SCHOPP A, DASSEN T, VALIMAKI M, LEINO-KILPI H K, BANSEMIR G, GASULL M, LEMONIDOU C, ARNDT M P, Marianne A
Institut für Medizin-/Pflegepädagogik und Pflegewissenschaft, Humboldt-Universität zu Berlin.
Pflege. 2001 Feb;14(1):29-37. doi: 10.1024/1012-5302.14.1.29.
The aim of this study was to describe patient autonomy, privacy and the implementation of the principle of informed consent in the care of elderly patients in facilities experienced by themselves. This study is part of the BIOMED 2 project "Patients' autonomy and privacy in nursing interventions" supported by the European Commission. Interview data (n = 95) were collected among elderly people in German facilities for geriatrics and in nursing homes. The results showed there was a lack of opportunity by the elderly people to make self-determined decisions. The principle of "informed consent" was hardly realised. The participants felt their privacy was not respected in multi-bedded rooms and in situations of dressing and eliminating. One can proceed on the assumption that the lack of information, the need of help and the fixed organizing structures of the facilities are the reasons why elderly people play a rather passive role as patients. It might be possible to improve the autonomy of elderly people if the nurses as an advocate supported them to make self-determined decisions. The implementation of the principle of informed consent with regard to nursing interventions would promote both autonomy and respect of privacy. Furthermore, one can assume that the autonomy and quality of life of elderly people could be promoted if the organizing structures of the facilities were more flexible.
本研究的目的是描述在老年人自身所经历的机构护理中患者自主权、隐私以及知情同意原则的实施情况。本研究是由欧盟委员会资助的BIOMED 2项目“护理干预中的患者自主权和隐私”的一部分。在德国老年护理机构和养老院的老年人中收集了访谈数据（n = 95）。结果显示，老年人缺乏自主做决定的机会。“知情同意”原则几乎没有得到落实。参与者感到在多人病房以及穿衣和排便等情况下，他们的隐私没有得到尊重。可以推测，信息缺乏、需要帮助以及机构固定的组织架构是老年人作为患者扮演相当被动角色的原因。如果护士作为倡导者支持老年人自主做决定，或许有可能提高老年人的自主权。护理干预方面知情同意原则的实施将促进自主权和对隐私的尊重。此外，可以设想，如果机构的组织架构更加灵活，老年人的自主权和生活质量可能会得到提高。
