Background: Patients have the right to equal, respectful treatment. Nowadays, one third of patient complaints concern health care staff's behavior towards patients. Ethically safe care requires ethical competence, which has been addressed as a core competence in physiotherapy. It has been defined in terms of character strength, ethical awareness, moral judgment skills in decision-making, and willingness to do good. The purpose of this study was to analyze the ethical competence of practicing physiotherapists. Method: A self-evaluation instrument (Physiotherapist's Ethical Competence Evaluation Tool) based on an analysis of a concept "ethical competence" was constructed in 2016 and physiotherapists (n = 839), working in public health services or private practice responded to the questionnaire. Results: Based on the results, most of the physiotherapists evaluated themselves highly ethically competent in all areas of ethical competence, subscales being Strength, Awareness, Skills and Will. Willingness to do good was evaluated as highest, while character strength, including the strength to support ethical processes and speak on behalf of the patient, was evaluated the lowest. Physiotherapists most commonly consult a colleague when encountering an ethical problem. Other methods for problem solving are not very familiar, neither are the international or national ethical codes of conduct. Conclusions: This was the first attempt to assess all aspects of ethical competence empirically in a clinical environment in physiotherapy, using a novel self-evaluation instrument. Even if physiotherapists evaluate themselves as competent in ethics, further exploration is needed for ethical awareness. Also the patients' viewpoints about ethically competent care should be considered, to better ensure ethical safety of the patient.
Acute haemorrhagic pancreatitis was induced in rats by injecting aqueous solution of sodium taurocholate into the common biliopancreatic duct. Lecithin and lysolecithin were separated from pulmonary homogenate by thin layer chromatography and quantified by phosphorus determination. The ratio of lysolecithin to lecithin increased after the sodium taurocholate injection as well as after i.v. administration of porcine pancreatic phospholipase A2. It was concluded that phospholipase A2, released from pancreatic acinar cells into blood, may convert pulmonary lecithin into lysolecithin during acute pancreatitis. Destruction of pulmonary surfactant may contribute to the development of the adult respiratory distress syndrome as seen in patients suffering from severe acute pancreatitis.
Evidence-based healthcare (EBHC) has been recognised worldwide as important for the quality of social and healthcare services and patient care. It improves patient/client safety and decreases the variability of care, adverse events, and healthcare costs (Rudman et al., 2020). Also, the World Health Organization (WHO) has assumed that healthcare services and practices should be based on the best available evidence (WHO, 2017). Therefore, the WHO produces, for example, evidence-based guidelines and recommendations for informing global healthcare policy and practices (WHO, 2014). Systematic reviews and evidence-based clinical guidelines represent the best evidence, which is a prerequisite for the implementation of EBHC (WHO, 2017).
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