| 1. |
- Breitholtz, Agneta, et al.
(författare)
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Carers’ ambivalence in conflict situations with older persons
- 2013
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 20:2, s. 226-237
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study was to illuminate the meaning of professional carers’ experiences in caring situations when a conflict of interest arises with the older person receiving care. The findings reveal the complexity of the carers’ ambivalence when facing a conflict of interest, weighing between the older persons’ right to self-determination and external demands. The carers are alone in their ambivalence and the conclusion is that they need help and support to be more present in the encounter. The implication for this study is a person-centred practice, and to focus on people as interdependent on support carers to maintain older people’s right to self-determination in the relationship.
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| 2. |
- Bremer, Anders, 1957-, et al.
(författare)
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Futile cardiopulmonary resuscitation for the benefit of others : An ethical analysis
- 2011
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 18:4, s. 495-504
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Tidskriftsartikel (refereegranskat)abstract
- It has been reported as an ethical problem within prehospital emergency care that ambulance professionals administer physiologically futile cardiopulmonary resuscitation (CPR) to patients having suffered cardiac arrest to benefit significant others. At the same time it is argued that, under certain circumstances, this is an acceptable moral practice by signalling that everything possible has been done, and enabling the grief of significant others to be properly addressed. Even more general moral reasons have been used to morally legitimize the use of futile CPR: That significant others are a type of patient with medical or care needs that should be addressed, that the interest of significant others should be weighed into what to do and given an equal standing together with patient interests, and that significant others could be benefited by care professionals unless it goes against the explicit wants of the patient. In this article we explore these arguments and argue that the support for providing physiologically futile CPR in the prehospital context fails. Instead, the strategy of ambulance professionals in the case of a sudden death should be to focus on the relevant care needs of the significant others and provide support, arrange for a peaceful environment and administer acute grief counselling at the scene, which might call for a developed competency within this field.
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| 3. |
- Brüggemann, Jelmer, et al.
(författare)
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Patients’ silence following healthcare staff’s ethical transgressions
- 2012
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 19:6, s. 750-763
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine to what extent patients remained silent to the health care system after they experienced abusive or wrongful incidents in health care. Female patients visiting a women’s clinic in Sweden (n = 530) answered the Transgressions of Ethical Principles in Health Care Questionnaire (TEP), which was constructed to measure patients’ abusive experiences in the form of staff’s transgressions of ethical principles in health care. Of all the patients, 63.6% had, at some point, experienced staff’s transgressions of ethical principles, and many perceived these events as abusive and wrongful. Of these patients, 70.3% had remained silent to the health care system about at least one transgression. This silence is a loss of essential feedback for the health care system and should not automatically be interpreted as though patients are satisfied.
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| 4. |
- Edlund, Margareta, et al.
(författare)
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Concept determination of human dignity
- 2013
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 20:8, s. 851-860
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Tidskriftsartikel (refereegranskat)abstract
- This study presents findings from an ontological and contextual determination of the concept of dignity. Thestudy had a caritative and caring science perspective and a hermeneutical design. The aim of this studywas to increase caring science knowledge of dignity and to gain a determination of dignity as a concept.Eriksson’s model for conceptual determination is made up of five part-studies. The ontological and contex-tual determination indicates that dignity can be understood as absolute dignity, the spiritual dimension char-acterized by responsibility, freedom, duty, and service, and relative dignity, characterized by the bodily,external aesthetic dimension and the psychical, inner ethical dimension. Dignity exists in human beings bothas absolute and relative dignity.
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| 5. |
- Eklund, Anna Josse, 1968-, et al.
(författare)
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Swedish nurses’ perceptions of influencers on patient advocacy – a phenomenographic study
- 2014
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 21:6, s. 673-683
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Tidskriftsartikel (refereegranskat)abstract
- Background: A limited number of studies have shown that patient advocacy can be influenced by both facilitators and barriers which can encourage and discourage nurses to act as patient advocates. Objective: This study’s aim was to describe Swedish nurses’ perceptions of influencers on patient advocacy.Research design and context: Interviews with 18 registered nurses from different Swedish clinical contexts were analysed using the phenomenographic method.Ethical considerations: Ethical revisions were made in accordance with national legislation and guidelines by committees for research ethics at Karlstad University. Findings: Three levels of hierarchically related influencers on patient advocacy were found in the descriptive categories. The fundamental influencer, the nurse’s character traits, was described in the perceptions that advocacy is influenced by nurse’s having a moral compass, having control over the care situation, being protective and feeling secure as a nurse. The second most vital influencer, the nurse’s bond with the patient, was expressed in the perceptions of knowing the patient and feeling empathy for the patient. The third level of influencers, the organisational conditions, was described in the perceptions that the organisational structures and organisational culture influence patient advocacy.Discussion: The results correspond with findings from earlier research but add an understanding that influencers on patient advocacy exist at three hierarchically related levels. Conclusion: The nurse’s character traits are the fundamental influencer to patient advocacy, but in order to be comfortable and secure when advocating for patients, nurses also need to be familiar with both the patient and the situation. A supposition could be that all influencers interact, which needs to be further addressed in future studies.
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| 6. |
- Erichsén, Eva, 1959-, et al.
(författare)
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A phenomenological study of nurse´s understanding of honesty in palliative care
- 2010
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Ingår i: Nursing Ethics. - UK : sagepublications. - 0969-7330 .- 1477-0989. ; 17:1, s. 39-50
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Honesty is essential for the care of seriously ill and dying patients. The current study aimed to describe how nurses experience honesty in their work with patients receiving palliative care at home. The interviews in this phenomenological study were conducted with 16 nurses working with children and adults in palliative home-based care. Three categories emerged from analyses of the interviews: the meaning of honesty, the reason for being honest and, finally, moral conflict when dealing with honesty. The essence of these descriptions was that honesty is seen as a virtue, a good quality that a nurse should have. The nurses’ ethical standpoint was shown in the moral character they show in their work and in their intention to do good. This study could help nurses to identify different ways of looking at honesty to promote more consciousness and openness in ethical discussions between colleagues and other staff members.
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| 7. |
- Ericson-Lidman, Eva, et al.
(författare)
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Dealing with troubled conscience in municipal care of older people
- 2013
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 20:3, s. 300-311
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Tidskriftsartikel (refereegranskat)abstract
- Troubled conscience may jeopardize the health of health-care personnel and, hence, the quality of care provided. Learning more about how personnel deal with their troubled conscience therefore seems important. The aim of this study was to describe personnel's experiences of how they deal with troubled conscience generated in their daily work in municipal care of older people. Interviews were conducted with 20 care providers and analysed with a thematic content analysis. The findings show that in order to deal with troubled conscience, personnel dialogued with themselves and with others. They took measures in a direction they perceived to be correct, and they expressed a need for distancing and re-energizing. It is of importance to share situations that generate troubled conscience in order to find ways to deal with them. Reconsidering one's ways of dealing with troubled conscience may give care providers an opportunity to reach consensus within themselves.
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| 8. |
- Eriksen, KA, et al.
(författare)
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Recognition as a valued human being: perspectives of mental health service users
- 2012
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Ingår i: Nursing ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 19:3, s. 357-368
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Tidskriftsartikel (refereegranskat)abstract
- The acknowledgement of basic human vulnerability in relationships between mental health service users and professionals working in community-based mental health services (in Norway) was a starting point. The purpose was to explore how users of these services describe and make sense of their meetings with other people. The research is collaborative, with researcher and person with experienced-based knowledge cooperating through the research process. Data is derived from 19 interviews with 11 people who depend on mental health services for assistance at least three times a week. Data is analysed according to the Interpretative Phenomenological Analysis (IPA). Results confirm that reciprocity is fundamental for relationships, and that recognizing the individual entails personal involvement. The participants describe a struggle, and recognizing this struggle may help the professional to achieve a deeper understanding of the individual.
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| 9. |
- Eriksen, KA, et al.
(författare)
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Strengthening practical wisdom: mental health workers' learning and development
- 2014
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Ingår i: Nursing ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 21:6, s. 707-719
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Tidskriftsartikel (refereegranskat)abstract
- Practical wisdom, understood as knowing how to be or act in any present situation with clients, is believed to be an essential part of the knowledge needed to be a professional mental health worker. Exploring processes of adapting, extending knowledge and refining tacit knowledge grounded in mental health workers’ experiences with being in practice may bring awareness of how mental health workers reflect, learn and practice professional ‘artistry’. Research question: The aim of the article was to explore mental health workers’ processes of development and learning as they appeared in focus groups intended to develop practical wisdom. The main research question was ‘How might the processes of development and learning contribute to developing practical wisdom in the individual as well as in the practice culture?’ Research design: The design was multi-stage focus groups, and the same participants met four times. A phenomenological hermeneutical method for researching lived experience guided the analysis. Participants and context: Eight experienced mental health workers representing four Norwegian municipalities participated. The research context was community-based mental health services. Ethical considerations: The study was reported to Norwegian Social Data Services, and procedures for informed consent were followed. Findings: Two examples of processes of re-evaluation of experience (Association, Integration, Validation, Appropriation and Outcomes and action) were explored. The health workers had developed knowledge in previous encounters with clients. In sharing practice experiences, this knowledge was expressed and developed, and also tested and validated against the aims of practice. Discussions led to adapted and extended knowledge, and as tacit knowledge was expressed it could be used actively. Discussion: Learning to reflect, being ready to be provoked and learning to endure indecisiveness may be foundational in developing practical wisdom. Openness is demanding, and changing habits of mind is difficult. Conclusion: Reflection on, and confrontation with, set practices are essential to building practice cultures in line with the aims of mental health services.
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| 10. |
- Gustafsson, Gabriella, et al.
(författare)
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Burnout and perceptions of conscience among health care personnel : a pilot study.
- 2010
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 17:1, s. 23-38
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Tidskriftsartikel (refereegranskat)abstract
- Although organizational and situational factors have been found to predict burnout, not everyone employed at the same workplace develops it, suggesting that becoming burnt out is a complex, multifaceted phenomenon. The aim of this study was to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among two groups of health care personnel from the same workplaces, one group on sick leave owing to medically assessed burnout (n = 20) and one group who showed no indications of burnout (n = 20). The results showed that higher levels of stress of conscience, a perception of conscience as a burden, having to deaden one's conscience in order to keep working in health care and perceiving a lack of support characterized the burnout group. Lower levels of stress of conscience, looking on life with forbearance, a perception of conscience as an asset and perceiving support from organizations and those around them (social support) characterized the non-burnout group.
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