Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Professional Autonomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,495 records · Page 83Linked to original sources
PubMed2002

Dental ethics for the 21st century: learning from the Charter on Medical Professionalism.

At chairside the dentist is obligated to act primarily in the patients' interests, to fully and honestly inform patients, enable them to make their own treatment choices, and provide competent, continually improving care. Dentists must also recognize that they have a responsibility to reduce existing barriers to access to care in their communities. These long-standing principles of health care practice have found a new expression in the "Charter of Medical Professionalism." The charter is the work of an international consortium that has reviewed the applicability of existing ethical standards to the challenges facing 21st century practitioners and has revised and restated the fundamental principles of ethical health care practice to effectuate a code of conduct for the new century. The author will review professional ethics in the context of the historical doctor-patient relationship, explore how the transition to modern treatment modalities has affected the professional-patient relationship, and will appraise the charter as a valuable resource in redefining dental professionalism for the future.

Clinical Competence↗
PubMed1976

Professional territoriality: a study of the expanded role of the nurse.

This study examines the expanded role of the nurse as a specific example of the extension of professional boundaries. Three characteristics of professional territoriality--autonomy, accountability, and identity--were selected as variables in the study. The specific objectives were to examine attitudes of members of the nursing and medical profession toward the expanded role of the nurse, and to test the usefulness of the concept of professional territoriality in understanding the expanded role of the nurse. Attitudes toward nurses functioning in an expanded role were examined for two aspects: beliefs as to what nurse practitioners are now doing and what they should be able to do. Data was obtained through questionnaries mailed to a random sample of nurses and physicians in Minnesota. As predicted, the researcher found that nurses held more positive attitudes toward nurse practitioners working in an expanded role than do physicians.

Attitude of Health Personnel↗
PubMed2005

Relationship between quality of care, staffing levels, skill mix and nurse autonomy: literature review.

AIMS: This paper reports a literature review exploring the relationship between quality of care and selected organizational variables through a consideration of what is meant by perceptions of quality, whose perceptions are accorded prominence, and whether changes in staffing, skill mix and autonomy affect perceptions of quality. BACKGROUND: Three basic ideas underpin this literature review: the growing focus on quality improvement in health care, concerns about the quality of care, and the move towards patient involvement and consultation. Of particular interest is the way in which changes in nurse staffing, skill mix and autonomy may affect the delivery of quality patient care. METHODS: A search was conducted using the CINAHL, Medline and Embase databases. Key words used were quality of health care; quality of nursing care; nurse; patient; skill mix; nurse-patient ratio; outcomes; adverse health care events and autonomy. The objective was to draw together a diverse collection of literature related to the field of health care quality. Papers were included for their relevance to the field of enquiry. The original search was conducted in 2003 and updated in 2004. FINDINGS: Quality of care is a complex, multi-dimensional concept which presents researchers with a challenge when attempting to evaluate it. Traditional nursing assessment tools have fallen out of use, partly because they have failed to provide opportunities to engage with and access the views of patients or nurses. There is also evidence that patient satisfaction as an indicator of quality is compromised on a number of fronts. There is conflicting information on how nurses and patients think about quality. Research looking at the relationship between the selected organizational variables and perceptions of quality also suffers from a number of limitations. We argue that there is a requirement for more patient-centred research exploring perceptions of quality and differences in nurse staffing, skill mix and autonomy.

Attitude of Health Personnel↗
PubMed1992

"I will give no deadly drug." Why doctors must not kill.

Is the profession of medicine ethically neutral? If so, whence shall we derive the moral norms or principles to govern its practices? If not, how are the norms of professional conduct related to the rest of what makes medicine a profession?

Ethics, Medical↗
PubMed2004

Ethics and care: an ethnographic study of psychiatric community health nursing practice.

The purpose of this ethnographic study was to explore, describe, and document the practice of a group of psychiatric community health nurses (CHNs), and to provide a forum through which their voices could be heard. Discovery of the nature of issues CHNs experience in an effort to meet the needs of patients with mental illness was the focus. The paper describes the ethical conflict experienced by many of these nurses who wanted to provide beneficial, high-quality care to patients with mental illness but encountered obstacles in practice. Insight into the difficulties nurses experience in applying an ethic of care in the context of administrative constraints, resulting from the strict regulatory mechanisms imposed by third party insurance payers is provided. The negative impact of increasingly stricter payment restrictions on nursing practice and on quality of care is exposed.

Adaptation, Psychological↗
PubMedDate not supplied

The significance of autonomy in the nursing home administrator profession: a qualitative study.

Nursing home administration is seeing high turnover and low entrance into the profession. Face-to-face interviews were conducted with thirty NH administrators and coded using qualitative analytical techniques. It was found that constrained autonomy contributes to job dissatisfaction in the nursing home administrator profession, and that autonomy contributes to increased satisfaction and may lower administrator turnover.

Adult↗
PubMed2001

Outcomes of written living wills in Japan--a survey of the deceased ones' families.

A study was recently done to investigate the outcomes of written living wills in Japan, which, unlike the United States, does not legally recognize advance directives. This study collected demographic information and predictors of living will use among families and guardians who used the living will form provided by the Japan Society for Dying with Dignity. According to the results of the study, affliction with cancer and death in a hospital was the best predictor of written living will use. Research on physicians' treatment limitation and withdrawal behaviors in the clinical setting is needed to better understand the actual impact of living wills. Such research can provide better understanding of where boundaries of self-determination are drawn and how to respect autonomy in Japan.

Advance Directive Adherence↗
PubMed2000

General practitioners, complementary therapies and evidence-based medicine: the defence of clinical autonomy.

Amidst the substantial change currently gripping primary health care are two developments central to contemporary debate regarding the very nature, territory and identity of general practice - the integration of complementary and alternative medicine (CAM) and the rise of evidence-based medicine (EBM). This paper reports findings from a study based upon 25 in-depth interviews with general practitioners (GPs) personally practising complementary therapies alongside more conventional medicine to treat their NHS patients. The paper outlines the GPs' perceptions of EBM, its relationship to their personal development of CAM, and their notions of good clinical practice more generally. Analysis of the GPs' accounts demonstrates how CAM can be seen as a useful resource with which some GPs defend their clinical autonomy from what they perceive to be the threat of EBM.

Complementary Therapies↗
PubMed1997

Market-level health maintenance organization activity and physician autonomy and satisfaction.

Managed care is widely expected to affect physicians throughout the healthcare system. In this study, we examined the relationship between health maintenance organization (HMO) activity and the level of competition, autonomy, and satisfaction perceived by physicians who do not work for HMOs. We obtained data on physicians from the 1991 Survey of Young Physicians, which contains a nationally representative sample of physicians younger than age 45 who had 2 to 9 years of practice experience in 1991. We examined the relationships between HMO market share and perceived competition, autonomy, and satisfaction using multivariate logistic regression. The main outcome measures were perceived level of competition; several measures of physicians' freedom to undertake common tasks that might be threatened by managed care (e.g., hospitalizing patients, ordering tests and procedures); satisfaction with current practice situation; perceived ability to practice quality medicine; whether the physician would attend medical school again; and satisfaction with medicine as a career. We found that an increase of 10 percentage points in HMO market share was associated with a 28% increase in the probability that physicians will regard their practice situation as very competitive as opposed to somewhat or not competitive (P < 0.01). Examinations of the relationship between HMO market share and autonomy and satisfaction revealed few significant results. We found no evidence that increases in HMO activity adversely affect physician autonomy. Only a limited amount of evidence indicates that increases in HMO activity reduce the satisfaction of specialist physicians, and no evidence associates HMO activity with the satisfaction of generalists. Although physicians perceive HMOs as competitors, HMO activity has not had a strong negative effect on the autonomy and satisfaction of physicians.

Attitude of Health Personnel↗
PubMedDate not supplied

Serf or citizen: physician status and organizational structure.

For more than a decade, dynamic changes in the health care industry have created new organizations for physicians. The major change for physicians has not been the organization itself, but the principles by which it is governed. This fundamental shift is studied with its impact on physicians, by analogy, becoming more like serfs or more like citizens. A review of the general organizational direction and results of non-physician health care organizations is made followed by the statistical trends of physician groups. Historical comparisons of non-health care industries are made with current organizational choices of physicians and physician groups. Observations of physician decisions are made identifying the direction they send physician status along the continuum from serf to citizen. Physicians are unknowingly making decisions regarding the principles by which they will be governed in new organizations. The choices they are making give them less autonomy and less opportunity to make future choices. The seductive invitation to spend less time in administrative matters and more time practicing medicine is a siren's call that will diminish the status of physicians and the autonomy by which medicine is practiced.

Collective Bargaining↗