The Role of Health care Professionals in the Decision-Making Process of Family Caregivers Regarding Placement of a Cognitively Impaired Elderly Relative

2012 ◽  
Vol 24 (6) ◽  
pp. 283-291 ◽  
Author(s):  
Mélanie Couture ◽  
Francine Ducharme ◽  
Julie Lamontagne
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
Cognitively Impaired ◽  
Decision Making Process

scholarly journals Understanding the perspectives of older adults and elderly regarding vaccination; a snapshot in four European countries

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Timen ◽  
R Eilers ◽  
S Lockhart ◽  
R Gavioli ◽  
S Paul ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Infectious Diseases ◽  
Health Care Professionals ◽  
Elderly Care ◽  
European Countries ◽  
Decision Making Process ◽  
Ageing Population ◽  
Syncytial Virus

Abstract Prevention of infectious diseases in elderly by immunization is a prerequisite to ensuring healthy ageing. However, in order for the vaccine programs to be effective, these need to be provided by health care professionals who have up-to-date knowledge and high motivation. Furthermore, the knowledge and attitudes towards vaccination in the targeted age groups needs to be fully understood. When focusing on the information provision, it is important to know from whom or which institution older adults and elderly would like to receive and in which form. In January 2019, an international project called the VITAL (The Vaccines and InfecTious diseases in the Ageing population) project was started, within the framework of IMI (Innovative Medicines Initiatives). One of the goals of the VITAL project is to develop strategies to educate and train health care professionals (HCPs) and to promote awareness among stakeholders involved in elderly care management. We briefly focus on the results of studies undertaken in four European countries (Italy, France, The Netherlands and Hungary), which reveal the perspective of older adults and elderly regarding influenza, pneumococcal, herpes zoster vaccination and respiratory syncytial virus (RSV) as well as generic characteristics of the vaccines and diseases. We will show how attitudes towards vaccination are represented in our study population and which determinants influence the decision-making process of accepting vaccination. Furthermore, we shall elaborate on how the decision-making process towards vaccination takes place and which additional information is needed. In the second part of the session, we shall invite the audience to reflect on the findings and identify the factors they consider most important for setting up a training and education programme on vaccination.

scholarly journals The identity and role of stakeholders in the medical tourism industry: state of the art

2020 ◽  
Vol 75 (3) ◽  
pp. 559-574 ◽  
Author(s):  
Ahmed Kamassi ◽  
Noor Hazilah Abd Manaf ◽  
Azura Omar
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Medical Tourism ◽  
Tourism Development ◽  
Tourism Industry ◽  
Decision Making Process ◽  
Care Providers ◽  
Content Type ◽  
Key Stakeholders

Purpose This paper aims to address and identify the major stakeholders in the medical tourism industry, based on their participation in medical tourism activities and their support for medical tourism development. Design/methodology/approach This paper systematically reviews the content of medical tourism studies from literature to identify key stakeholders and address the roles they play in the medical tourism industry. Findings This study shows that the key stakeholders in the medical tourism industry are eight, namely, medical tourists, health-care providers, government agencies, facilitators, accreditation and credentialing bodies, health-care marketers, insurance providers and infrastructure and facilities. These stakeholders strongly influence medical tourists’ decision-making process in seeking medical treatment abroad. Besides, a successful medical tourism development depends greatly on the excellent partnership between all stakeholders. Practical implications This paper sheds light on the crucial role of these stakeholders that can be an important consideration in medical tourists’ decision-making process and industry growth. The study can facilitate policymakers in designing and developing policies to improve medical tourism practices. Originality/value This paper expands the knowledge about medical tourism literature by identifying and explaining the significant role of each stakeholder in the industry. The results of this paper are quite revealing to all practitioners in terms of the potential strategies and medical tourism growth. The study establishes a foundation for future medical tourism research in the rapidly growing industry.

The Covert Administration of Medications: Legal and Ethical Complexities for Health Care Professionals

2017 ◽  
Vol 45 (2) ◽  
pp. 182-192 ◽  
Author(s):  
L. Martina Munden
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Codes Of Ethics ◽  
Legal Framework ◽  
Decision Making Process ◽  
Legal Questions ◽  
Professional Codes ◽  
Professional Codes Of Ethics ◽  
The Right

The practice of covertly administering medications to patients without their consent is often discussed in the framework of legal questions around the right of patients to consent and refuse medical treatment. However, this practice also raises significant questions surrounding the professional duties and obligations of health care professionals as it relates to the decision-making process of whether to engage in the covert administration of medications. In this paper, I present an overview of the origin of those duties and obligations, and discuss how those duties and obligations when seen from different perspectives may either justify or prohibit the practice. Further, I discuss whether the duties and obligations of health care professionals as they are currently framed are suited to address the complexities of this issue both from the health care professional and patient perspectives. This analysis is conducted in the context of duties and obligations that arise from not only legal framework but also from the ethical requirements from professional codes of ethics.

Supporting the Decision Making of Children With Cancer: A Meta-synthesis

2020 ◽  
Vol 37 (6) ◽  
pp. 431-443
Author(s):  
Noyuri Yamaji ◽  
Maiko Suto ◽  
Yo Takemoto ◽  
Daichi Suzuki ◽  
Katharina da Silva Lopes ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Data Sources ◽  
Future Research ◽  
Decision Making Process ◽  
Inclusion Criteria ◽  
Children With Cancer ◽  
Prisma Statement

Background: Recently, awareness of children’s decision making has increased in an effort to enhance palliative care. However, the conceptual framework for decision making among children with cancer remains unclear. Aims: We clarified the decision-making process of children with cancer regarding their care, treatment, and support from family and health care professionals, and identified their needs and preferences. Design: We used metaethnography to conduct a metasynthesis of relevant studies. Data sources: We searched PubMed, EMBASE, PsycINFO, MEDLINE, and CINAHL. This report was prepared in accordance with the PRISMA statement. Results: Of the 7,237 retrieved studies, 27 met our inclusion criteria. Four themes emerged that reflected the decision-making process of children with cancer: (a) facing changes brought about by a health threat, (b) preparing for action, (c) asserting one’s choice, and (d) internal and external influences. Conclusion: Children with cancer initially undergo a decision-making process. Respecting children’s preferences, values, and emotions may help build trusting relationships and promote their decision-making capability. Future research should focus on children’s emotions, cognition, development, and interactions with parents and health care professionals.

scholarly journals Family and health-care professionals managing medicines for patients with serious and terminal illness at home: a qualitative study

2021 ◽  
Vol 9 (14) ◽  
pp. 1-162
Author(s):  
Kristian Pollock ◽  
Eleanor Wilson ◽  
Glenys Caswell ◽  
Asam Latif ◽  
Alan Caswell ◽  
...  
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
End Of Life Care ◽  
Terminal Illness ◽  
Life Care ◽  
Medicines Management ◽  
At Home

Background More effective ways of managing symptoms of chronic and terminal illness enable patients to be cared for, and to die, at home. This requires patients and family caregivers to manage complex medicines regimens, including powerful painkillers that can have serious side effects. Little is known about how patients and family caregivers manage the physical and emotional work of managing medicines in the home or the support that they receive from health-care professionals and services. Objective To investigate how patients with serious and terminal illness, their family caregivers and the health-care professionals manage complex medication regimens and routines of care in the domestic setting. Design A qualitative study involving (1) semistructured interviews and group discussions with 40 health-care professionals and 21 bereaved family caregivers, (2) 20 patient case studies with up to 4 months’ follow-up and (3) two end-of-project stakeholder workshops. Setting This took place in Nottinghamshire and Leicestershire, UK. Results As patients’ health deteriorated, family caregivers assumed the role of a care co-ordinator, undertaking the everyday work of organising and collecting prescriptions and storing and administering medicines around other care tasks and daily routines. Participants described the difficulties of navigating a complex and fragmented system and the need to remain vigilant about medicines prescribed, especially when changes were made by different professionals. Access to support, resilience and coping capacity are mediated through the resources available to patients, through the relationships that they have with people in their personal and professional networks, and, beyond that, through the wider connections – or disconnections – that these links have with others. Health-care professionals often lacked understanding of the practical and emotional challenges involved. All participants experienced difficulties in communication and organisation within a health-care system that they felt was complicated and poorly co-ordinated. Having a key health professional to support and guide patients and family caregivers through the system was important to a good experience of care. Limitations The study achieved diversity in the recruitment of patients, with different characteristics relating to the type of illness and socioeconomic circumstances. However, recruitment of participants from ethnically diverse and disadvantaged or hard-to-reach populations was particularly challenging, and we were unable to include as many participants from these groups as had been originally planned. Conclusions The study identified two key and inter-related areas in which patient and family caregiver experience of managing medicines at home in end-of-life care could be improved: (1) reducing work and responsibility for medicines management and (2) improving co-ordination and communication in health care. It is important to be mindful of the need for transparency and open discussion about the extent to which patients and family caregivers can and should be co-opted as proto-professionals in the technically and emotionally demanding tasks of managing medicines at the end of life. Future work Priorities for future research include investigating how allocated key professionals could integrate and co-ordinate care and optimise medicines management; the role of domiciliary home care workers in supporting medicines management in end-of-life care; patient and family perspectives and understanding of anticipatory prescribing and their preferences for involvement in decision-making; the experience of medicines management in terminal illness among minority, disadvantaged and hard-to-reach patient groups; and barriers to and facilitators of increased involvement of community pharmacists in palliative and end-of-life care. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 14. See the NIHR Journals Library website for further project information.

scholarly journals The Decision-Making Process for Palliative Sedation for Patients with Advanced Cancer–Analysis from a Systematic Review of Prospective Studies

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 301
Author(s):  
Alazne Belar ◽  
Maria Arantzamendi ◽  
Johan Menten ◽  
Sheila Payne ◽  
Jeroen Hasselaar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Decision Making ◽  
Palliative Care ◽  
Prospective Studies ◽  
Health Care Professionals ◽  
Disease Process ◽  
Palliative Sedation ◽  
Clinical Aspects ◽  
Decision Making Process

Background. The involvement of patients in decision making about their healthcare plans is being emphasized. In the context of palliative sedation, it is unclear how these decisions are made and who are involved in. The aim of the study is to understand how this decision-making is taken. Method. Information from a systematic review on clinical aspects of palliative sedation prospective studies were included. PubMed, CINAHL, Cochrane, MEDLINE, and EMBASE were searched (January 2014–December 2019). Data extraction and analysis regarded: (a) When and by whom the decision-making process is initiated; (b) patient involvement; (c) family involvement and (d) healthcare involvement. Results. Data about decision making were reported in 8/10 included articles. Palliative sedation was reported in 1137 patients (only 16 of them were non-cancer). Palliative sedation was introduced by the palliative care team during the disease process, at admission, or when patients experienced refractory symptoms. Only two studies explicitly mentioned the involvement of patients in decision making. Co-decision between families and the regular health care professionals was usual, and the health care professionals involved had been working in palliative care services. Conclusion. Patient participation in decision making appeared to be compromised by limited physical or cognitive capacity and family participation is described. The possibility of palliative sedation should be discussed earlier in the disease process.

scholarly journals Proposta di un percorso decisionale ed assistenziale per la sedazione palliativa

2013 ◽  
Vol 62 (1) ◽  
Author(s):  
Massimiliano Carassiti ◽  
Anna De Benedictis ◽  
Nunziata Comoretto ◽  
Bruno Vincenzi ◽  
Vittoradolfo Tambone
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Cultural Context ◽  
Clinical Decision Making ◽  
Health Workers ◽  
Clinical Work ◽  
University Hospital ◽  
Decision Making Process ◽  
Ethical Implications

Premessa: Nonostante una generale giustificabilità sul piano etico, la sedazione palliativa (SP) presenta ancora numerosi aspetti controversi che richiedono un ulteriore dibattito e chiarificazione. Dal punto di vista pratico, inoltre, si osserva una notevole variabilità per quanto riguarda la procedura clinica della SP e un confine tra la SP alla fine della vita e l’eutanasia involontaria sempre più sottile e incerto. Questa situazione rende particolarmente necessaria l’elaborazione di percorsi decisionali trasparenti, anche nella forma di linee-guida locali, che chiariscano le procedure e le implicazioni etiche della sedazione palliativa. Obiettivi: Lo scopo di questo lavoro è di presentare le principali caratteristiche del percorso decisionale e assistenziale per la SP elaborato presso il Policlinico Universitario “Campus Bio-Medico” di Roma. Metodi: L’elaborazione della proposta presentata è stata preceduta da uno studio, attraverso la somministrazione di questionari semistrutturati, sulle conoscenze del personale medico e infermieristico in merito alla SP e da uno studio retrospettivo sulle cartelle cliniche, per verificare le modalità di utilizzo della SP all’interno dell’ospedale. Risultati: Il percorso decisionale ed assistenziale elaborato considera non solo gli aspetti farmacologici, ma affronta con chiarezza anche le implicazioni etiche e legali della procedura di SP, e in particolare la comunicazione, la cura dei familiari e degli operatori sanitari, la possibilità di avvalersi della consulenza di etica clinica nei casi più complessi o nei quali è difficile raggiungere una decisione condivisa. Si sottolinea, inoltre, come l’applicazione di un percorso decisionale e assistenziale per la SP debba essere supportata da momenti formativi e di confronto attivo tra gli operatori sanitari, per favorire l’adeguata comprensione e il corretto utilizzo di tali strumenti operativi, ma anche per assicurare il rispetto della coscienza degli operatori sanitari coinvolti. Conclusioni: È raccomandabile che tutte le istituzioni sanitarie producano percorsi decisionali ed assistenziali per la SP, attenti non solo agli standard scientifici, ma anche alla sensibilità etica e culturale del contesto in cui verranno utilizzate. Percorsi decisionali ed assistenziali così strutturati forniscono non solo un orientamento operativo e formativo per l’agire clinico, ma costituiscono anche un doveroso strumento di trasparenza nei confronti dei pazienti, dei loro familiari, della stessa struttura sanitaria e di tutta la società. ---------- Background: Despite a general ethical basis for justification, palliative sedation (PS) still has many controversial aspects that require further discussion and clarification. From a practical standpoint, moreover, there is considerable variability in the clinical procedure and an increasingly uncertain boundary between PS and involuntary euthanasia. This situation makes it necessary to develop local guidelines to clarify the procedures and the ethical implications of PS. Purpose: The aim of this paper is to present the main features of the ethical and clinical decision-making process for PS developed at the University Hospital “Campus Bio-Medico”, in Rome. Methods: The development of the present proposal was preceded by a survey, through a questionnaire, on the knowledge of medical and nursing staff on PS, and a retrospective study on medical records, to see how PS is used inside the hospital. Results: The benefit of this decision-making process is that it considers the pharmacological aspects, but also clearly addresses the ethical and legal procedure of PS, communication, the care for family members and health workers, the possibility of taking advantage of a clinical ethics consultation in complex cases or where it is difficult to reach a joint decision. We also emphasize that the application of the decision-making process must be supported by training sessions and active confrontation, to promote proper understanding and correct use of the guidelines themselves, but also to ensure respect for the conscience of health care professionals who are involved in the procedures of PS. Conclusions: It is recommended that all health care institutions produce local guidelines for PS, attentive to scientific standards, but also sensitive to the ethical and cultural context in which they are used. Ethical and clinical guidelines provide not only a well-structured operational guidance and training for clinical work, but are also a necessary tool for transparency with regard to all society.

scholarly journals PENGAMBILAN KEPUTUSAN TENTANG PENATALAKSANAAN SINDROM PREMENOPAUSE PADA WANITA

2016 ◽  
Vol 2 (1) ◽  
pp. 28
Author(s):  
Chindy Maria Orizani
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Care Provider ◽  
Full Text ◽  
Symptom Management ◽  
Menopausal Symptom ◽  
Management Decision ◽  
Decision Making Process ◽  
Management Decision Making

ABSTRAKWanita berhak memilih penanganan premenopause namun penentuan keputusan menimbulkan masalah baru. Penelitian ini bertujuan untuk menelaah literature mengenai pengalaman penentuan keputusan dalam memilih penanganan gejala menopause dan peran petugas kesehatan terutama perawat untuk membantu proses penentuan keputusan. Sumber diambil dari database PubMed, ScienceDirect, dan SAGEPub. Enam kata kunci yang digunakan adalah fulltext, berbahasa Inggris, penelitian kualitatif berhubungan dengan penentuan keputusan dalam memilih penanganan gejala menopause. Total terdapat 42 artikel dari empat Negara yang berbeda dan setelah dilakukan pemilihan kriteria inklusi, empat artikel yang ditelaah. Dari empat artikel menemukan bahwa wanita mengungkapkan perasaan mereka tentang kurangnya informasi tentang menopause dan manajemen gejala menopause sehingga mereka menemukan kesulitan ketika memutuskan untuk terapi. Sebagian besar itu menunjukkan tentang kurangnya dukungan dari petugas kesehatan. Dari artikel juga menemukan mengenai faktor tentang pengambilan keputusan, dibagi menjadi empat kategori: (1) karakteristik individu (demografi, pengalaman menopause, gejala); (2) nilai-nilai, sikap, keyakinan, dan preferensi (sikap dan keyakinan tentang menopause dan perawatan, modalitas disukai, toleransi untuk risiko / efek samping); (3) fakta dan informasi tentang menopause dan manajemen gejala (jumlah, jenis, sumber, kredibilitas, ketersediaan); dan (4) konteks pelayanan kesehatan (perawatan kesehatan penyedia komunikasi, kepercayaan, ketersediaan / waktu, pengetahuan, hubungan). Sebuah model yang komprehensif pengambilan keputusan manajemen gejala menopause harus dibuat di Indonesia. Perawat sebagai penyedia layanan harus meningkatkan kemampuan komunikasi yang efektif untuk membantu perempuan dalam proses pengambilan keputusan misalnya dengan menggunakan intervensi Coacing Decision di acara bimbingan atau konsultasi.Kata kunci: penentuan keputusan wanita menopause, penetuan keputusan, peran perawatABSTRACTWomen have a right for choose the best premenopause treatment for her ownself, but decision making process sometime become new problem. Aim of this study was to review the literature regarding experience related to women’s menopausal symptoms management decision making and role of care provider especially nurse for helping client in decision making process. Reference lists collected from PubMed, ScienceDirect, and SAGEPub database. There are six keywords have been used for searching the article. Full- text, English language, qualitative study articles related to women’s menopausal symptom management decision making were reviewed. A total of 42 articles from four different countries and after considered inclusion criteria, four articles were reviewed. From four articles found that women expressed their feeling about a lack menopause information and its menopausal symptom management so they found difficulties when decided for the therapy. Most of it showed about a lack of support from care provider. From articles also found about factors about decision making, devided to four catagories: (1) individual characteristics (demographics, menopause experience, symptomatology); (2) values, attitudes, beliefs, and preferences (attitudes and beliefs about menopause and treatments, preferred modalities, tolerance for risks/side effects); (3) facts and information about menopause and symptom management (amount, type, source, credibility, availability); and (4) health care context (health care provider communication, trust, availability/time, knowledge, relationship). A comprehensive model of menopausal symptom management decision making should be made in Indonesia. Nurse as a care provider must increase an effective communication ability to help women in decision making process for example by using Decision Coacing Intervention at tutoring or consultation event. Keywords: woman’s menopause decision making, decision making, role of nurse DOWNLOAD FULL TEXT PDF >>

Universalism vs. Particularism in Medical Ethics

1998 ◽  
Vol 8 (11) ◽  
pp. 53-60
Author(s):  
Tamayo Okamoto ◽  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Informed Consent ◽  
Medical Ethics ◽  
Health Care Professionals ◽  
Decision Making Process ◽  
Traditional Society ◽  
The People ◽  
Practice Of Medicine ◽  
Universal Nature

In the context of medical ethics, how can the concept of informed consent be effectively implemented in a traditional society such as Japan? If the need for more openness and transparency is not felt in the practice of medicine and welfare, the clients must remain under the spell of paternalistic data. Patients and health-care professionals other than doctors are taken to be "responsible for what they do but not to be accountable for their conduct" (according to a feudal lord's slogan regarding rule over the people) because they do not participate in a decision-making process. I explore the possibility of the concept's full implementation against the particularists' (cultural relativists) and communitarian ethicists' effort to reject the universal nature of the concept.

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