Podgorica Nertila, Pjetri Emiljano, Müller Andreas W, Deufert Daniela
UMIT-Private University for Health Sciences, Medical Informatics and Technology, Austria; FH Gesundheit-Health University of Applied Sciences Tyrol, Austria.
University of Shkoder, Albania.
Nurs Ethics. 2021 Nov-Dec;28(7-8):1194-1209. doi: 10.1177/0969733020981761. Epub 2021 Feb 3.
As a non-European Union member state, Albania is increasingly orienting itself on Western models regarding human rights, patient rights, and legal regulations for healthcare. Due to its limited fiscal and legal power, enforcing legal and ethical regulations poses a major problem.
The aim of this study is to investigate nurse's knowledge and experiences regarding ethical and legal issues in Albanian elder care in state-funded and privately run institutions.
The study was conducted using an inductive and qualitative design, utilizing a focused ethnographic approach, based on Roper and Shapira's framework.
Data were collected between June 2017 and September 2018 using participant observation, field notes, and semi-structured interviews with 15 nurses in seven different elder care institutions. In total, 100 h of observation and 15 interviews were performed. Data analysis was based on Mayring's qualitative content analysis.
The approval for the study was obtained from UMIT-The Health and Life Sciences University, Austria.
The findings of the study fell into the following main categories: "Everyday care issues," "End-of-life issues," "Legal issues," and "Ethical-legal education and conflicts."
The participants reported many ethical and legal issues when describing their everyday challenges and displayed a strong lack of ethical and legal education. Despite a wide spectrum in the quality of care between private and state-funded nursing homes, older people mostly do not know their own diagnosis.
This study indicates that further ethical and legal education is needed. Furthermore, nurses need to be better prepared for ethical conflicts with families, as strengthening patient rights could come into conflict with traditional rights of the Albanian family.
作为一个非欧盟成员国，阿尔巴尼亚在人权、患者权利以及医疗保健法律法规方面越来越倾向于西方模式。由于其财政和法律权力有限，执行法律和道德规范成为一个重大问题。
本研究的目的是调查护士在阿尔巴尼亚国有和私立机构中照顾老年人时，对伦理和法律问题的了解及经验。
本研究采用归纳性定性设计，基于罗珀和夏皮拉的框架，运用聚焦民族志方法。
2017年6月至2018年9月期间，通过参与观察、实地记录以及对七个不同老年护理机构的15名护士进行半结构化访谈来收集数据。总共进行了100小时的观察和15次访谈。数据分析基于迈林的定性内容分析。
本研究已获得奥地利UMIT健康与生命科学大学的批准。
研究结果主要分为以下几类：“日常护理问题”“临终问题”“法律问题”以及“伦理法律教育与冲突”。
参与者在描述日常挑战时提到了许多伦理和法律问题，并且明显缺乏伦理和法律教育。尽管私立和国有养老院的护理质量差异很大，但老年人大多不知道自己的诊断情况。
本研究表明需要进一步开展伦理和法律教育。此外，护士需要更好地应对与家庭的伦理冲突，因为加强患者权利可能会与阿尔巴尼亚家庭的传统权利产生冲突。
