| 31. |
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| 32. |
- 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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| 33. |
- 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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| 34. |
- 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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| 35. |
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| 36. |
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| 37. |
- Girma Kebede, Betlehem, et al.
(författare)
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Communicative challenges among physicians, patients, and family caregivers in cancer care: An exploratory qualitative study in Ethiopia
- 2020
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cancer is a growing concern in Ethiopia. Though communication is essential for the treatment process, few studies have looked at communication in Ethiopian cancer care. Due to the large number of patients and scarcity of resources, it is vital to understand how to manage consultations in order to effectively help as many patients as possible in this challenging work environment. Thus, research is needed to analyze and understand the communicative challenges experienced by physicians, patients, and family caregivers, in order to successfully handle patient care in practice. Objective We explore communication in Ethiopian cancer care and present the main challenges faced by physicians, patients, and family caregivers. Methods This explorative qualitative study was conducted at the Oncology Department of the Tikur Anbessa (Black Lion) Specialized Teaching Hospital (TASH) in Addis Ababa, Ethiopia. A triangulation of data collection methods was used: 91 audio-recorded, semi-structured interviews and 21 video-recordings of authentic interactions during hospital rounds. The aim was to obtain as complete a picture as possible of communication from the perspectives of physicians, patients, and family caregivers. The interviews were analyzed using thematic content analysis and the identified themes were supported by excerpts from the transcribed recordings. Results Eight themes emerged from the data. Workload and time pressure, in combination with restricted space for privacy, limited the possibilities for physicians to deliver detailed information and provide emotional support. Furthermore, patient literacy levels, in combination with no or little cancer awareness, financial problems, reliance on traditional and religious treatments, the stigma of cancer, and a fatalistic attitude, resulted in delays in patients seeking care and participating in positive health behaviors, and, subsequently, often resulted in an unwillingness to openly discuss problems with physicians and adhere to treatment. The study also illustrates the paramount role of family in physician-patient communication in Ethiopia. Though family caregivers provide a valuable interpreting support when patients have limited language skills, they can also prevent patients from sharing information with physicians. Another important finding is that family caregivers were often responsible for making decisions about treatment and avoided telling patients about a poor prognosis, believing that conveying bad news may upset them. All of these themes have important implications for the role of ethically acceptable communication in patient-centered care. Conclusions This study has identified a number of serious challenges for successful and ethically acceptable health communication in Ethiopian cancer care. The study contributes to our understanding of the complexity around the role of family, combined with patients’ dependency on family members for communication, support, and access to care, which creates particular ethical dilemmas for the medical staff. The questions raised by this study concern how to organize consultations to achieve patient-centered health communication, while maintaining a constructive alliance with the family and not jeopardizing the patient’s continued access to care. The integration of communication training for medical students in Ethiopia, with a focus on ethical guidelines for family-centered patient consultation suitable for these circumstances, would be an essential step.
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| 38. |
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| 39. |
- 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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| 40. |
- Gustavsson, Erik, et al.
(författare)
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Etiska och praktiska utmaningar med ökat patientinflytande
- 2015
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Ingår i: Läkartidningen. - Stockholm. - 0023-7205 .- 1652-7518. ; 112
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)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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