Results for 'complex care'

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  1.  16
    Finding meaning in complex care nursing in a hospital setting.Felice Borghmans, Stella Laletas, Venesser Fernandes & Harvey Newnham - 2024 - Nursing Inquiry 31 (3):e12633.
    This study explores the experiences of nurses that provide ‘complex’, generalist healthcare in hospital settings. Complex care is described as care for patients experiencing acute issues additional to multimorbidity, ageing or psychosocial complexity. Nurses are the largest professional group of frontline healthcare workers and patients experiencing chronic conditions are overrepresented in acute care settings. Research exploring nurses’ experiences of hospital‐based complex care is limited, however. This study aims to add to what is known (...)
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  2.  16
    The Lifeworld of the Complex Care Hospital Doctor: A Complex Adaptive Phenomenological Study.Felice Borghmans, Stella Laletas, Harvey Newnham & Venesser Fernandes - forthcoming - Health Care Analysis:1-21.
    The ever-increasing prevalence of chronic conditions over the last half century has gradually altered the demographic of patients admitted to acute care settings; environments traditionally associated with episodic care rather than chronic and complex healthcare. In consequence, the lifeworld of the hospital medical doctor often entails healthcare for a complex, multi-morbid, patient cohort. This paper examines the experience of providing complex healthcare in the pressurised and fast-paced acute care setting. Four medical doctors from two (...)
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  3.  90
    Hospital-Based Medical-Legal Partnerships for Complex Care Patients: Intersectionality and Ethics Considerations.Megha Garg, Jennifer Oliva, Alice Lu, Marlene Martin & Sarah Hooper - 2023 - Journal of Law, Medicine and Ethics 51 (4):764-770.
    Health systems are integrating medical-legal partnerships (MLPs) into clinical care and increasingly center “complex care” patients. These patients have intersecting medical and social needs and often face systemic inequities that exacerbate their chronic health conditions. This paper describes a role for MLPs in hospital quality initiatives; examines the ethics of MLPs assisting with guardianship and institutionalization of hospital patients including marginalized groups; and advocates for MLP interventions designed to address intersectional and ethical concerns.
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  4.  13
    Emergency Department Boarding of a Teen Requiring Complex Care: How Should an Ethics Consultant Respond?Anita Tarzian - 2024 - American Journal of Bioethics 24 (7):132-134.
    In 1979, the U.S. Surgeon General published the first “Healthy People” report, launching subsequent initiatives in ten-year intervals to improve the nation’s health by focusing on preventive care a...
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  5.  3
    Emergency Department Boarding of a Teen Requiring Complex Care: How Should an Ethics Consultant Respond?Anita Tarzian U. M. Carey School of Law - 2024 - American Journal of Bioethics 24 (7):132-134.
    Volume 24, Issue 7, July 2024, Page 132-134.
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  6.  98
    The Complexities of Care: Nursing Reconsidered.Sioban Nelson & Suzanne Gordon (eds.) - 2006 - Cornell University Press.
    This book offers a long-overdue exploration of care at a pivotal moment in the history of health care.
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  7.  35
    Complex adaptive chronic care.Carmel Martin & Joachim Sturmberg - 2009 - Journal of Evaluation in Clinical Practice 15 (3):571-577.
  8.  11
    Complex Decision-Making in Paediatric Intensive Care: A Discussion Paper and Suggested Model.Melanie Jansen, Katie M. Moynihan, Lisa S. Taylor & Shreerupa Basu - forthcoming - Journal of Bioethical Inquiry:1-11.
    Paediatric Intensive Care Units (PICU) are complex interdisciplinary environments where challenging, high stakes decisions are frequently encountered. We assert that appropriate decisions are more likely to be made if the decision-making process is comprehensive, reasoned, and grounded in thoughtful deliberation. Strategies to overcome barriers to high quality decision-making including, cognitive and implicit bias, group think, inadequate information gathering, and poor quality deliberation should be incorporated. Several general frameworks for decision-making exist, but specific guidance is scarce. In this paper, (...)
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  9.  40
    Complexity and contradiction: home care in a multicultural area.Carola Skott & Solveig M. Lundgren - 2009 - Nursing Inquiry 16 (3):223-231.
    The aim of this study was to explore the meaning of experience for home‐care nurses in a multicultural area of Sweden. Interviews and group discussions with a team of five home‐care nurses were interpreted in accordance with a hermeneutical perspective. The meaning was expressed in connection with the complexities of place, and space for care. Contradictions developed from diversities of perspectives incorporated in this particular multicultural area. Nurses saw themselves as mediators and allowed complexity to be considered (...)
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  10.  67
    Complex adaptive chronic care – typologies of patient journey: a case study.Carmel M. Martin, Deirdre Grady, Susan Deaconking, Catherine McMahon, Atieh Zarabzadeh & Brendan O'Shea - 2011 - Journal of Evaluation in Clinical Practice 17 (3):520-524.
  11. Care, Disability, and Violence: Theorizing Complex Dependency in Eva Kittay and Judith Butler.Stacy Clifford Simplican - 2015 - Hypatia 30 (1):217-233.
    How do we theorize the experiences of caregivers abused by their children with autism without intensifying stigma toward disability? Eva Kittay emphasizes examples of extreme vulnerability to overturn myths of independence, but she ignores the possibility that dependents with disabilities may be vulnerable and aggressive. Instead, her work over-emphasizes caregivers' capabilities and the constancy of disabled dependents' vulnerability. I turn to Judith Butler's ethics and her conception of the self as opaque to rethink care amid conflict. Person-centered planning approaches, (...)
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  12.  18
    Medically Complex Children in Foster Care: Do Research “Protections” Make This “Vulnerable Population” More Vulnerable?Renee D. Boss, Erin P. Williams, Megan Kasimatis Singleton & Rebecca R. Seltzer - 2018 - Journal of Clinical Ethics 29 (2):145-149.
    Children in foster care are considered a “vulnerable population” in clinical care and research, with good reason. These children face multiple medical, psychological, and social risks that obligate the child welfare and healthcare systems to protect them from further harms. An unintended consequence of the “vulnerable population” designation for children in foster care is that it may impose barriers on tracking and studying their health that creates gaps in knowledge that are key to their receipt of medical (...)
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  13.  40
    How Health Care Complexity Leads to Cooperation and Affects the Autonomy of Health Care Professionals.Eric Molleman, Manda Broekhuis, Renee Stoffels & Frans Jaspers - 2008 - Health Care Analysis 16 (4):329-341.
    Health professionals increasingly face patients with complex health problems and this pressurizes them to cooperate. The authors have analyzed how the complexity of health care problems relates to two types of cooperation: consultation and multidisciplinary teamwork (MTW). Moreover, they have analyzed the impact of these two types of cooperation on perceived professional autonomy. Two teams were studied, one team dealing with geriatric patients and another treating oncology patients. The authors conducted semi-structured interviews, studied written documents, held informal discussions (...)
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  14.  25
    Complexity and the health care professions.William E. Doll Jr & Donna Trueit - 2010 - Journal of Evaluation in Clinical Practice 16 (4):841-848.
  15.  47
    Ethically complex decisions in the neonatal intensive care unit: impact of the new French legislation on attitudes and practices of physicians and nurses.Micheline Garel, Laurence Caeymaex, François Goffinet, Marina Cuttini & Monique Kaminski - 2011 - Journal of Medical Ethics 37 (4):240-243.
    Next SectionObjectives A statute enacted in 2005 modified the legislative framework of the rights of terminally ill persons in France. Ten years after the EURONIC study, which described the self-reported practices of neonatal caregivers towards ethical decision-making, a new study was conducted to assess the impact of the new law in neonatal intensive care units (NICU) and compare the results reported by EURONIC with current practices. Setting and design The study was carried out in the same two NICU as (...)
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  16. Complexity in Caring and Empathy.Nel Noddings - 2010 - Abstracta 5 (S5):6-12.
  17.  24
    The Complex Cancer Care Coverage Environment — What is the Role of Legislation? A Case Study from Massachusetts.Christine Leopold, Rebecca L. Haffajee, Christine Y. Lu & Anita K. Wagner - 2020 - Journal of Law, Medicine and Ethics 48 (3):538-551.
    Over the past decades, anti-cancer treatments have evolved rapidly from cytotoxic chemotherapies to targeted therapies including oral targeted medications and injectable immunooncology and cell therapies. New anti-cancer medications come to markets at increasingly high prices, and health insurance coverage is crucial for patient access to these therapies. State laws are intended to facilitate insurance coverage of anti-cancer therapies.Using Massachusetts as a case study, we identified five current cancer coverage state laws and interviewed experts on their perceptions of the relevance of (...)
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  18.  9
    Caring for biosocial complexity. Articulations of the environment in research on the Developmental Origins of Health and Disease.Michael Penkler - 2022 - Studies in History and Philosophy of Science Part A 93:1-10.
  19.  35
    Using complexity to promote group learning in health care.Holly Arrow & Kelly B. Henry - 2010 - Journal of Evaluation in Clinical Practice 16 (4):861-866.
  20.  13
    Gender, Care Work, and the Complexity of Family Membership in Japan.Kristen Schultz Lee - 2010 - Gender and Society 24 (5):647-671.
    This research investigates sociological ambivalence in negotiating care work in Japanese families. Women and their aging parents experience ambivalence based on conflicting norms of filial obligation, gender ideology, and cultural beliefs about the parent—child bond. Analysis of in-depth interview data showed ambivalence was based on conflict between norms and cultural beliefs and intergenerational differences in norms of caregiving. Not only are norms of care work in Japan gendered, but they also create conflicting demands for women who are torn (...)
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  21. Taking care of the future? The complex responsibility of education and politics.Deborah Osberg - 2010 - In Deborah Osberg & Gert Biesta, Complexity Theory and the Politics of Education. Sense Publishers. pp. 157--170.
     
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  22.  32
    Caring for people with chronic disease: is 'muddling through' the best way to handle the multiple complexities?Joachim P. Sturmberg - 2012 - Journal of Evaluation in Clinical Practice 18 (6):1220-1225.
  23. Caring on the Clock: The Complexities and Contradictions of Paid Care Work.[author unknown] - 2015
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  24.  14
    Understanding person‐centered care within a complex social context: A qualitative study of Saudi Arabian acute care nursing.Mashael Hasan Alamrani & Shira Birnbaum - 2024 - Nursing Inquiry 31 (3):e12650.
    Policy reforms implemented in Saudi Arabia in recent years aim to modernize the culture and infrastructure of healthcare delivery and are expected to integrate person‐ and patient‐centered care principles throughout the national healthcare system. However, in a complex multicultural environment where most nurses are international migrant workers, unique challenges emerge that frame the delivery of care. Better understanding is needed about what nurses perceive to be high‐quality, person‐centered care in Saudi Arabia and how they manage to (...)
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  25.  44
    Implementation of complex adaptive chronic care: the Patient Journey Record system (PaJR).Carmel M. Martin, Carl Vogel, Deirdre Grady, Atieh Zarabzadeh, Lucy Hederman, John Kellett, Kevin Smith & Brendan O’ Shea - 2012 - Journal of Evaluation in Clinical Practice 18 (6):1226-1234.
  26.  32
    Practical ethical theory for nurses responding to complexity in care.Roseanne Moody Fairchild - 2010 - Nursing Ethics 17 (3):353-362.
    In the context of health care system complexity, nurses need responsive leadership and organizational support to maintain intrinsic motivation, moral sensitivity and a caring stance in the delivery of patient care. The current complexity of nurses’ work environment promotes decreases in work motivation and moral satisfaction, thus creating motivational and ethical dissonance in practice. These and other work-related factors increase emotional stress and burnout for nurses, prompting both new and seasoned nurse professionals to leave their current position, or (...)
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  27.  54
    Beyond evidence-based medicine: complexity and stories of maternity care.Soo Downe - 2010 - Journal of Evaluation in Clinical Practice 16 (1):232-237.
    Despite the entrenched acceptance of normal science in health care, it appears that authoritative, positivist, linear, risk averse, certainty-based thinking can only get us so far along the route of optimum health. This paper examines labor and childbirth as a paradigm case of a complex adaptive system (CAS) and offers the example of techniques used in a master-level course on normal childbirth to illustrate how maternity care clinicians can be introduced to complexity-based thinking through reflexive analysis of (...)
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  28.  22
    Moral flux in primary care : the effect of complexity.John Spicer, Sanjiv Ahluwalia & Rupal Shah - 2021 - Journal of Medical Ethics 47 (2):86-89.
    In this article, we examine the inter-relationship between moral theory and the unpredictable and complex world of primary health care, where the values of patient and doctor, or groups of patients and doctors, may often clash. We introduce complexity science and its relevance to primary care; going on to explore how it can assist in understanding ethical decision making, as well as considering implications for clinical practice. Throughout the article, we showcase aspects and key concepts using examples (...)
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  29. Emerging complexities in pediatric palliative care.Renee Boss & Nancy Hutton - 2014 - In Timothy E. Quill & Franklin G. Miller, Palliative care and ethics. New York: Oxford University Press.
     
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  30.  24
    Complexities of expanding and financing insurance coverage, and difficulties in design? Ing incentive mechanisms that will both ensure more efficient use of medical care and slow the growth in health care spending.Mary E. Stefl - 2009 - Inquiry: The Journal of Health Care Organization, Provision, and Financing 46.
  31.  23
    Divinity in nursing: The complexities of adopting a spiritual basis for care.Bernie Garrett - 2021 - Nursing Philosophy 22 (3):e12355.
    In this paper, the historical alignment of nursing with divinity‐based perspectives and modern New Age nursing theories are explored. The nature of divinity in nursing is examined, together with the complexities and issues that arise in adopting a spiritual basis for care. The work of the key theorists in this area (Rogers, Newman, Parse, Watson, Dossey) is reconsidered and fundamental epistemological problems inherent in this approach reviewed. Specific concerns with the interpretation of holistic care, adoption of doxastic logic, (...)
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  32.  91
    Who Cares? Moral Obligations in Formal and Informal Care Provision in the Light of ICT-Based Home Care.Elin Palm - 2013 - Health Care Analysis 21 (2):171-188.
    An aging population is often taken to require a profound reorganization of the prevailing health care system. In particular, a more cost-effective care system is warranted and ICT-based home care is often considered a promising alternative. Modern health care devices admit a transfer of patients with rather complex care needs from institutions to the home care setting. With care recipients set up with health monitoring technologies at home, spouses and children are likely (...)
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  33.  70
    Relational autonomy in end-of-life care ethics: a contextualized approach to real-life complexities.Carlos Gómez-Vírseda, Yves de Maeseneer & Chris Gastmans - 2020 - BMC Medical Ethics 21 (1):1-14.
    BackgroundRespect for autonomy is a paramount principle in end-of-life ethics. Nevertheless, empirical studies show that decision-making, exclusively focused on the individual exercise of autonomy fails to align well with patients’ preferences at the end of life. The need for a more contextualized approach that meets real-life complexities experienced in end-of-life practices has been repeatedly advocated. In this regard, the notion of ‘relational autonomy’ may be a suitable alternative approach. Relational autonomy has even been advanced as a foundational notion of palliative (...)
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  34.  41
    Trends in the perceived complexity of primary health care: a secondary analysis.David Katerndahl, Michael Parchman & Robert Wood - 2010 - Journal of Evaluation in Clinical Practice 16 (5):1002-1008.
  35.  69
    “The edge of harm and help”: ethical considerations in the care of transgender youth with complex family situations.Beth A. Clark, Alice Virani & Elizabeth M. Saewyc - 2020 - Ethics and Behavior 30 (3):161-180.
    Health-care providers frequently face clinical ethical dilemmas when working with transgender youth who require hormone therapy but lack parental support for this intervention. Through semi-structured interviews and grounded theory analysis, we explored ethical and clinical decision-making processes of health-care providers, as well as the health care experiences of trans youth with family discordance. We analyzed responses in relation to North American bioethics principles, best interests standard, and the harm principle, exploring issues of autonomy, evidence, and anti-trans bias. (...)
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  36. Caring: Gender-Sensitive Ethics.Peta Bowden - 1996 - New York: Routledge.
    In _Caring_, Peta Bowden extends and challenges recent debates on feminist ethics. She takes issue with accounts of the ethics of care that focus on alleged principles of caring rather than analysing caring in practice. Caring, Bowden argues, must be understood by 'working through examples'. Following this approach, Bowden explores four main caring practices: mothering, friendship, nursing and citizenship. Her analysis of the differences and similarities in these practices - their varying degrees of intimacy and reciprocity, formality and informality, (...)
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  37.  51
    Implications of complex adaptive systems theory for interpreting research about health care organizations.Michelle Jordon, Holly Jordan Lanham, Ruth A. Anderson & Reuben R. McDaniel Jr - 2010 - Journal of Evaluation in Clinical Practice 16 (1):228-231.
  38.  27
    Care is a fundamental aspect of human life. Care consists of ''everything we do to continue, repair, and maintain ourselves so that we can live in the world as well as possible''(Fisher and Tronto 1990, 41). Most of us think about care in the intimate relationships of our lives: care for ourselves and our families and friends. In its broadest meanings, care is complex and multidimensional: it refers both to the dispositional qualities we need to care for ourselves and others, such as being. [REVIEW]A. Modest Proposal - 2005 - In Marilyn Friedman, Women and Citizenship. New York, US: Oup Usa. pp. 130.
  39.  22
    Factors influencing practitioners’ who do not participate in ethically complex, legally available care: scoping review.Mary Chipanshi, Alexandra Hodson, Lilian Thorpe, Donna Goodridge & Janine Brown - 2021 - BMC Medical Ethics 22 (1):1-10.
    BackgroundEvolving medical technology, advancing biomedical and drug research, and changing laws and legislation impact patients’ healthcare options and influence healthcare practitioners’ (HCPs’) practices. Conscientious objection policy confusion and variability can arise as it may occasionally be unclear what underpins non-participation. Our objective was to identify, analyze, and synthesize the factors that influenced HCPs who did not participate in ethically complex, legally available healthcare.MethodsWe used Arksey and O’Malley’s framework while considering Levac et al.’s enhancements, and qualitatively synthesized the evidence. We (...)
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  40.  30
    Advance care planning with chronically ill patients: A relational autonomy approach.Tieghan Killackey, Elizabeth Peter, Jane Maciver & Shan Mohammed - 2020 - Nursing Ethics 27 (2):360-371.
    Advance care planning is a process that encourages people to identify their values, to reflect upon the meanings and consequences of serious illness, to define goals and preferences for future medical treatment and care, and to discuss these goals with family and health-care providers. Advance care planning is especially important for those who are chronically ill, as patients and their families face a variety of complex healthcare decisions. Participating in advance care planning has been (...)
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  41.  31
    Status Update: The Complexities of the Internet Age Bring Urgency for Deliberately Making Advance Health Care Decision Wishes Known.Samantha Siess & Anne Moyer - 2012 - American Journal of Bioethics 12 (10):49-50.
    The American Journal of Bioethics, Volume 12, Issue 10, Page 49-50, October 2012.
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  42.  48
    Accessing the Ethics of Complex Health Care Practices: Would a “Domains of Ethics Analysis” Approach Help? [REVIEW]Jeffrey Kirby - 2010 - HEC Forum 22 (2):133-143.
    This paper explores how using a domains of ethics analysis approach might constructively contribute to an enhanced understanding (among those without specialized ethics training) of ethically-complex health care practices through the consideration of one such sample practice, i.e., deep and continuous palliative sedation (DCPS). For this purpose, I select four sample ethics domains (from a variety of possible relevant domains) for use in the consideration of this practice, i.e., autonomous choice, motives, actions and consequences. These particular domains were (...)
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  43.  37
    Implementing clinical ethics committees as a complex intervention: presentation of a feasibility study in community care.Morten Magelssen, Heidi Karlsen, Reidar Pedersen & Lisbeth Thoresen - 2020 - BMC Medical Ethics 21 (1):1-9.
    BackgroundHow should clinical ethics support services such as clinical ethics committees (CECs) be implemented and evaluated? We argue that both the CEC itself and theimplementationof the CEC should be considered as ‘complex interventions’.Main textWe present a research project involving the implementation of CECs in community care in four Norwegian municipalities. We show that when both the CEC and its implementation are considered as complex interventions, important consequences follow – both for implementation and the study thereof. Emphasizing four (...)
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  44.  16
    The Simple Reality of Our Complex System: The Future of Health Care.Sylvia Mathews Burwell - 2018 - Journal of Law, Medicine and Ethics 46 (4):825-828.
    The incredible complexity of the United States health care system can be connected to three simple outcomes: access, affordability, and quality. We should measure our progress against these three measures. While historic progress on access was made through implementation of the Affordable Care Act, the next area of focus for more results across all three measures is delivery system reform.
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  45.  24
    What Happened to Dad? The Complexity of Paternal Trauma and Ethical Care.Saajidha Rizvydeen & Dalia M. Feltman - 2022 - American Journal of Bioethics 22 (5):74-76.
    Having a premature or critically ill infant in a neonatal intensive care unit is a traumatic experience for parents that can alter their lives. Parents navigate complex emotions of fear, unc...
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  46. A Theoretical Lens for Revealing the Complexity of Chronic Care.Liesbeth Borgermans, Jan De Maeseneer, Hub Wollersheim & Bert Vrijhoef - 2013 - Perspectives in Biology and Medicine 56 (2):289-299.
    The study of complexity in chronic care is an emergent discipline that has not yet developed a consistent theoretical framework. Thinking in the field of complexity encompasses complexity science and complexity theories, which represent a convergence of different types of ideas and theories that focus on the interactions of individual parts that make up a complex system. In this context, an important distinction is to be made between "complex" and "complicated." If a system—despite the fact that it (...)
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  47.  49
    The Covert Administration of Medications: Legal and Ethical Complexities for Health Care Professionals.L. Martina Munden - 2017 - Journal of Law, Medicine and Ethics 45 (2):182-192.
    The practice of covertly administering medications to patients without their consent is often discussed in the framework of legal questions around the right of patients to consent and refuse medical treatment. However, this practice also raises significant questions surrounding the professional duties and obligations of health care professionals as it relates to the decision-making process of whether to engage in the covert administration of medications. In this paper, I present an overview of the origin of those duties and obligations, (...)
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  48.  54
    Ethical dilemmas in caring for people with complex disabilities.Keith Andrews - 2007 - In Audrey Leathard & Susan Goodinson-McLaren, Ethics: contemporary challenges in health and social care. Bristol, UK: Policy Press. pp. 229.
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  49.  50
    The Ethics of Care and Empathy, by Michael Slote.The Impossibility of Perfection: Aristotle, Feminism, and the Complexities of Ethics, by Michael Slote.Michael S. Brady - 2015 - Mind 124 (495):980-988.
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  50.  35
    Edgeware: Insights from complexity science for health care leaders by Brenda Zimmerman, Curt Lindberg, and Paul Plsek.Kevin Dooley - 1999 - Complexity 4 (5):38-38.
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