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[奥地利护理人员处理预立医疗指示的经验]

[Experiences of Austrian nursing staff in dealing with advance directives].

作者信息

Heindl Patrik, Ruppert Sabine, Kozon Vlastimil

机构信息

Abteilung Organisationsentwicklung, AKH Wien Medizinischer Universitätscampus, Österreich.

出版信息

Pflege. 2014 Oct;27(5):337-46. doi: 10.1024/1012-5302/a000380.

Abstract

BACKGROUND

Advance directive is a contemporary issue because of accentuation of patients' autonomy and the increasing medical progress. But problems arise in drafting an advance directive as well as in realisation of advance directives in institutions. The duties and the influence of nursing in this context are hardly an object of scientific investigations. This article first describes empirically the role of nurses in connection with advance directives.

AIM

AIM of this study is the description of nurses' experiences in connection with advance directives.

METHOD

A descriptive-explorative cross-section design was used for this study. Data were recorded by means of a semi-structured questionnaire. This questionnaire was handed out to 266 nurses working at an Austrian university hospital.

RESULTS

On the part of nurses there is a great insecurity with concurrent existence of sufficient theoretical professional knowledge and missing structures of the part of organisation. Because of these situations some interdisciplinary conflicts arise in connection with realisation of advanced directives.

CONCLUSION

To avoid conflicts and to improve the handling and realisation of advance directives in practice it is recommendable to establish clinical ethical consultation. The tasks of the clinical ethical consultation are the creation and implementation of ethical directives in the institution, the realisation of individual case discussions and the ethical education of the affected health care professionals.

摘要

背景

由于患者自主权的凸显和医学的不断进步,预立医疗指示成为一个当代问题。但在起草预立医疗指示以及在机构中实施预立医疗指示时都会出现问题。在此背景下,护理工作的职责和影响几乎未成为科学研究的对象。本文首先通过实证描述护士在预立医疗指示方面的作用。

目的

本研究的目的是描述护士在预立医疗指示方面的经历。

方法

本研究采用描述性探索性横断面设计。数据通过半结构化问卷收集。该问卷发放给了奥地利一家大学医院的266名护士。

结果

护士方面存在很大的不安全感,同时存在足够的理论专业知识,但组织方面缺乏相应架构。由于这些情况,在实施预立医疗指示时出现了一些跨学科冲突。

结论

为避免冲突并在实践中改进预立医疗指示的处理和实施,建议建立临床伦理咨询。临床伦理咨询的任务包括在机构中制定和实施伦理准则、开展个案讨论以及对相关医护人员进行伦理教育。

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