Assuntos
Bioética , Teoria Ética/história , Bioética/história , História do Século XX , História do Século XXI , HumanosAssuntos
Instituições de Caridade , Saúde Global , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Pandemias , Pobreza , Justiça Social , Tuberculose , Colonialismo , Congressos como Assunto , Democracia , Acessibilidade aos Serviços de Saúde/economia , Acessibilidade aos Serviços de Saúde/ética , Disparidades em Assistência à Saúde/economia , Disparidades em Assistência à Saúde/ética , Disparidades em Assistência à Saúde/etnologia , História do Século XX , História do Século XXI , Humanismo , Humanos , Indústria Manufatureira/economia , Pandemias/economia , Pandemias/ética , Grupos Raciais , Tuberculose/epidemiologia , Tuberculose/história , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/história , Armas/economiaRESUMO
BACKGROUND: There is often a mismatch between patients' desire to be informed about errors and clinical reality. In closing the "disclosure gap" an understanding of the views of all members of the healthcare team regarding errors and their disclosure to patients is needed. However, international research on nurses' views regarding this issue is currently limited. OBJECTIVES: Explore nurses' attitudes and experiences concerning disclosing errors to patients and perceived barriers to disclosure. DESIGN: Inductive, exploratory study employing semi-structured interviews with participants, followed by conventional content analysis in which investigators read and discussed transcribed data to identify important themes. SETTINGS: Nursing departments from hospitals in two German-speaking cantons in Switzerland. PARTICIPANTS: Purposive sample of 18 nurses from a range of fields, positions in organisational hierarchy, work experience, hospitals, and religious perspectives. METHODS: Data were collected via individual, face-to-face interviews using a researcher-developed semi-structured interview guide. Interviews were transcribed in German and analysed using the qualitative data analysis software package Atlas-Ti (Berlin) and conventional content analysis. The most illustrative quotes were translated into English. RESULTS: Nurses generally thought that patients should be informed about every error, but only a very few nurses actually reported disclosing errors in practice. Indeed, many nurses reported that most errors are not disclosed to the patient. Nurses identified a number of barriers to error disclosure that have already been reported in the literature among all clinicians, such as legal consequences and the fear of losing patients' trust. However, nurses in this study more frequently reported personal characteristics and a lack of guidance from the organisation as barriers to disclosure. Both issues suggest the need for a systematic institutional approach to error disclosure in which the decision to inform the patient stems from within the organisation and is not shouldered by individual nurses alone. CONCLUSIONS: Our study suggests that hospitals need to do more to support and train nurses in relation to error disclosure. Such measures as hospitals establishing a disclosure support system, providing background disclosure education, ensuring that disclosure coaching is available at all times, and providing emotional support for all parties involved, would likely go a long way to address the barriers identified by nurses.
Assuntos
Enfermeiras e Enfermeiros/psicologia , Revelação da Verdade , Educação em Enfermagem , Feminino , Humanos , Entrevistas como Assunto , MasculinoAssuntos
Arqueologia , Bioética , Ciências Humanas , Disciplinas das Ciências Naturais , Antropologia , Arqueologia/métodos , Arqueologia/tendências , Arte , Atenção à Saúde/normas , Empatia , Humanos , Medicina , NarraçãoAssuntos
Conservação dos Recursos Naturais , Saúde Global , Relação entre Gerações , Responsabilidade Social , Bases de Dados Factuais/estatística & dados numéricos , Saúde Global/educação , Saúde Global/ética , Saúde Global/normas , Saúde Global/tendências , Humanos , Expectativa de Vida , Obrigações Morais , Populações VulneráveisAssuntos
Surtos de Doenças/prevenção & controle , Doença pelo Vírus Ebola/prevenção & controle , Internacionalidade , Meios de Comunicação de Massa , Narcisismo , Pinturas , Prevenção Primária/ética , Adulto , África Ocidental/epidemiologia , Feminino , Infecções por HIV/terapia , Infecções por HIV/transmissão , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/transmissão , História do Século XX , Humanos , Libéria , Masculino , Meios de Comunicação de Massa/ética , Meios de Comunicação de Massa/normas , Pinturas/história , Gestão de Riscos , Espanha , Tecnologia , Texas , Estados UnidosRESUMO
The issue of apologising to patients harmed by adverse events has been a subject of interest and debate within medicine, politics, and the law since the early 1980s. Although apology serves several important social roles, including recognising the victims of harm, providing an opportunity for redress, and repairing relationships, compelled apologies ring hollow and ultimately undermine these goals. Apologies that stem from external authorities' edicts rather than an offender's own self-criticism and moral reflection are inauthentic and contribute to a "moral flabbiness" that stunts the moral development of both individual providers and the medical profession. Following a discussion of a recent case from New Zealand in which a midwife was required to apologise not only to the parents but also to the baby, it is argued that rather than requiring health care providers to apologise, authorities should instead train, foster, and support the capacity of providers to apologise voluntarily.