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Survival protection of patients undergoing hematopoietic stem cell transplantation: grounded theory.

PurposeFor patients with blood malignancies, hematopoietic stem cell transplantation (HSCT) is a significant challenge. These patients have hope to be completely cured after the transplantation, but deal with the dread of dying at the same time. This study presents a deep understanding of the psychological process of the treatment including perception, emotion, interactions, and its consequences in patients undergoing HSCT.MethodsThis study utilized a qualitative method based on the Strauss and Corbin Approach toward the grounded theory. The research population comprised all patients undergoin

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… Altruism Patients understood each other better when they were weak and in pain. They showed a sense of altruism and empathy toward other patients. “I am very interested in sharing my experiences with patients who are hospitalized after me in this ward. … These strategies help remove debris, rebuild their character, and become fond of life, which elevates patients’ spirits to continue lives and enjoy a new beginning, peace in life, and altruism. …

The role of the altruistic unbalanced chain in exchange living donor renal transplantation: single-center experience.

BACKGROUND: The exchange donor program in renal transplantation is an efficient solution for recipients with a blood type or crossmatch-incompatible donor. However, this program has some difficulties to define unacceptable human leukocyte antigen matches, deteriorating clinical potential recipient condition, and withdrawal of donor consent. We analyzed the outcomes of exchange donor renal transplantation through the altruistic unbalanced chain. METHODS: Among 152 cases of exchange donor renal transplantation from 1991 to 2010 in our hospital, we performed 58 procedures through altruistic unba

[Does the French Big Five Inventory evaluate facets other than the Big Five factors?].

INTRODUCTION: The Big Five Inventory (BFI) developed by John et al. (1991) is one of the most widely accepted tools for assessing dimensions … emporal stability. We found a single facet for Extraversion (Assertiveness), two for Agreeableness (Altruism and Compliance), two for Conscientiousness (Self-Discipline and Order), one for Neuroticism (Anxiety), and two for Openness to Experience (Openness to aesthetics and Openness to ideas). Based on their convergence with the corresponding facets in the …

Equipoise, design bias, and randomized controlled trials: the elusive ethics of new drug development.

The concept of 'equipoise', or the 'uncertainty principle', has been represented as a central ethical principle, and holds that a subject may be enrolled in a randomized controlled trial (RCT) only if there is true uncertainty about which of the trial arms is most likely to benefit the patient. We sought to estimate the frequency with which equipoise conditions were met in industry-sponsored RCTs in rheumatology, to explore the reasons for any deviations from equipoise, to examine the concept of 'design bias', and to consider alternative ethical formulations that might improve subject safety a

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… Contrary to the altruism expressed by many patients, equipoise gives weight neither to personal autonomy nor to personal satisfaction. … A common circumstance is altruism, with the patient valuing social progress higher than personal risks. In other instances, minimal increases in risks, although real, may be of little importance to the patient. …

Sterilization, Catholic health care, and the legitimate autonomy of culture.

Disagreement over the legitimacy of direct sterilization continues within Catholic moral debate, with painful and at times confusing ramifications for Catholic healthcare systems. This paper argues that the medical profession should be construed as a key moral authority in this debate, on two grounds. First, the recent revival of neo-Aristotelianism in moral philosophy as applied to medical ethics has brought out the inherently moral dimensions of the history and current practice of medicine. Second, this recognition can be linked to Catholic morality through Vatican II's affirmation of the le

"What I wanted to do was build myself back up and prepare": qualitative findings from the PERCEPT trial of prehabilitation during autologous stem cell transplantation in myeloma.

BackgroundThe addition of qualitative methodology to randomised controlled trials evaluating complex interventions allows better understanding of contextualised factors and their potential influence on trial delivery and outcomes, as well as opportunities for feedback on trial participation to improve future trial protocols. This study explored the experiences of participation in cancer rehabilitation research during active cancer treatment. Participants were people living with haematological cancer myeloma, undergoing autologous stem cell transplantation (ASCT) recruited to the PERCEPT myelom

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… Altruism is known to be an important influence in recruitment to health-related RCTs with evidence that trial participants can be motivated by a genuine wish to contribute to knowledge and improvement in care as well as a way of ‘giving back’ [ 26 , 27 ]. … It has been established that perceived personal gain comes before altruism as motivating factors in trial participation, but it has also been proposed that altruism becomes the primary motivator for control participants after randomisation has occurred [ 39 ]. …

Exploring motivations of peer supporters for caregivers of patients with hematological malignancies-a qualitative study.

PurposeSocial support interventions, particularly peer support from former family caregivers, offer unique assistance to caregivers of newly diagnosed patients. Since voluntary peer support is driven by personal choice, understanding the motivations for participating and how motivation evolves over time is essential. This study explores the motivations for becoming a peer support provider for family caregivers of patients with hematological malignancies and how motivation changes over time.MethodsThis qualitative study encompasses 18 semi-structured interviews with family caregivers providing

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… Likewise, our results show that FCAs were primarily driven by intrinsic motivations, such as the desire to help others and the personal satisfaction derived from feelings of purpose, meaningfulness, and altruism. … One possible explanation is that FCAs, being caregivers of former patients themselves, are particularly motivated by altruism and empathetic emotions focused on the well-being of others [ 37 ]. …

"Something Good Has to Come Out of the Horror": A Qualitative Examination of Cancer Survivors' Attitudes Towards Participation in Research During the First Year of the COVID-19 Pandemic.

Introduction: The first year of the COVID-19 pandemic has been highly disruptive for people with cancer. Furthermore, it has been shown that accrual to cancer trials dropped substantially in 2020. Building on findings from a previous pilot survey, the present study used qualitative methods to gain insights into attitudes towards participation in research studies amongst people who have experienced cancer, in the context of the first year of the COVID-19 pandemic. Materials and Methods: We interviewed 13 participants from the UK, who were purposively sampled, including a broad sample of cancer

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… patient's degree of trust and confidence in their healthcare professionals; (2) the style of communication of information about the trial between physician and patient (which, when suboptimal or rushed, could lead to patients feeling uninformed and alienated); (3) the sense of moral obligation, or altruism … Viljoen et al. also reported that a sense of altruism towards society was a key factor in motivating individuals to take part in research studies. …

Measuring quality of life in people living with and beyond cancer in the UK.

PurposeThe aim of this study was to identify the most appropriate measure of quality of life (QoL) for patients living with and beyond cancer.MethodsOne hundred eighty-two people attending cancer clinics in Central London at various stages post-treatment, completed a series of QoL measures: FACT-G, EORTC QLQ-C30 , IOCv2 (positive and negative subscales) and WEMWBS, a wellbeing measure. These measures were chosen as the commonest measures used in previous research. Correlation tests were used to assess the association between scales. Participants were also asked about pertinence and ease of com

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… The Impact of Cancer (IOCv2) questionnaire was specifically developed to measure not only the unique negative impacts of cancer, such as worry and body change concerns, but also the positive impact of cancer associated with long-term survivorship, such as increased altruism and positive self-evaluation … The four positive subscales include: Altruism/Empathy, Health Awareness, Meaning of Cancer and Positive Self-Evaluation; a higher score signifies better QoL. The negative subscales include Appearance Concerns, Body Change Concerns, Life Interferences and Worry. A higher score signifies worse QoL. …

Conflicts of interest: research and clinical care.

Conflicts of interest and other ethical dilemmas occur in Alzheimer disease (AD) patient care and research but often are underrecognized by physicians. One or more bioethical principles of autonomy, confidentiality, truth telling, beneficence, and justice, which apply to demented individuals as they do to other patients, may conflict in everyday clinical situations. For example, when demented patients wish to continue driving, autonomy (the patient's right to self-determination) conflicts with beneficence (the duty to promote the patient's welfare). Cognitively impaired patients depend on othe

Negotiating international bioethics: a response to Tom Beauchamp and Ruth Macklin.

Can the bioethical theories that have served American bioethics so well, serve international bioethics as well? In two papers in the previous issue of the Kennedy Institute of Ethics Journal, I contend that the form of principlist fundamentalism endorsed by American bioethicists like Tom Beauchamp and Ruth Macklin will not play on an international stage. Deploying techniques of postmodern scholarship, I argue that principlist fundamentalism justifies neither the condemnation of the Nazi doctors at Nuremberg, nor, as the Report of the Advisory Committee on the Human Radiation Experiments (ACHRE

Understanding Why Parents Say Yes or No to Organ Donation When Their Child Dies: Mixed-Methods Study.

AIM: To explore why parents consent to or decline organ donation after their child's death and identify the factors that influence their dec … are, cultural and religious beliefs and the need for surgery. Factors facilitating consent included altruism, creating a positive legacy, and prior knowledge of organ donation. Parents fell into four decision groups: those who immediately consented, hesitated but consented, hesitated but declined and immediately declined. CONCLUSION: This study provides n …

Barriers and facilitators to the implementation of lay health worker programmes to improve access to maternal and child health: qualitative evidence synthesis.

BACKGROUND: Lay health workers (LHWs) perform functions related to healthcare delivery, receive some level of training, but have no formal p … HWs added to their workload and feared a loss of authority.LHWs were motivated by factors including altruism, social recognition, knowledge gain and career development. Some unsalaried LHWs wanted regular payment, while others were concerned that payment might threaten their social status or lead recipients to question their motives. Some salaried LHWs wer …

The penumbra of thalidomide, the litigation culture and the licensing of pharmaceuticals.

Fifty years ago several thousand children were born with severe limb defects after their mothers had been given thalidomide in pregnancy. This tragedy caused procedures for licensing new medicines to become much stricter. Where, nevertheless, significant side effects were found it became common to sue for damages. These consequences have caused possibly an even greater disaster damaging many more people and threatening ruin to health services everywhere. The huge increase in both time and cost in bringing medicines to market is increasing their price to unsupportable levels; and only wealthy c

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… There are serious moral objections to this sort of advertising and of course these lawyers do not act entirely out of altruism but also for their own profit. Figure 5 Advertising class actions—a public harm. …

A defense of fundamental principles and human rights: a reply to Robert Baker.

This article seeks to rebut Robert Baker's contention that attempts to ground international bioethics in fundamental principles cannot withstand the challenges posed by multiculturalism and postmodernism. First, several corrections are provided of Baker's account of the conclusions reached by the Advisory Committee on Human Radiation Experiments. Second, a rebuttal is offered to Baker's claim that an unbridgeable moral gap exists between Western individualism and non-Western communalism. In conclusion, this article argues that Baker's "nonnegotiable primary goods" cannot do the work of "classi

Intuitive vs Deliberative Approaches to Making Decisions About Life Support: A Randomized Clinical Trial.

ImportancePatients with serious illnesses are often encouraged to actively deliberate about the desirability of life support. Yet it is unknown whether deliberation changes the substance or quality of such decisions.ObjectiveTo identify differences in decisions about life support interventions and goals of care made intuitively vs deliberatively by patients with serious illnesses.Design, setting, and participantsRandomized clinical trial in which patients were asked to express treatment preferences in a series of clinical scenarios. Participants were 199 hospitalized patients aged 60 years and

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… Nature . 2012 ; 489 ( 7416 ): 427 - 430 . doi: 10.1038/nature11467 22996558 23 Rand DG , Epstein ZG Risking your life without a second thought: intuitive decision-making and extreme altruism . …

Chidamide in Combination With DCAG With or Without Venetoclax for Relapsed/Refractory Acute Myeloid Leukemia.

INTRODUCTION: Currently, there are only a few avaailable treatment options for patients with relapsed and refractory acute myeloid leukemia (R/R AML). METHODS: We conducted a single-center, phase 1 prospective study (ChiCTR2200065634) to evaluate the efficacy and safety of chidamide, demethylating drugs (azacitidine), cytarabine, aclacinomycin, and G-CSF plus venetoclax (CDCAG-VEN) in patients with R/R AML. The previous CDCAG regimen was used as a historical control to compare its efficacy and safety. Thirty and 22 patients received one course of CDCAG with or without a 14-day course of venet

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… Acknowledgments The authors wish to acknowledge the courage and bravery of the patients and their families who participated in this study; without their hope and altruism, progress in this field would not be possible. …