This thesis presents an ethical model to guide the nurse in the application of moral standards or principles in the clinical and community setting. The study is concerned with looking at ethics primarily in terms of patients'/events' rights, not ethics in general. The contribution of contemporary nurse theorists and philosophers in the international arena are considered to see how their contributions relate to the present and future developments and trends in the field of nursing, and how they may be translated into action in the daily care of patients/clients in the clinical and community setting. The research methods include an historical review of local, national and international nurse educational, philosophical and ethical literature. The central theme investigates the caring roles of nurses and the commitment to patient/client care which are the basis of the ethical perspective of nursing. The ethical principles inherent in the nursing discipline, such as patients'/clients' rights and autonomy are examined, to see how these principles may be applied at the bedside and in the community. Validation criteria are adapted and this validation tool, together with the ethical constructs/components, are used as a framework to ensure that an ethical perspective is included and utilised in all nursing models. As ethics is concerned with human conduct and relationships, the author concludes that an ethical model is vital and may be used with all models which guide nursing practice currently in use and in future developments. An Ethical Analysis Framework and Model has been developed by the author, to serve as a tool for the inclusion of ethical constructs/components in models which guide the practice of nursing in the clinical and community setting. It also aids in the application of ethical principles. The Ethical Analysis Model will hopefully contribute to the theoretical framework of curriculum development as curriculum is concerned with shaping attitudes towards knowledge and creating a forum for discussion and criticism. Ethical knowledge is part of that subject matter. Through deliberation and judgement the definition and solution of curriculum and ethical problems may be effected as curriculum development, like ethics, is concerned with what is, and what might be. An example is presented of how the Framework and Model can be used, and is strongly recommended for use with any model which guides the practice of nursing. The findings, their limitations and the relevant discussions and recommendations are highlighted, and areas for further research are identified.

Diss. Uppsala : Univ., 2003.

Aim of the study. To evaluate mental health care institution staff’ and patients’ opinion about application of the doctrine of informed consent. Objectives: 1. To evaluate personal health care specialists’ opinion about application of the doctrine of informed consent in the health care institution. 2. To evaluate patients’ opinion about procedure of the written consent. 3. To compare personal health care specialists’ and patients’ opinion about application of the doctrine of informed consent. Methods. Anonymous survey of 138 personal health care specialists (response rate – 84 percent) and 315 patients (response rate – 90 percent) at Vilnius mental health centre was carried out. SPSS 13.0 version of statistic analysis packet was used to process the data. Diagrams and tables were prepared using Microsoft Excel 2003 program. Results. In evaluation of necessity of given information, 54,1% of personal health care specialists indicated that patient should be fully informed about his health status and diagnosis, 42,2% indicated that such information for mental health patients should be given just partially. 21,7% of patients claimed that information about prognosis and possible results of treatment given by doctors was unclear. In evaluation of procedure of written consent, 31,2% of specialists evaluated it as a manner for the doctor’s insurance and 24,9% – as an instrument for the protection of patient’s rights. Half of patients (49,9%) maintained that procedure of written consent... [to full text]

Although the health care in the Czech Republic is widely available and it is provided often on a high level, there is still a problem in medical facilities to keep a dignity of hospitalized people or their relatives. Particularly patients´ personal rights are often violated. Also, psychological dimensions of a treatment are often underestimated, which is most evident at the most vulnerable groups of hospitalized patients, such as minors, women in labour or dying people. If doctors violate their duties, only a small number of patients are seeking a justice in the court, either from a fear from financial costs of the litigation or a public stigmatization. At present, there might be a turning point in this situation. As of 1st April 2012 Act No. 372/2011 Coll., on the provision of health services, was adopted, that highly emphasises the patients´ right. The aim of the thesis was to summarize a current legislation to the given issue, to map knowledge of patients´ rights in the general public and to find out whether the rights are respected by the medical staff. The chosen method was a method of the quantitative research, a technique of a questionnaire survey. There was designed a questionnaire that ascertained a public awareness of patients´ rights, a process of instructions for patients and a provision of an agreement with the provided care. Respondents were inhabitants of the South Bohemian region older than 18 years. The research shows that respondents know their rights related to the provision of the health care especially in relation to the informed consent. However they consider the medical staff´s instructions to be insufficient. The research results proved that it is still necessary to put an emphasis on the education of the medical staff in the area of instructions for the patients on their health conditions and the care provided, on requirements of the informed consent, the way how to give instructions etc. It is necessary to encourage patients not to be afraid to say their doctor that they do not understand his/her way of the instructions on the intervention, to find a common consensus between patients´ and medical professionals´ demands.

Thesis (M.A. (Nursing Science) -- University of Limpopo, 2020 / Background Patient’s awareness of the patients’ rights charter was assessed as it was not known and strategies were developed to improve patients’ awareness in the selected hospitals of the Limpopo Province. Aim To assess, describe and explore patients’ awareness of their rights and to develop strategies to improve patients’ awareness of their rights. Study methodology A qualitative exploratory and descriptive research approach were used. Data were collected from 30 patients using semi-structured face-to-face interviews. Data were audiotaped and field notes were taken. The Turfloop Research Ethics Committee gave ethical clearance. The Department of Health permitted for the study to be conducted in the selected hospitals. Ethical considerations and measures to ensure trustworthiness were observed. Results Results showed that patients lacked awareness of the Patients’ Rights Charter and they could not give examples or name the rights they have as patients. The study revealed that sources of information regarding the Patients’ Rights were limited. Patients indicated that Patients’ Rights implementation was situational. Patients also experienced disrespect regarding their rights. In addition, strategies to improve patients’ awareness regarding the Patients’ Rights Charter were developed from the themes that emerged from this study.

Darbo tikslas- įvertinti pacientų teisių užtikrinimą pirminės sveikatos priežiūros lygmenyje, pacientų ir sveikatos priežiūros specialistų požiūriu. Darbo uždaviniai: 1. Įvertinti pacientų teisių užtikrinimą pirminiame sveikatos priežiūros lygmenyje pacientų požiūriu. 2. Įvertinti pacientų teisių užtikrinimą pirminiame sveikatos priežiūros lygmenyje sveikatos priežiūros specialistų požiūriu. 3. Palyginti pacientų teisių užtikrinimą pacientų ir sveikatos priežiūros specialistų požiūriu.Tyrimo metodika: tyrimas atliktas 2014 m. kovo- balandžio mėnesiais anoniminės apklausos būdu Vilniuje, atsitiktiniu atrankos būdu parinktoje pirminės sveikatos priežiūros įstaigoje. Tyrimo metu apklausti 48 bendrosios praktikos gydytojai, 54 slaugytojai ir 223 pacientai. Tyrimo rezultatai: 81,5 proc. pacientų žino savo teises. 49,5 proc. pacientų informaciją apie tyrimo rezultatus, 50,5 proc. ligos prognozę, 58,3 proc. gydymo eigą, suprato tik iš dalies. 62,3 proc. pacientų įvardijo, jog gydytojai, slaugytojai nepakankamai skiria laiko informavimui. Apie 50 proc. sveikatos priežiūros specialistų požiūriu, informacija apie ligos diagnozę, gydymo eigą, komplikacijas turi būti visiškai konfidenciali. 69,9 proc. pacientų manė, jog jų teisės užtikrinamos tik iš dalies. Tyrimo išvados: 1. Didžioji dauguma respondentų žinojo savo teises, tačiau daugiau kaip pusė respondentų teigė, kad nebuvo pakankamai informuoti apie savo ligą, o 34,7 proc. respondentų nebuvo įtraukit į sprendimų priėmimą, susijusį... [toliau žr. visą tekstą] / Aim of study: to evaluate an assurance of the patients` rights in the primary health care. Objectives: 1. To evaluate an assurance of the patients` rights in the primary health care from a patients` point of view. 2.To evaluate an assurance of the patients` rights in the primary health care from a health care proffessionals` point of view. 3.To compare an assurance of the patients` rights from the patients` and health care proffessionals` point of view. Methods: the cross-sectional study was performed at one Vilnius PHC institution, in 2014 March-April. The anonymous questionnaire was used in survey. There were 48 physicians, 54 nurses and 223 patients. Completed questionnaires were suitable for further investigation and statistical analysis. An anonymous questionnaire was used, which was developed according to literature analysis. Results: 81,5% of the patients knew their rights. 49,5% patients about medical examination results, 50,5% - disease prognosis and 56,5% - treatment process understood just partially. 62,3% of the patients identified, that physicians, nurses for the information share not enough time. About 50% of health care professionals` attitude related to information about diagnosis, treatment course, complications must be kept absolutely confidential. 69.9% patients felt that their rights are guaranteed only in part. Conclusions: 1. The majority of a respondents were aware of their rights, but more than half of them said that they were not sufficiently informed... [to full text]

Estudo exploratório, descritivo e de abordagem qualitativa que objetivou verificar o significado do termo humanização para enfermeiros e médicos de uma instituição hospitalar; conhecer como eles percebem a humanização na prática profissional e identificar os fatores que dificultam e facilitam a humanização da assistência. Após a autorização da instituição e aprovação do Comitê de Ética em Pesquisa, foram entrevistados 19 profissionais, sendo nove enfermeiros e dez médicos de uma instituição hospitalar privada do Município de São Paulo. Para a coleta de dados, foi elaborado instrumento contendo dados referentes à caracterização dos participantes e as questões norteadoras: para você o que significa o termo humanização hospitalar?, como você percebe a humanização da assistência nessa instituição? e quais os fatores que dificultam e facilitam a humanização da assistência nessa instituição?. Após a transcrição das entrevistas, os dados foram analisados, conforme o método de Análise de Conteúdo de Bardin, emergindo as seguintes categorias e subcategorias: 1. Significado do termo humanização: 1.1 Respeito, 1.2 Acolhimento e 1.3 Empatia; 2. Fatores que facilitam a humanização: 2.1 Cultura organizacional, 2.2 Equipe multiprofissional, 2.3 Autonomia; 3. Sobrecarga de atividades como fator que dificulta a humanização. Foi evidenciado que humanizar o atendimento à saúde é respeitar as crenças, valores e direitos do paciente; adaptar as rotinas hospitalares aos hábitos do paciente; oferecer, além do cuidado técnico, um atendimento individualizado; melhorar a qualidade do relacionamento entre profissional e paciente pela empatia e promover a autonomia do paciente. A cultura institucional que apresenta características, tais como orientação religiosa, tratamento digno do funcionário, promoção de treinamentos, orientação em relação aos direitos do paciente e à importância do acolhimento, implantação de protocolos assistenciais que permitem o gerenciamento dos riscos e a qualidade da assistência, bem como programas de Acreditação Hospitalar, pode facilitar a humanização. Ao respeitar os funcionários e promover sua autonomia, transferindo-lhes autoridade e apoiando suas decisões, as instituições podem ajudar seus profissionais a desenvolver processos de trabalho mais criativos, participativos, responsáveis e humanizados. A sobrecarga de atividades foi apontada como fator que mais dificulta a humanização da assistência, pois escalas de serviço enxutas, grande quantidade de tarefas e processos de trabalho pouco ágeis dificultam que os profissionais dediquem o tempo necessário ao paciente para atendê-lo de forma humanizada, uma vez que precisam fazer escolhas em relação às demandas dos pacientes e, em consequência, não conseguem atender todas as solicitações. Observou-se uma mudança no perfil das atividades dos entrevistados, que desempenham cada vez menos atividades assistenciais e, cada vez mais, atividades consideradas burocráticas, o que pode dificultar a humanização / Exploratory, descriptive, qualitative study aimed at checking the meaning of the term humanization for nurses and physicians at a hospital, knowing how they perceive humanization in professional practice and identifying factors that hinder and facilitate humanization in care. Upon the authorization of the institution and approval of the Research Ethics Committee, we interviewed 19 professionals (nine nurses and ten physicians) of a private hospital in the city of São Paulo. In order to collect data, we developed an instrument including data on the characterization of participants and the guiding questions: what does the term hospital humanization mean to you?, how do you perceive humanization of care at this institution? and what factors do hinder and facilitate the humanization of care at this institution?. Interviews were transcribed and data were analyzed in accordance with Bardins Content Analysis methodology, emerging the following categories and subcategories: Meaning of the term humanization: 1.1 Respect, 1.2 Reception and 1.3 Empathy; 2. Factors that facilitate humanization: 2.1 Organizational culture, 2.2 Multiprofessional team, 2.3 Autonomy; 3. Overload activities as a factor that hinders humanization. We evidenced that humanizing health care is to respect patients beliefs, values and rights; adapt hospital routines to patients habits; provide individualized care in addition to technical care; improve the quality of the relationship between the professional and the patient through empathy and promote patients autonomy. The institutional culture that presents characteristics such as religious orientation, dignified treatment of employees, promotion of training, orientation regarding patients rights and the importance of reception, implementation of assistance protocols enabling the management of risks and the quality of care, as well as Hospital Accreditation programs, may facilitate humanization. By respecting employees and promoting their autonomy, giving them authority and supporting their decisions, institutions can help its professionals to develop more creative, participative, responsible and humanized processes. The overload of activities was pointed out as the factor that most hinders humanization of care, because lean works schedules, large number of tasks and slow working processes hinders professionals from devoting the time needed to treat patients in a humanized manner, since they need to make choices regarding patients demands and, consequently they are unable to meet all requests. We observed a change in the profile of activities of respondents, which increasingly perform care activities and more and more activities regarded as bureaucratic, what may hinder humanization.

Estudo exploratório, descritivo e de abordagem qualitativa que objetivou verificar o significado do termo humanização para enfermeiros e médicos de uma instituição hospitalar; conhecer como eles percebem a humanização na prática profissional e identificar os fatores que dificultam e facilitam a humanização da assistência. Após a autorização da instituição e aprovação do Comitê de Ética em Pesquisa, foram entrevistados 19 profissionais, sendo nove enfermeiros e dez médicos de uma instituição hospitalar privada do Município de São Paulo. Para a coleta de dados, foi elaborado instrumento contendo dados referentes à caracterização dos participantes e as questões norteadoras: para você o que significa o termo humanização hospitalar?, como você percebe a humanização da assistência nessa instituição? e quais os fatores que dificultam e facilitam a humanização da assistência nessa instituição?. Após a transcrição das entrevistas, os dados foram analisados, conforme o método de Análise de Conteúdo de Bardin, emergindo as seguintes categorias e subcategorias: 1. Significado do termo humanização: 1.1 Respeito, 1.2 Acolhimento e 1.3 Empatia; 2. Fatores que facilitam a humanização: 2.1 Cultura organizacional, 2.2 Equipe multiprofissional, 2.3 Autonomia; 3. Sobrecarga de atividades como fator que dificulta a humanização. Foi evidenciado que humanizar o atendimento à saúde é respeitar as crenças, valores e direitos do paciente; adaptar as rotinas hospitalares aos hábitos do paciente; oferecer, além do cuidado técnico, um atendimento individualizado; melhorar a qualidade do relacionamento entre profissional e paciente pela empatia e promover a autonomia do paciente. A cultura institucional que apresenta características, tais como orientação religiosa, tratamento digno do funcionário, promoção de treinamentos, orientação em relação aos direitos do paciente e à importância do acolhimento, implantação de protocolos assistenciais que permitem o gerenciamento dos riscos e a qualidade da assistência, bem como programas de Acreditação Hospitalar, pode facilitar a humanização. Ao respeitar os funcionários e promover sua autonomia, transferindo-lhes autoridade e apoiando suas decisões, as instituições podem ajudar seus profissionais a desenvolver processos de trabalho mais criativos, participativos, responsáveis e humanizados. A sobrecarga de atividades foi apontada como fator que mais dificulta a humanização da assistência, pois escalas de serviço enxutas, grande quantidade de tarefas e processos de trabalho pouco ágeis dificultam que os profissionais dediquem o tempo necessário ao paciente para atendê-lo de forma humanizada, uma vez que precisam fazer escolhas em relação às demandas dos pacientes e, em consequência, não conseguem atender todas as solicitações. Observou-se uma mudança no perfil das atividades dos entrevistados, que desempenham cada vez menos atividades assistenciais e, cada vez mais, atividades consideradas burocráticas, o que pode dificultar a humanização / Exploratory, descriptive, qualitative study aimed at checking the meaning of the term humanization for nurses and physicians at a hospital, knowing how they perceive humanization in professional practice and identifying factors that hinder and facilitate humanization in care. Upon the authorization of the institution and approval of the Research Ethics Committee, we interviewed 19 professionals (nine nurses and ten physicians) of a private hospital in the city of São Paulo. In order to collect data, we developed an instrument including data on the characterization of participants and the guiding questions: what does the term hospital humanization mean to you?, how do you perceive humanization of care at this institution? and what factors do hinder and facilitate the humanization of care at this institution?. Interviews were transcribed and data were analyzed in accordance with Bardins Content Analysis methodology, emerging the following categories and subcategories: Meaning of the term humanization: 1.1 Respect, 1.2 Reception and 1.3 Empathy; 2. Factors that facilitate humanization: 2.1 Organizational culture, 2.2 Multiprofessional team, 2.3 Autonomy; 3. Overload activities as a factor that hinders humanization. We evidenced that humanizing health care is to respect patients beliefs, values and rights; adapt hospital routines to patients habits; provide individualized care in addition to technical care; improve the quality of the relationship between the professional and the patient through empathy and promote patients autonomy. The institutional culture that presents characteristics such as religious orientation, dignified treatment of employees, promotion of training, orientation regarding patients rights and the importance of reception, implementation of assistance protocols enabling the management of risks and the quality of care, as well as Hospital Accreditation programs, may facilitate humanization. By respecting employees and promoting their autonomy, giving them authority and supporting their decisions, institutions can help its professionals to develop more creative, participative, responsible and humanized processes. The overload of activities was pointed out as the factor that most hinders humanization of care, because lean works schedules, large number of tasks and slow working processes hinders professionals from devoting the time needed to treat patients in a humanized manner, since they need to make choices regarding patients demands and, consequently they are unable to meet all requests. We observed a change in the profile of activities of respondents, which increasingly perform care activities and more and more activities regarded as bureaucratic, what may hinder humanization.

SUMMARY Management of Public Health KNOWLEDGE OF MEDICAL STAFF ABOUT PATIENTS’ RIGHTS AND POSSIBILITIES TO ASSURE THEM IN THE HOSPITAL Greta Girštautaitė Supervisor Danutė Dučinskienė, Dr., Department of Social medicine, Faculty of Public Health, Kaunas University of Medicine. – Kaunas, 2005. – P.61 Aim of the study was to evaluate knowledge of medical staff about patients’ rights and possibilities to assure them in Kaunas 2nd clinical hospital. Health care professionals’ view about confidentiality of patient’s information, knowledge about patient’s right to select physician, nursing specialist and health care institution, the right of complaint, the right to information, possibilities to assure patients’ rights in the hospital were assessed. Methods. Anonymous surveys of 260 physicians and nurses were carried out (response rate 72 percent). Results. The results revealed that 80,8 percent of medical staff claimed that information about patient must be confidential. 91,6 percent of health care professionals thought that patient can select health care institution. 83,8 percent of medical staff thought that patient can select a physician and nursing specialist. 29,2 percent of the respondents indicated that the patient who is dissatisfied with medical care services can apply to director of health care institution. 18,6 percent of medical staff indicated that don’t know where the patient can make a complaint against health care institution’s activity if patient is dissatisfied... [to full text]

Darbo tikslas: Įvertinti nėščiųjų pacienčių požiūrį į informuoto sutikimo doktrinos taikymą stacionarią pagalbą teikiančioje gydymo įstaigoje. Uždaviniai: Įvertinti nėščiųjų pacienčių informuotumą apie jų teises gydymo įstaigoje. Įvertinti pacienčių požiūrį į rašytinio sutikimo davimo procedūrą. Nustatyti ryšį tarp pacienčių savo sveikatos vertinimo, išsilavinimo ir jų nuomonės apie informuoto sutikimo doktrinos taikymą. Tyrimo metodika: Atlikta anoniminė anketinė KMUK Akušerijos–ginekologijos klinikos Akušerijos skyriaus pacienčių apklausa. Buvo apklaustos 304 nėščios pacientės (atsako dažnis 84,4 proc.). Duomenų analizei naudota SPSS 10.0 statistinės analizės paketas. Rezultatai: Atlikus tyrimą paaiškėjo, jog Pacientų teisių ir žalos sveikatai atlyginimo įstatymą žinojo 76,3 proc. respondenčių. Dauguma pacienčių (98,0 proc.) tvirtino, žinančios, jog turi teisę į informaciją apie savo sveikatos būklę. 92,6 proc. respondenčių nurodė, kad buvo supažindintos su visomis procedūromis, kurios bus atliekamos įstaigoje. Dauguma pacienčių (92,4 proc.) buvo patenkintos gauta informacija iš gydytojų. Statistiškai reikšmingai didesnė dalis pacienčių tvirtino, kad suprantamą informaciją apie jų sveikatos būklę: ligos diagnozę, gydymo metodus ir gydymo eigą, gydymo prognozę ir galimus gydymo rezultatus, galimus alternatyvius gydymo metodus joms suteikė gydytojas lyginant su pacientėmis, tvirtinusiomis, jog minėtą informaciją suprantamai pateikė akušerė (p<0,001). 77,9 proc. nėščiųjų... [toliau žr. visą tekstą] / Aim of the study. To evaluate the pregnant patients’ opinion about application of the doctrine of informed consent. Objectives: 1. To evaluate knowledge of pregnant patient about their rights in the health care institution. 2. To evaluate patients’ opinion about procedure of the written consent. 3. To compare patients’ opinion about application of the doctrine of informed consent with self -assessed health and education. Methods. Anonymous survey of 304 pregnant patients (response rate – 84.4 percent) at Kaunas Medical University Clinic was carried out. SPSS 10.0 version of statistic analysis program was used to process the data. Results. Study revealed that the Law on patients‘rights and the compensation of the damage inflicted upon patients’ heath were known for 76.3% of the respondents. The majority of patients (98.0%) maintained aware about the right to information about their health status. 92.6% of respondents claimed, that they were informed about all procedure performed in the institution. The majority of patients (92.4%) were satisfied with the information delivered by the physician. Statistically significant higher part of patients maintained, that comprehensible information about their health: diagnosis, treatment, prognosis, results was delivered by the physician in comparison with the patients who emphasised that given information was provided by obstetrician (p<0,001). 77.9% of pregnant revealed being satisfied with the informed consent procedure. 22.1% of... [to full text]