relational autonomy Dotaz Zobrazit nápovědu
Článek se zabývá etickou problematikou principu autonomie v psychoterapii. Jsou definovány základní předpoklady autonomie pacienta a postavení tohoto principu mezi dalšími základními etickými principy podle Beauchampa a Childresse. Je probrána autonomie pacienta v rámci problematiky informovaného souhlasu a jeho tří složek: odkrytí informace, kompetence pacienta a dobrovolnosti. Dále je popsáno, jak autonomie pacienta souvisí se vztahem psychoterapeut - pacient a jak může být v tomto vztahu narušována, je popsán zejména paternalistický, maternalistický a partnerský přístup k pacientovi a některá jejich úskalí. Článek je zakončen úvahou o etických problémech při práci s obrannými mechanismy pacienta v psychoterapii.
Following text inquires ethical problematic of the autonomy principle in psychotherapy. There is a definition of basic preconditions of autonomy of patient and a place of this principle among other basic ethical principles according to Beauchamp and Childress. Autonomy of the patient is discussed in the context of the informed consent and its three parts: disclosure of information, competence of patient and voluntariness. The article further describes the link between autonomy and psychotherapist-patient's relationship and how it can be violated in this context, there is described especially paternalistic, maternalistic and partnership approach to the patient and some of their pitfalls. The text concludes with discussion about ethical problems of work with defense mechanisms of patient in psychotherapy.
- Klíčová slova
- maternalismus, partnerský vztah, informovaný souhlas,,
- MeSH
- informovaný souhlas pacienta etika psychologie MeSH
- lidé MeSH
- obranné mechanismy MeSH
- osobní autonomie MeSH
- pacienti psychologie MeSH
- paternalismus etika MeSH
- profesionální etika MeSH
- psychoterapie etika MeSH
- vztahy mezi lékařem a pacientem etika MeSH
- Check Tag
- lidé MeSH
CONTEXT: The predominating definition of autonomy as a capacity to make an independent rational choice may not be suitable for patients in palliative care. Therefrom arises the actual need for more contextualized perspectives on autonomy to promote the quality of life and satisfaction with care of terminally ill patients. OBJECTIVES: This review aimed to develop a theoretical structural model of autonomy at the end of life based on patients' end-of-life care preferences. METHODS: In this review, we used systematic strategy to integrate and synthesize findings from both qualitative and quantitative studies investigating patients' view on what is important at the end of life and which factors are related to autonomy. A systematic search of EMBASE (OVID), MEDLINE (OVID), Academic Search Complete (EBSCO), CINAHL (EBSCO), and PsycINFO (EBSCO) was conducted for studies published between 1990 and December 2015 providing primary data from patients with advanced disease. RESULTS: Of the 5540 articles surveyed, 19 qualitative and eight quantitative studies met the inclusion criteria. We identified two core structural domains of autonomy: 1) being normal and 2) taking charge. By analyzing these domains, we described eight and 13 elements, respectively, which map the conceptual structure of autonomy within this population of patients. CONCLUSION: The review shows that maintaining autonomy at the end of life is not only a concern of making choices and decisions about treatment and care but that emphasis should be also put on supporting the patients' engagement in daily activities, in contributing to others, and in active preparation for dying.
- MeSH
- kvalita života * MeSH
- lidé MeSH
- osobní autonomie * MeSH
- pacientova volba * MeSH
- paliativní péče * MeSH
- péče o umírající * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
International library of ethics, law, and the new medicine ; Vol. 2
[1st ed.] xvii, 202 s.
Aim: We investigated to what extend nurses find the possibility of retraining patient autonomy, intimacy and support of human dignity in hospital setting. We also investigated whether todays nursing (provided nursing care) fulfills patient right for human dignity from patient point of view. Method: The survey used qualitative research by the use of half structured interviews with nurses and patients from surgical and long term patient wards (LTPW). The interviews were hold in January 2015 in South Bohemian hospital in Ceske Budejovice. The research population comprised of 10 general nurses out of which were 5 from surgical ward and 5 from (LTPW). Out of 20 respondents patients were 10 from surgical ward and 10 from (LTPW). Respondent selection was random and participation was voluntary. Six questions for nurses were focused on their opinion about patient autonomy assurance, dignity care, and obstacles which hinder that. Seven questions for patients inquired their opinion about possibilities for decision making about care, and experiences how is expressed dignity and assured intimacy to them. Data were recorded, rewrote with method “pencil paper”, and concepts were made according Grounded theory analyses. Results: Expressions of nurses from surgical ward show assurance of higher measurement of patient autonomy, intimacy and human dignity support in contradiction of nurses from LTPW. This status in influenced by the number of personnel, status of patients in general and space possibilities. Most of patients are at least aware of the decision making possibility even in the circumstances when all the initiative is left to the doctor especially on LTPW. Intimacy assurance patients perceive positively. Conclusion: Today’s nursing fulfills the patient right for human dignity expressed with autonomy and intimacy probably on average level. We see the possibility for quality improvement of provided nursing care to patients not only with high tech equipment and modern aids. It is necessary to be aware all the time that especially the man with all its human needs is the center of our concern. The assurance of autonomy, intimacy and human dignity support is not possible to do with the perfect devices without human approach and understanding of the man on the base of professional communication. The communication is needed not only to know and be skilled to apply it but also to have conditions for its realization.
- Klíčová slova
- intimita pacientů,
- MeSH
- důstojnost lidského života MeSH
- hospitalizovaní pacienti MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- ošetřovatelská etika * MeSH
- ošetřovatelská péče * MeSH
- ošetřovatelský výzkum MeSH
- osobní autonomie MeSH
- rozhovory jako téma MeSH
- soukromí MeSH
- vztahy mezi ošetřovatelkou a pacientem MeSH
- zdravotní sestry v klinické praxi MeSH
- Check Tag
- lidé MeSH
Prostorová mobilita seniorů patří k aktuálním zkoumaným tématům. Její aktuálnost je dána jednak stárnutím populace, jednak otázkami spojenými s kvalitou života seniorů. Je spojena s tím, jakým způsobem prostorová mobilita seniorů ovlivňuje jejich osobní nebo rodinný život, ale také život komunitní a veřejný. Předmětem soudobých zkoumání jsou faktory, které podporují prostorovou mobilitu, a naopak ty, které jí zabraňují. Ke zkoumaným tématům spojeným se stárnutím a stářím je také autonomie seniorů, která zahrnuje řadu aspektů. V průniku obou témat, tj. prostorové mobility a autonomie, vznikají otázky, jak spolu tyto jevy i procesy souvisejí, nakolik se podmiňují a ve výsledku, jaké takto pojatá mobilní autonomie plní funkce, či naopak za jakých okolností přestává být funkční. Byla provedena analýza 24 hloubkových rozhovorů se seniory staršími 70 let. Hlavním cílem bylo zjistit, jaký význam přisuzují senioři venkovní mobilitě pro svou autonomii. Cíl byl rozpracován do následujících výzkumných otázek: a) Jaký význam senioři přisuzují využívaným módům venkovní mobility? b) Jaké okolnosti senioři identifikují jako ovlivňující jejich mobilitu? c) Jak se senioři vyrovnávají s vnímanými omezeními venkovní mobility? Zvláště se ukázalo, jak významný je modus automobilu, význam je však diferencován podle různých kritérií, např. zda senior sám řídí, zda řídí jeho partner nebo zda je odkázán na pomoc druhých. Velkou otázkou je, jak se právě řidiči vyrovnávají se situací, kdy řídit přestanou či jsou nuceni přestat. Význam kola spjatý obvykle s širším rádiem každodenního žitého prostoru seniora závisí na zdravotní situací, kondici a životním způsobu. Z rozhovorů je patrné, že situaci seniorů a jejich strategie zvládání stárnutí zvláště v případě pokročilého stáří dobře charakterizuje to, jak jsou schopni pěšího pohybu a jak se mu věnují. Analýza rozhovorů vede k typologii přístupu seniorů k mobilitě a jejímu významu pro vlastní autonomii.
Spatial mobility of seniors is one of the current topics under investigation. Its relevance is due to both the ageing population and issues related to the quality of life of seniors. It is linked to how the spatial mobility of seniors affects their personal or family life, but also community and public life. The factors that promote spatial mobility and those that hinder it are the subject of contemporary research. Among the topics related to ageing and old age, the autonomy of seniors, which encompasses several aspects, is also under investigation. The intersection of these two topics, i.e., spatial mobility and autonomy, raises the questions of how these phenomena and processes are related, to what extent they condition each other and, as a result, what functions mobile autonomy, so conceived, fulfils or, conversely, under what circumstances it ceases to be functional. An analysis of 24 semi-structured interviews with seniors over 70 years of age was conducted. The main objective of the study was to discover what importance seniors attach to the outdoor mobility for their individual autonomy. We deconstructed this goal into the following research questions: (a) What importance do seniors attach to the outdoor mobility modes they use? (b) What circumstances do seniors identify as affecting their mobility? (c) How do seniors respond to the limitations in their outdoor mobility? In particular, the modus of the car has been shown to be important, but the importance is differentiated according to different criteria, e.g., whether the senior drives alone, whether his/her partner drives or whether s/he relies on the help of others. A big question is how drivers cope when they stop driving or are forced to stop. The importance of the bicycle, usually linked to the wider radius of the elderly person's daily living space, depends on health, fitness, and lifestyle. From the interviews, it is evident that the situation of seniors and their coping strategies, especially in the case of advanced old age, are well characterized by their ability and commitment to walking. The analysis of the interviews leads to a typology of seniors' attitudes towards mobility and its importance for their own autonomy.
- MeSH
- adaptace psychologická MeSH
- chůze psychologie MeSH
- lidé MeSH
- osobní autonomie MeSH
- pohybová aktivita * MeSH
- rozhovory jako téma MeSH
- samostatný způsob života * psychologie MeSH
- senioři nad 80 let psychologie MeSH
- senioři psychologie MeSH
- stárnutí MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- senioři nad 80 let psychologie MeSH
- senioři psychologie MeSH
- Publikační typ
- práce podpořená grantem MeSH
Aim: To determine the relationship between perceived satisfaction with childbirth and perceived autonomy in decision making during the childbirth process. Design: Cross-sectional study. Methods: The study took place within the international INTERSECT project. Data were collected in four hospitals in Slovakia. The research group consisted of 437 female respondents (average age 30.5 ± 4.8). Birth Satisfaction was measured by the Birth Satisfaction Scale - Revised (BSS-R). Level of autonomy in decision making during childbirth was measured by the Mothers' Autonomy in Decision Making Scale (MADM). Results: Respondents who perceived a higher level of autonomy in decision making during childbirth perceived higher overall satisfaction with childbirth (p = 0.001, r = 0.416). Higher age of mothers was also associated with higher birth satisfaction (p = 0.004, r = 0.139). Almost 17% of respondents perceived their childbirth to be a traumatic event. Respondents described lower levels of satisfaction with childbirth (p = 0.001) and lower levels of autonomy in decision making during childbirth (p = 0.002) if they subjectively perceived their childbirth as traumatic. Significant associations for the BSS-R score were also demonstrated regarding parity (p = 0.001), mode of delivery (p = 0.001), and type of delivery (p = 0.001). Conclusion: The involvement of the mother in the decision-making process of her own birth is a fundamental aspect of healthcare during childbirth and overall satisfaction with the birth.
- MeSH
- komplikace porodu psychologie MeSH
- lidé MeSH
- osobní autonomie * MeSH
- porod * psychologie MeSH
- průřezové studie metody MeSH
- průzkumy a dotazníky MeSH
- rozhodování MeSH
- spokojenost pacientů * MeSH
- věkové faktory MeSH
- vztahy mezi zdravotnickým pracovníkem a pacientem MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
CIEĽ: Cieľom štúdie bolo preskúmať vzťah medzi osobnostnými faktormi vyššieho radu plasticitou (extroverzia, otvorenosť voči skúsenosti), stabilitou (emocionálna stabilita/neuroticizmus, prívetivosť, svedomitosť) a problematickým používaním internetu (PlU) s prihliadnutím na úlohu autonómie v tomto vzťahu. METÓDY: Autonomy (škála na meranie autonómie). Ten Item Personality Inventory (Desaťpoložkový osobnostný dotazník), GPlU2-Generalized Problematic Internet Use Scale 2 (Škála na meranie problematického používania internetu). VÝSKUMNÁ VZORKA: Vzorka pozostávala z 1525 študentov prvých ročníkov univerzít troch krajín: Slovenska (N=587; 73 % žien; 19,6 priemerný vek; 38,5 % vzorky), Litvy (N=555; 71 % žien; 20,0 priemerný vek; 36,4 % vzorky) a Maďarska (N=383; 76 % žien; 21,4 priemerný vek; 25,1 % vzorky). Výskum je súčasťou štúdie SĽiCE (Študent life cohort in Európe). VÝSLEDKY: Modelmi lineárnej regresie bol zistený podiel všetkých skúmaných prediktorov na vysvetlení PlU pri kontrole rodu a krajiny. Bol potvrdený negatívny vzťah medzi plasticitou a PIU, medzi stabilitou a PIU ako aj autonómiou a PIU a Sobelov test preukázal, že autonómia bola mediátorom vzťahu plasticita a PIU a stabilita a PIU. ZAVER: Upozornením na významnú protektívnu úlohu autonómie vo vzťahu k PIU ako aj na jej mediačnú funkciu vo vzťahu osobnostných faktorov vyššieho radu a PIU umožŕiujeme implementáciu týchto poznatkov v prevenčných a intervenčných programoch pre vysokoškolákov.
AIM: The aim of this study was to explore the relationship between the higher-order personality factors Plasticity (Extraversion, Openness to Experience) and Stability (Emotional stability I Neuroticism, Agreeableness, Conscientiousness) and Problematic Internet Use (PIU) with respect to the role of autonomy in this relationship. METHODS: Autonomy (A scale for measuring autonomy), Ten-Item Personality Inventory, GPIU2 (Generalized Problematic Internet Use Scale 2). SAMPLE: The sample consisted of 1525 first-year university students from three countries: the Slovak Republie (38.5%, N=814, 73% of them females, mean age 19.6), Lithuania (36.4%, N=936, 71% of them females, mean age 20.0), and Hungary (25.1%, N=940, 16% of them females, mean age 21.4). This research is part of SLICE (a European cohort study looking into university students' behaviour and perspectives on life). RESULTS: Models of linear regression showed that all the predictors under scrutiny explained the variance in PIU after controlling for gender and country. The analysis showed a negative relationship between Plasticity and PIU, between Stability and PIU, and between autonomy and PIU. Furthermore, the Sobel test showed that autonomy was a mediator of the relationship between Plasticity and PIU and between Stability and PIU. CONCLUSION: Highlighting the significant protective role of autonymy in relation to PIU as well as the mediating role of autonomy in the relationship between the higher-order personality factors and PIU, the findings of this study can be implemented in prevention and intervention programmes for university students.
- MeSH
- behaviorální výzkum * metody trendy MeSH
- internet trendy využití MeSH
- lidé MeSH
- longitudinální studie MeSH
- mladý dospělý MeSH
- multicentrické studie jako téma MeSH
- osobní autonomie MeSH
- průzkumy a dotazníky normy využití MeSH
- psychologické testy MeSH
- sebepojetí MeSH
- statistika jako téma MeSH
- studenti klasifikace psychologie statistika a číselné údaje MeSH
- testování osobnosti * MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- Geografické názvy
- Litva MeSH
- Maďarsko MeSH
- Slovenská republika MeSH
Aim: Autonomy in nursing refers to nurses' ability to make independent decisions in providing nursing care without outside influence or control. Nurse autonomy is a key part of the provision of quality and safe care. Design: A narrative literature review was used for the study, performed according to the PRISMA ScR checklist. Methods: Relevant studies obtained from four databases were included in the narrative review. The data review was performed according to the PRISMA checklist. For data extraction and synthesis, the method of summative content analysis, in accordance with COSMIN criteria, was used. Results: The search identified four relevant studies published between 2003-2014. All instruments used in the studies were designed to measure nurse autonomy and were also used in combination with other instruments closely related to autonomy in nursing. The instruments demonstrated acceptable psychometric properties. Conclusion: Autonomy is an unexplored phenomenon in the context of the Slovak Republic and it deserves attention since nurse autonomy affects not only patients but also nurses themselves and their job satisfaction. It is important to enable nurses to participate in decision-making, planning and development of nursing as autonomous professionals.
- MeSH
- bezpečnost pacientů MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- ošetřovatelská péče metody MeSH
- poskytování zdravotní péče organizace a řízení MeSH
- profesionální nezávislost * MeSH
- zdravotní sestry * organizace a řízení MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- Geografické názvy
- Slovenská republika MeSH
