Faculty of Health, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
Nurs Ethics. 2024 Mar-May;31(2-3):176-188. doi: 10.1177/09697330231166085. Epub 2023 Jul 31.
Interest in strengthening residents' autonomy in nursing homes is intensifying and professional caregivers' experience ethical dilemmas when the principles of beneficence and autonomy conflict. This increased focus requires expanded knowledge of how residents experience decision-making in nursing homes and how being subject to paternalism affects residents' dignity.
RESEARCH QUESTION/AIM: This study explored how residents experience paternalism in nursing homes.
This study involved a qualitative interpretive design with participant observations and semi-structured interviews. The interpretations were informed by Gadamer's hermeneutics.
Eleven residents were interviewed after a period of participant observation in two nursing homes.
The study was performed in accordance with the Helsinki declaration. The Regional Ethics Committee (REK) permitted the researcher to perform participant observation in the nursing homes. The use of audio recordings of interviews was registered and supervised by Sikt - Norwegian Agency for Shared Services in Education and Research. The resident's consent was assessed continuously. Three interviews were terminated for ethical reasons.
The resident interviews revealed that residents found it obvious for caregivers to possess the decision-making authority in nursing homes. When residents explained their views, three main themes emerged: (1) To be included even though caregivers make the decisions, (2) Surrender to dependency, and (3) Adherence to nursing home norms.
Residents submit to their caregivers and give caregivers the responsibility and function as leaders. Paternalism was experienced as dignifying in situations where it contributed to residents being able to live according to second order desires and values, and when it implied respect and appraisal of residents' capabilities. Paternalism was experienced as debasing when residents felt left out, and when residents felt that their capabilities were underestimated. This also included their capability to withstand paternalistic influence.
人们对加强养老院居民自主权的兴趣日益浓厚，当善行和自主权原则发生冲突时，专业护理人员会遇到伦理困境。这种关注度的提高要求扩大对居民在养老院中决策体验的了解，以及了解居民受到家长式作风的影响如何影响居民的尊严。
研究问题/目的：本研究探讨居民在养老院中经历家长式作风的方式。
本研究采用定性解释性设计，包括参与观察和半结构化访谈。解释受伽达默尔解释学的启发。
在两个养老院进行了一段时间的参与观察后，对 11 名居民进行了访谈。
本研究符合赫尔辛基宣言。地区伦理委员会（REK）允许研究人员在养老院进行参与观察。采访的音频记录的使用已注册并由 Sikt-挪威教育和研究共享服务机构监督。居民的同意得到了持续评估。出于伦理原因，有三个访谈被终止。
居民访谈显示，居民认为护理人员在养老院拥有决策权是理所当然的。当居民解释他们的观点时，出现了三个主要主题：（1）即使护理人员做出决策，也要被包括在内；（2）向依赖投降；（3）遵守养老院规范。
居民服从护理人员并赋予他们责任和领导职能。在有助于居民能够根据第二顺序的愿望和价值观生活的情况下，家长式作风被体验为有尊严的，并且当它意味着对居民能力的尊重和赞赏时，家长式作风被体验为有尊严的。当居民感到被排斥时，当居民感到自己的能力被低估时，家长式作风被体验为贬低。这还包括他们承受家长式作风影响的能力。
