Alodhialah Abdulaziz M, Almutairi Ashwaq A, Almutairi Mohammed
Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia.
School of Nursing & Midwifery, Monash University, Melbourne, VIC 3800, Australia.
Healthcare (Basel). 2024 Aug 9;12(16):1585. doi: 10.3390/healthcare12161585.
This study explores the ethical and legal challenges faced by nurses in caring for older adults with multimorbidities, focusing on issues related to patient autonomy, polypharmacy, and end-of-life care. Through semi-structured interviews with 15 nurses in Riyadh, Saudi Arabia, the research highlights the complexities of obtaining informed consent from patients with cognitive impairments and the ethical dilemmas of balancing autonomy and safety. The management of polypharmacy emerged as a significant concern, with nurses emphasizing the importance of thorough documentation and coordination among healthcare providers to prevent adverse drug interactions. End-of-life care and advance directives posed further challenges, particularly when family members disagreed with patients' documented wishes. The study underscores the need for comprehensive strategies, including ongoing education, clear communication, and supportive institutional policies, to address these issues effectively. The findings suggest that enhancing nurses' understanding of ethical principles and legal requirements is crucial for improving patient care and ensuring compliance with regulatory standards. Future research should aim to develop evidence-based guidelines to support nursing practice in managing these ethical and legal challenges.
本研究探讨了护士在照顾患有多种疾病的老年人时所面临的伦理和法律挑战，重点关注与患者自主权、多重用药和临终关怀相关的问题。通过对沙特阿拉伯利雅得的15名护士进行半结构化访谈，该研究突出了从认知受损患者那里获得知情同意的复杂性，以及平衡自主权和安全性的伦理困境。多重用药的管理成为一个重大问题，护士们强调了医疗保健提供者之间进行全面记录和协调以防止药物不良相互作用的重要性。临终关怀和预先指示带来了进一步的挑战，尤其是当家庭成员不同意患者记录的意愿时。该研究强调需要采取全面的策略，包括持续教育、清晰沟通和支持性的机构政策，以有效解决这些问题。研究结果表明，增强护士对伦理原则和法律要求的理解对于改善患者护理和确保符合监管标准至关重要。未来的研究应旨在制定基于证据的指南，以支持护理实践应对这些伦理和法律挑战。
