A vallásosság szerepe az intenzív osztályon dolgozó orvosok és ápolók véleményének kialakításában az életvégi döntések meghozatalakor

Összefoglaló. Bevezetés: A haldoklást minden korban kulturális és vallási szabályok vették körül, melyek a mai napig hatnak a társadalomban. A 21. században számos beteg a kórházban, az intenzív osztályon fejezi be életét, ahol nem ritkán kerülhet sor életvégi döntés meghozatalára. Célkitűzés: Vizsgálatunk célja annak feltárása volt, milyen hatással van az orvosok és ápolók vallásossága a kezeléskorlátozással kapcsolatos döntésekre az intenzív osztályon. Módszer: Magyarországi intenzív osztályokon dolgozó orvosok és szakdolgozók körében végeztünk kérdőíves felmérést a vallás életvégi döntésekre gyakorolt hatásáról. 189 orvos és 105 ápoló által anonim módon kitöltött kérdőívet elemeztünk. Eredmények: Az intenzív osztályra történő betegfelvételre nem volt hatással a vallásosság, azonban a szabad ágyak száma a vallásos orvosokat erősebben befolyásolta, mint az ateista és választ nem adó orvosokat (<0,0001). A vallásukat gyakorló orvosok szignifikánsan jobban figyelembe vették a hozzátartozó kérését, mint az ateisták (p = 0,0002). A vallásos ápolók gyakrabban folytatnák a beteg kezelését a hozzátartozó kérése ellenére is, ha még látnának esélyt a gyógyulásra, mint a nem vallásosak. Következtetés: Vizsgálatunk alátámasztotta, hogy a világnézet befolyásolja az orvosokat és ápolókat az élet végéről hozott döntésekben. A kezeléskorlátozásról hozott döntés összetett, elengedhetetlen megismerni hozzá a beteg és családjának haldoklással kapcsolatos vallási szokásait, mivel jó életvégi döntés a világnézeti szempontok figyelembevétele nélkül nem hozható. Orv Hetil. 2021; 162(51): 2047–2054. Summary. Introduction: Death has always been surrounded by habits in all ages, influenced by cultural and religious differences. Many patients finish their lives at intensive care units where end-of-life decisions are the part of everyday practice in the 21th century. Objective: The goal of our study was to assess how the religious beliefs of physicians and nurses affect their decision on therapy restriction. Method: We have performed questionnaire-based enquiries among physicians and nurses working at intensive care units on how religion affects end-of-life decisions. We have analyzed the anonymous questionnaires filled out by 189 physicians and 105 nurses. Results: Our results have confirmed the hypothesis that religion affects decision making about therapy restriction. Patients’ admissions were not affected by religious beliefs, but the number of available patient beds influenced the religious physicians more than the atheists ones or the non-responders (<0.0001). Actively religious physicians complied significantly better with the relatives than atheists (p = 0.0002). Religious nurses would continue patient treatment even against the will of relatives more often than atheists if they see a chance for recovery. Conclusion: The study supports that religion influences physicians and nurses in their end-of-life decisions. Decisions on therapy restriction are complex; it is important to find out religious beliefs and perception of death among patients and families because good end-of-life decision cannot be made disregarding religious considerations. Orv Hetil. 2021; 162(51): 2047–2054.

Studying adolescent information behavior in the context of making everyday life decisions: Methodological approach, main concerns and lessons learned

This paper presents the main methodological issues met with during the research on adolescent everyday life information behavior in the context of making informed decisions, which was carried out in Croatia from 2018 to 2020. It does not focus on the research results, but rather on the methodological issues and concerns that had occurred stemming from the specific life period of the population being investigated, and on the ways the researchers delt with them. They are offered as potentially useful for consideration to those who will investigate adolescent information behavior in other contexts. Six main methodological dilemmas arose while planning the design of research methodology coming out from six questions: what would be the appropriate research approach and design to investigate adolescent information behavior in the context of making informed everyday life decisions, what would be the developmentally appropriate way to investigate the phenomena, how to gain access to the potential adolescent research participants, how to negotiate an adult researcher’s position when interacting with adolescents, how to get adolescent participants’ trust needed to collect rich data and what ethical issues need to be considered. We offer an overview of the dilemmas and concerns, as well as the ways they were dealt with, acknowledging the contribution of those scholars who had responded to similar challenges in the past.

One World: One Dream

In this chapter, I consider the growing influence of China and growing numbers of Chinese in Laos and argue that managing this relationship may well be the biggest challenge facing the Lao authorities and is the most likely cause of any legitimacy crisis in Laos. Lao people are making life decisions with increasing reference to China and responding in ways that are marked by pragmatism as Chinese influence increases. Fundamentally, the rise of China in Laos is leading to a renewed sense of Laos and Laoness. This provides the Lao authorities with a renewed sense of legitimacy, as they are expected to do something for the population in response to rising adverse influences from China. Whether they will do anything meaningful to address these concerns is another question.

Trends and Patterns in the Public Awareness of Palliative Care, Euthanasia, and End-of-Life Decisions in 3 Central European Countries Using Big Data Analysis From Google: Retrospective Analysis

Background End-of-life decisions, specifically the provision of euthanasia and assisted suicide services, challenge traditional medical and ethical principles. Austria and Germany have decided to liberalize their laws restricting assisted suicide, thus reigniting the debate about a meaningful framework in which the practice should be embedded. Evidence of the relevance of assisted suicide and euthanasia for the general population in Germany and Austria is limited. Objective The aim of this study is to examine whether the public awareness documented by search activities in the most frequently used search engine, Google, on the topics of palliative care, euthanasia, and advance health care directives changed with the implementation of palliative care services and new governmental regulations concerning end-of-life decisions. Methods We searched for policies, laws, and regulations promulgated or amended in Austria, Germany, and Switzerland between 2004 and 2020 and extracted data on the search volume for each search term topic from Google Trends as a surrogate of public awareness and interest. Annual averages were analyzed using the Joinpoint Regression Program. Results Important policy changes yielded significant changes in search trends for the investigated topics. The enactment of laws regulating advance health care directives coincided with a significant drop in the volume of searches for the topic of euthanasia in all 3 countries (Austria: −24.48%, P=.02; Germany: −14.95%, P<.001; Switzerland: −11.75%, P=.049). Interest in palliative care increased with the availability of care services and the implementation of laws and policies to promote palliative care (Austria: 22.69%, P=.01; Germany: 14.39, P<.001; Switzerland: 17.59%, P<.001). The search trends for advance health care directives showed mixed results. While interest remained steady in Austria within the study period, it increased by 3.66% (P<.001) in Switzerland and decreased by 2.85% (P<.001) in Germany. Conclusions Our results demonstrate that legal measures securing patients’ autonomy at the end of life may lower the search activities for topics related to euthanasia and assisted suicide. Palliative care may be a meaningful way to raise awareness of the different options for end-of-life care and to guide patients in their decision-making process regarding the same.

How Does it Feel to Be Part of the Minority?: Impacts of Perspective Taking on Prosocial Behavio

Can online experiences that illustrate the lives of vulnerable populations improve prosocial behaviors and reduce prejudice? We randomly assign 850 individuals to: i) an online game that immerses individuals in the life decisions of a Venezuelan migrant and ii) a documentary about the migration process of Venezuelans to Colombia. Both treatments effectively improve altruism and reduce prejudice towards migrants. The impacts of both treatments are not statistically different in any of the other outcomes that we examine. The effects of the game are mainly driven by changes in perspective-taking while the effects of the video are induced by changes in both empathy and perspective-taking.