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- Title
A European multicenter study on systematic ethics work in nursing homes.
- Authors
Bollig, Georg; Rosland, Jan Henrik; Gjengedal, Eva; Schmidt, Gerda; May, Arnd T.; Heller, Andreas
- Abstract
Background There are many existing ethical challenges in nursing homes. Although different methods and approaches to discussing the ethical challenges have been established, systematic ethics work is not yet a standard in all nursing homes. The aim of the present study was to explore ethical challenges and approaches to implementing systematic ethics work in nursing homes. Methods Data from five institutions in Austria, Germany and Norway were collected, and a mixed-methods two-tiered study approach was chosen. Documentation of ethics discussions was combined with qualitative focus group interviews with staff members regarding the implementation of systematic ethics work in nursing homes. Results One hundred and five ethics meetings were documented. The main topics were advance care planning, ethical challenges associated with artificial nutrition, hospitalisation and end-of-life decision-making. Of the meetings, 33% focused mainly on everyday ethical challenges. In 76% of prospective case discussions, agreements about a solution were reached; however, in 29% of these no residents or relatives participated. The advantages of systematic ethics work described by the staff were enhanced openness and dialogue, overall, and a greater ethical awareness. Many voiced a need for structure and support from the administration. Conclusions Systematic ethics work is greatly appreciated by the staff and helps to reach a consensus in the majority of case discussions. It should be implemented in all nursing homes. Attention to everyday ethical challenges is important. The participation of relatives and physicians could be improved. The participation of the residents' in ethics discussions should be encouraged to strengthen their autonomy and dignity.
- Subjects
AUSTRIA; GERMANY; NORWAY; PALLIATIVE treatment; HOSPITAL care; NURSING care facilities; ADVANCE directives (Medical care); COMPARATIVE studies; DIGNITY; FOCUS groups; INTERVIEWING; RESEARCH methodology; MEDICAL cooperation; MEDICAL personnel; NURSING home employees; NUTRITION; QUESTIONNAIRES; RESEARCH; RESEARCH funding; RESPECT; QUALITATIVE research; ETHICAL decision making; HUMAN services programs; PATIENTS' families; DATA analysis software; MEDICAL coding; DESCRIPTIVE statistics; PATIENT autonomy; ETHICS
- Publication
Scandinavian Journal of Caring Sciences, 2017, Vol 31, Issue 3, p587
- ISSN
0283-9318
- Publication type
Article
- DOI
10.1111/scs.12373