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2.
Br J Community Nurs ; 25(4): 162-166, 2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32267767

RESUMO

Nurses in primary care are often the first point of access for those seeking health care, and it is well known that accessing health services can be difficult for some, especially those on a low income. A charity initiative has been developed in a low-income area in England to help such individuals, wherein volunteers help local residents to access local services and support. This study explores the experiences of service users in order to understand their perceptions and feelings about the service, using an instrumental case study method with semi-structured interviews. Qualitative data were collected from six service users and transcribed by the researcher for subsequent thematic analysis. The participants' experiences were characterised by reduced social isolation, reduced emotional distress, improved mobility and transport options, improved confidence and control over life, and effective management of memory issues. Various aspects of advocacy and empowerment were also observed. Further, the coping strategies used by the participants while facing the challenges of social isolation and ageing were highlighted. The findings provide important insight into the support needs of populations on low income, the ways in which they access healthcare and how the volunteer service can best support them.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Defesa do Paciente , Pobreza/estatística & dados numéricos , Atenção Primária à Saúde , Inglaterra , Humanos , Enfermagem de Atenção Primária , Pesquisa Qualitativa , Voluntários
3.
Nurse Res ; 28(1): 17-24, 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32026662

RESUMO

BACKGROUND: The use of focus groups to collect data has increased in nursing research and provides rich, in-depth understanding of a phenomenon that can inform clinical practice. Guidance has been developed on facilitating focus groups. However, there is little guidance about how to translate, analyse or present focus group data from countries with linguistic differences. AIM: To explore contemporary examples of translating, analysing and presenting focus group data from countries with linguistic differences and to provide an in-depth example of decision-making in a study involving focus group data from two countries. DISCUSSION: The study highlights the need for a clear rationale and transparency in the reporting of the translation, analysis and presentation of data. Detailed and transparent reporting needs to include not only translation, but also when this occurred and if the data were amalgamated. CONCLUSION: There is a need for evidence-based guidance concerning how to report the translation, transcription and analysis of focus group data from countries with linguistic differences. IMPLICATIONS FOR PRACTICE: The authors provide recommendations concerning information that researchers should provide about translation when publishing studies, and argue for the use of a bilingual lead researcher.

5.
Nurse Res ; 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31523942

RESUMO

BACKGROUND: Memory, as a concept, is rarely discussed or described in qualitative research. However, memories are central to the stories people tell about their experiences of health and illness, which are often the focus of nursing enquiry. Memories also have the potential to be sensitive or traumatic. AIM: To consider the implications of memory for qualitative research by exploring the following issues: What is memory? What are the implications for using it in research? How can research participants and researchers best be supported in qualitative research when sensitive or traumatic memories are involved? DISCUSSION: Memory is imperfect, complex and dependent on context. Memories are connected to meaning and are central to identity. Qualitative research should appreciate the complexities of memory. Nurses undertaking qualitative research should be mindful of the potentially sensitive or traumatic nature of memories. Both participants and researchers can be affected and care should be taken during the research. CONCLUSION: Memory should not be taken for granted. The meanings underpinning memories are central to qualitative enquiry and are to be valued. IMPLICATIONS FOR PRACTICE: The strategies described in this paper can support researchers and participants when dealing with traumatic or sensitive memories.

6.
Nurse Res ; 27(3): 27-32, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31524339

RESUMO

BACKGROUND: Memory, as a concept, is rarely discussed or described in qualitative research. However, memories are central to the stories people tell about their experiences of health and illness, which are often the focus of nursing enquiry. Memories also have the potential to be sensitive or traumatic. AIM: To consider the implications of memory for qualitative research by exploring the following issues: What is memory? What are the implications for using it in research? How can research participants and researchers best be supported in qualitative research when sensitive or traumatic memories are involved? DISCUSSION: Memory is imperfect, complex and dependent on context. Memories are connected to meaning and are central to identity. Qualitative research should appreciate the complexities of memory. Nurses undertaking qualitative research should be mindful of the potentially sensitive or traumatic nature of memories. Both participants and researchers can be affected and care should be taken during the research. CONCLUSION: Memory should not be taken for granted. The meanings underpinning memories are central to qualitative enquiry and are to be valued. IMPLICATIONS FOR PRACTICE: The strategies described in this paper can support researchers and participants when dealing with traumatic or sensitive memories.


Assuntos
Memória , Narração , Pesquisa em Enfermagem/métodos , Humanos , Pesquisa Qualitativa
7.
Nurse Res ; 27(3): 14-19, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31468923

RESUMO

BACKGROUND: Nursing research is dedicated to improving care, but research into end of life care can be challenging because of a possible reluctance by researchers to invite bereaved people to take part in studies. AIM: To use a focused mapping approach to explore the recruitment to studies of grieving and bereaved people. DISCUSSION: There is no 'gold standard' method of recruitment and no best way to approach participants. The outcome of each method, measured by the percentage of potential participants recruited, appears to be unrelated to the approach used. CONCLUSION: There is no evidence that participation in research harms those who have recently been bereaved, but there is evidence of benefits from participating. IMPLICATIONS FOR PRACTICE: Researchers should not feel they need to protect the bereaved from participating in research and can invite bereaved individuals to join a study without worrying about causing them harm.

8.
BMC Med Res Methodol ; 19(1): 105, 2019 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-31096917

RESUMO

BACKGROUND: In this paper we discuss the emergence of many different methods for doing a literature review. Referring back to the early days, when there were essentially two types of review; a Cochrane systematic review and a narrative review, we identify how the term systematic review is now widely used to describe a variety of review types and how the number of available methods for doing a literature review has increased dramatically. This led us to undertake a review of current practice of those doing a literature review and the terms used to describe them. METHOD: We undertook a focused mapping review and synthesis. Literature reviews; defined as papers with the terms review or synthesis in the title, published in five nursing journals between January 2017-June 2018 were identified. We recorded the type of review and how these were undertaken. RESULTS: We identified more than 35 terms used to describe a literature review. Some terms reflected established methods for doing a review whilst others could not be traced to established methods and/or the description of method in the paper was limited. We also found inconsistency in how the terms were used. CONCLUSION: We have identified a proliferation of terms used to describe doing a literature review; although it is not clear how many distinct methods are being used. Our review indicates a move from an era when the term narrative review was used to describe all 'non Cochrane' reviews; to a time of expansion when alternative systematic approaches were developed to enhance rigour of such narrative reviews; to the current situation in which these approaches have proliferated to the extent so that the academic discipline of doing a literature review has become muddled and confusing. We argue that an 'era of consolidation' is needed in which those undertaking reviews are explicit about the method used and ensure that their processes can be traced back to a well described, original primary source.

9.
Cancer Nurs ; 42(4): 295-306, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29787385

RESUMO

BACKGROUND: Lung cancer survival rates are increasing; however, lung cancer survivors' mental and physical well-being can suffer from experiencing symptoms of fatigue, dyspnea, and depression. Exercise can improve these symptoms. However, no studies have examined the effects of different exercise interventions on these symptoms. OBJECTIVE: This review aims to examine the evidence on the effects of exercise interventions on fatigue, dyspnea, and depression in lung cancer survivors. METHODS: PRISMA guidelines were followed. CINAHL, MEDLINE, EMBASE, and Cochrane databases were searched between 2000 and May 2017. Gray literature was searched. All identified studies were screened for inclusion. Quantitative data were narratively synthesized. RESULTS: From 852 records retrieved and screened, 10 full-text articles were included. Seven studies had a high risk of bias, 2 had an unclear risk, and 1 study had a low risk, limiting the robustness of findings. Exercise interventions included pulmonary rehabilitation, aerobic exercise, resistance training, exercise and balance programs, and medical qigong. Six studies reported statistically significant reductions in fatigue; 2 reported significant improvements in dyspnea, and one a significant reduction in depression postintervention. CONCLUSIONS: Exercise interventions may be effective and are unlikely to cause harm for lung cancer survivors. However, evidence quality is limited. More rigorous study designs are required to provide guidance about which interventions may help lung cancer survivors self-manage these symptoms. IMPLICATIONS FOR PRACTICE: Health professionals should provide comprehensive, customized exercise screening and treatment plans to lung cancer survivors to complement their lifestyle needs and ensure appropriate recommendations aimed at improving symptom control are communicated to them.

10.
BMC Health Serv Res ; 18(1): 695, 2018 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-30200943

RESUMO

BACKGROUND: Assistant practitioners have knowledge and skills beyond the level of traditional support workers, and work in many clinical settings. However, some assistant practitioners lack a clearly defined role and may be under-used due to issues around accountability and uncertainty about their purpose. This paper explores the assistant practitioner role from the perspectives of assistant practitioners and registered nurses. METHODS: This study aimed to explore the role of the assistant practitioner from the perspectives of assistant practitioners and registered nurses in two NHS hospital trusts in Oxfordshire, United Kingdom. Six qualitative focus groups were undertaken between February-March 2017. Ethical approval was obtained (FREC 2016/05) and written consent was provided by participants. Data was analysed thematically analysed using the Framework method. RESULTS: Nineteen participants (assistant practitioners, n = 12; registered nurses, n = 7) were recruited using convenience sampling. Emerging themes related to 'fluctuating roles and responsibilities of assistant practitioners', 'role differences between registered nurses and assistant practitioners', 'working relationships', 'supervision' and 'redefining nursing pathways'. The Results and Discussion sections highlight a lack of role clarity and blurring of boundaries between the roles of assistant practitioners and registered nurses, with many tasks undertaken by both. This lack of ownership of 'nurse-specific' roles by registered nurses was evident and clear differences were only encountered with regard to accountability. The development of the Nursing Associate role provides managers with the opportunity to redefine staff banding hierarchies to ensure that clinical staff are aware of their role capabilities and limitations and are practicing safely, whilst promoting career development and progression pathways. CONCLUSION: Addressing issues around role clarity can benefit professional development, satisfaction, role identity and ownership for registered nurses and assistant practitioners, by recognising the individual and collective value they bring to the clinical team. The findings can help inform the development of the Nursing Associate role.


Assuntos
Papel do Profissional de Enfermagem , Enfermeiras e Enfermeiros/estatística & dados numéricos , Assistentes Médicos/estatística & dados numéricos , Papel do Médico , Adolescente , Adulto , Idoso , Atitude do Pessoal de Saúde , Mobilidade Ocupacional , Tomada de Decisão Clínica , Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Assistência à Saúde/estatística & dados numéricos , Feminino , Grupos Focais , Humanos , Relações Interprofissionais , Masculino , Responsabilidade Social , Reino Unido , Adulto Jovem
11.
Int J Nurs Stud ; 87: 149-156, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30125834

RESUMO

BACKGROUND: Inflammatory Bowel Disease is a chronic, untreatable condition represented by two illnesses, Crohn's and Ulcerative Colitis. Despite high incidence in well-developed industrialised countries, and the significant impact of symptoms on patient's quality of life, little is known about living with Inflammatory Bowel Disease. AIM: To explore the patients' experiences of living with Inflammatory Bowel Disease. DESIGN: A qualitative systematic review. DATA SOURCES: CINAHL, Medline, British Nursing Index and PsycINFO were searched using the following keywords: Inflammatory Bowel Disease AND experiences. We have limited the search to studies published in English from 2000 to 2017. REVIEW METHOD: Thematic synthesis. RESULTS: Data from 23 studies, identified that fatigue, incontinence and uncertainty about future, body image, and lack of information from healthcare professionals dominated the experiences of those living with Inflammatory Bowel Disease. Also, patients living with Inflammatory Bowel Disease were reluctant to disclose their illness due to lack of public awareness and stigma surrounding symptoms. From these, an overarching theme has been identified: Living in isolation and exclusion. CONCLUSION: Patients with Inflammatory Bowel Disease face a variety of problems, often their priorities and those of healthcare professionals differ greatly. Healthcare professionals have little evidence needed to provide adequate, holistic care to this group. With a rise in the Inflammatory Bowel Disease population in newly industrialised countries it is estimated that the condition is turning into a global disease, potentially making long term care unsustainable. More evidence is needed to understand the concerns of this group.


Assuntos
Doenças Inflamatórias Intestinais/fisiopatologia , Humanos , Pesquisa Qualitativa , Qualidade de Vida
12.
Int J Nurs Stud ; 85: 106-117, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29885547

RESUMO

AIM: The aim of this integrative literature review was to explore the quality of the dying and death experience in the Emergency Department from the perspective of staff and carers. BACKGROUND: Death in the Emergency Department is common. Understanding the quality of the death and dying experience of patients and their family members is crucial to building knowledge and improving care. DESIGN: Systematic integrative literature review reported following the PRISMA guidelines. DATA SOURCES: Pubmed, Cumulative Index to Nursing and Allied Health Literature, Magonline (internurse), and the Cochrane library. Articles used were published in English during 1990- 2017. REVIEW METHOD: Appraisal and thematic analysis. RESULTS: Sixteen articles are included. Eight themes emerged from the literature: care in the Emergency Department is about living not dying, staff perceive that death is a failure, staff feel underprepared to care for the dying patient and family in this environment, there is limited time for safe standards of care, staff stress and distress, staff use of distancing behaviours, the care of the dying role is devolved from medics to nurses at the end of life, and patients and staff perceive that the Emergency Department is not the preferred place of death CONCLUSION: There are areas of concern about end of life care in the Emergency Department. To improve practice and to ensure that a good death occurs, further research is needed. There is a need to understand more about the experience of caregivers when a relative or friend dies in the Emergency Department.


Assuntos
Atitude do Pessoal de Saúde , Morte , Serviço Hospitalar de Emergência , Recursos Humanos em Hospital/psicologia , Atitude Frente a Morte , Família/psicologia , Humanos , Pacientes Internados/psicologia
13.
J Clin Nurs ; 27(7-8): 1329-1345, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29423965

RESUMO

AIMS AND OBJECTIVES: To review patients' and healthcare professionals' perceptions of patient involvement in promoting hand hygiene compliance in the hospital setting. BACKGROUND: Initiatives continue to emphasise the importance of involving patients in their safety at the point of care. A patient-centred care approach aimed to empower patients to become active members of the healthcare team. However, understanding the perceptions of patients and healthcare professionals of patient involvement in promoting hand hygiene compliance among healthcare professionals has yet to be fully explored. DESIGN: Integrative literature review. METHODS: A five-stage review process informed by Whittemore and Knafl's methodology was conducted. MEDLINE and CINAHL were searched for papers published between January 2009-July 2017. Data were extracted manually, organised using NVivo 11 and analysed using thematic analysis. RESULTS: From an identified 240 papers, 19 papers were included in this review. Thematic analysis revealed two main themes with three related subthemes. Patients were willing to remind healthcare professionals (especially nurses) to wash their hands, healthcare professionals perception towards patients' involvement varied from one study to another. However, an overall positive attitude towards patient involvement was related to how patients asked and how healthcare professionals responded to being asked. CONCLUSION: There is limited evidence regarding patients' actual intention to ask healthcare professionals to wash their hands, and some evidence that patients are reluctant to do so. Further research is required to understand this area thoroughly, including which situations patients would feel more empowered to speak up. RELEVANCE TO CLINICAL PRACTICE: Simple messages promoting patient involvement may lead to complex reactions in both patients and healthcare professionals. It is unclear, yet how patients and staff react to such messages in clinical practice. There is a need for a deeper understanding of how they can work together to support harm free care.


Assuntos
Atitude do Pessoal de Saúde , Higiene das Mãos/normas , Recursos Humanos de Enfermagem no Hospital/psicologia , Participação do Paciente , Assistência Centrada no Paciente/métodos , Relações Médico-Enfermeiro , Humanos , Cooperação do Paciente , Percepção
14.
J Clin Nurs ; 26(23-24): 3906-3916, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28328169

RESUMO

AIMS AND OBJECTIVES: To explore the way in which sexual health care is perceived and experienced by students in clinical practice. BACKGROUND: Student nurses understand the need to learn about sexual health but report a variety of learning needs and experience challenges acquiring skills to deliver such care in part due to varied clinical experience. Furthermore, there is a paucity of data exploring clinical competence of sexual health care among student nurses. DESIGN AND METHODS: A literature review of the published literature was conducted following a search of online databases. Articles were selected for analysis according to inclusion and exclusion criteria. Eight articles were critically appraised and thematically analysed. RESULTS: The following themes were identified: student nurses report having a positive attitude towards sexual health care; however, many felt uncomfortable about addressing sexual health and are reluctant to initiate a conversation; many student nurses lack knowledge about sexual health; they also lack role models at university and on clinical placement. Student nurse caregiving in relation to sexual health was also noted. CONCLUSIONS: It is encouraging that student nurses have some knowledge, but their knowledge assessed is narrow. Their attitude is generally positive although many feel uncomfortable discussing issues of sexual health and sexuality. Very few student nurses report delivering sexual health care. There is a lack of positive role models both on clinical placement and at university. RELEVANCE TO CLINICAL PRACTICE: The reasons behind a lack of sexual health care delivery by student nurses should be understood. Student nurses should be supported to assess patient need and provide holistic care. Positive role models should be established in clinical and educational environments along with a focus on wider sexual health knowledge and skills.


Assuntos
Atitude do Pessoal de Saúde , Saúde Sexual , Estudantes de Enfermagem/psicologia , Competência Clínica , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pesquisa em Educação de Enfermagem
15.
Contemp Nurse ; 53(6): 698-712, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29421948

RESUMO

AIM: To explore the experience of readmissions to hospital from the perspective of older adults. METHODS: A systematic review with an interpretative approach was conducted. CINAHL, Embase, and Medline were consulted in October 2016. RESULTS: Six studies with data collection between 2004 and 2013 fit the relevant criteria and included a total of 68 older adults. Two overarching themes were developed with relevant subthemes: Experience during initial hospital stay distinguished by exclusion (Feeling powerless; Feeling disregarded; Perception of readiness for discharge); Patients experience uncertainty following discharge (Perception that community-based services are not available or adequate; Perception that hospital is the only safe place; Difficulty in adapting to a "new normal"). CONCLUSIONS: A cycle of exclusion exists during the initial hospital stay and beyond. The experience of being readmitted to hospital is challenging, mostly perceived as negative, and, existential, emotional and psychological well-being is not satisfactorily addressed by healthcare professionals.


Assuntos
Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Pacientes/psicologia , Estresse Psicológico , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino
16.
Int J Nurs Stud ; 43(8): 929-39, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16412445

RESUMO

BACKGROUND: Despite concern expressed in recent government documents in the UK about the inappropriate use of sedation when a patient is agitated or confused and cannot consent, there is little nursing literature on the topic. The general legal and ethical principles apply that a patient who is unable to consent should be given care that is in his or her 'best interests'. AIM: The aim of this paper is to report on qualitative data concerning nurses' use of sedation which were obtained as part of a larger study to explore the way in which nurses obtain consent prior to nursing care procedures. METHOD: A purposive sample of 30 qualified nurses in two teaching hospitals in England was obtained. One hundred critical incidents were collected through 30 in-depth interviews as a means of focusing on specific incidents concerning informed consent prior to nursing care procedures in clinical practice. FINDINGS: The administration of sedation to patients who cannot consent was a major theme to emerge. Sedation was sometimes given in the interests of other patients or staff rather than the patient and before alternative strategies had been considered. Nurses were uneasy about the use of sedation in such circumstances, and lacked knowledge as to when it may be appropriate to do so. CONCLUSIONS: Nurses need to be familiar with the relevant ethical and legal principles and professional guidance in their own countries for caring for people who cannot consent, and need to be confident in their understanding and application of these principles to ensure that sedation is administered appropriately.


Assuntos
Atitude do Pessoal de Saúde , Hipnóticos e Sedativos/uso terapêutico , Consentimento Livre e Esclarecido , Competência Mental , Recursos Humanos de Enfermagem no Hospital/psicologia , Defesa do Paciente , Agressão/efeitos dos fármacos , Agressão/psicologia , Competência Clínica/legislação & jurisprudência , Confusão/tratamento farmacológico , Confusão/enfermagem , Inglaterra , Feminino , Necessidades e Demandas de Serviços de Saúde , Hospitais de Ensino , Humanos , Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/legislação & jurisprudência , Consentimento Livre e Esclarecido/psicologia , Masculino , Competência Mental/legislação & jurisprudência , Competência Mental/psicologia , Papel do Profissional de Enfermagem/psicologia , Pesquisa Metodológica em Enfermagem , Recursos Humanos de Enfermagem no Hospital/ética , Recursos Humanos de Enfermagem no Hospital/legislação & jurisprudência , Defesa do Paciente/ética , Defesa do Paciente/legislação & jurisprudência , Defesa do Paciente/psicologia , Seleção de Pacientes , Guias de Prática Clínica como Assunto , Ética Baseada em Princípios , Pesquisa Qualitativa , Autoeficácia , Inquéritos e Questionários , Análise e Desempenho de Tarefas
17.
J Interprof Care ; 19(1): 63-9, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15842081

RESUMO

OBJECTIVES: The aim of this project was to identify core topics of health care ethics that could be taught through an inter-professional approach to undergraduate education. DESIGN: Five nominal group technique workshops. SETTING AND PARTICIPANTS: Teaching staff from different professional disciplines in our university (nursing branches, occupational therapy and physiotherapy). RESULTS: Seven core topics of health care ethics that are common across all disciplines were identified. However participants in all workshops identified the need for case studies used in teaching and learning to be specific to the clinical setting encountered by the student. CONCLUSION: Despite the identification of core topics that apply to all disciplines, caution should be taken when seeking to integrate these into an inter-professional undergraduate programme. There is evidence from other studies that students have difficulty in transferring knowledge from one context to another. In view of this, an inter-professional approach to health care ethics teaching to a group, members of which do not encounter shared clinical ethical problems may be inappropriate. It is suggested that inter-professional learning in undergraduate health care ethics should focus on facilitating learning in the clinical area with students who share similar ethical encounters, in which case the learning will be truly inter-professional.


Assuntos
Bioética/educação , Educação Profissionalizante/métodos , Comunicação Interdisciplinar , Confidencialidade/ética , Ética , Alocação de Recursos para a Atenção à Saúde/ética , Humanos , Consentimento Livre e Esclarecido/ética
18.
Nurs Ethics ; 12(1): 19-29, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15685965

RESUMO

It is largely undisputed that nurses should obtain consent prior to nursing care procedures. This article reports on a qualitative study examining the way in which nurses obtain such informed consent. Data were collected through focus group discussion and by using a critical incident technique in order to explore the way in which nurses approach consent prior to nursing care procedures. Qualified nurses in two teaching hospitals in England participated in the study. An analysis of the data provides evidence that consent was often not obtained by those who participated in the study and that refusals of care were often ignored. In addition, participants were often uncertain how to proceed with care when the patient was unable to consent. Consent prior to nursing care procedures is an essential but undeveloped concept, for which a new ethos is required.


Assuntos
Consentimento Livre e Esclarecido/ética , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente/ética , Cuidados de Enfermagem/ética , Educação de Pacientes como Assunto/ética , Recusa do Paciente ao Tratamento/ética , Anedotas como Assunto , Comportamento de Escolha , Inglaterra , Grupos Focais , Humanos , Consentimento Livre e Esclarecido/psicologia , Cuidados de Enfermagem/psicologia , Educação de Pacientes como Assunto/métodos , Direitos do Paciente , Comunicação Persuasiva , Inquéritos e Questionários , Recusa do Paciente ao Tratamento/psicologia
19.
Int J Nurs Stud ; 40(7): 697-705, 2003 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12965161

RESUMO

The aim of this paper is to examine the way in which nurses manage patients who are unable to consent to nursing care procedures. This paper reports on a qualitative study using focus groups and critical incidents collected through in-depth interviews to explore the way in which nurses obtain consent prior to nursing care procedures. The finding indicate that nurses are uneasy about administering care to a patient who cannot consent. When complicating factors are present this unease is exacerbated and sometimes the appropriate delivery of care is withheld.


Assuntos
Ética em Enfermagem , Papel do Profissional de Enfermagem/psicologia , Relações Enfermeiro-Paciente/ética , Autonomia Pessoal , Anedotas como Assunto , Pesquisa em Enfermagem Clínica/ética , Grupos Focais , Humanos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia
20.
J Adv Nurs ; 39(2): 201-7, 2002 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12100665

RESUMO

UNLABELLED: THE AIM OF THE PAPER is to demonstrate the nurses should be wary of relying on the concept of implied consent prior to nursing care procedures. RATIONALE: The difference between a patient who implies consent and who merely complies with a procedure is almost undetectable. METHODS: An exploratory study, incorporating use of focus groups and critical incident technique to examine the way in which nurses obtain consent prior to nursing care procedures. FINDINGS: Many nurses administer care without seeking verbal or written consent, but claim that the patient's consent is implied. However, there is evidence that care is often administered in the absence of information-giving and that this perceived implied consent should more realistically be called compliance. Implied consent is consent for which information is a crucial component. There is evidence that the term implied consent signifies different things to different nurses. Furthermore, even if there is agreement about what constitutes implied consent, in practice, implied consent may be indistinguishable from compliance. Nurses who assume that they have the patient's implied consent, when in reality only have compliance, risk carrying out care procedures without the patient's consent. CONCLUSIONS: Nurses should be familiar with the principles of implied consent. They should be wary of relying on the use of implied consent prior to nursing care procedures because of the difficulty in distinguishing implied consent and compliance. Nurses should approach all aspects of care-giving with the offer of information. In order to reduce the risk of misinterpretation of a patient's implied consent, they should seek the verbal affirmation of a patient prior to a nursing care procedure. Where nurses rely on the patient's implied consent, they should do so at their own discretion and with full understanding of the meaning of the term.


Assuntos
Consentimento Livre e Esclarecido , Cuidados de Enfermagem/normas , Humanos , Autonomia Pessoal
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