Blurred lines : Ethical challenges related to autonomy in home-based care
BACKGROUND: Home-based care workers mainly work alone in the patient's home. They encounter a diverse patient population with complex health issues. This inevitably leads to several ethical challenges.
AIM: The aim is to gain insight into ethical challenges related to patient autonomy in home-based care and how home-based care staff handle such challenges.
RESEARCH DESIGN: The study is based on a 9-month fieldwork, including participant observation and interviews in home-based care. Data were analysed with a thematic analysis approach.
PARTICIPANTS AND RESEARCH CONTEXT: The study took place within home-based care in three municipalities in Eastern Norway, with six staff members as key informants.
ETHICAL CONSIDERATIONS: The Norwegian Agency for Shared Services in Education and Research evaluated the study. All participants were competent to consent and signed an informed consent form.
FINDINGS: A main challenge was that staff found it difficult to respect the patient's autonomy while at the same time practicing appropriate care. We found two main themes: Autonomy and risk in tension; and strategies to balance autonomy and risk. These were explicated in four sub-themes: Refusing and resisting care; when choosing to live at home becomes risky; sweet-talking and coaxing; and building trust over time. Staff's threshold for considering the use of coercion appeared to be high.
CONCLUSIONS: Arguably, home-based care staff need improved knowledge of coercion and the legislation regulating it. There is also a need for arenas for ethics reflection and building of competence in balancing ethical values in recurrent ethical problems.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
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| Enthalten in: |
Nursing ethics - (2023) vom: 20. Dez., Seite 9697330231215951 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hertzberg, Cecilie Knagenhjelm [VerfasserIn] |
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| Links: |
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| Themen: |
Autonomy |
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| Anmerkungen: |
Date Revised 20.12.2023 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1177/09697330231215951 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM36608366X |
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| 245 | 1 | 0 | |a Blurred lines |b Ethical challenges related to autonomy in home-based care |
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| 520 | |a BACKGROUND: Home-based care workers mainly work alone in the patient's home. They encounter a diverse patient population with complex health issues. This inevitably leads to several ethical challenges | ||
| 520 | |a AIM: The aim is to gain insight into ethical challenges related to patient autonomy in home-based care and how home-based care staff handle such challenges | ||
| 520 | |a RESEARCH DESIGN: The study is based on a 9-month fieldwork, including participant observation and interviews in home-based care. Data were analysed with a thematic analysis approach | ||
| 520 | |a PARTICIPANTS AND RESEARCH CONTEXT: The study took place within home-based care in three municipalities in Eastern Norway, with six staff members as key informants | ||
| 520 | |a ETHICAL CONSIDERATIONS: The Norwegian Agency for Shared Services in Education and Research evaluated the study. All participants were competent to consent and signed an informed consent form | ||
| 520 | |a FINDINGS: A main challenge was that staff found it difficult to respect the patient's autonomy while at the same time practicing appropriate care. We found two main themes: Autonomy and risk in tension; and strategies to balance autonomy and risk. These were explicated in four sub-themes: Refusing and resisting care; when choosing to live at home becomes risky; sweet-talking and coaxing; and building trust over time. Staff's threshold for considering the use of coercion appeared to be high | ||
| 520 | |a CONCLUSIONS: Arguably, home-based care staff need improved knowledge of coercion and the legislation regulating it. There is also a need for arenas for ethics reflection and building of competence in balancing ethical values in recurrent ethical problems | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Autonomy | |
| 650 | 4 | |a clinical ethics | |
| 650 | 4 | |a coercion | |
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| 650 | 4 | |a participant observation | |
| 650 | 4 | |a qualitative research | |
| 700 | 1 | |a Heggestad, Anne Kari Tolo |e verfasserin |4 aut | |
| 700 | 1 | |a Magelssen, Morten |e verfasserin |4 aut | |
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