Ethical Decision Makings of Nurse Case Managers for Chronic Diseases in General Hospitals of Southern Part of Thailand
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Abstract
Objective: This qualitative research aimed to investigate ethical decision makings of nurse case managers for chronic diseases in general hospitals, Southern Thailand. Methods: Thirty-two nurse case managers for chronic diseases who met the inclusion critical were purposively recruited from general hospitals in the Southern Thailand. Data were collected by individual interviews by using the open-ended question. Data were analyzed using the Flanagan’s critical incident technique. Results: The results are as follows: 1) the critical incidents of ethical dilemmas in nurse case managers for chronic disease in practice were: treatment does not meet patient/relative needs, the patient has no money to pay for treatment, and patient is not treated and according to practice guidelines. The most critical incidents were: treatment does not meet patient/relative needs (57.57%). 2) the ethical decision makings of nurse case managers for chronic diseases were including; consulting with caregivers/multidisciplinary team (40.90%), finding resources to help patients (27.27%), and providing an advocacy for patients (19.70%). 3) the most frequently reasons/principles of ethical decision making were the higher benefit /safety of the patient (33.30%), respect for patients/relatives (30.30%), and quality of nursing (21.20%). Discussion/Conclusion: The results of this study can be used as base line data for nursing administrators to improve the efficiency of ethical decisionmaking skills of nurse case managers for chronic diseases.
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