasoned action and planned behavior. A positive and significant correlation was shown between nurses' attitude to promoting and maintaining patient privacy and their planned behavior, while perceived behavioral control was the best variable for predicting the nurses' behavior. Better educated nurses believed that they had fewer resources and anticipated more obstacles in acting to promote and maintain patient privacy. This research adds a new dimension to what is already known about nurses' attitudes to maintaining patients' privacy, nurses' planned behavior and their actual behavior. The practical implications of the findings are the identification of factors that influence the attitudes and behavior of nursing staff, which, in turn, will enable allocation of resources for solving difficulties and removing obstacles. The results will allow the formulation of educational programs to guide staff and also the application of policies based on both patient and nursing staff needs.

Adult↗

PubMed2004

Patient rights and law: tobacco smoking in psychiatric wards and the Israeli Prevention of Smoking Act.

In August 2001, the Israeli Ministry of Health issued its Limitation of Smoking in Public Places Order, categorically forbidding smoking in hospitals. This forced the mental health system to cope with the issue of smoking inside psychiatric hospitals. The main problem was smoking by compulsorily hospitalized psychiatric patients in closed wards. An attempt by a psychiatric hospital to implement the tobacco smoking restraint instruction by banning the sale of cigarettes inside the hospital led to the development of a black market and cases of patient exploitation in return for cigarettes. This article surveys the literature dealing with smoking among psychiatric patients, the role of smoking in patients and the moral dilemmas of taking steps to prevent smoking in psychiatric hospitals. It addresses the need for public discussion on professional caregivers' dilemmas between their commitment to uphold the law and their duty to act as advocates for their patients' rights and welfare.

Commitment of Persons with Psychiatric Disorders↗

PubMed2003

The relationship between the application of the nursing ethical code and nurses' work satisfaction.

Work satisfaction is known to be one of the major factors related to nurses' quality of care. Being able to apply the professional principles of training influences work satisfaction. The nursing ethical code is a good manifestation of these professional principles. The everyday strains on nurses' work might compromise the amount of energy invested in following the ethical code. The gap between the ethical requirements (as perceived by the nurse) and the perceived extent to which they are applied will influence work satisfaction through the mediating effect of role conflict. Demographic variables including age, tenure and number of children might also exert an effect. Structured questionnaires were used to measure the perceptions of nurses regarding their ability to follow the ethical code in a large hospital in Israel. Practical considerations meant that the questionnaire focused on client privacy issues in the ethical code. Results support the mediating hypothesis as the 'ethical gap' did not correlate directly with work satisfaction. This paper highlights that professionalization, manifested by the ethical code, should be applied on an everyday basis in the workplace.

Adult↗

PubMed2003

A philosophy underlying excellence in teaching.

This article discusses nursing education and changing paradigms of knowledge, emphasizing critical thinking, nursing praxis, and the place of the educator as a role model who provides knowledge, facilitates critical thinking, and teaches students how to cope with the knowledge. It interprets the connection between knowledge and power as a potential source of injustice and inequality in the student-teacher relationship; and tries to solve this problematic issue by annulling the differences in power. Examples from clinical areas are presented to illustrate differential power the educator-teacher-researcher has in different clinical areas.

Education, Nursing↗

PubMed2003

Use of restraints on dementia patients: an ethical dilemma of a nursing staff in Israel.

UNLABELLED: This quality improvement project investigates the ethical dilemmas faced by nursing staff (ie, registered nurses, practical nurses, and nurse aids) using restraints for dementia patients in "realistic" and "idealistic" situations. RATIONALE: There is a need to offer adequate care for a growing number of patients suffering from dementia and to ensure their safety. Restraints are a common practice for this purpose; however, they may inflict harm and contradict patient rights of freedom, autonomy, and respect. The issue becomes more complex in view of the multiple studies showing that the various justifications for using restraints are often based on caregiver interests and institutional considerations rather than on the patient's benefit. DESIGN: The project was conducted on a sample of 200 Israeli nursing staff members, half from internal medicine wards of 3 hospitals and the other half from 3 psychogeriatric nursing homes, all treating dementia patients. The project used a questionnaire composed of demographic data and an ethical preference questionnaire built on 18 situations concerning restraints. Situations were categorized into 3 purposes: (a) patient's benefit, (b) other patients' benefit, and (c) institutional benefit. These situations referred to realistic (ie, expressing views of daily practice) and idealistic (ie, expressing personal and professional beliefs and values) situations. RESULTS: The project exposes a discrepancy between the manner in which the nursing staff perceive use of restraints in an idealistic situation and in a realistic situation and the greater tendency to use restraints in the realistic situation than in the idealistic situation. The main contribution of the project is in revealing the conflict between the personal beliefs of the nursing staff and the nurses' perceptions of their institutional obligations. CONCLUSIONS: The project uncovered a discrepancy among the beliefs, the personal and professional values of the nursing staff, and their perception regarding the actual use of restraints in the daily work routine.

Adult↗

PubMed2003

The use of physical restraints for patients suffering from dementia.

This study reviews the ethical dilemmas of nursing staff about using restraints on patients suffering from dementia in two types of health care settings in Israel: internal medicine wards of three general hospitals; and psychogeriatric wards of three nursing homes. The nurses' level of knowledge about the Patient's Rights Law, the Israeli Code of Ethics, and the guidelines on restraints was analysed. The purposes of restraints were defined as beneficial to: (1) the patient; (2) other patients; or (3) the institution. The concept was evaluated in a realistic situation (expressing views of daily practice) and in an idealistic situation (expressing personal and professional beliefs and values). It was shown that nurses in internal medicine wards of general hospitals agreed more with the use of restraints than those in psychogeriatric wards in nursing homes. Differences were more pronounced when restraints were beneficial to the institution. In addition, nurses working in psychogeriatric wards of nursing homes had more knowledge about the guidelines on restraints and were less inclined than their counterparts to agree with the use of restraints for the benefit of other patients or the institution.

Accidental Falls↗

PubMed2002

Interventions used by nursing staff members with psychogeriatric patients resisting care.

Although resistance to care can have a major impact on the provision of care, relatively limited research has been reported on the topic. This research examined differences in the use of interventions by nurses in different care settings to manage resistance to care with eating and dressing. A convenience sample of 50 nurses (34 working in psychiatric hospitals and 16 in nursing homes) participated in the study. Nurses in both settings reported using similar interventions for both problems. Non-nursing interventions were consistently mentioned to be more common when resistance was accompanied by physical aggression than by verbal aggression.

Alzheimer Disease↗

PubMed2002

Elderly residents' participation and autonomy within a geriatric ward in a public institution.

In this study the importance of the concept of autonomy among residents in geriatric institutions was investigated. By granting the residents more autonomy, their satisfaction increased, their daily routine changed, and their participation in social activity increased. Correlation was found between the degree of autonomy and the degree of the participation in different activities within the ward. The conclusion reached is that the residents' quality of life improves with more autonomy within the institution's framework.

Age Factors↗

PubMedDate not supplied

Sexuality and Alzheimer's disease: can the two go together?

The issue of sexual relations in nursing homes between patients with Alzheimer-related dementia is in ward practice largely characterized by confusion and ignorance. Staff are seriously conflicted on how to respond and almost totally untrained on the subject. Patients are being mistreated and humiliated. Central to this state of affairs is insufficient awareness of the ethical and human rights elements in nursing care. Two case studies illustrate the practical dilemmas nurses must solve. A decision-making process is set out to reach an ethical and practical conclusion. Recommendations for action by nurses, the nursing profession, nursing home owners, and policy-makers are given.

Aged↗