| 1. |
- Bolmsjö, Ingrid, et al.
(författare)
-
Everyday ethical problems in dementia care: a teleological model.
- 2006
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 13:4, s. 340-359
-
Tidskriftsartikel (refereegranskat)abstract
- In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care.
|
|
| 2. |
- Bolmsjö, Ingrid, et al.
(författare)
-
Everyday ethics in the care of elderly people
- 2006
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 13:3, s. 249-263
-
Tidskriftsartikel (refereegranskat)abstract
- This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection.
|
|
| 3. |
- Eldh, Ann Catrine, et al.
(författare)
-
Conditions for patient participation and non-participation in health care
- 2006
-
Ingår i: Nursing Ethics. - Malden, USA : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:5, s. 503-514
-
Tidskriftsartikel (refereegranskat)abstract
- This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making.
|
|
| 4. |
- Franklin, Lise-Lotte, et al.
(författare)
-
Views on dignity of elderly nursing home residents
- 2006
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:2, s. 130-146
-
Tidskriftsartikel (refereegranskat)abstract
- Discussion about a dignified death has almost exclusively been applied to palliative care and people dying of cancer. As populations are getting older in the western world and living with chronic illnesses affecting their everyday lives, it is relevant to broaden the definition of palliative care to include other groups of people. The aim of the study was to explore the views on dignity at the end of life of 12 elderly people living in two nursing homes in Sweden. A hermeneutic approach was used to interpret the material, which was gathered during semi-structured interviews. A total of 39 interviews were transcribed. The analysis revealed three themes: (1) the unrecognizable body; (2) fragility and dependency; and (3) inner strength and a sense of coherence.
|
|
| 5. |
- Glasberg, Ann-Louise, et al.
(författare)
-
Development and initial validation of the Stress of Conscience Questionnaire.
- 2006
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:6, s. 633-48
-
Tidskriftsartikel (refereegranskat)abstract
- Stress in health care is affected by moral factors. When people are prevented from doing 'good' they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach's alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: 'internal demands' and 'external demands and restrictions'. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts.
|
|
| 6. |
- Lindström, Irma, 1947, et al.
(författare)
-
Documentation of patients' participation in care at the end of life
- 2006
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:4, s. 394-403
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe how patients' participation in the care they received was documented in their health care records during the last three months of their lives. Two hundred and twenty-nine deceased adult persons were randomly identified from 12 municipalities in a Swedish county and their records were selected from different health care units. Content analysis was used to analyse the text. Four categories of patient participation were described: refusing offered care and treatments; appealing for relief; desire for everyday life; and making personal decisions. The most common way for these patients to be involved in their care at the end of their life was by refusal of the treatment and care offered. Characteristic of the different ways of participation were the diverse activities represented. The description of patients' involvement in their life situation at this time indicated their dissociation from the health care offered more than consenting to it.
|
|
| 7. |
- Lützen, Kim, et al.
(författare)
-
Developing the concept of moral sensitivity
- 2006
-
Ingår i: Nursing Ethics. - 0969-7330 .- 1477-0989. ; 13:2, s. 187-196
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this Swedish study was to develop the concept of moral sensitivity in health care practice. This process began with an overview of relevant theories and perspectives on ethics with a focus on moral sensitivity and related concepts, in order to generate a theoretical framework. The second step was to construct a questionnaire based on this framework by generating a list of items from the theoretical framework. Nine items were finally selected as most appropriate and consistent with the research team’s understanding of the concept of moral sensitivity. The items were worded as assumptions related to patient care. The questionnaire was distributed to two groups of health care personnel on two separate occasions and a total of 278 completed questionnaires were returned. A factor analysis identified three factors: sense of moral burden, moral strength and moral responsibility. These seem to be conceptually interrelated yet indicate that moral sensitivity may involve more dimensions than simply a cognitive capacity, particularly, feelings, sentiments, moral knowledge and skills.
|
|
| 8. |
- Lützén, Kim, et al.
(författare)
-
Developing the concept of moral sensitivity in health care practice.
- 2006
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:2, s. 187-96
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this Swedish study was to develop the concept of moral sensitivity in health care practice. This process began with an overview of relevant theories and perspectives on ethics with a focus on moral sensitivity and related concepts, in order to generate a theoretical framework. The second step was to construct a questionnaire based on this framework by generating a list of items from the theoretical framework. Nine items were finally selected as most appropriate and consistent with the research team's understanding of the concept of moral sensitivity. The items were worded as assumptions related to patient care. The questionnaire was distributed to two groups of health care personnel on two separate occasions and a total of 278 completed questionnaires were returned. A factor analysis identified three factors: sense of moral burden, moral strength and moral responsibility. These seem to be conceptually interrelated yet indicate that moral sensitivity may involve more dimensions than simply a cognitive capacity, particularly, feelings, sentiments, moral knowledge and skills.
|
|
| 9. |
- Norberg, Astrid
(författare)
-
The meaning of evidence-based nursing.
- 2006
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:5, s. 453-4
-
Tidskriftsartikel (refereegranskat)abstract
- The article discusses the meaning of evidence-based nursing. Evidence-based medicine is an explicit and conscientious use of current best medical approach in the care of individual patients. In clarifying this issue, several considerations are needed to be underlined. These are clinical experience, local context, and patient's preference. The need to reflect and research about ethics relative to evidence-based nursing is mentioned.
|
|
| 10. |
- Norbergh, Karl-Gustaf, et al.
(författare)
-
Nurses' attitudes towards people with dementia : the semantic differential technique
- 2006
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:3, s. 264-274
-
Tidskriftsartikel (refereegranskat)abstract
- One important aspect of the nurse-patient relationship is the nurses' attitudes towards their patients. Nurses' attitudes towards people with dementia have been studied from a wide range of approaches, but few of them have focused on the structure in nurses' attitudes. This study aimed to identify a structure in licensed practical nurses' attitudes towards people with dementia. Twenty-one group dwelling units for people with dementia at eleven nursing homes participated in the study. In all, 1,577 assessments of 178 patients were sent out to 181 respondents and 1,237 answers were returned. The semantic differential technique was used. The scale has 57 bipolar pairs of adjectives, which estimate an unknown number of dimensions of nurses' attitudes towards an identified patient. The assessments were analysed using entropy-based measures of association combined with structural plots. The analysis revealed four dimensions. These four dimensions related to licensed practical nurses' opinion of the patients; from an ethical and aesthetic dimension; their ability to understand; their ability to experience; their ability for social interaction. The study indicates that, on the positive to negative attitude continuum, attitudes fall at the positive to neutral end of the continuum. This is an important finding due to the personhood perspective. From this perspective, it is reasonable to assume that with a more positive attitude to people with dementia, the prerequisites for person-centred care will improve.
|
|
