Etične dileme pri obravnavi oseb z demenco : pregled literature

Kavčič, Marjeta (author), Ovijač, Darja (mentor), Sotler, Robert (co-mentor)

Uvod: Trend staranja prebivalstva se v svetovni populaciji opazno povečuje, hkrati se veča tudi število oseb z demenco. Demenca nima vpliva le na posameznika z demenco, ampak tudi na vse njihove oskrbovalce, strokovnjake zdravstvene nege in druge, ki sodelujejo pri oskrbovanju. Pri negovanju pacientov z demenco se pogosto pojavljajo etične dileme. Medicinske sestre so lahko neformalnim oskrbovalcem v veliko pomoč in podporo pri soočanju z njimi. Namen: Namen diplomskega dela je opredeliti in predstaviti najpogostejše etične dileme na področju obravnave oseb z demenco. Metode dela: Uporabljena je bila deskriptivna metoda dela s sistematičnim pregledom domače in tuje literature. Iskali smo v podatkovnih bazah CINAHL, Medline in COBIB.SI. Pri iskanju smo se omejili na časovni okvir od leta 2006 do 2016. Pri izboru člankov smo izključili vse tiste, kjer nismo imeli dostopa do celotnega besedila, so se podvajali ter se niso nanašali na področje etike, zdravstvene nege in demence. V pregled smo vključili 55 člankov. Rezultati: Ugotovili smo, da lahko oskrbovanje osebe z demenco predstavlja zelo veliko breme. Kot glavni razlog se pogosteje navaja soočanje z etičnimi dilemami, kot so etične dileme ob zagotavljanju varnosti na eni strani in omejevanjem svobode na drugi, etične dileme ob uporabi podporne tehnologije, etične dileme ob koncu življenja in etične dileme pri raziskovanju. Za lažje soočanje z etičnimi dilemami je ključno dodatno izobraževanje. Medicinska sestra ima pomembno vlogo pri nudenju podpore ter prenosu znanja v prakso, tako v skupnosti kot tudi v ustanovah za dolgotrajno oskrbo. Razprava in sklep: Zavedanje in reševanje etičnih dilem je ključno za etično obravnavo pacienta z demenco. Za zagotovitev kakovostne in celovite zdravstvene nege in oskrbe je pomembno, da imajo neformalni oskrbovalci in medicinske sestre razvit pozitiven, empatičen odnos pacienta ter so ustrezno izobraženi. Za premostitev vseh vrzeli v znanju, ki so še prisotne na področju etičnih dilem in demence, je prisotna velika potreba po sistematičnem raziskovanju.

• Language: Slovenian
• Keywords: zdravstvena nega, neformalni oskrbovalci, etika, oskrba
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-95562
• COBISS.SI-ID: 5332331
• Publication date in RUL: 20.09.2017

Secondary language

• Language: English
• Title: Ethical dilemmas in the care of people with dementia : literature review

Abstract

Introduction: The trend of aging society is significantly increasing and so is expanding the population of patients with dementia. Dementia does not only affect a person with dementia but also their carers, health care professionals, and others, who are involved in the care. Carers are often coping with ethical dilemmas in the care of people with dementia due to the nature of the disease. Nurses play an important role in providing help and support to carers and their families in coping with ethical dilemmas. Purpose: The aim of the diploma is to identify and present the most common ethical dilemmas in the care of people with dementia. Methods: A systematic review of the domestic and foreign literature was made. A descriptive method was used. The literature was searched in the following databases: CINAHL, Medline, and COBIB.SI. The search was limited to the time frame from 2006 to 2016. In the selection of articles, we excluded those, where we did not have access to the full text, those, which were duplicates and those articles, which were not related to the field of ethics, nursing, and dementia. We included 55 articles in the concluding analysis. Results: We found out that caring for a person with dementia often represents a very heavy burden. The main reason for that is dealing with ethical dilemmas, such as balancing safety and freedom, ethical dilemmas concerning assistive technologies, ethical dilemmas in the end-of-life care and ethical dilemmas concerning research. To make coping with ethical dilemmas easier, it is crucial to have some additional knowledge. The nurses play an important role in providing support to carers and transferring the knowledge into practice, both to the community and in institutions for long-term care. Discussion and conclusion: Awareness about ethical dilemmas and resolving them is crucial for ethical treatment of patients with dementia. It is important that carers and nurses develop a positive and emphatic attitude towards the patients with dementia and the disease to ensure quality and complete health care. It is also important that carers and nurses are properly trained and have some additional knowledge about dementia care. There is a great need for systematic research to bridge all the gaps in knowledge that are still present around ethical dilemmas and dementia.

• Keywords: nursing, informal carers, ethics, care