Sarah Banks (2012) describes ethics work mainly as the effort people put into developing themselves as good practitioners. She discerns six aspects of ethics work: identity work, framing work, reason work, emotion work, role work and performance work. Although ethics work focuses on the ethical development of individual practitioners within their profession, the concept and all its aspects can be transferred into an ethical guideline for the collective development of practitioners in interprofessional cooperation. As such the concept of collective interprofessional ethics work can also be used as a set of criteria for the ethical evaluation of interprofessional cooperation, as is shown on the basis of an experiment in Belgium
In this article, we describe a study on the impact of an ethics program aimed at strengthening the ethical agency of 15 social workers of three welfare organizations. The goal of the study was to make an inventory of the impact of the program, and to evaluate the relevance of this impact with the help of several stakeholders. The most significant change (MSC) approach was used as a research strategy, though some changes to the approach were made with a view to our research goal. We explain the MSC approach and how we used it in our study design. Further, we describe the research process, answering the question whether our adaptation of the MSC was helpful to inventory the impact of our ethics program and the evaluation of its relevance. The implications of MSC's focus on "most significant" changes and the need for a thorough feedback of the results of the evaluation process in the participating organizations are discussed.
MULTIFILE
OBJECTIVE: To investigate the level of agreement of the behavioural mapping method with an accelerometer to measure physical activity of hospitalized patients. DESIGN: A prospective single-centre observational study. SETTING: A university medical centre in the Netherlands. SUBJECTS: Patients admitted to the hospital. MAIN MEASURES: Physical activity of participants was measured for one day from 9 AM to 4 PM with the behavioural mapping method and an accelerometer simultaneously. The level of agreement between the percentages spent lying, sitting and moving from both measures was evaluated using the Bland-Altman method and by calculating Intraclass Correlation Coefficients. RESULTS: In total, 30 patients were included. Mean (±SD) age was 63.0 (16.8) years and the majority of patients were men (n = 18). The mean percentage of time (SD) spent lying was 47.2 (23.3) and 49.7 (29.8); sitting 42.6 (20.5) and 40.0 (26.2); and active 10.2 (6.1) and 10.3 (8.3) according to the accelerometer and observations, respectively. The Intraclass Correlation Coefficient and mean difference (SD) between the two measures were 0.852 and -2.56 (19.33) for lying; 0.836 and 2.60 (17.72) for sitting; and 0.782 and -0.065 (6.23) for moving. The mean difference between the two measures is small (⩽2.6%) for all three physical activity levels. On patient level, the variation between both measures is large with differences above and below the mean of ⩾20% being common. CONCLUSION: The overall level of agreement between the behavioural mapping method and an accelerometer to identify the physical activity levels 'lying', 'sitting' and 'moving' of hospitalized patients is reasonable.
