Skip header and navigation

3 records – page 1 of 1.

Ethical dilemmas around the dying patient with stroke: a qualitative interview study with team members on stroke units in Sweden.

https://arctichealth.org/en/permalink/ahliterature258547
Source
J Neurosci Nurs. 2014 Jun;46(3):162-70
Publication Type
Article
Date
Jun-2014
Author
Helene Eriksson
Gisela Andersson
Louise Olsson
Anna Milberg
Maria Friedrichsen
Source
J Neurosci Nurs. 2014 Jun;46(3):162-70
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Attitude to Death
Communication Barriers
Female
Hospice and Palliative Care Nursing - ethics
Humans
Male
Neuroscience Nursing - ethics
Nurses' Aides - ethics - psychology
Nursing Staff, Hospital - ethics - psychology
Nursing, Team - ethics
Palliative Care - ethics
Physical Therapists - ethics - psychology
Qualitative Research
Right to Die - ethics
Stroke - nursing - rehabilitation
Sweden
Terminal Care - ethics
Abstract
In Sweden, individuals affected by severe stroke are treated in specialized stroke units. In these units, patients are attended by a multiprofessional team with a focus on care in the acute phase of stroke, rehabilitation phase, and palliative phase. Caring for patients with such a large variety in condition and symptoms might be an extra challenge for the team. Today, there is a lack of knowledge in team experiences of the dilemmas that appear and the consequences that emerge. Therefore, the purpose of this article was to study ethical dilemmas, different approaches, and what consequences they had among healthcare professionals working with the dying patients with stroke in acute stroke units. Forty-one healthcare professionals working in a stroke team were interviewed either in focus groups or individually. The data were transcribed verbatim and analyzed using content analysis. The ethical dilemmas that appeared were depending on "nondecisions" about palliative care or discontinuation of treatments. The lack of decision made the team members act based on their own individual skills, because of the absence of common communication tools. When a decision was made, the healthcare professionals had "problems holding to the decision." The devised and applied plans could be revalued, which was described as a setback to nondecisions again. The underlying problem and theme was "communication barriers," a consequence related to the absence of common skills and consensus among the value system. This study highlights the importance of palliative care knowledge and skills, even for patients experiencing severe stroke. To make a decision and to hold on to that is a presupposition in creating a credible care plan. However, implementing a common set of values based on palliative care with symptom control and quality of life might minimize the risk of the communication barrier that may arise and increases the ability to create a healthcare that is meaningful and dignified.
PubMed ID
24796473 View in PubMed
Less detail

Ethical issues in physiotherapy--reflected from the perspective of physiotherapists in private practice.

https://arctichealth.org/en/permalink/ahliterature122850
Source
Physiother Theory Pract. 2013 Feb;29(2):96-112
Publication Type
Article
Date
Feb-2013
Author
Jeanette Praestegaard
Gunvor Gard
Author Affiliation
Department of Physiotherapy Health Sciences, Health Sciences Center, Lund University, Lund, Sweden. j.praestegaard@oncable.dk
Source
Physiother Theory Pract. 2013 Feb;29(2):96-112
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Ambulatory Care - ethics
Attitude of Health Personnel
Beneficence
Codes of Ethics
Conflict (Psychology)
Denmark
Female
Health Knowledge, Attitudes, Practice
Humans
Interviews as Topic
Male
Moral Obligations
Physical Therapists - ethics - psychology
Physical Therapy Specialty - ethics
Private Practice - ethics
Professional Autonomy
Professional-Patient Relations - ethics
Qualitative Research
Abstract
An important aspect of physiotherapy professional autonomy is the ethical code of the profession, both collectively and for the individual member of the profession. The aim of this study is to explore and add additional insight into the nature and scope of ethical issues as they are understood and experienced by Danish physiotherapists in outpatient, private practice.
A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analyzed, using a phenomenological hermeneutic framework.
One main theme emerged: The ideal of being beneficent toward the patient. Here, the ethical issues uncovered in the interviews were embedded in three code-groups: 1) ethical issues related to equality; 2) feeling obligated to do one's best; and 3) transgression of boundaries.
In an ethical perspective, physiotherapy in private practice is on a trajectory toward increased professionalism. Physiotherapists in private practice have many reflections on ethics and these reflections are primarily based on individual common sense arguments and on deontological understandings. As physiotherapy by condition is characterized by asymmetrical power encounters where the parties are in close physical and emotional contact, practiced physiotherapy has many ethical issues embedded. Some physiotherapists meet these issues in a professional manner, but others meet them in unconscious or unprofessional ways. An explicit ethical consciousness among Danish physiotherapists in private practice seems to be needed. A debate of how to understand and respect the individual physiotherapist's moral versus the ethics of the profession needs to be addressed.
PubMed ID
22765019 View in PubMed
Less detail

Physiotherapy as a disciplinary institution in modern society - a Foucauldian perspective on physiotherapy in Danish private practice.

https://arctichealth.org/en/permalink/ahliterature265080
Source
Physiother Theory Pract. 2015 Jan;31(1):17-28
Publication Type
Article
Date
Jan-2015
Author
Jeanette Praestegaard
Gunvor Gard
Stinne Glasdam
Source
Physiother Theory Pract. 2015 Jan;31(1):17-28
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Denmark
Female
Humans
Interviews as Topic
Male
Middle Aged
Organizational Innovation
Physical Therapists - ethics - psychology
Physical Therapy Specialty - ethics - organization & administration
Physician's Practice Patterns - organization & administration
Power (Psychology)
Private Practice - organization & administration
Professional Autonomy
Professional-Patient Relations
Psychological Theory
Abstract
In many Western countries, physiotherapy in a private context is practiced and managed within a neoliberal ideology. Little is known about how private physiotherapeutic practice functions, which is why this study aims to explore how physiotherapy is practiced from the perspective of physiotherapists in Danish private practice, within a Foucauldian perspective. This study consisted of 21 interviews with physiotherapists employed in private practice and observation notes of the clinic. Interviews and observation notes were analyzed through the lens of Foucault's concepts of discipline, self-discipline, power and resistance. Three categories were constructed: (1) the tacit transition from person to patient; (2) the art of producing docile bodies; and (3) the inhibition of freedom of action by practicing in private homes. From a Foucauldian perspective, private physiotherapeutic practices have a disciplinary function in modern society as the physiotherapists produce docile bodies through disciplinary technologies, whereby their business becomes profitable. Most patients support the physiotherapists' "regime of truth" but if they resist, they are either excluded or accepted as "abnormal" but as a necessary source of income. The physiotherapists appear to be unconscious of the bio-powers working "behind their backs" as they are subject to the Western medical logic, and the neoliberal framework that rules their businesses.
PubMed ID
25004357 View in PubMed
Less detail