...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Nursing research >Ethical conflict in nurse practitioners and physician assistants in managed care.
【24h】

Ethical conflict in nurse practitioners and physician assistants in managed care.

机译：管理式护理中护士执业者和医师助理的道德冲突。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: More patients are receiving healthcare services from nurse practitioners (NPs) and physician assistants (PAs). These providers are likely to be confronted with a variety of ethical issues as they balance quality care with their patients' rising cost concerns. However, very little is known about the ethical conflicts and causes of these conflicts experienced by these clinicians in their daily practice. OBJECTIVE: To identify ethical concerns and conflicts NPs and PAs encounter related to managed care in the delivery of primary care to patients and the factors that influence ethical conflict. METHODS: A cross-sectional self-administered mailed questionnaire was sent to 3,900 NPs and PAs randomly selected from primary care and primary care subspecialties in the United States (adjusted response rate, 50.6%). Respondents were surveyed on ethical issues and concerns, ethics preparedness, and ethical conflict. Bivariate and multiple linear regression analyses were used to evaluate predictors of ethical conflict. RESULTS: Insurance constraints were reported to have interfered with the ability to provide quality patient care by 72% of respondents, with 55.3% reporting daily to weekly interferences. Nearly half of respondents (47%) have been asked by a patient to mislead insurers to assist them in receiving care. A perceived obligation to advocate for patients, even if it means exaggerating the severity of a patient's condition, was the single most significant predictor of ethical conflict, explaining 25% of the variance. DISCUSSION: NPs and PAs are experiencing ethical conflict often associated with their perceived professional obligations to advocate for patients. Being well-prepared in ethics and having sufficient professional independence help clinicians balance the ethical complexities and demands of meeting patients' needs within a constrained healthcare system.
机译：背景：越来越多的患者从护士（NP）和医生助理（PA）获得医疗服务。这些提供者很可能会面临各种道德问题，因为他们会在高质量护理与患者不断增长的成本担忧之间取得平衡。但是，关于这些临床医生在日常实践中所遇到的道德冲突和冲突原因的了解甚少。目的：确定与伦理管理有关的问题和冲突NP和PA在向患者提供初级护理时遇到与可管理的护理有关的问题以及影响伦理冲突的因素。方法：将横断面自我管理的邮寄问卷发送到美国的3900个NP和PA中，这些NP和PA是从初级保健和初级保健亚专业中随机选择的（调整后的回应率为50.6％）。对受访者进行了道德问题和疑虑，道德准备和道德冲突的调查。使用双变量和多元线性回归分析来评估道德冲突的预测因素。结果：据报道，有72％的受访者认为保险约束影响了提供优质患者护理的能力，其中55.3％的受访者每天或每周报告干扰。病人要求将近一半的受访者（47％）误导保险公司以协助他们接受护理。即使有可能夸大患者病情的严重性，也可以认为主张患者提倡义务是道德冲突的最重要的预测因素，可以解释25％的差异。讨论：NP和PA正在经历道德冲突，这些冲突通常与他们认为拥护患者的专业义务有关。具备充分的道德操守和足够的专业独立性，可以帮助临床医生在有限的医疗保健系统中平衡道德上的复杂性和满足患者需求的需求。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号