scholarly journals Gerenciamento profissional na ação do enfermeiro em problemas éticos na atenção básica / Professional management in the action of nurses on ethical problems in primary care

2021 ◽  
Vol 7 (12) ◽  
pp. 113848-113869
Author(s):  
Sheila Rodrigues de Carvalho ◽  
Rosana Maria Faria Vador ◽  
Fátima Aparecida Ferreira Barbosa
2016 ◽  
Vol 42 (12) ◽  
pp. 805-808 ◽  
Author(s):  
Rosalind McDougall ◽  
Dominique Martin ◽  
Lynn Gillam ◽  
Nina Hallowell ◽  
Alison Brookes ◽  
...  

Ethical concerns about therapeutic misconception have been raised since the early 1980s. This concept was originally described as research participants' assumptions that decisions relating to research interventions are made on the basis of their individual therapeutic needs. The term has since been used to refer to a range of ‘misunderstandings’ that research participants may have. In this paper, we describe a new concept—therapeutic appropriation. Therapeutic appropriation occurs when patients, or clinicians, actively reframe research participation as an opportunity to enhance patients' clinical care, while simultaneously acknowledging the generalised research aims. To illustrate the concept of therapeutic appropriation, we draw on data from an interview study which we conducted to investigate the experiences of patients and general practitioners involved in clinical trials in primary care. We argue that therapeutic appropriation has two key elements: comprehension that the research project is not necessarily aiming to benefit participants and the deliberate use of incidental features of the research for personal therapeutic benefit of various kinds. We conclude that therapeutic appropriation is a useful concept that refines understanding of potential ethical problems in clinical research, and points to strategies to address them.


2014 ◽  
Vol 35 (1) ◽  
pp. 148-156 ◽  
Author(s):  
José Roque JUNGES ◽  
Elma Lourdes Campos Pavone Zóboli ◽  
Rafaela SCHAEFER ◽  
Carlise Rigon Dalla NORA ◽  
Mikaela BASSO

The study aimed to validate the comprehensiveness of an instrument on the occurrence of ethical problems in primary health care and discuss their results. This is a methodological research. The technique used was Delphi, which seeks to obtain a consensus on a subject by experts, using structured questionnaires that are modified to obtain consensus on the comprehensibility of content. The sample was composed by nine professionals with expertise in primary health care in São Leopoldo. Data collection was in March and April 2011. In the first round, the professional was asked to respond whether the described situation has represented an ethical problem, whether the statement was clear and whether there was any suggestion to rewriting the problem. Were presented thirty-six statements, and to twenty was suggested new rewrite. After the review and systematization the proposed amendments, has begun the second round to seek consensus among all the statements that its writing had changed. In the second round, the consensus required by the method was obtained. Using the method supported significantly to build the instrument in its initial stage, what makes it appropriated and comprehensive for the subsequent steps of the validation.


2014 ◽  
Vol 22 (4) ◽  
pp. 428-439 ◽  
Author(s):  
Flávia Regina Souza Ramos ◽  
Laura Cavalcanti de Farias Brehmer ◽  
Mara Ambrosina Vargas ◽  
Ana Paula Trombetta ◽  
Luciana Ramos Silveira ◽  
...  

Background: Nursing students on clinical placements as part of their professional training are routinely faced with situations involving ethical conflicts. The initial act of perceiving a situation as causing an ethical dilemma is the result of both the students’ personal values, drawn from their culture and families, and of the professional knowledge and values that they have acquired through training and experience. Objectives: Nursing students’ experiences on clinical placements in primary care settings were investigated in order to identify situations that they perceived as involving ethical conflict and describe the elements they took into consideration during their decision-making processes in these situations. Methods: The research design was qualitative descriptive case study. Around 50 students from three different intakes to a nursing degree answered a questionnaire and discussed it in focus groups. Ethical considerations: The study was designed in accordance with the principles guiding research with human beings and was approved by the Human Research Ethics Committee. Results: Synthesised into two principal axes: (a) ethical conflicts in primary care, linked with the domains of working processes, professional nursing ethics and human and social rights and (b) students’ decision-making processes – realisation, reflection and intervention. Conclusion: The student nurses saw themselves both as actors and spectators in situations involving ethical problems and demanding moral deliberation, demonstrating the ability to base their arguments soundly. They tended to emphasise the possibilities offered by dialogue and that different ethical values must be respected to find fair solutions to ethical problems.


2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.


ASHA Leader ◽  
2016 ◽  
Vol 21 (6) ◽  
pp. 18-19
Author(s):  
Barbara E. Weinstein

Addiction ◽  
1997 ◽  
Vol 92 (12) ◽  
pp. 1705-1716 ◽  
Author(s):  
Sandra K. Burge ◽  
Nancy Amodei ◽  
Bernice Elkin ◽  
Selina Catala ◽  
Sylvia Rodriguez Andrew ◽  
...  

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