The Influence on Physicians and Nurses of Clinical Ethics Case Conferences using the Four Quadrants Approach described by Jonsen : A Qualitative Study

DOI Web Site

Bibliographic Information

Other Title
  • Jonsen 4分割表を用いた臨床倫理カンファレンスが医師と看護師に与える影響
  • Jonsen4ブンカツヒョウ オ モチイタ リンショウ リンリ カンファレンス ガ イシ ト カンゴシ ニ アタエル エイキョウ

Search this article

Abstract

<p>Abstract</p><p>The primary aim of this study was to identify the components of influence on physicians and nurses participating in clinical ethics case conferences using the four quadrants approach described by Jonsen et al. The second aim was to determine how physicians and nurses feel about clinical ethics, through qualitative interviews. From March 2006, we scheduled a weekly conference in the Hematology Ward. Three physicians and ten nurses were recruited from the ward for semi-structured interviews. Content analysis was applied to their answers；14 categories were extracted and classified into the following 4 core categories as the components of influence on nurses: (1) self-growth, (2) awareness of the primary nurse, (3) awareness of the importance of the team approach and (4) sense of accomplishment. Alternatively, 8 categories were extracted and classified into the following 4 core categories as the components of influence on physicians: (1) self-growth, (2) awareness of the importance of the team approach, (3) understanding nurses’ professional development, and (4) increase in motivation of the medical care team. We then presented 6 categories as clinical ethics issues considered by physicians and nurses: (1) patient distrust of nurses and physicians, and nurse and physician distrust and negative response to patients, (2) anxiety and hesitation due to many serious decisions, (3) immature ability to address problems, (4) dilemma of treatment strategy, (5) weaknesses in communication between physicians and nurses, and (6) physicians’ limited opportunities to think about the psychological aspects of the patient. Through the conference using the four quadrants approach, nurses were able to understand patients from many perspectives including disease status, medical indications, patient preferences, patient quality of life, and contextual features. Physicians recognized that the professional development of individual nurses created an atmosphere change for the entire ward. The conference is an opportunity for the nurses to share their perceptions with physicians, which benefits the team approach. The conference is useful for physicians and nurses to discuss resolving clinical ethics issues and understanding detailed information about patients as individuals.</p>

Journal

Keywords

Details 詳細情報について

Report a problem

Back to top