OsloMet - Oslo Metropolitan University, Norway.
VID Specialized University, Norway.
Nurs Ethics. 2019 Nov-Dec;26(7-8):2124-2134. doi: 10.1177/0969733018819125. Epub 2019 Jan 27.
Due to the major changes occurring in the demographic composition of the world's population, the number of older individuals is increasing, which puts pressure on the healthcare systems in many different countries. The involvement of volunteers and family members may become necessary to fulfil a patient's needs for follow-up treatments and long-term care in their homes.
This study aimed to explore how nurses and physicians experienced and addressed ethical challenges when they dealt with relatives in what have traditionally been one-on-one consultations at two Norwegian hospital outpatient clinics.
A total of eight nurses and two physicians from two different hospitals participated in individual in-depth interviews. The transcribed interviews were analysed using an eclectic approach called 'bricolage' inspired by Kvale and Brinkmann. We combined cross-case thematic and theoretical normative analyses.
The principles of voluntariness, confidentiality, withdrawal and anonymity were respected throughout the research process. In addition, the Norwegian Social Science Data Services approved this study.
The findings showed that respect for a patient's autonomy was used as an argument for delimiting the relatives' access to the patient's consultations. We found that there were insufficient routines in place for inviting and involving relatives in the patient consultations in the outpatient clinics.
The traditional Western attitudes towards the principles of patient autonomy will likely be challenged due to the growing need for family involvement in the care of a patient in the future.
This study's description of the nurses and physicians' interpretations of 'patient autonomy' as a phenomenon uncover the need for systematic ethical deliberation in the clinical setting. On an organisational level, there is a strong indication of the need to discuss the routines that are in place to invite the next of kin to participate in such patient's healthcare consultations.
由于世界人口构成发生重大变化，老年人口数量不断增加，这给许多国家的医疗保健系统带来了压力。为了满足患者在家中接受后续治疗和长期护理的需求，志愿者和家庭成员的参与可能变得必要。
本研究旨在探讨护士和医生在挪威两家医院的两个门诊诊所传统上一对一咨询中与亲属打交道时，如何体验和应对伦理挑战。
共有 8 名护士和 2 名医生参加了两个不同医院的个人深入访谈。转录的访谈使用一种名为“拼凑”的折衷方法进行分析，该方法受到 Kvale 和 Brinkmann 的启发。我们结合了跨案例主题和理论规范分析。
在整个研究过程中，尊重了自愿性、保密性、退出和匿名性的原则。此外，挪威社会科学数据服务局批准了这项研究。
研究结果表明，尊重患者的自主权被用作限制亲属访问患者咨询的论据。我们发现，门诊诊所邀请和让亲属参与患者咨询的常规做法不足。
由于未来对家庭参与患者护理的需求不断增加，传统的西方患者自主权原则可能会受到挑战。
本研究对护士和医生对“患者自主权”作为一种现象的解释进行了描述，揭示了在临床环境中需要进行系统的伦理思考。在组织层面上，强烈表明需要讨论现有的邀请近亲参与此类患者医疗保健咨询的常规做法。
