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.

• Klíčová slova
• Autonomy, end of life, palliative care, patient preference, quality of life, terminally ill,
• 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

BACKGROUND: Autonomy has become a key organizing principle in the official and expert discourses of the social services focused on strengthening of clients' independence and self-sufficiency. While "caring" has been seen as a threat to the autonomy of an individual, the care dependency and need for palliative care for people with dementia living in residential institutions are growing. METHODS: Participatory action research was realized in 9 homes providing services for people with dementia with the aim to improve the quality of care. Research teams from the homes were involved in assisted self-assessment which included observation, documentation analysis, workshops, interviews and interventions targeting the issues arising from practice. Ethnographic research was performed by the consultant/researcher to reflect on the experience. RESULTS: Over the last 15 years, the needs of clients in the residential care institutions in the Czech Republic have changed significantly and the pressure on people involved in direct care is growing. I suggest that relational approach to care, enhancing personal commitment of care workers and their appreciation of sociomateriality of caring relations, is well suited for enacting autonomy and dignity of people living and dying with dementia. The relational approach to care improvement is embedded in everyday practices and thus brings a wider scope of possibilities for providing good care than the controlling mode of improvement, measuring evidence against the national standards. CONCLUSIONS: If we are, as a collective, to build up appropriate structures and resources in dementia care, more attention must be paid to the needs of residents and care workers alike, as well as to realities of the daily practices.

• Klíčová slova
• Ethics of care, dementia, improvement, relational autonomy,
• MeSH
• demence ošetřování   MeSH
• lidé MeSH
• paliativní péče etika   normy   MeSH
• pečovatelské domovy * MeSH
• zdravotní služby pro seniory etika   normy   MeSH
• zlepšení kvality MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Mentors' initial perceptions of the mentoring role in formal youth mentoring bonds; and the subsequent characteristics of autonomy support or autonomy control in mentoring interactions developed by mentors after 5 months of mentoring experience are discussed in this paper. The data is drawn from a longitudinal phenomenological study conducted in the Czech mentoring scheme between 2010 and 2017. In-depth semi-structured interviews were collected with 10 mentoring matches over 1 year of mentoring involvement. The results of Interpretive phenomenological analysis showed differences in mentors' initial perceptions of the role, and related autonomy-supportive or autonomy-controlling characteristics in mentors' approach. The benefits and risks of resulting autonomy support or control in mentoring interactions are discussed. The results argue for the theoretical conceptualisation of a child-centred perspective in youth mentoring that aims at mentees' support of autonomy, active agency and empowement, thus arguing for further in-depth exploration of natural mentoring principles in child-centred perspective, supporting approaches such as youth-initiated mentoring, and broadening the discussion on good evidence-based mentoring practice in the EU context.

• Klíčová slova
• IPA, autonomy social support, empowerment, mentoring experience, significant adults, youth agency, youth mentoring,
• MeSH
• lidé MeSH
• longitudinální studie MeSH
• mentoring * MeSH
• mladiství MeSH
• percepce MeSH
• školitelé * MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

Grounded in self-determination theory, the present study examined the weekly fluctuations in different forms of work-related rumination depending on perceived autonomy support and fear of failure at the workplace. Work-related rumination has three dimensions, affective rumination (negative emotions or affect), problem-solving pondering (thinking over the actions to handle the problems), and psychological detachment (mentally distancing oneself from work during nonwork time). In total, 111 employees (Mage = 34.88, SD = 10.43) from various occupations were followed over the course of three weeks via weekly measurements, resulting in 333 matched observations. Multilevel random coefficient modeling showed that on the weeks when employees reported higher levels of perceived autonomy support from the leader, they engaged in affective rumination and problem-solving pondering less. However, weekly fluctuations in psychological detachment from work was not associated with perceived autonomy support. Moreover, on the weeks when employees experienced high fear of failure, they reported less psychological detachment from work during nonwork time. Lastly, within-and and between-person fear of failure moderated the negative link between perceived autonomy support and affective rumination. Findings showed that perceived autonomy support is a protective factor for employees high in both state and trait fear of failure in decreasing affective rumination. Directions for future research and implication for practice were discussed.

• MeSH
• lidé MeSH
• pracoviště MeSH
• řešení problému * MeSH
• strach MeSH
• zaměstnání * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

When someone violates a social norm, others may think that some sanction would be appropriate. We examine how the experience of emotions like anger and disgust relate to the judged appropriateness of sanctions, in a pre-registered analysis of data from a large-scale study in 56 societies. Across the world, we find that individuals who experience anger and disgust over a norm violation are more likely to endorse confrontation, ostracism and, to a smaller extent, gossip. Moreover, we find that the experience of anger is consistently the strongest predictor of judgments of confrontation, compared to other emotions. Although the link between state-based emotions and judgments may seem universal, its strength varies across countries. Aligned with theoretical predictions, this link is stronger in societies, and among individuals, that place higher value on individual autonomy. Thus, autonomy values may increase the role that emotions play in guiding judgments of social sanctions.

• MeSH
• emoce MeSH
• lidé MeSH
• mínění MeSH
• mravy MeSH
• odpor * MeSH
• zlost MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The authors apply the language and concepts of ethics to the problem of differences between the gynecologist and the patient about what is in the patient's interest. We develop a framework for clinical judgment and decision making about the ethical dimensions of the gynecologist-patient relationship. To achieve this goal we define the ethical principles of beneficence and respect for autonomy. We then show how these two principles interact in clinical judgement and decision making using common examples from gynecologic practice. We examine factors that influence the relative weight of these principles, including subject matter, probability of net medical benefit, availability of reasonable alternatives, and ability of the patient to participate in the informed consent process.

• Klíčová slova
• Professional Patient Relationship,
• MeSH
• dobročinnost * MeSH
• gynekologie * MeSH
• lékařská etika * MeSH
• lidé MeSH
• morální závazky MeSH
• osobní autonomie * MeSH
• paternalismus MeSH
• rozhodování MeSH
• sociální hodnoty MeSH
• vztahy mezi lékařem a pacientem MeSH
• zveřejnění MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The article gives a small reflection on the term human dignity which is sometimes used in medicine, but is not always considered what is meant by the term. Together with the development of science and health technology health care providers give more preference to physical aspects of human existence. Terms such as human dignity trail off their vocabulary. More often we meet it in codes of ethics and in different proclamations then in discussion on concrete patients. It is discussed in the text how we can understand the term from philosophical and practical perspectives and how we can use it for the benefit of our patients.

• MeSH
• lékařská etika * MeSH
• lidé MeSH
• mravy MeSH
• osobní autonomie * MeSH
• postoj zdravotnického personálu MeSH
• práva pacientů * MeSH
• vztahy mezi lékařem a pacientem * MeSH
• vztahy mezi ošetřovatelkou a pacientem * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• kvalita života MeSH
• lékařská etika * MeSH
• lidé MeSH
• osobní autonomie MeSH
• popálení terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Quality of life for people with intellectual disabilities has been reported in the research literature across differing demographics. There has been, however, little research that has examined in-depth the experiences of women with intellectual disabilities aged 40 years or older. MATERIALS AND METHODS: Fifty-five women from Sydney, Australia, and Prague, Czech Republic, were recruited to the study. Participants were recruited through agencies known to the researchers, ensuring ethical conduct of all procedures. RESULTS: Each participant completed a semi-structured interview, and using a grounded theory approach, a series of themes were identified common across all women. The strongest theme identified throughout the interviews was the lack of control participants perceived they had over their lives. CONCLUSIONS: The results of this study further the call for people with intellectual disabilities to be provided the opportunity to participate in decisions about their life choices.

• MeSH
• dospělí MeSH
• interview psychologický MeSH
• kvalita života * MeSH
• kvalitativní výzkum MeSH
• lidé středního věku MeSH
• lidé MeSH
• osobní autonomie * MeSH
• osoby s mentálním postižením psychologie   MeSH
• senioři MeSH
• srovnání kultur MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Austrálie MeSH
• Česká republika MeSH

The large-scale change of Czech society since 1989 has involved the democratic transformation of the health system. To empower the patient was one important goal of the healthcare reform launched immediately after the Velvet Revolution. The process has been enhanced by the accession of the Czech Republic to the European Union and the adoption of important European conventions regulating the area. The concept of informed consent and a culture of negotiation are being inserted into a traditionally paternalistic culture. Our article describes the current situation on the issue of the communication of information on state of health and treatment, and on the question of the participation of the patient in decisions on treatment. We present empirical results of a public opinion survey on this issue. The results show a still prevailing submissive attitude towards the physicians, despite the fact that the concept of informed consent has become more and more publicly familiar (42% of respondents gave the completely correct answer regarding informed consent). The impact of age, education and sex on answers to the questionnaire was analysed. Men, younger and more educated respondents were more likely to show the autonomous attitude, whereas women, older and less educated people tended to show the traditional submissive attitude. Further, our article raises the question of the cultural and historical background within which the current ethically and legally binding norms (products of western democracies, in fact) are interpreted. The question is how far cultural modifications are tolerable in the practical implementation of universal ethical constructs (informed consent).

• MeSH
• dospělí MeSH
• informovaný souhlas pacienta etika   zákonodárství a právo   MeSH
• lidé středního věku MeSH
• lidé MeSH
• moc (psychologie) MeSH
• osobní autonomie MeSH
• poskytování zdravotní péče MeSH
• postoj zdravotnického personálu MeSH
• průzkumy a dotazníky MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vztahy mezi lékařem a pacientem etika   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH