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Knowledge, Attitude and Practice of HealthCare Ethics among resident doctors and ward nurses from a resource poor setting in Lahore “(descriptive cross-sectional study)”
SYNOPSIS
By
Muhammad Ramzan
Roll No. 14256
Session: 2013-2018
Registration NO: DPHY-1456

Department of Physical Therapy,
Azra Naheed Medical College,
The Superior University, Lahore.

-2018

Section 1: Particulars of the Supervisor
1.1 Full Name Dr Umair Awan
1.2 Designation Lecturer

Section 2: Particulars of the Student
2.1 Full Name MUHAMMAD RAMZAN
2.2 Father’s Name MUHAMMAD YAR
2.3 Registration Number DPHY-14256
2.4 Program Doctor of physical therapy

Section 3: Particulars of the synopsis
3.1 Title Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting in Lahore (descriptive cross-sectional study)”

3.2 Date of Submission

Section 4: Declaration of originality
4.1 I, MUHAMMAD.RAMZAN, hereby solemnly declare that this project is my original work, completed under the guidance of my worthy supervisor. Any change required in the content of this synopsis during thesis writing could only be incorporated after supervisor’s approval

4.2 Student’s Full signature Muhammad Ramzan
4.3 Date 6 September 2018

Section 5: Supervisor’s Consent
5.1 I certify that:
a. The above name student has completed the cited synopsis under my guidance and supervision.
b. I am satisfied with quality of the student’s work, and
c. I consider it worthy of proceeding for thesis writing
5.2 Supervisor’s Full signature
5.3 Date

INTRODUCTION
Important number of doctors and nurses were ignorant of three main documents on healthcare ethics which are the essential ideologies in clinical practice. If a high proportion of defendants has inspiration for education in medical ethics and enquired for presence of medical ethics in the prospectus, it is authoritative to advantage info on medical ethics through donation in newsletters and volumes on ethics in medical libraries in adding to speeches and teaching in workroom on medical ethics which can suggestively recover the present scarcity of information on medical morals.1
Determine the knowledge, attitude, practice and related factor Calculation of knowledge, attitude and practice and related issues to soothing caution in nurses employed in nominated hospitalsThe employed nurses had deprived knowledge and knowledge according to their practice, but employed nurses’ attitude to soothing caution was satisfactory. Commendations is that due care would be taken to palliative care through the nationwide healthiness rule and wants to be combined in the nationwide prospectus of nurse teaching.2
Health care ethics is a sensitive domain, which if ignored, can lead to patient dissatisfaction, weakened doctor–patient interaction and episodes of violence. Little importance has been paid to medical ethics within undergraduate medical education in developing countries such as Pakistan. Three doctors in Pakistan are presently facing an authorized police protest and capture charges, next the expiry of a sanitary employee, who fell insensible while scrubbing a gutter and was supposedly declined treatment as he was enclosed in manure immorality. The medical certificate of the doctors in enquiry should be invalid, if originate shamefaced following a thorough examination into the situation. The ‘right to life’ has been collectively guaranteed by all ethical, national and permitted codes and no civilization can ever claim against the sacredness of a human life. It is fairly clear that the aforesaid doctors’ movements are not only against the core moralities of the doctors’ code, but also go against the doctrine of human rights. If serious exertions on an urgent basis are not complete by the supervisory and leading frames, one can certainly imagine like events for at least a few more decades before any visible change is seen.3
With the data explosion and increasing public consciousness, doctors must be able and sympathetic. Upcoming doctors and medical students must be providing outstanding technical information within the context of the ethical base of their association with the patients and they must comprehend how the human morals are surrounded in clinical result making. However the present syllabus take in the topics related to ethics and there are studies emphasizing the status of joining ethical and lawful topics into medical programs still the old-style medical physical activity suggestions tiny benefit in deciding the applied ethical problems encountered by healthcare experts. There are views and discussion on the subject of presence of official teaching of applied ethics in medical syllabuses as it has been created that ethics teaching has a profound influence on medical professionals’ arrogances and choice making Moreover, some organizations have industrial guidelines for ethics in scientific teaching and medical post programs it is early step in this way is to control the usual knowledge and attitude of healthcare specialists in the concerned region. In this admiration, some teachings have been complete in the past in different areas The current education has been done to assess the knowledge.4
Healthcare physicians are fantasy to bring comprehensive care for patients, their families and gatherings but still dissatisfaction is specified round the preservation they get. Dissatisfaction is replicated in words about poor ethical performance. Increasing community awareness concerning the ethical behavior of healthcare physicians and protests against doctors look to be growing. This may replicate an increase in unprincipled performs by healthcare workers or growing public awareness of such unprincipled performs. The recent raise in trial against healthcare doctors is certainly a subject of instantaneous concern Bad publicity in the broadcasting about the profession has done additional injury and created a gap in people’s faith on healthcare workers. Only a few studies have been conducted in India to judge the behavior design of healthcare world towards ethics. There is a disagreement that doctors and nurses should be trained medical ethics concurrently. Doctors and nurses work together carefully for patient-care, but these two professional groups may have variances with admiration to their knowledge and attitudes towards patient-care .Therefore current study was conducted to assess the knowledge of and attitudes concerning healthcare ethics among the north Indian doctors and nurses.5
Medical practice throughout the world has become progressively commercialized, and ethics has taken a backseat. Ethics education has been publicized to have an imperative motivation on the professionalism and ethical potentials of medical specialists. Numerous governments have been tried to inspire well ethical conduct in health experts, such as lectures, sessions, interactive workshops, and case meetings. The efficiency of clinically-oriented knowledge approaches is well documented. Against this background, this study was undertaken to assess the knowledge of and attitudes to medical ethics among scholar students along with a contrast of the scores of students at different levels of seniority in the college.6
2-GAP/ RATIONAL:
Previous study had study gap while in Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting explains and fulfil study criteria. This study will enhance knowledge attitude of healthcare ethic in society. This study will fulfill criteria regarding doctors and nurses
3-OBJECTIVE:
Main object of this study is described the Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting in Lahore

4-OPERATIONAL DEFINITION:
self-administered questionnaire was use to access Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting in Lahore

LITERATURE REVIEW;
Olivia Numminen et,al conducted a cross sectional study in 2009 in which he Manage Research on the codes of ethics in nursing is rare. The main field of attention was teaching, nurses’ knowledge and usage of codes
More research would be attention predominantly on the teaching of the codes, cover the comprehension of the education procedure, assessment of consequences and group of teaching.7
Elisabeta Ioana Hiriscau et,al. conducted a cross sectional study in 2016 which he manage. to displays that a progression of considerable sensitization was activated with those complicated. This might be probable—and make intelligence—with superior viewers as well in order to increase the image on ethical subjects in research with slight
The result of research were they exposed six themes that were benefit for the minor , minimal risk/no harm, the nature or consequences of the research parents’ status, minor’s status and special circumstances .8
Kathleen Oberle, et,al. manage a cross sectional study in 1999 It was decided to observe studies between doctors and nurses and he role out that both have a role and work of according to their specialization.9
Surjit Singh,et,al. conducted a cross sectional study in 2016 which he manage
, on health-care ethics, can performance as a means of informing to doctors and nursing so that shall support to joining this dump and defend the well-being and secrecy of the patients. Such an struggle may conveyance about harmonious variation in the doctor-patient association. 10

Mallela, K.K., et al. conducted a cross sectional study in 2015 We arrange that ethical standards would be harshly followed by taking due admiration to secrecy or confidentiality of research members to realize the goal of nominal dangers and extreme welfares to patients and there is requirement of physical activity to investigators and scholars to make them conscious about several study ethics .4
Samaj Adhikar et,al. conducted a cross sectional study in 2016 Important quantity of nurses and doctors was ignorant of three main documents on healthcare morals which are the essential principles in investigational training. if a high section of defendants had inspiration for education medical morals and questioned for enclosure of medical morals in the syllabus, it is authoritative to advantage info on medical morals complete subscription of magazines and books on ethics in health public library in addition to lectures and training at workshop on medical morals which can suggestively recover the present scarcity of knowledge on medical ethics. 1
Misbahuddin Rafeeq et,al. conducted a cross sectional study in 2011, Physicians very frequently come across ethical dilemmas in their day to day practice. They are not provided formal training in practical aspects of ethics in their medical curricula. In addition to this; as the findings of the study identify that departmental lectures/teaching is also not very favorable among them, so there is an urgent need to include practical education of ethics, that too in an interesting manner, particularly in a multidisciplinary setting, to bridge the gap in the knowledge, attitude and practices regarding ethics in clinical practice & research. The state of medical education in India presents a scenario marked by rhetoric and wishful thinking rather than concrete steps in right direction.11
Mukul Chopra et,al. conducted a cross sectional study in 2003 in the knowledge about practical aspects of health care ethics among physicians and nurses which they encounter in day to day practice at their workplace. Practical education in ethics could assist in bridging the gap in ethical approaches among different levels of healthcare staff. Measures of workplace education like sensitization workshops, CMEs, conferences on health care ethics would assist in bridging this gap to a certain extent.5
C Janakiram et,al. conducted a cross sectional study in 2014 The medical and dental postgraduates come across ethical issues during their training, but are not equipped to resolve the ethical dilemmas they encounter. The dental postgraduates have less of an appreciation of healthcare ethics than their medical counterparts. The incorporation of a bioethics curriculum in the initial period of the postgraduate program would be beneficial.12

6-MATERIAL & METHOD:
STUDY DESIGN:
descriptive cross-sectional study

STUDY POPULATION:
Study will conduct about nurses and doctors in hospitals
Study SETTINGS:
Data will be collected from hospitals in Lahore
d) STUDY DURATION:
6-month latter after the accepting of synopsis.
e) SAMPLE SIZE:

f) SAMPLING METHOD:

g) ETHICAL ISSUE:
There will be no ethical issue because we will inform the subject of the purpose of study. The data will be collected after consent.

h) ELIGIBILITY CRITERIA:
INCLUSION CRITERIA:
resident doctors and ward nurses which have two year experience
EXCLUSION CRITERIA:
Those doctors and nurses are excluded in study who have have these issue like Recent surgery fractures and trauma
7-DATA COLLECTION & PROCEDURE:
A descriptive cross-sectional study will be conducted in Lahore. The participant persons are doctors and nurses which employed of hospitals in Lahore. Convenience sampling method will be used to study. The study will be conducted for the period of 6 month after the approval of synopsis. Before the collection of data consent foam must be filled from participants.

8-STATISTICAL PROCEDURE:

9-REFERENCES

1. Adhikari, S., et al., Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting, Nepal. BMC medical ethics, 2016. 17(1): p. 68.
2. Kassa, H., et al., Assessment of knowledge, attitude and practice and associated factors towards palliative care among nurses working in selected hospitals, Addis Ababa, Ethiopia. BMC palliative care, 2014. 13(1): p. 6.
3. Pasha, S.B., et al., Sanitary Worker’s Death Unnerves Pakistan’s Health Care Ethics to the Core. Science and engineering ethics, 2017: p. 1-6.
4. Mallela, K.K., et al., Knowledge, attitudes and practice about research ethics among dental faculty in the North India. Journal of international oral health: JIOH, 2015. 7(Suppl 2): p. 52.
5. Chopra, M., et al., Current status of knowledge, attitudes and practices towards health care ethics among doctors and nurses from Northern India-A multicenter study. Journal of Krishna Institute of Medical Sciences University, 2013. 2: p. 102-107.
6. Chatterjee, B. and J. Sarkar, Awareness of medical ethics among undergraduates in a West Bengal medical college. Indian J Med Ethics, 2012. 9(2): p. 93-100.
7. Numminen, O., A. Van Der Arend, and H. Leino?Kilpi, Nurses’ codes of ethics in practice and education: a review of the literature. Scandinavian journal of caring sciences, 2009. 23(2): p. 380-394.
8. Hiriscau, E.I., et al., Identifying ethical issues in mental health research with minors adolescents: results of a Delphi study. International journal of environmental research and public health, 2016. 13(5): p. 489.
9. Oberle, K. and D. Hughes, Doctors’ and nurses’ perceptions of ethical problems in end?of?life decisions. Journal of advanced nursing, 2001. 33(6): p. 707-715.
10. Singh, S., et al., Knowledge, awareness and practice of ethics among doctors in tertiary care hospital. Indian journal of pharmacology, 2016. 48(Suppl 1): p. S89.
11. Mohammad, M., et al., Knowledge, attitudes and practices of bioethics among doctors in a tertiary care government teaching hospital in India. J Clinic Res Bioeth, 2011. 2(118): p. 2.
12. Janakiram, C. and S.J. Gardens, Knowledge, attitudes and practices related to healthcare ethics among medical and dental postgraduate students in south India. Indian J Med Ethics, 2014. 11(2): p. 99-104.