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- El-Alti, Leila, 1986, et al.
(författare)
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Caregiver perspectives on patient capacities and institutional pathways to person centered forensic psychiatric care
- 2022
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:9
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Tidskriftsartikel (refereegranskat)abstract
- The ethical discourse surrounding patients’ agential capacities, vis-à-vis their active participation in shared decision-making (SDM) in forensic psychiatric (FP) contexts, is an unexplored area of inquiry. The aim of this paper is to explore caregivers’ perceptions of patient agential capacities and institutional pathways and barriers to person centered care (PCC) in the context of FP. Following an exploratory qualitative design, we conducted eight semi-structured interviews with hands-on caregivers at an in-patient FP facility in Sweden. A deductive framework method of analysis was employed, and four themes emerged: “Fundamental Variability in Patient Capacity”, “Patient Participation: Narration or Compliance?”, “Antagonism Rooted in Power Struggles”, and “System Structure Thwarts Patient Release”. While the results generally paint a bleak picture for the possibility of a person-centered FP care, we describe a constrained version of PCC with high-level SDM dynamics which promotes a certain degree of patient empowerment while allowing care strategies, within set restrictions, to promote patient adherence and treatment progress.
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| 2. |
- El-Alti, Leila, 1986, et al.
(författare)
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Person Centered Care and Personalized Medicine: Irreconcilable Opposites or Potential Companions?
- 2019
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Ingår i: Health Care Analysis. - : Springer Science and Business Media LLC. - 1065-3058 .- 1573-3394. ; 27:1, s. 45-59
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Tidskriftsartikel (refereegranskat)abstract
- In contrast to standardized guidelines, personalized medicine and person centered care are two notions that have recently developed and are aspiring for more individualized health care for each single patient. While having a similar drive toward individualized care, their sources are markedly different. While personalized medicine stems from a biomedical framework, person centered care originates from a caring perspective, and a wish for a more holistic view of patients. It is unclear to what extent these two concepts can be combined or if they conflict at fundamental or pragmatic levels. This paper reviews existing literature in both medicine and related philosophy to analyze closer the meaning of the two notions, and to explore the extent to which they overlap or oppose each other, in theory or in practice, in particular regarding ethical assumptions and their respective practical implications.
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| 3. |
- Fahlström, Gunilla, et al.
(författare)
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Etiska aspekter på insatser inom det sociala området: En vägledning för att identifiera relevanta etiska frågor
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Dessa vägledande frågor är framtagna med syftet att utgöra ett stöd för att identifiera och reflektera kring etiska aspekter vid systematisk utvärdering av insatser inom det sociala området, dvs. socialtjänst och funktionshinderområdet. Syftet är att frågorna ska minska risken för att missa relevanta etiska aspekter avseende specifika insatser. Underlaget är tänkt att användas som ett av flera steg i arbetet med etiska aspekter i SBU:s rapporter.
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| 4. |
- Gustavsson, Erik, et al.
(författare)
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Etiska och praktiska utmaningar med ökat patientinflytande : Ethical and practical challenges with increased patient influence
- 2015
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Ingår i: Läkartidningen. - 0023-7205. ; 112:17
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Tidskriftsartikel (refereegranskat)abstract
- Det finns ett ökat intresse för patientinflytande i vården. Ett sådant fokus kan dock komma i konflikt med ett antal värden/praktiker inom vården. I denna artikel identifierar vi att följande värden/praktiker kan påverkas: Idén om patientens vårdbehov förefaller tappa sin moraliska och politiska ställning. Prioriteringar på gruppnivå kan bli svårare att tillämpa på individnivå. Det kan bli svårare att bedöma nyttan med behandlingar. Det kan bli svårare att få fram evidens för behandlingar. Det tycks komplicera idén om den följsamme patienten. Det kan innebära vissa implikationer för resursanvändning. Det kan ge ett nytt perspektiv på idén om att prioritera efter en ansvarsprincip.
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| 5. |
- Heintz, Emelie, et al.
(författare)
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FRAMEWORK FOR SYSTEMATIC IDENTIFICATION OF ETHICAL ASPECTS OF HEALTHCARE TECHNOLOGIES: THE SBU APPROACH
- 2015
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Ingår i: International Journal of Technology Assessment in Health Care. - : Cambridge University Press. - 0266-4623 .- 1471-6348. ; 31:3, s. 124-130
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Assessment of ethical aspects of a technology is an important component of health technology assessment (HTA). Nevertheless, how the implementation of ethical assessment in HTA is to be organized and adapted to specific regulatory and organizational settings remains unclear. The objective of this study is to present a framework for systematic identification of ethical aspects of health technologies. Furthermore, the process of developing and adapting the framework to a specific setting is described. Methods: The framework was developed based on an inventory of existing approaches to identification and assessment of ethical aspects in HTA. In addition, the framework was adapted to the Swedish legal and organizational healthcare context, to the role of the HTA agency and to the use of non-ethicists. The framework was reviewed by a group of ethicists working in the field as well as by a wider set of interested parties including industry, interest groups, and other potential users. Results: The framework consists of twelve items with sub-questions, short explanations, and a concluding overall summary. The items are organized into four different themes: the effects of the intervention on health, its compatibility with ethical norms, structural factors with ethical implications, and long term ethical consequences of using the intervention. Conclusions: In this study, a framework for identifying ethical aspects of health technologies is proposed. The general considerations and methodological approach to this venture will hopefully inspire and present important insights to organizations in other national contexts interested in making similar adaptations.
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| 10. |
- Munthe, Christian, 1962, et al.
(författare)
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Person centred care and shared decision making: Implications for ethics, public health and research
- 2012
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Ingår i: Health Care Analysis. - : Springer Science and Business Media LLC. - 1065-3058 .- 1573-3394. ; 20:3, s. 231-249
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view of broad advancements towards PCC/SDM, need to be considered by health care ethics researchers. Given a PCC/SDM-based reorientation of health care practice, such ethics research is essential from a quality assurance perspective.
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