Introduction and objectives: Informed consent, fundamental in health care, provides patients with clear information clear information about treatment options and their consequences. It is a legal formula that acts as a bridge between the patient, society and the professional, thus broadening the horizons of medical and nursing care. However, the practice of this medical act has become complex and sometimes contradictory, affecting the daily work of the doctor and of the nurse. This research aims to explore how nursing skills nursing skills can guarantee the patient's freedom of choice and support decision-making for their well-being, in the processes of information and granting of informed consent. Materials and methods: The thesis uses the methodology of narrative review to examine the scientific literature on a specific topic. The search for articles was conducted via PubMed, PMC and Bookshelf. Six search strings were generated using specific specific keywords. Of the 438 articles obtained, 187 were included after the application of inclusion and exclusion criteria. Included were articles published in the ten years preceding the review were included, while those those that did not fit the subject of the research were excluded. The selection was guided by the PRISMA Statement 2020 guidelines. Inclusion criteria included original articles, research articles and systematic reviews. Exclusion criteria included articles published more than ten years previously previous ten years and those that treated informed consent as a mere ethical tool. Results: The selection and analysis of articles were were conducted in a systematic manner, focusing on the patient-nurse relationship and informed consent, with attention to the Italian context and cues from foreign legal systems. The results were organised in tables containing information on the title, the authors, the journal, the year of publication, study design, objective and results. Seven articles were considered seven articles, including literature reviews, a case report and observational studies. Discussion: Informed consent, fundamental to patient autonomy, highlights, in everyday clinical practice, a dissonance between theory and practice, leaving room for ideas involving a conceptual and lexical revolution in the conceptual and lexical revolution in healthcare. Approaches such as shared decision making emphasise the importance of an authentic partnership between patient and professionals, reflecting an interconnected ethic in healthcare. Compassion and dialogue, for a professional such as nurse play, in this medico-legal field, a key role in preserving the dignity and providing appropriate care, while the nursing diagnosis of decision-making conflict requires assessment and targeted interventions, also through the use of specific instruments such as the Decision Conflict Scale and the SURE test. Conclusions: The thesis paper highlights the role of organisational mechanisms in undermining informed consent. While emphasising the importance of such consent, it focuses on the structures organisational structures that may hinder it, proposing a reflection on the role of the nursing professional on a pragmatic and effective basis. The analysis extends to the nature of relationships between health professionals, emphasising the importance of a re-evaluation of the nursing role with a view to facilitating the decision-making process of the patient. The importance is emphasised of the ethical training of nurses and the active involvement of the patient in the healthcare organisation in order to balance the power of communication in the care relationship.
Introduzione ed obiettivi: Il consenso informato, fondamentale nell'assistenza sanitaria, garantisce al paziente informazioni chiare sulle opzioni di trattamento e le loro conseguenze. Si tratta di una formula giuridica che fa da ponte tra il paziente, la società e il professionista, ampliando così gli orizzonti dell'assistenza medica e infermieristica. Tuttavia, la pratica di tale atto medico è diventata complessa e talvolta contraddittoria, influenzando il lavoro quotidiano del medico e dell'infermiere. Questa ricerca si propone di esplorare come le competenze infermieristiche possano garantire la libertà di scelta del paziente e supportare il processo decisionale per il suo benessere, nei processi di informazione e rilascio del consenso informato. Materiali e metodi: La tesi utilizza la metodologia della revisione narrativa per esaminare la letteratura scientifica su un argomento specifico. La ricerca degli articoli è stata condotta tramite PubMed, PMC e Bookshelf. Sono state generate sei stringhe di ricerca utilizzando parole chiave specifiche. Dei 438 articoli ottenuti, sono stati inclusi 187 dopo l'applicazione di criteri di inclusione ed esclusione. Sono stati inclusi articoli pubblicati nei dieci anni precedenti la revisione, mentre sono stati esclusi quelli che non aderivano all'oggetto della ricerca. La selezione è stata guidata dalle linee guida PRISMA Statement 2020. I criteri di inclusione comprendevano articoli originali, di ricerca e revisioni sistematiche. I criteri di esclusione includevano articoli pubblicati oltre i dieci anni precedenti e quelli che trattavano il consenso informato come un semplice strumento etico. Risultati: La scelta e l'analisi degli articoli sono stati condotti in modo sistematico, focalizzandosi sul rapporto paziente-infermiere e sul consenso informato, con attenzione al contesto italiano e spunti da ordinamenti giuridici esteri. I risultati sono stati organizzati in tabelle contenenti informazioni sul titolo, gli autori, la rivista, l'anno di pubblicazione, il disegno di studio, l'obiettivo e i risultati. Sono stati considerati sette articoli, tra cui revisioni della letteratura, un case report e studi osservazionali. Discussione: Il consenso informato, fondamentale per l'autonomia del paziente, evidenzia, nella quotidianità clinica, una dissonanza tra teoria e pratica, lasciando spazio a idee che prevedano una rivoluzione concettuale e lessicale nell'ambito sanitario. Approcci come lo shared decision making pongono l'accento sull'importanza di una partnership autentica tra paziente e professionisti, riflettendo un'etica interconnessa nell'assistenza sanitaria. La compassione e il dialogo, per un professionista come l’infermiere, giocano in questo ambito medico-legale, un ruolo chiave nel preservare la dignità e offrire cure adeguate, mentre la diagnosi infermieristica di conflitto decisionale richiede valutazione e interventi mirati, anche attraverso l'uso di strumenti specifici come la Scala del Conflitto Decisionale e il test SURE. Conclusioni: L’elaborato di tesi evidenzia il ruolo dei meccanismi organizzativi nel compromettere il consenso informato. Pur sottolineando l'importanza di tale consenso, si focalizza sulle strutture organizzative che possono ostacolarlo, proponendo una riflessione sul ruolo del professionista infermiere su basi pragmatiche ed efficaci. L'analisi si estende alla natura delle relazioni tra i professionisti sanitari, sottolineando l'importanza di una rivalutazione del ruolo infermieristico nell'ottica di favorire il processo decisionale dell’assistito. Si sottolinea l'importanza della formazione etica degli infermieri e del coinvolgimento attivo del paziente nell'organizzazione sanitaria per bilanciare il potere comunicativo nel rapporto di cura.
Il consenso informato nella quotidianità assistenziale: una revisione narrativa della letteratura.
D'ANNA, MARIA ORNELLA
2022/2023
Abstract
Introduction and objectives: Informed consent, fundamental in health care, provides patients with clear information clear information about treatment options and their consequences. It is a legal formula that acts as a bridge between the patient, society and the professional, thus broadening the horizons of medical and nursing care. However, the practice of this medical act has become complex and sometimes contradictory, affecting the daily work of the doctor and of the nurse. This research aims to explore how nursing skills nursing skills can guarantee the patient's freedom of choice and support decision-making for their well-being, in the processes of information and granting of informed consent. Materials and methods: The thesis uses the methodology of narrative review to examine the scientific literature on a specific topic. The search for articles was conducted via PubMed, PMC and Bookshelf. Six search strings were generated using specific specific keywords. Of the 438 articles obtained, 187 were included after the application of inclusion and exclusion criteria. Included were articles published in the ten years preceding the review were included, while those those that did not fit the subject of the research were excluded. The selection was guided by the PRISMA Statement 2020 guidelines. Inclusion criteria included original articles, research articles and systematic reviews. Exclusion criteria included articles published more than ten years previously previous ten years and those that treated informed consent as a mere ethical tool. Results: The selection and analysis of articles were were conducted in a systematic manner, focusing on the patient-nurse relationship and informed consent, with attention to the Italian context and cues from foreign legal systems. The results were organised in tables containing information on the title, the authors, the journal, the year of publication, study design, objective and results. Seven articles were considered seven articles, including literature reviews, a case report and observational studies. Discussion: Informed consent, fundamental to patient autonomy, highlights, in everyday clinical practice, a dissonance between theory and practice, leaving room for ideas involving a conceptual and lexical revolution in the conceptual and lexical revolution in healthcare. Approaches such as shared decision making emphasise the importance of an authentic partnership between patient and professionals, reflecting an interconnected ethic in healthcare. Compassion and dialogue, for a professional such as nurse play, in this medico-legal field, a key role in preserving the dignity and providing appropriate care, while the nursing diagnosis of decision-making conflict requires assessment and targeted interventions, also through the use of specific instruments such as the Decision Conflict Scale and the SURE test. Conclusions: The thesis paper highlights the role of organisational mechanisms in undermining informed consent. While emphasising the importance of such consent, it focuses on the structures organisational structures that may hinder it, proposing a reflection on the role of the nursing professional on a pragmatic and effective basis. The analysis extends to the nature of relationships between health professionals, emphasising the importance of a re-evaluation of the nursing role with a view to facilitating the decision-making process of the patient. The importance is emphasised of the ethical training of nurses and the active involvement of the patient in the healthcare organisation in order to balance the power of communication in the care relationship.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/17366