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Problematic Situations (problematic + situation)
Selected AbstractsAddressing complex ethical issues in the treatment of children and adolescents with eating disorders: application of a framework for ethical decision-makingEUROPEAN EATING DISORDERS REVIEW, Issue 3 2001Ronald S. Manley Abstract Ethically problematic situations frequently arise in the care of children and adolescents with eating disorders. The younger person with anorexia nervosa can often deteriorate quickly, therefore the child who is in denial with respect to the seriousness of her condition and/or markedly ambivalent regarding renourishment is at grave risk. Involuntary treatment is likely to be a consideration during such a medical crisis. In this paper we outline an ethical decision-making framework that can assist the clinician in engaging the young patient and her family well in advance of a crisis, so that decisions can be made at a time when recourse to establishing incompetency or enforcing involuntary treatment are unnecessary. We have adopted a narrative approach in our application of the decision-making framework, and safety is emphasized as the central concept underlying the application of this model. Finally, a number of recommendations are made regarding application of the ethical decision-making framework with younger persons. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Maintaining the integrity of older patients in long-term institutions: relatives' perceptionsJOURNAL OF CLINICAL NURSING, Issue 5 2007Sari Teeri MSc Aim., To study relatives' views on how the integrity of older patients is maintained in long-term institutions in Finland. Background., Maintaining patient integrity is considered a key prerequisite for good quality care and treatment and a characteristic of ethical care. Institutionalization, dependence on others and vulnerability may all threaten the integrity of the older patient and, in this sense, pose ethical problems. Design/methods., The data for this descriptive and explorative survey were collected by questionnaires from 213 relatives of older patients in four long-term institutions in Finland. The response rate was 78%. Data were analysed using statistical methods. Results., Relatives rated the maintenance of patient integrity quite highly. The highest ratings were recorded for the maintenance of physical integrity and the lowest to the maintenance of psychological integrity. The main source of problems were patients' and/or relatives' wishes concerning elimination. There were also shortcomings in the provision of intimacy. Relatives who thought that admission to the long-term institution had been problematic, either for the patient or for themselves, felt that patient integrity was poorly maintained. Conclusion., The findings highlight the importance of nurses' efforts in long-term care facilities to preserve the integrity of patients and to maintain close contact and cooperation with relatives. Although relatives generally were quite pleased with how patient integrity was maintained, the results also provide evidence on problems that may threaten patient integrity. Relevance to clinical practice., Greater emphasis should be placed on the need for cooperation between older patients, their relatives and nursing staff, especially before admission to long-term care. Furthermore, increased efforts are needed in maintaining the integrity of older patients and in reducing ethically problematic situations. [source] Nurses' ethical perceptions about coercionJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 4 2004M. LIND mscnrn Purpose of the study: The purpose of this study was to describe Finnish psychiatric nurses' ethical perceptions about coercive measures in acute psychiatric setting. Methods: The data were collected with a questionnaire developed for this study. The sample included 170 Finnish psychiatric nurses on acute wards in five psychiatric hospitals. The data were analysed using frequency and percentage distributions, mean and standard deviations. The internal consistency of the instrument was explored with Cronbach's alpha. The association between the background variables and the sum score of the items of the questionnaire was tested with Mann,Whitney U -test and Kruskal,Wallis test. The open-ended question was analysed with content analysis. Results: Some psychiatric nurses perceived coercive measures as ethically problematic. In particular, the implementation of forced medication (18%), four-point restraints (16%) and patient seclusion (11%) were perceived as ethically problematic. Female nurses and nurses who worked on closed wards perceived the measures to be more problematic than male nurses and nurses who did not work on closed wards. Conclusion: In Finland, special attention has been paid to ethical questions related to the care of psychiatric patients and to the enhancement of patients' rights, yet the majority of the nurses participating in the survey did not perceive coercive measures as ethically problematic. More research on this issue as well as further education of the personnel and more extensive teaching of ethics in nursing schools are needed to support the ability of the psychiatric personnel to identify ethically problematic situations. In addition, it is important to consider new measures for generating genuine moral reflection among the personnel on the usage of coercive measures as well as on their effectiveness and legitimacy in the psychiatric care. [source] Self-perception levels of mothers dealing with infant care problems for babies 0,12 months oldPEDIATRICS INTERNATIONAL, Issue 5 2009nar Bayhan Abstract Background:, Babies need the presence of an adult, especially their mothers, from the moment they are born in order to have their needs fulfilled. The significance of the care, particularly during the newborn and the babyhood period, increases gradually as the children grow older. The adequate and efficient fulfillment of needs during the newborn and babyhood period are fundamental in terms of child development. On the other hand, many mothers don't know what to do about problematic situations related to infant care that they might encounter when they have a newborn baby. Methods:, The self-perception of 864 mothers, in various educational level groups, with 432 male and 432 female babies, was analyzed in regards to dealing with problems that arise related to infant care. A questionnaire, developed by Pridham and Chang (1991), was filled out during interviews with the mothers. The analyses of the data obtained as the result of the study were evaluated with the Kruskal,Wallis test while the statistically significant findings were dually compared using the Mann,Whitney test. Results:, At the conclusion of the study it was determined that the gender of the baby did not effect the mother's self-perception during problem solving, whereas their educational levels created remarkable differences amongst their responses. [source] | ||||||||||