A phenomenon explored in the field of the cognitive neuroscience of morality is moral sensitivity, which is a collective name for a subjective experience related to the ability to detect and respond to morally relevant cues in a given social situation. This thesis will review the underlying neural mechanisms of moral sensitivity and three key components: Empathy, moral disgust and moral intuition, also called moral “gut-feeling.” Initially, the thesis provides a basic explanation of what moral sensitivity entails and the primary observations of which brain regions are often associated with moral sensitivity. Studies show that emotion and cognition seem to be essential to the experience of moral sensitivity, which will be further emphasized by reviewing the chosen key components. Research on morality and empathy suggests that the affective and the cognitive components of empathy each are essential to moral sensitivity. The second key component, moral disgust, describes how moral sensitive people react to violations to society by being motivated to keep away from social interactions with poor moral influence. Research on the third key component explains how moral sensitivity can be affected by moral intuitions, here moral “gut-feelings,” depending on the closeness and emotional salience in a given situation.

The overall aim of this thesis is twofold: first, to develop and validate questionnaires that could be used for investigating relationships between perceptions of conscience, moral sensitivity and burnout and second, to describe patterns of self-comfort used to ease stress and illuminate meanings of living with a troubled conscience. The thesis comprises five studies and is based on both quantitative and qualitative data. In study I, a questionnaire was constructed to assess perceptions of conscience; the Perceptions of Conscience Questionnaire (PCQ). This 15 item-questionnaire was distributed to 444 care providers. Statistical analyses of responses showed sufficient distribution and a stable six factor solution congruent with reviewed literature. The six factors were labelled: ‘the voice of authority’, ‘warning signal’, ‘demanding sensitivity’, ‘asset’, ‘burden’ and ‘depending on culture’. The findings suggest that the PCQ is a valid questionnaire. The aim of study II was further development of an existing questionnaire assessing care providers’ moral sensitivity, enabling its use in various care contexts. The revised nine-item questionnaire, the Moral Sensitivity Questionnaire Revised version (MSQ-R), was distributed to 278 care providers with various professional backgrounds. Statistical analyses of responses showed sufficient distribution and a three-factor solution congruent with reviewed literature. The three factors were labelled: ‘sense of moral burden’, ‘sense of moral strength,’ and ‘sense of moral responsibility.’ The findings suggest that MSQ-R is valid for use in various healthcare contexts. In study III, the PCQ, the MSQ-R and the Maslach Burnout Inventory (MBI) were distributed to a population of psychiatric care providers (n=101) to investigate relationships between perceptions of conscience and moral sensitivity and levels of burnout. The hierarchical cluster analysis shows two clusters with Pearson’s r >.50. Cluster A comprising items such as: being sensitive, interpreting and following the voice of conscience that warns us against hurting other or ourselves and developing as human beings was labelled ‘experiencing a sense of moral integrity’. Cluster B comprising items such as: feeling inadequate, doing more than one has strengths for, feeling always responsible, having difficulties to deal with wearing feelings, perceiving that conscience gives wrong signals and express social values, having to deaden one’ conscience, were all related to scores of the MBI subscales emotional exhaustion (EE) and depersonalisation (DP). Cluster B was labelled ‘experiencing a burdening accountability’. The results show that levels of ‘experiencing a burdening accountability’ are closely related to levels of being at risk of burnout. The aim of study IV was to describe patterns of self-comforting measures used to ease stress. The written accounts of 168 care providers and healthcare students were analysed by means of qualitative content analysis. The findings disclose two dimensions: an ability to use early learned measures to take care of oneself (ingression) and an ability to feel intimately related to life, other human beings and universe or God (transcendence). The findings provide valuable knowledge about self-comfort as a coping strategy. The aim of study V was to illuminate meanings of living with a troubled conscience. Ten psychiatric care providers, respondents of study III with various perceptions of conscience were interviewed. The interviews were interpreted using a phenomenological - hermeneutical method. The findings show that one meaning of living with a troubled conscience is being confronted with inadequacy and struggling to view oneself as ‘good enough.’ The comprehensive understanding indicates that inadequacy, both one’s own and that of organization one represents, infuse feelings of shame rather than feelings of guilt. Shame concerns one’s identity and need of reconciliation. Conclusions: The results reveal two ways of encountering a troubled conscience. One is being unable to interpret the ethical demand from a troubled conscience. This is indicated by connections between levels of moral burden and levels of burnout. The other way is being able to interpret the ethical demand and using one’s troubled conscience to develop practical wisdom. This means facing shame of feeling inadequate, reconciling images of the ideal self and self-contempt, and becoming realistic about what one can do. In this process comfort seems to be a mediator of reconciliation.

The overall aim of this thesis is twofold: first, to develop and validate questionnaires that could be used for investigating relationships between perceptions of conscience, moral sensitivity and burnout and second, to describe patterns of self-comfort used to ease stress and illuminate meanings of living with a troubled conscience. The thesis comprises five studies and is based on both quantitative and qualitative data. In study I, a questionnaire was constructed to assess perceptions of conscience; the Perceptions of Conscience Questionnaire (PCQ). This 15 item-questionnaire was distributed to 444 care providers. Statistical analyses of responses showed sufficient distribution and a stable six factor solution congruent with reviewed literature. The six factors were labelled: ‘the voice of authority’, ‘warning signal’, ‘demanding sensitivity’, ‘asset’, ‘burden’ and ‘depending on culture’. The findings suggest that the PCQ is a valid questionnaire. The aim of study II was further development of an existing questionnaire assessing care providers’ moral sensitivity, enabling its use in various care contexts. The revised nine-item questionnaire, the Moral Sensitivity Questionnaire Revised version (MSQ-R), was distributed to 278 care providers with various professional backgrounds. Statistical analyses of responses showed sufficient distribution and a three-factor solution congruent with reviewed literature. The three factors were labelled: ‘sense of moral burden’, ‘sense of moral strength,’ and ‘sense of moral responsibility.’ The findings suggest that MSQ-R is valid for use in various healthcare contexts. In study III, the PCQ, the MSQ-R and the Maslach Burnout Inventory (MBI) were distributed to a population of psychiatric care providers (n=101) to investigate relationships between perceptions of conscience and moral sensitivity and levels of burnout. The hierarchical cluster analysis shows two clusters with Pearson’s r >.50. Cluster A comprising items such as: being sensitive, interpreting and following the voice of conscience that warns us against hurting other or ourselves and developing as human beings was labelled ‘experiencing a sense of moral integrity’. Cluster B comprising items such as: feeling inadequate, doing more than one has strengths for, feeling always responsible, having difficulties to deal with wearing feelings, perceiving that conscience gives wrong signals and express social values, having to deaden one’ conscience, were all related to scores of the MBI subscales emotional exhaustion (EE) and depersonalisation (DP). Cluster B was labelled ‘experiencing a burdening accountability’. The results show that levels of ‘experiencing a burdening accountability’ are closely related to levels of being at risk of burnout. The aim of study IV was to describe patterns of self-comforting measures used to ease stress. The written accounts of 168 care providers and healthcare students were analysed by means of qualitative content analysis. The findings disclose two dimensions: an ability to use early learned measures to take care of oneself (ingression) and an ability to feel intimately related to life, other human beings and universe or God (transcendence). The findings provide valuable knowledge about self-comfort as a coping strategy. The aim of study V was to illuminate meanings of living with a troubled conscience. Ten psychiatric care providers, respondents of study III with various perceptions of conscience were interviewed. The interviews were interpreted using a phenomenological - hermeneutical method. The findings show that one meaning of living with a troubled conscience is being confronted with inadequacy and struggling to view oneself as ‘good enough.’ The comprehensive understanding indicates that inadequacy, both one’s own and that of organization one represents, infuse feelings of shame rather than feelings of guilt. Shame concerns one’s identity and need of reconciliation. Conclusions: The results reveal two ways of encountering a troubled conscience. One is being unable to interpret the ethical demand from a troubled conscience. This is indicated by connections between levels of moral burden and levels of burnout. The other way is being able to interpret the ethical demand and using one’s troubled conscience to develop practical wisdom. This means facing shame of feeling inadequate, reconciling images of the ideal self and self-contempt, and becoming realistic about what one can do. In this process comfort seems to be a mediator of reconciliation.

With this dissertation I developed a new theory and measure of ethical work climate (EWC). Currently, there exists one dominant theory and measure of EWC developed by Victor and Cullen (1988, 1987). Even though researchers have identified problems with this theory, such as inconsistencies with regard to its limited theoretical scope and troubling psychometric properties, it is the most widely utilized framework for conceptualizing and testing EWC. Therefore, I propose to develop an improved theory and measure of EWC, one capable of addressing some of the principle shortcomings of earlier efforts. Building on Rest's (1986, 1979) "Four-Component" model of individual-level ethical decision-making and behavior, I specify four dimensions of EWC necessary for the emergence of ethical behavior: collective moral sensitivity, collective moral judgment, collective moral motivation, and collective moral character. I developed a multidimensional instrument capable of capturing each of these dimensions at the climate level. I anticipate that this theory and instrument will allow researchers to understand EWCs and their impact on attitudes and behaviors more effectively than previous approaches. Chapter 1 reviews the organizational climate and culture literatures, so as to gain a comprehensive understanding of the organizational climate construct in general and how it differs from organizational culture in particular. Chapter 2 includes a review and evaluation the EWC literature. This helped to identify opportunities and suggestions for a new theory and measure of EWC. Chapter 3 describes the development of the new theory of EWCs, the Psychological Process Model, with propositions for future research. Chapter 4 informs about the development of the Ethical Climate Index, the measure used to assess the new theory of EWCs. It describes 3 studies that were used to construct the Ethical Climate Index to measure the ethical work climate dimensions of collective moral sensitivity (12-items), collective moral judgment (10-items), collective moral motivation (8-items), and collective moral character (6-items). Study 1 and 2 resulted in parsimonious and reliable scales for each one of the four dimensions. Results of the 3rd study support convergent and discriminant validity for each one of the scales and suggest that the ECI is a valid and reliable predictor of ethical and unethical behavior. Implications and suggestions for the use of this measure in future research is discussed.

No description available.

Face aos obstáculos presentes em salas de aula de ciências e à busca por ações que vão ao encontro das necessidades educacionais atuais, a inserção de práticas argumentativas ganha espaço na literatura científica. Dentre as estratégias promotoras da argumentação, a abordagem de questões sociocientíficas (QSC) é de particular interesse, uma vez que, consoante suas características, pode não somente contribuir para a formação de cidadãos que entendam a natureza da ciência, suas aplicações e implicações sociais, econômicas e políticas do conhecimento científico, como também auxiliar no desenvolvimento moral dos mesmos. Contudo, para que práticas sugeridas pela literatura possam ser empregadas de maneira eficaz em sala de aula da educação básica, faz-se necessário a formação de professores que, para além de possuir as habilidades fundamentais, como da argumentação, compreendam e valorizem essas diferentes práticas como formas viáveis de promoção da aprendizagem significativa em ciências. Nesse contexto, temos como objetivo promover, exercitar e analisar a argumentação e a sensibilidade moral exibida por licenciandos em química diante de QSC, a partir do estabelecimento de práticas de leitura de histórias em quadrinhos (HQ). Dessa forma, para a promoção da argumentação e exercício da sensibilidade moral dos futuros professores foram extraídos três casos da HQ \"Trinity - a história em quadrinhos de primeira bomba atômica\", a qual foi previamente submetida a análise para identificação da sua pertinência para pesquisa, bem como do seu potencial pedagógico. Os casos para argumentação foram elaborados com base no material Moral reasoning in scientific research e permite o contato com o raciocínio informal dos licenciandos, mais especificamente com a sua sensibilidade moral. No que diz respeito aos dados coletados, estes foram inicialmente estudados à luz do Padrão de Argumento de Toulmin (TAP) e, posteriormente, analisados com base no Modelo dos Quatro Componentes, que permitiu a investigação da sensibilidade moral dos educandos. Foram identificados neste estudo, em consonância com a literatura, argumentos de pouco complexidade estrutural, que apesar de aprimorados no decorrer das atividades foram pouco influenciados pela leitura da HQ. Em contraponto, a sensibilidade moral exibida pelos licenciandos, embora limitada, foi diretamente afetada pela leitura do texto quadrinizado, o que pode ser atribuído a diferentes recursos da linguagem dos quadrinhos que promovem uma maior sensibilização no leitor. Outrossim, os resultados discutidos neste trabalho reforçam a necessidade de práticas não somente voltadas para o desenvolvimento das habilidades argumentativas de professores em formação, como também para o desenvolvimento moral. Cabe também salientar a validade do Modelo dos Quatro Componentes e do material Moral reasoning in scientific research para estudos envolvendo o raciocínio moral, o que se torna ainda mais relevante face o número incipiente de trabalhos existentes sobre a temática na literatura nacional / Faced with obstacles encountered in lessons and the search for actions that meet current educational needs, some attention has been paid to argumentative practices in the literature. Among the strategies encouraging argumentation, the approach to socio-scientific issues (SSI) is of particular interest, as, according to its characteristics, it does not only contribute to peoples´ education who understand the nature of science, its applications and social implications, economic and political aspects of scientific knowledge, but also helps their moral development. However, so that the practices suggested by the literature can be effectively used in basic education lessons, teachers need to be trained in fundamental skills such as the ability to argue, understand and value these different practices as viable ways of promoting meaningful learning in science. In this context, we aim to encourage, practice and analyze argumentation and the moral sensitivity shown by Chemistry Education undergraduates considering SSI, based on establishing practices of reading graphic novels. Thus, to promote future teachers´ argumentation skills and practice moral sensitivity, three cases from the graphic novel \"Trinity - a Graphic History of the First Atomic Bomb\", were extracted, which were previously analyzed to identify their importance for research, as well as the pedagogical potential. The cases for argumentation were developed based on the material Moral Reasoning in Scientific Research and enables contact with the undergraduates´ informal reasoning, more specifically with their moral sensitivity. Collected data were initially studied considering the Toulmin\'s Argument Pattern (TAP) and later analyzed based on the Four Component Model, which enabled us to investigate the students´ moral sensitivity. In this study, in agreement with the literature, we identified arguments of low structural complexity that, although improved while doing the activities, were little influenced by the reading the graphic novel. In contrast, the moral sensitivity shown by the undergraduates, although limited, was directly affected by reading the graphic text, which can be attributed to different language resources of graphic novels that encourage greater sensitivity in the reader. Moreover, the results discussed in this paper reinforce the need for practices not only aimed at developing trainee teachers´ argumentative skills, but also for moral development. The validity of the Four Component Model and the Moral Reasoning in Scientific Research material for studies involving moral reasoning should be emphasized, which is even more relevant given the incipient number of studies on the subject in the literature in Brazil.

Nesta tese defende-se que a sensibilidade moral é necessária para reconhecer, interpretar e responder de forma apropriada os problemas éticos vivenciados pelos enfermeiros nos Cuidados de Saúde Primários. Este estudo possui uma perspetiva lusobrasileira na medida em que se insere no acordo de dupla titulação realizado entre a Universidade Católica Portuguesa e a Escola de Enfermagem da Universidade de São Paulo. A comparação luso-brasileira de resultados possibilita absorver a realidade de cada país, estratégias e caminhos para qualificar cada vez mais o cuidado da enfermagem. Esse estudo tem como objetivo avaliar a sensibilidade moral dos enfermeiros que atuam nos cuidados de saúde Primários em Portugal e no Brasil. Mais especificamente, traduzir e adaptar o questionário de sensibilidade moral para os enfermeiros da atenção primária à saúde de Portugal e do Brasil, validar o questionário de sensibilidade moral com os enfermeiros da atenção primária à saúde de Portugal e do Brasil e caracterizar os fatores associados ao nível de sensibilidade moral dos enfermeiros na atenção primária à saúde de Portugal e do Brasil. Trata-se de um estudo quantitativo, transversal, observacional e correlacional descritivo de duas amostras independentes. A amostra foi constituída por 331 enfermeiros de Portugal e 316 enfermeiros do Rio Grande do Sul/Brasil. O questionário de sensibilidade moral versão Brasil (MSQ-B) e versão Portugal (MSQ-P) após a validação permaneceram com 27 itens, distribuídos em quatro dimensões: orientação interpessoal, conhecimento profissional, conflito moral e significado moral. O MSQ-B explicou 55,8% da variância total e teve um alfa de Cronbach de 0,82. O MSQ-P apresentou uma variância de 54,0% e um alfa de 0,89. A média de sensibilidade moral dos enfermeiros atenção primária à saúde no Rio Grande do Sul/Brasil foi de 4,49 e em Portugal 4,94 em 7. O questionário de sensibilidade moral é um instrumento válido e apropriado para avaliar a sensibilidade moral dos enfermeiros no Rio Grande do Sul/Brasil e em Portugal. Este estudo observou todos os preceitos éticos e legais das pesquisas envolvendo seres humanos, pois garantiu uma participação livre e voluntária. A pesquisa é desenvolvida sob a modalidade Bolsa de Doutorado Pleno no Exterior, concedida pela Coordenação de Aperfeiçoamento de Pessoal de Nível Superior- CAPES. / In this thesis it is argued that moral sensitivity is necessary to recognize, interpret and respond appropriately the ethical problems experienced by nurses in Primary Health Care. This study has a Luso-Brazilian perspective insofar as it is part of the double degree agreement between the Universidade Católica Portuguesa and the School of Nursing of the University of São Paulo. The Luso-Brazilian comparison of results makes it possible to absorb from the reality of each country, strategies and ways to increasingly qualify nursing care. This study aims to evaluate the moral sensitivity of nurses working in primary health care in Portugal and Brazil. More specifically, to translate and adapt the moral sensitivity questionnaire for nurses in primary health care in Portugal and Brazil, to validate the questionnaire of moral sensitivity with nurses of primary health care in Portugal and Brazil and to characterize the factors associated with Level of moral sensitivity of nurses in primary health care in Portugal and Brazil. This is a descriptive, cross-sectional, observational and correlational study of two independent samples. The sample consisted of 331 nurses from Portugal and 316 nurses from Rio Grande do Sul/Brazil. The Moral Sensitivity Questionnaire Brazilian version (MSQ-B) and Portuguese version (MSQ-P) after validation remained with 27 items, distributed in four dimensions: interpersonal orientation, professional knowledge, moral conflict and moral meaning. The MSQ-B explained 55.8% of the total variance and had a Cronbach\'s alpha of 0.82. The MSQ-P presented a variance of 54.0% and a Cronbach\'s alpha of 0.89. The mean of moral sensitivity of nurses in primary health care in Rio Grande do Sul/Brazil was 4.49 and in Portugal was 4.94 of 7. The moral sensitivity questionnaire is a valid and appropriate instrument to evaluate the moral sensitivity of nurses in Rio Grande do Sul/Brazil and Portugal. The study observed all ethical and legal precepts of research involving human beings, since it guarantees a free and voluntary participation. The research is developed under the modality of full doctorate abroad, granted by the Coordination for the Improvement of Higher Education Personnel-CAPES.

Nesta tese defende-se que a sensibilidade moral é necessária para reconhecer, interpretar e responder de forma apropriada os problemas éticos vivenciados pelos enfermeiros nos Cuidados de Saúde Primários. Este estudo possui uma perspetiva lusobrasileira na medida em que se insere no acordo de dupla titulação realizado entre a Universidade Católica Portuguesa e a Escola de Enfermagem da Universidade de São Paulo. A comparação luso-brasileira de resultados possibilita absorver a realidade de cada país, estratégias e caminhos para qualificar cada vez mais o cuidado da enfermagem. Esse estudo tem como objetivo avaliar a sensibilidade moral dos enfermeiros que atuam nos cuidados de saúde Primários em Portugal e no Brasil. Mais especificamente, traduzir e adaptar o questionário de sensibilidade moral para os enfermeiros da atenção primária à saúde de Portugal e do Brasil, validar o questionário de sensibilidade moral com os enfermeiros da atenção primária à saúde de Portugal e do Brasil e caracterizar os fatores associados ao nível de sensibilidade moral dos enfermeiros na atenção primária à saúde de Portugal e do Brasil. Trata-se de um estudo quantitativo, transversal, observacional e correlacional descritivo de duas amostras independentes. A amostra foi constituída por 331 enfermeiros de Portugal e 316 enfermeiros do Rio Grande do Sul/Brasil. O questionário de sensibilidade moral versão Brasil (MSQ-B) e versão Portugal (MSQ-P) após a validação permaneceram com 27 itens, distribuídos em quatro dimensões: orientação interpessoal, conhecimento profissional, conflito moral e significado moral. O MSQ-B explicou 55,8% da variância total e teve um alfa de Cronbach de 0,82. O MSQ-P apresentou uma variância de 54,0% e um alfa de 0,89. A média de sensibilidade moral dos enfermeiros atenção primária à saúde no Rio Grande do Sul/Brasil foi de 4,49 e em Portugal 4,94 em 7. O questionário de sensibilidade moral é um instrumento válido e apropriado para avaliar a sensibilidade moral dos enfermeiros no Rio Grande do Sul/Brasil e em Portugal. Este estudo observou todos os preceitos éticos e legais das pesquisas envolvendo seres humanos, pois garantiu uma participação livre e voluntária. A pesquisa é desenvolvida sob a modalidade Bolsa de Doutorado Pleno no Exterior, concedida pela Coordenação de Aperfeiçoamento de Pessoal de Nível Superior- CAPES. / In this thesis it is argued that moral sensitivity is necessary to recognize, interpret and respond appropriately the ethical problems experienced by nurses in Primary Health Care. This study has a Luso-Brazilian perspective insofar as it is part of the double degree agreement between the Universidade Católica Portuguesa and the School of Nursing of the University of São Paulo. The Luso-Brazilian comparison of results makes it possible to absorb from the reality of each country, strategies and ways to increasingly qualify nursing care. This study aims to evaluate the moral sensitivity of nurses working in primary health care in Portugal and Brazil. More specifically, to translate and adapt the moral sensitivity questionnaire for nurses in primary health care in Portugal and Brazil, to validate the questionnaire of moral sensitivity with nurses of primary health care in Portugal and Brazil and to characterize the factors associated with Level of moral sensitivity of nurses in primary health care in Portugal and Brazil. This is a descriptive, cross-sectional, observational and correlational study of two independent samples. The sample consisted of 331 nurses from Portugal and 316 nurses from Rio Grande do Sul/Brazil. The Moral Sensitivity Questionnaire Brazilian version (MSQ-B) and Portuguese version (MSQ-P) after validation remained with 27 items, distributed in four dimensions: interpersonal orientation, professional knowledge, moral conflict and moral meaning. The MSQ-B explained 55.8% of the total variance and had a Cronbach\'s alpha of 0.82. The MSQ-P presented a variance of 54.0% and a Cronbach\'s alpha of 0.89. The mean of moral sensitivity of nurses in primary health care in Rio Grande do Sul/Brazil was 4.49 and in Portugal was 4.94 of 7. The moral sensitivity questionnaire is a valid and appropriate instrument to evaluate the moral sensitivity of nurses in Rio Grande do Sul/Brazil and Portugal. The study observed all ethical and legal precepts of research involving human beings, since it guarantees a free and voluntary participation. The research is developed under the modality of full doctorate abroad, granted by the Coordination for the Improvement of Higher Education Personnel-CAPES.