Residents’ experiences of paternalism in nursing homes

BackgroundInterest in strengthening residents’ autonomy in nursing homes is intensifying and professional caregivers’ experience ethical dilemmas when the principles of beneficence and autonomy conflict. This increased focus requires expanded knowledge of how residents experience decision-making in...

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Bibliographic Details
Authors: Mortensen, Anne Helene (Author) ; Nåden, Dagfinn (Author) ; Karterud, Dag (Author) ; Lohne, Vibeke (Author)
Format: Electronic Article
Language:English
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Published: Sage 2024
In: Nursing ethics
Year: 2024, Volume: 31, Issue: 2/3, Pages: 176-188
Further subjects:B Dignity
B Paternalism
B long-term care facilities
B Qualitative Research
B Autonomy
Online Access: Volltext (kostenfrei)
Description
Summary:BackgroundInterest in strengthening residents’ autonomy in nursing homes is intensifying and professional caregivers’ experience ethical dilemmas when the principles of beneficence and autonomy conflict. This increased focus requires expanded knowledge of how residents experience decision-making in nursing homes and how being subject to paternalism affects residents’ dignity.Research question/aimThis study explored how residents experience paternalism in nursing homes.Research designThis study involved a qualitative interpretive design with participant observations and semi-structured interviews. The interpretations were informed by Gadamer’s hermeneutics.Participants and research contextEleven residents were interviewed after a period of participant observation in two nursing homes.Ethical considerationsThe study was performed in accordance with the Helsinki declaration. The Regional Ethics Committee (REK) permitted the researcher to perform participant observation in the nursing homes. The use of audio recordings of interviews was registered and supervised by Sikt - Norwegian Agency for Shared Services in Education and Research. The resident’s consent was assessed continuously. Three interviews were terminated for ethical reasons.FindingsThe resident interviews revealed that residents found it obvious for caregivers to possess the decision-making authority in nursing homes. When residents explained their views, three main themes emerged: (1) To be included even though caregivers make the decisions, (2) Surrender to dependency, and (3) Adherence to nursing home norms.ConclusionsResidents submit to their caregivers and give caregivers the responsibility and function as leaders. Paternalism was experienced as dignifying in situations where it contributed to residents being able to live according to second order desires and values, and when it implied respect and appraisal of residents’ capabilities. Paternalism was experienced as debasing when residents felt left out, and when residents felt that their capabilities were underestimated. This also included their capability to withstand paternalistic influence.
ISSN:1477-0989
Contains:Enthalten in: Nursing ethics
Persistent identifiers:DOI: 10.1177/09697330231166085