International Journal of Environmental Research and Public Health
Background—Public safety personnel (PSP) are at heightened risk of developing mental health chall... more Background—Public safety personnel (PSP) are at heightened risk of developing mental health challenges due to exposures to diverse stressors including potentially psychologically traumatic experiences. An increased focus on protecting PSP mental health has prompted demand for interventions designed to enhance resilience. While hundreds of available interventions are aimed to improve resilience and protect PSPs’ mental health, research evidence regarding intervention effectiveness remains sparse. Methods—Focus groups with PSP elicited a discussion of psychoeducational program content, preferred modes of program delivery, when such training should occur, and to whom it ought to be targeted. Results—The results of thematic analyses suggest that PSP participants feel that contemporary approaches to improving mental health and resilience are lacking. While welcomed, the provision of sporadic one-off mental health and resilience programs by organizations was seen as insufficient, and the ...
... to the School of Graduate Studies of the University of Ottawa in partial fulfillment of the r... more ... to the School of Graduate Studies of the University of Ottawa in partial fulfillment of the requirements for the degree of Doctor cf Philosophy (::)David Cruise Malloy ... Summary of Information Related to Research Questions from Bommer, Gratto, Gravender, and Tuttle (1987 ...
In this paper we argue that while attention to and acting upon ethical codes of conduct is paramo... more In this paper we argue that while attention to and acting upon ethical codes of conduct is paramount in professional nursing conduct, a critical antecedent to ethical behaviour is ontological perception, that is, and how we view the patient as a person. We argue that the nurse’s perspective of the essence of patients (e.g., are they a means to our ends or ends in themselves?) will form the groundwork for the quality of ethical care provided. As a foil for our discussion, we use the 2013 case at the Mid Staffordshire General Hospital in the United Kingdom in which unethical practice among staff place patient health, safety, and dignity at risk. We conclude by offering an ontological dimension to a truly ‘patient first’ strategy which places the very essence of the patient as primary.
This research explores moral agency among a group of nurses in an urban hospital located in a Wes... more This research explores moral agency among a group of nurses in an urban hospital located in a Western Canadian province. For this study, six Nurses were recruited and their stories describe various limitations within the culture of the healthcare system appears to constrict moral agency and possibly lead to moral distress among nurses. Moral agency seems to be influenced by hierarchy and taking initiatives, time/workload, and the “politics of healthcare”. Nurses also shared experiences of resiliency in facing moral dilemmas in the nursing profession. In conclusion, nurses appear to juggle conflicting priorities between providing quality care to patients and being efficient in the health system. As suggested by previous research, this climate leads to moral distress and may negatively influence the wellbeing of nurses in the care they provide to patients. Elisabeth Fortier was a graduate student in the Master of Science in Kinesiology & Health Studies program at the University of Reg...
International Journal of Environmental Research and Public Health, 2021
The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do ... more The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews (n = 3) and focus groups (n = 3) were conducted with 19 participants (public safety communicators (n = 2); paramedics (n = 7); and firefighters (n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of “frustrating moral expectations” emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated...
OJIN: The Online Journal of Issues in Nursing, 2015
Sixty nurses from five countries (Canada, India, Ireland, Japan, and Korea) took part in 11 focus... more Sixty nurses from five countries (Canada, India, Ireland, Japan, and Korea) took part in 11 focus groups that discussed the question: Do you consider your work meaningful? Fostering meaning and mentorship as part of the institutional culture was a central theme that emerged from the discussions. In this article, we begin with a background discussion of meaning and meaningful work as presented in the literature related to existentialism and hardiness. Next, we describe the method and analysis processes we used in our qualitative study asking how nurses find meaning in their very challenging work and report our findings of four themes that emerged from the comments shared by nurses, specifically relationships, compassionate caring, identity, and a mentoring culture. After offering a discussion of our findings and noting the limitations of this qualitative study, we conclude that nursing leaders and a culture of mentorship play an important role in fostering meaningful work and develop...
BackgroundPublic Safety Personnel (e.g., firefighters, paramedics, and police officers) are routi... more BackgroundPublic Safety Personnel (e.g., firefighters, paramedics, and police officers) are routinely exposed to human suffering and need to make quick, morally challenging decisions. Such decisions can affect their psychological wellbeing. Participating in or observing an event or situation that conflicts with personal values can potentially lead to the development of moral injury. Common stressors associated with moral injury include betrayal, inability to prevent death or harm, and ethical dilemmas. Potentially psychologically traumatic event exposures and post-traumatic stress disorder can be comorbid with moral injury; however, moral injury extends beyond fear to include spiritual, cognitive, emotional or existential struggles, which can produce feelings of severe shame, guilt, and anger.ObjectiveThis scoping review was designed to identify the extant empirical research regarding the construct of moral injury, its associated constructs, and how it relates to moral distress in f...
South-East Asian Journal of Medical Education, 2012
Research in ethical decision-making has received considerable attention in the realm of the busin... more Research in ethical decision-making has received considerable attention in the realm of the business community in the last three decades due in part to numerous high profile scandals (e.g., Enron). The medical community has been less engaged in this line of investigation as the primary scholar focus has been in biomedical as opposed to social science/humanities. However, recently researchers and their methods have been attracted to the medical field. The purpose of this paper is to explore whether an ethical decision-making measure prominent in the business literature can be applied to the medical contexts.
The purpose of this study is to investigate the influence that significant others have upon the p... more The purpose of this study is to investigate the influence that significant others have upon the perception of ethical climate in a Canadian provincial nonprofit sport federation. The study was theoretically based upon the concepts of differential association and role-set configuration as well as the ethical climate dimensions developed in a non-profit context by Agarwal and Malloy (1999). The results demonstrate some support for the earlier empirical and theoretical findings that suggest that members of non-profit organizations may not be influenced by internal strategies of control and conformity. While this study was based upon a single provincial sport federation, the authors cautiously draw attention to the implications that the results may have for other non-profit organizations.
With ethics fast becoming a mainstay in tourism studies and the tourism industry in general, this... more With ethics fast becoming a mainstay in tourism studies and the tourism industry in general, this volume provides a timely and intensive look at the theory and practice of codes of ethics in tourism. While the book includes a broad overview of what has been done to date in ...
The primary purpose of this paper is to provide an overview of the theoretical underpinnings of e... more The primary purpose of this paper is to provide an overview of the theoretical underpinnings of ethical decision making for the sport administrator. A secondary purpose is to argue for changes to the pedagogical nature and process in sport administration programs so that students have the ability to make decisions with a critically conscious praxis. Four philosophical approaches to ethics and two psychological approaches to moral reasoning are briefly discussed. A synthesis of philosophical and psychological approaches is suggested as a means to understand, in a comprehensive manner, the ethical decision-making behavior of the sport administrator within what may well be a contradiction-based sport organization. Finally, some comments are made on ways that this synthesized approach might be used in a critical active pedagogy in sport administration programs.
Developments in marketing science: proceedings of the Academy of Marketing Science, 2015
Models of ethical decision-making in marketing generally have been developed from means or proces... more Models of ethical decision-making in marketing generally have been developed from means or process oriented and ends-oriented theoretical foundations (e.g., Hunt and Vitell 1986; Ferrell, Gresham, and Fraedrich 1989; Malhotra and Miller 1998). These two approaches have provided the decision-maker with ethical views that focus upon the established principles of ethical conduct and upon the consequences of one's actions. Though there exists many variations and attempts at hybridization within these two approaches (e.g., Ross' (1975) primae facie theory and Berkley's (1957) rule utilitarianism), essentially they lead toward decisions that are duty-bound (i.e., deontology) or results-bound (i.e., teleology). The recurring emphasis upon these two approaches in the business context is not surprising as they methodologically suit the business environment. For example, the deontological approach is rule-based. So whether one is abiding by the individual firm's code of ethics or by the profession's code of ethics (e.g., American Marketing Association Code of Ethics) one may be perceived to be acting deontologically. Similarly, if one's decisions are based from the teleological perspective, then the decision-maker will be adhering to a rational calculation that factors in the greatest good for the firm (local-utilitarianism) and/or for the commonweal (cosmopolitan utilitarianism). Generally speaking then, this Janus-headed approach has more or less defined the "theoretical universe" for business and marketing ethics implicitly and in recent years explicitly, for the practitioner and scholar (Brady 1985; Beauchamp and Bowie 1988; Hunt and Vitell 1986; Kavathatzopoulos 1993). In this paper, we argue for the expansion of this business ethics "universe" to include a third and radically different theoretical approach to ethical decision-making in marketing. This third approach is existentialism.
International Journal of Nonprofit and Voluntary Sector Marketing, 2003
His research interests include marketing ethics and research methodology. His research has been p... more His research interests include marketing ethics and research methodology. His research has been published in several peer-reviewed journals focusing on marketing, business, the nonprofit sector and ethics.
Although some individual and organizational contributors to person-centred care or quality of car... more Although some individual and organizational contributors to person-centred care or quality of care have been studied, they have rarely been examined together. Our goal was to investigate the association of personal and organizational-environmental characteristics with self-reported person-centred behaviours in long-term residential care settings. We asked 109 long-term care staff from two Canadian long-term care homes to complete scales assessing self-reported person-centred care, organizational support for person-centred care, beliefs about personhood in dementia, and burnout. Independent variables included four employee background characteristics (age, gender, occupation, and years of education), beliefs about personhood in dementia, burnout, and three aspects of organizational support for person-centred care (the physical environment of residents, collaboration on care, and support from management). Dependent variables included five aspects of person-centred care: autonomy, personhood, knowing the person, comfort care, and support for relationships .We used multiple linear regression analysis and changes in R(2) to test variable associations. Including organizational variables in regression models resulted in statistically significant (p < .05) changes in R(2) for each of the five dependent variables. Including personal variables resulted in statistically significant changes in R(2) for some dependent variables, but not others. In particular, including employee background characteristics resulted in a statistically significant change in R(2) for comfort care, and including beliefs about personhood and burnout resulted in statistically significant changes in R(2) for personhood but not for other dependent variables. Organizational characteristics are associated with several aspects of person-centred dementia care. Individual characteristics, including gender, beliefs about personhood, and burnout, appear to be more important to some aspects of person-centred dementia care (e.g., respect for personhood and comfort care) than others.
To study resilience among long-term care (LTC) nurses and its relationship to organisational empo... more To study resilience among long-term care (LTC) nurses and its relationship to organisational empowerment, self-reported quality of care, perceptions of resident personhood (i.e. viewing another person as a person, implying respect) and absenteeism. Although resilience has been examined among nurses, it has not been studied in LTC nurses where resident rates of dementia are high, and nurses may experience stress affecting care and the way residents are perceived. A sample of one hundred and thirty LTC nurses from across North America completed a series of questionnaires. Resilient nurses were more likely to report higher quality of care and to view residents as having higher personhood status (despite deteriorating cognitive function). Resilience was not predictive of absenteeism. Organisational empowerment did not add to the predictive power of resilience. Resilience is of importance in LTC nursing research and future studies could examine this construct in relation to objectively m...
International Journal of Environmental Research and Public Health
Background—Public safety personnel (PSP) are at heightened risk of developing mental health chall... more Background—Public safety personnel (PSP) are at heightened risk of developing mental health challenges due to exposures to diverse stressors including potentially psychologically traumatic experiences. An increased focus on protecting PSP mental health has prompted demand for interventions designed to enhance resilience. While hundreds of available interventions are aimed to improve resilience and protect PSPs’ mental health, research evidence regarding intervention effectiveness remains sparse. Methods—Focus groups with PSP elicited a discussion of psychoeducational program content, preferred modes of program delivery, when such training should occur, and to whom it ought to be targeted. Results—The results of thematic analyses suggest that PSP participants feel that contemporary approaches to improving mental health and resilience are lacking. While welcomed, the provision of sporadic one-off mental health and resilience programs by organizations was seen as insufficient, and the ...
... to the School of Graduate Studies of the University of Ottawa in partial fulfillment of the r... more ... to the School of Graduate Studies of the University of Ottawa in partial fulfillment of the requirements for the degree of Doctor cf Philosophy (::)David Cruise Malloy ... Summary of Information Related to Research Questions from Bommer, Gratto, Gravender, and Tuttle (1987 ...
In this paper we argue that while attention to and acting upon ethical codes of conduct is paramo... more In this paper we argue that while attention to and acting upon ethical codes of conduct is paramount in professional nursing conduct, a critical antecedent to ethical behaviour is ontological perception, that is, and how we view the patient as a person. We argue that the nurse’s perspective of the essence of patients (e.g., are they a means to our ends or ends in themselves?) will form the groundwork for the quality of ethical care provided. As a foil for our discussion, we use the 2013 case at the Mid Staffordshire General Hospital in the United Kingdom in which unethical practice among staff place patient health, safety, and dignity at risk. We conclude by offering an ontological dimension to a truly ‘patient first’ strategy which places the very essence of the patient as primary.
This research explores moral agency among a group of nurses in an urban hospital located in a Wes... more This research explores moral agency among a group of nurses in an urban hospital located in a Western Canadian province. For this study, six Nurses were recruited and their stories describe various limitations within the culture of the healthcare system appears to constrict moral agency and possibly lead to moral distress among nurses. Moral agency seems to be influenced by hierarchy and taking initiatives, time/workload, and the “politics of healthcare”. Nurses also shared experiences of resiliency in facing moral dilemmas in the nursing profession. In conclusion, nurses appear to juggle conflicting priorities between providing quality care to patients and being efficient in the health system. As suggested by previous research, this climate leads to moral distress and may negatively influence the wellbeing of nurses in the care they provide to patients. Elisabeth Fortier was a graduate student in the Master of Science in Kinesiology & Health Studies program at the University of Reg...
International Journal of Environmental Research and Public Health, 2021
The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do ... more The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews (n = 3) and focus groups (n = 3) were conducted with 19 participants (public safety communicators (n = 2); paramedics (n = 7); and firefighters (n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of “frustrating moral expectations” emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated...
OJIN: The Online Journal of Issues in Nursing, 2015
Sixty nurses from five countries (Canada, India, Ireland, Japan, and Korea) took part in 11 focus... more Sixty nurses from five countries (Canada, India, Ireland, Japan, and Korea) took part in 11 focus groups that discussed the question: Do you consider your work meaningful? Fostering meaning and mentorship as part of the institutional culture was a central theme that emerged from the discussions. In this article, we begin with a background discussion of meaning and meaningful work as presented in the literature related to existentialism and hardiness. Next, we describe the method and analysis processes we used in our qualitative study asking how nurses find meaning in their very challenging work and report our findings of four themes that emerged from the comments shared by nurses, specifically relationships, compassionate caring, identity, and a mentoring culture. After offering a discussion of our findings and noting the limitations of this qualitative study, we conclude that nursing leaders and a culture of mentorship play an important role in fostering meaningful work and develop...
BackgroundPublic Safety Personnel (e.g., firefighters, paramedics, and police officers) are routi... more BackgroundPublic Safety Personnel (e.g., firefighters, paramedics, and police officers) are routinely exposed to human suffering and need to make quick, morally challenging decisions. Such decisions can affect their psychological wellbeing. Participating in or observing an event or situation that conflicts with personal values can potentially lead to the development of moral injury. Common stressors associated with moral injury include betrayal, inability to prevent death or harm, and ethical dilemmas. Potentially psychologically traumatic event exposures and post-traumatic stress disorder can be comorbid with moral injury; however, moral injury extends beyond fear to include spiritual, cognitive, emotional or existential struggles, which can produce feelings of severe shame, guilt, and anger.ObjectiveThis scoping review was designed to identify the extant empirical research regarding the construct of moral injury, its associated constructs, and how it relates to moral distress in f...
South-East Asian Journal of Medical Education, 2012
Research in ethical decision-making has received considerable attention in the realm of the busin... more Research in ethical decision-making has received considerable attention in the realm of the business community in the last three decades due in part to numerous high profile scandals (e.g., Enron). The medical community has been less engaged in this line of investigation as the primary scholar focus has been in biomedical as opposed to social science/humanities. However, recently researchers and their methods have been attracted to the medical field. The purpose of this paper is to explore whether an ethical decision-making measure prominent in the business literature can be applied to the medical contexts.
The purpose of this study is to investigate the influence that significant others have upon the p... more The purpose of this study is to investigate the influence that significant others have upon the perception of ethical climate in a Canadian provincial nonprofit sport federation. The study was theoretically based upon the concepts of differential association and role-set configuration as well as the ethical climate dimensions developed in a non-profit context by Agarwal and Malloy (1999). The results demonstrate some support for the earlier empirical and theoretical findings that suggest that members of non-profit organizations may not be influenced by internal strategies of control and conformity. While this study was based upon a single provincial sport federation, the authors cautiously draw attention to the implications that the results may have for other non-profit organizations.
With ethics fast becoming a mainstay in tourism studies and the tourism industry in general, this... more With ethics fast becoming a mainstay in tourism studies and the tourism industry in general, this volume provides a timely and intensive look at the theory and practice of codes of ethics in tourism. While the book includes a broad overview of what has been done to date in ...
The primary purpose of this paper is to provide an overview of the theoretical underpinnings of e... more The primary purpose of this paper is to provide an overview of the theoretical underpinnings of ethical decision making for the sport administrator. A secondary purpose is to argue for changes to the pedagogical nature and process in sport administration programs so that students have the ability to make decisions with a critically conscious praxis. Four philosophical approaches to ethics and two psychological approaches to moral reasoning are briefly discussed. A synthesis of philosophical and psychological approaches is suggested as a means to understand, in a comprehensive manner, the ethical decision-making behavior of the sport administrator within what may well be a contradiction-based sport organization. Finally, some comments are made on ways that this synthesized approach might be used in a critical active pedagogy in sport administration programs.
Developments in marketing science: proceedings of the Academy of Marketing Science, 2015
Models of ethical decision-making in marketing generally have been developed from means or proces... more Models of ethical decision-making in marketing generally have been developed from means or process oriented and ends-oriented theoretical foundations (e.g., Hunt and Vitell 1986; Ferrell, Gresham, and Fraedrich 1989; Malhotra and Miller 1998). These two approaches have provided the decision-maker with ethical views that focus upon the established principles of ethical conduct and upon the consequences of one's actions. Though there exists many variations and attempts at hybridization within these two approaches (e.g., Ross' (1975) primae facie theory and Berkley's (1957) rule utilitarianism), essentially they lead toward decisions that are duty-bound (i.e., deontology) or results-bound (i.e., teleology). The recurring emphasis upon these two approaches in the business context is not surprising as they methodologically suit the business environment. For example, the deontological approach is rule-based. So whether one is abiding by the individual firm's code of ethics or by the profession's code of ethics (e.g., American Marketing Association Code of Ethics) one may be perceived to be acting deontologically. Similarly, if one's decisions are based from the teleological perspective, then the decision-maker will be adhering to a rational calculation that factors in the greatest good for the firm (local-utilitarianism) and/or for the commonweal (cosmopolitan utilitarianism). Generally speaking then, this Janus-headed approach has more or less defined the "theoretical universe" for business and marketing ethics implicitly and in recent years explicitly, for the practitioner and scholar (Brady 1985; Beauchamp and Bowie 1988; Hunt and Vitell 1986; Kavathatzopoulos 1993). In this paper, we argue for the expansion of this business ethics "universe" to include a third and radically different theoretical approach to ethical decision-making in marketing. This third approach is existentialism.
International Journal of Nonprofit and Voluntary Sector Marketing, 2003
His research interests include marketing ethics and research methodology. His research has been p... more His research interests include marketing ethics and research methodology. His research has been published in several peer-reviewed journals focusing on marketing, business, the nonprofit sector and ethics.
Although some individual and organizational contributors to person-centred care or quality of car... more Although some individual and organizational contributors to person-centred care or quality of care have been studied, they have rarely been examined together. Our goal was to investigate the association of personal and organizational-environmental characteristics with self-reported person-centred behaviours in long-term residential care settings. We asked 109 long-term care staff from two Canadian long-term care homes to complete scales assessing self-reported person-centred care, organizational support for person-centred care, beliefs about personhood in dementia, and burnout. Independent variables included four employee background characteristics (age, gender, occupation, and years of education), beliefs about personhood in dementia, burnout, and three aspects of organizational support for person-centred care (the physical environment of residents, collaboration on care, and support from management). Dependent variables included five aspects of person-centred care: autonomy, personhood, knowing the person, comfort care, and support for relationships .We used multiple linear regression analysis and changes in R(2) to test variable associations. Including organizational variables in regression models resulted in statistically significant (p < .05) changes in R(2) for each of the five dependent variables. Including personal variables resulted in statistically significant changes in R(2) for some dependent variables, but not others. In particular, including employee background characteristics resulted in a statistically significant change in R(2) for comfort care, and including beliefs about personhood and burnout resulted in statistically significant changes in R(2) for personhood but not for other dependent variables. Organizational characteristics are associated with several aspects of person-centred dementia care. Individual characteristics, including gender, beliefs about personhood, and burnout, appear to be more important to some aspects of person-centred dementia care (e.g., respect for personhood and comfort care) than others.
To study resilience among long-term care (LTC) nurses and its relationship to organisational empo... more To study resilience among long-term care (LTC) nurses and its relationship to organisational empowerment, self-reported quality of care, perceptions of resident personhood (i.e. viewing another person as a person, implying respect) and absenteeism. Although resilience has been examined among nurses, it has not been studied in LTC nurses where resident rates of dementia are high, and nurses may experience stress affecting care and the way residents are perceived. A sample of one hundred and thirty LTC nurses from across North America completed a series of questionnaires. Resilient nurses were more likely to report higher quality of care and to view residents as having higher personhood status (despite deteriorating cognitive function). Resilience was not predictive of absenteeism. Organisational empowerment did not add to the predictive power of resilience. Resilience is of importance in LTC nursing research and future studies could examine this construct in relation to objectively m...
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