Main Article Content
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.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Available from: http://www.who.int/nmh/publications/ncdstatus-report-2014/en/.
2. Ministry of Public Health. Hdc serviceplan [Internet]. [cited 2018 Jun 1]. Available from: https: //hdcservice. moph.go.th/hdc/main/index_pk.php.
3. Srivanikorn S, Supapol S, Yana T, et al. editor. Knowledge management and synthesis of district health promotion hospital practices: Management of chronic disease patients in diabetes and hypertension. Nonthaburi: Sahamit printing and publishing; 2010. Thai.
4. Sindhu S, Wongrod P. editor. Case management for clients with diabetes mellitus and hypertension. 2 nd ed. Bangkok: Wattanakanpim Printing; 2014. Thai
5. Frolich A. Identifying organizational principles and management practices important to the quality of health care services for chronic conditions. Dan Med J. 2012; 59(2): B4387.
6. CestaT. Case Management Insider: The process of ethical decision-making [Internet] New York: Lutheran Medical Center Brooklyn; 2011 [cited 2011 Aug 1]. Available from: https://www.reliasmedia.com/articles/131257-case-management-insider-the-process-of-ethical-decision-making.
7. Sirilai S. editor. Ethics for Nursing. Bangkok: Chulalongkorn university Printing; 2013. Thai.
8. Haahr A, Norlyk A, Martinsen B. Nurses experiences of ethical dilemmas: A review. Nurs Ethics. 2020; 27(1): 258-
72. doi: 10.1177/0969733019832941.
9. Pato T, Suttarungsee W, Nasae T. Nurses’ ethical dilemmas and ethical decision making in providing care for psychiatric patients with violent behavior in psychiatric hospitals, Southern Thailand. Songklanagarind J Nurs. 2013; 33(2): 1-4. Thai.
10. Supamanee T, Thana K. Ethical Problem in Nursing Practice. Nursing Journal. 2014; 41(4): 178-83. Thai.
11. Fry ST, Johnstone M. Ethic in nursing practice: A guide to ethical decision making. 3 rd ed. Oxford: Blackwell Publishing; 2008.
12. Jonsen AR, Siegler M, Winslade WJ. Clinical ethic: A practical approach to ethical decisions in clinical medicine.
5 th ed. New York: McGraw-Hill; 2006.
13. Beauchamp TL, Childress JF. Principle of biomedical ethics. 7 th ed. New York: Oxford University Press; 2013.
14. Flanagan JC. The critical incident technique. Psychological Bulletin. 1954; 51(4): 327-57.
15. Thailand Nursing and Midwifery Council: Ethics promotion manual for nursing organizations: Mechanisms and Practices Bangkok: golden point cold; 2013. Thai.
16. Apaipakdee Y, Suttarangsee W, Nasae T. Nurses’ practices in respecting psychiatric patients’ autonomy in psychiatric hospitals, Southern Thailand. Songklanagarind J Nurs. 2014; 33(2): 15-30. Thai.
17. Chinnawong T. Case management for clients with diabetes mellitus and hypertension in a community. Songklanagarind J Nurs. 2017; 37(1): 148-57. Thai.
18. Sari D, Baysal E, Celik GG, et al. Ethical decision-making levels of nursing students. Pak J Med Sci. 2018; 34(3): 724-9. doi: 10.12669/pjms.343.14922.
19. Suttarangsee W. Ethical dilemmas and ethical decision making in caring for persons with emotional crisis. Songklanagarind J Nurs. 2013; 33(2): 47-54. Thai.