Marianne Arndt

Privacy: a review of the literature

The concept of privacy is used in many disciplines and is recognised as one of the important concepts also in nursing. In this review, a description about the perspectives and dimensions of the concept will be made and empirical studies in the area will be analysed. Perspectives include units experiencing privacy, desired-achieved state, and reactiveness. Dimensions are divided into physical, psychological, social and informational. In the empirical studies, the concept of the privacy has mainly been studied in hospital organisations using the physical dimension. The concept needs further clarification in future.

Perceptions of Autonomy in the Care of Elderly People in Five European Countries

The focus of this article is perceptions of elderly patients and nurses regarding patients’ autonomy in nursing practice. Autonomy is empirically defined as having two components: information received/given as a prerequisite and decision making as the action. The results indicated differences between staff and patient perceptions of patient autonomy for both components in all five countries in which this survey was conducted. There were also differences between countries in the perceptions of patients and nurses regarding the frequency with which patients received information from nursing staff or were offered opportunities to make decisions. This is the second of a set of five articles published together in this issue of Nursing Ethics in which the results of this comparative research project are presented.

Perceptions of Autonomy, Privacy and Informed Consent in the Care of Elderly People in Five European Countries: comparison and implications for the future:

This article discusses nurses’ and elderly patients’ perceptions of the realization of autonomy, privacy and informed consent in five European countries. Comparisons between the concepts and the countries indicated that both nurses and patients gave the highest ratings to privacy and the lowest to informed consent. There were differences between countries. According to the patient data, autonomy is best realized in Spain, privacy in the UK (Scotland), and informed consent in Finland. For the staff data, the best results tended to concentrate in the UK. The conceptual and methodological limitations of the study are identified and discussed. Implications of the results are divided into three areas: nursing practice, education and research. In practice, the analysis of patients’ values and the ethical sensitivity of nurses are important as part of ethically good care. In nurse education, students should learn to recognize ethical problems, generally and particularly, among vulnerable groups of patients. Multicultural international research is needed in this area. This is the last of a set of five articles published together in this issue of Nursing Ethics in which the results of this comparative research project are presented.

A comparison of surgical patients’ and nurses’ perceptions of patients’ autonomy, privacy and informed consent in nursing interventions

Abstract Objective: To investigate and compare Greek patients’ and nurses’ perceptions of the realisation of autonomy, informed consent and privacy in surgical nursing care. Design and setting: The study used a non-experimental comparative descriptive design and the data were collected from a convenience sample of 275 surgical patients and 222 nurses of six hospitals using two parallel self-completed questionnaires. Results: Nurses perceived that information-giving was realised more than any other concept and that they had given patients an opportunity to decide on alternative treatments, length of stay, eating and drinking, pain relief, sleeping pills, bladder and bowel function, hygiene and wound care. Nurses believed more than patients that patients’ privacy was protected, while neither patients nor nurses perceived the provision of informed consent. Patients who had never been operated on previously and had a planned admission felt more that they were offered the opportunity to make decisions. Those with a planned admission who had been offered informed consent believed that they had received information, their privacy had been protected and they had given informed consent. Nurses with training on ethics believed more strongly that patients had received information and informed consent. Conclusion: Nurses perceived autonomy, informed consent, and privacy were more often realised than the patients perceived.

Perceptions of Informed Consent in the Care of Elderly People in Five European Countries

The focus of this article is on elderly patients’ and nursing staff perceptions of informed consent in the care of elderly patients/residents in five European countries. The results suggest that patients and nurses differ in their views on how informed consent is implemented. Among elderly patients the highest frequency for securing informed consent was reported in Finland; the lowest was in Germany. In contrast, among nurses, the highest frequency was reported in the UK (Scotland) and the lowest in Finland. In a comparison of patients’ and nurses’ perceptions, nurses had more positive views than patients in all countries except Finland. Patients with less need for nursing interventions in Greece and Spain gave their consent less often. The German and Greek patients were older, and the results also point to an association between this and their lower frequency of giving consent. In Spain, patients who were married or who had a family member or friend to look after their personal affairs were more likely to be included in the group whose consent was sought less often. This is the fourth of a set of five articles published together in this issue of Nursing Ethics in which the results of this comparative research project are presented.

Nurses' and elderly patients’ perceptions regarding autonomy, privacy and informed consent in nursing interventions in Greece

Ethics increasingly becomes a forefront issue in health care decision-making, as health care becomes more technologically and organizationally complex. Hence, a great number of new laws on the status and rights of patients and professional codes have been adopted in Europe. However, research suggests that violation of patients’ rights of autonomy, informed consent and privacy may still be common, especially in elderly care.

Autonomie und informierte Zustimmung in der Pflege chirurgischer Patienten aus Sicht von Patienten und Pflegenden

Ziel dieser Untersuchung war es, Autonomie und informierte Zustimmung in der Pflege der chirurgischen Patienten zu beschreiben. Die Untersuchung ist ein Teil des internationalen, durch die EU-Kommi...

Autonomía y consentimiento informado: cuestiones éticas de los cuidados maternales en España

Resumen El presente trabajo es el primer articulo de un estudio multicentrico y multicultural sobre el respeto de la autonomia y el consentimiento informado en las intervenciones de enfermeria, que ha contado con la participacion de Finlandia, Alemania, Gran Bretana (Escocia), Grecia y Espana. Solo se expondran los resultados correspondientes a la muestra de Espana. Su objetivo es describir y analizar las percepciones de las madres y enfermeras/matronas sobre el principio de autonomia y el consentimiento informado en las unidades de puerperas. Ambos principios han sido considerados como unos derechos que merecen un respeto y, a su vez, han sido analizados tanto desde la dimension juridica como etica. Los datos han sido recogidos en 6 maternidades de Espana, mediante unos cuestionarios estructurados y especialmente disenados para este estudio. La muestra corresponde a 223 madres y 192 enfermeras/matronas. Los resultados han sido tratados estadisticamente y ponen de manifiesto que existen diferentes percepciones entre las madres y enfermeras/matrona respecto a las actividades de enfermeria referentes a la autonomia y consentimiento informado. Igualmente, se han hallado relaciones estadisticamente significativas entre los antecedentes.

Autonomía y consentimiento informado en centros sociosanitarios en Cataluña. Percepciones de ancianos y enfermeras en España (III)

En este tercer articulo se exponen los resultados parciales de la muestra correspondiente al grupo de ancianos del estudio multicentrico financiado por la Comision Europea: Autonomia, Privacidad y Consentimiento Informado e Intervenciones de Enfermeria. Dicho estudio ha contado con la participacion de Finlandia, Alemania, Grecia, Reino Unido y Espana. Su objetivo es describir y analizar desde la dimension juridica y etica el principio de autonomia y el consentimiento informado en centros sociosanitarios de Cataluna. Los datos han sido recogidos en cuatro centros, mediante entrevistas y basandose en unos cuestionarios estructurados (ancianos y enfermeras), disenados especialmente para este estudio. La muestra corresponde a 100 ancianos y 132 enfermeras. Los resultados han sido tratados estadisticamente y muestran que existen diferencias entre las percepciones de los ancianos y las enfermeras respecto a las intervenciones de enfermeria, concernientes a la autonomia y el consentimiento informado. Asimismo, se hallaron diferencias en funcion de los antecedentes. El primer y el segundo articulos del estudio acerca de los cuidados maternales y cuidados quirurgicos fueron publicados en el volumen 11, numeros 5 y 6 de Enfermeria Clinica.

Book Review: Eine Ethik für die Altenpflege: Ein transdisziplinärer Versuch aus der Auseinandersetzung mit Peter Singer, Hans Jonas und Martin Buber

tion, doctrine or dogma, since there is much that can be readily criticized, but more to the rigour and power evident in the author’s engagement with that tradition in the development and delivery of argument. This is a work of outstanding scholarship and rigour. Engelhardt offers a narrative that embraces and celebrates the ‘articles of faith’ that have defined the Christian tradition and links their intrinsic connectedness to morality. Faith, by its very nature, relates to an engagement with what goes beyond reason. Engelhardt supports this premise with an exposition of superb cogency that roots his argument fervently in sound, reasoned and eloquently focused argument. The real worth of this academic venture lies in its ability to offer a depth of richness and resonance to moral analysis that is absent from the terms of reference that inform secular tomes. One does not have to identify with the Christian tradition to enjoy and celebrate the erudition that the author has used to make his case. The work casts down an unapologetic challenge to secular ethics that will resound controversially throughout the world of academe and beyond. It is, in this reviewer’s humble and considered opinion, one of the most demanding, challenging and refreshing books of the modern age.