Os direitos do paciente e suas repercussões na relação enfermeiro-paciente: uma revisão de escopo
DOI:
https://doi.org/10.5216/ree.v27.78263Palavras-chave:
Direitos do Paciente, Defesa do Paciente, Relações Enfermeiro-Paciente, Ética em Enfermagem, RevisãoResumo
Objetivo: mapear conteúdos formalmente produzidos sobre direitos do paciente que repercutem no âmbito da relação enfermeiro-paciente. Métodos: revisão de escopo que seguiu recomendações do Joanna Briggs Institute e do PRISMA Extension for Scoping Reviews. Envolveu busca de artigos em quatro bases de dados e uma biblioteca eletrônica, textos obtidos a partir das referências dos artigos selecionados, documentos de organizações nacionais e internacionais relacionadas à proteção dos direitos do paciente e entidades e autarquias de enfermagem. Resultados: foram selecionados 34 artigos, publicados entre 2002 e 2022, e 11 documentos, publicados entre 1974 e 2022. Os temas foram agrupados em quatro classes: direitos do paciente - significado do conceito; ferramentas que materializam os direitos do paciente (consentimento informado e diretivas antecipadas); características dos enfermeiros e da relação enfermeiro-paciente que indicam que esses profissionais respeitam os direitos do paciente; referencial teórico, correntes e princípios éticos que embasam a atuação do enfermeiro. Conclusão: o respeito aos direitos do paciente se materializa em ações de defesa do paciente pelo enfermeiro e no uso do consentimento informado e das diretivas antecipadas de vontade, tendo como fundamento a dignidade humana, marcos teóricos e legais dos direitos humanos e as correntes e princípios éticos que permeiam a profissão.
Downloads
Referências
Ming Y, Wei H, Cheng H, Ming J, Beck M. Analyzing Patients' Complaints: Awakening of the Ethic of Belonging. ANS Adv Nurs Sci. 2019 Oct/Dec;42(4):278-88. https://doi.org/10.1097/ANS.0000000000000278
Aydin Er R, Incedere A, Öztürk S. Respectful care of human dignity: how is it perceived by patients and nurses? J Med Ethic. 2018 Oct;44(10):675-80. https://doi.org/10.1136/medethics-2017-104666
European Commission, Directorate-General for Health and Food Safety. Patients’ rights in the European Union. Mapping eXercise - final report. Luxembourg: Publications Office of the European Union; 2016. https://doi.org/10.2875/751285
Kwame A, Petrucka PM. Universal healthcare coverage, patients' rights, and nurse-patient communication: a critical review of the evidence. BMC Nurs. 2022 Mar 7;21:54. https://doi.org/10.1186/s12912-022-00833-1
Cohen J, Ezer T. Human rights in patient care: a theoretical and practical framework. Health Hum Rights [Internet]. 2013 Dec 12 [cited 2022 Sept 8];15(2):7-19. Available from: https://pubmed.ncbi.nlm.nih.gov/24421170/
Albuquerque A, Paranhos D, Cardoso A, Persijn A, Rech C, Tanure C, et al. Mapeo de los derechos de los pacientes en América Latina. Informe Final. Rev. Redbioética/UNESCO [Internet]. 2020 July-Dec [cited 2022 Sept 8];2(22):129-46. Available from: https://redbioetica.com.ar/revista-redbioetica-unesco-no-22/
Albuquerque A. Os Direitos dos Pacientes no Brasil: análise das propostas legislativas e o papel do Sistema Único de Saúde. Rev Bras Bioética. 2020 Jan 7;15:1-24. https://doi.org/10.26512/rbb.v15.2019.27130
Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z, editors. JBI Reviewer's Manual. 2020 June. https://doi.org/10.46658/jbimes-20-12
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018 Sept 4;169(7):467-73. https://doi.org/10.7326/M18-0850
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021 Mar 29;372:n71. https://doi.org/10.1136/bmj.n71
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan — a web and mobile app for systematic reviews. Syst Rev. 2016 Dec 5;5:210. https://doi.org/10.1186/s13643-016-0384-4
Curran WJ. The Patient’s Bill of Rights Becomes Law. N Engl J Med. 1974 Jan 3;290:32-3. https://doi.org/10.1056/nejm197401032900108
European Comission Public Health, Active Citizenship Network. European Charter of Patients´Rights. Active Citizenship Network [Internet]; 2002 Nov [cited 2021 Jan 28]. Available from: https://ec.europa.eu/health/ph_overview/co_operation/mobility/docs/health_services_co108_en.pdf
Briggs L, Colvin E. The nurse's role in end-of-life decision-making for patients and families. Geriatr Nurs. 2002 Dec 24;23(6):302-10. https://doi.org/10.1067/mgn.2002.130271
Trevizan MA, Mendes IAC, Lourenço MR, Shinyashiki GT. Aspectos éticos na ação gerencial do enfermeiro. Rev Latino-am Enfermagem. 2002 Nov 12;10(1):85-9. https://doi.org/10.1590/S0104-11692002000100013
Smith AP. Patient advocacy: roles for nurses and leaders. Nurs Econ [Internet]. 2004 Mar/Apr [cited 2021 Jan 28];22(2):88-90. Available from: https://www.proquest.com/scholarly-journals/patient-advocacy-roles-nursesleaders/docview/236963677/se-2
Negarandeh R, Oskouie F, Ahmadi F, Nikravesh M, Hallberg IR. Patient advocacy: barriers and facilitators. BMC Nurs. 2006 Mar 1;5:3. https://doi.org/10.1186/1472-6955-5-3
Ventura CAA, Mendes IAC, Trevizan MA. Psychiatric nursing care in Brazil: legal and ethical aspects. Med Law [Internet]. 2007 Dec [cited 2021 Jan 28];26(4):829-40. Available from: https://pubmed.ncbi.nlm.nih.gov/18284121
Shirley JL. Limits of autonomy in nursing's moral discourse. Adv Nurs Sci. 2007 Jan;30(1):14-25. https://doi.org/10.1097/00012272-200701000-00003
Visentin A, Labronici L, Lenardt MH. Autonomia do paciente idoso com câncer: o direito de saber o diagnóstico. Acta Paul Enferm. 2008 Jan 18;20(4):509-13. https://doi.org/10.1590/S0103-21002007000400021
Peretti-Watel P, Bendiane MK, Galinier A, Favre R, Ribiere C, Lapiana JM, et al. District nurses' attitudes toward patient consent: the case of mechanical ventilation on amyotrophic lateral sclerosis patients: results from a French national survey. J Crit Care. 2008 Apr 23;23(3):332-8. https://doi.org/10.1016/j.jcrc.2007.11.007
Freitas GF. Bioética no cuidado e direitos dos pacientes e familiares. Cultura de los Cuidados. 2008;24(2):75-81. https://doi.org/10.14198/cuid.2008.24.12
Portaria nº 1.820 do Ministério da Saúde, de 13 de agosto de 2009 (BR) [Internet]. Dispõe sobre os direitos e deveres dos usuários da saúde. Diário Oficial da União. 2009 Aug 13 [cited 2021 Jan 28]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2009/prt1820_13_08_2009.html
Ojwang BO, Ogutu EA, Matu PM. Nurses' impoliteness as an impediment to patients' rights in selected Kenyan hospitals. Health Hum Rights [Internet]. 2010 Dec 15 [cited 2022 Sept 8];12(2):101-17. Available from: https://pubmed.ncbi.nlm.nih.gov/21178193/#affiliation-1
Vaartio-Rajalin H, Leino-Kilpi H. Nurses as patient advocates in oncology care: activities based on literature. Clin J Oncol Nurs. 2011 Oct;15(5):526-32. https://doi.org/10.1188/11.CJON.526-532
Spence K. Ethical advocacy based on caring: a model for neonatal and pediatric nurses. J Paediatr Child Health. 2011 Sept 27;47(9):642-5. https://doi.org/10.1111/j.1440-1754.2011.02178.x
Resolução nº 1.995 do Conselho Federal de Medicina, de 9 de Agosto de 2012 (BR) [Internet]. Dispõe sobre as diretivas antecipadas de vontade dos pacientes. Diário Oficial da União. 2012 Aug 9 [cited 2021 Jan 28]. Available from: https://sistemas.cfm.org.br/normas/visualizar/resolucoes/BR/2012/1995
Vorderstrasse AA, Hammer MJ, Dungan JR. Nursing implications of personalized and precision medicine. Semin Oncol Nurs. 2014 May 9;30(2):130-6. https://doi.org/10.1016/j.soncn.2014.03.007
Barlem JGT, Lunardi VL, Barlem ELD, Ramos AM, Figueira AB, Fornari NC. Nursing beliefs and actions in exercising patient advocacy in a hospital context. Rev Esc Enferm USP. 2015 Oct;49(5):806-12. https://doi.org/10.1590/S0080-623420150000500015
Akca SO, Akpinar YY, Habbani T. Knowledge and attitudes of nurses regarding patient rights: a Corum/Turkey sample. Rev Assoc Med Bras. 2015 Sept-Oct;61(5):452-7. https://doi.org/10.1590/1806-9282.61.05.452
Morley G, Briggs E, Chumbley G. Nurses' experiences of patients with substance-use disorder in pain: a phenomenological study. Pain Manag Nurs. 2015 May 13;16(5):701-11. https://doi.org/10.1016/j.pmn.2015.03.005
Betancur MAL. Care at the end of life: an opportunity to strengthen the pattern of emancipatory nursing skills. Av Enferm. 2015 Jan 1;33(1):124-32. https://doi.org/10.15446/av.enferm.v33n1.37514
Dadzie G, Aziato L, Aikins AG. "We are the best to stand in for patients”: a qualitative study on nurses' advocacy characteristics in Ghana. BMC Nurs. 2017 Nov 14;16:61. https://doi.org/10.1186/s12912-017-0259-6
Farmer L, Lundy A. Informed consent: ethical and legal considerations for advanced practice nurses. J Nurse Pract. 2017 Feb 8;13(2):124-30. https://doi.org/10.1016/j.nurpra.2016.08.011
Resolução nº 564 do Conselho Federal de Enfermagem de 6 de novembro de 2017 (BR) [Internet]. Aprova o novo código de ética dos profissionais de enfermagem. Diário Oficial da União. 2017 Nov 6 [cited 2021 Jan 28]. Available from: https://www.cofen.gov.br/resolucao-cofen-no-5642017/
Ramos AM, Barlem ELD, Barlem JGT, Rocha LP, Amarijo CL, Mattos LM. Preditores da advocacia em saúde identificados por enfermeiros no contexto hospitalar. Aquichan. 2018 Sept;18(3):355-65. https://doi.org/10.5294/aqui.2018.18.3.9
Toro-Flores R, Bravo-Agüi P, Catalán-Gómez MV, González-Hernando M, Guijarro-Cenisergue MJ, Moreno-Vázquez M, et al. Opinions of nurses regarding conscientious objection. Nurs Ethics. 2017 Nov 12;26(4):1027-38. https://doi.org/10.1177/0969733017731915
Luz KR, Vargas MAO, Peter E, Barlem E, Viana RAPP, Ventura CAR. Advocacy in intensive care and hospitalization by court order: what are the perspectives of nurses? Texto contexto - enferm. 2019 Oct 24;28:e20180157. https://doi.org/10.1590/1980-265X-TCE-2018-0157
Capella VB. Problemas bioéticos en la prestación de los cuidados enfermeros durante la pandemia del COVID-19. Index Enferm [Internet]. 2020 June [cited 2022 Sept 8];29(1-2):46-50. Available from: https://pesquisa.bvsalud.org/portal/resource/pt/ibc-ET2-7435
Henning E, Wu J, Battin G, Munar K, Oh C, Stevenson E. Ensuring informed consent for hearing impaired patients: There are a range of ways nurses can ensure they obtain informed consent from hearing-impaired patients. Kai Tiaki [Internet]. 2020 Nov 1 [cited 2022 Sept 8];26(10). Available from: https://link.gale.com/apps/doc/A643418293/AONE?u=capes&sid=bookmark-AONE&xid=8d840f0
Souza ES, Lorena SB, Ferreira CCG, Amorim AFC, Peter JVS. Ética e Profissionalismo nas Redes Sociais: Comportamentos On-Line de Estudantes de Medicina. Rev. bras. educ. med. 2017 Oct-Dec;41(4):564-75. https://doi.org/10.1590/1981-52712015v41n3RB20160096
Wilson MR, Wiechula R, Cusack L, Wilson M. Nurses' intentions to respond to requests for legal assisted-dying: a Q-methodological study. J Adv Nurs. 2019 Nov 8;76(2):642-53. https://doi.org/10.1111/jan.14257
Fountouki A, Sanchez MA, Theofanidis D. Paternalism VS Patient Empowerment: Nursing Challenges from Spain and Greece. International Journal of Caring Sciences [Internet]. 2020 Sept-Dec [cited 2022 Aug 7];13(3):2288-93. Available from: https://internationaljournalofcaringsciences.org/docs/83_foundouki_special_13_3.pdf
European Nurse Directors Associaton - ENDA. The European nurse directors' proto-code of ethics and conduct [Internet]. Arnhem: European Nurse Directors Associaton; 2019 [cited 2022 Aug 7]. 6 p. Available from: https://enda-europe.com/wp-content/uploads/2019/04/enda-proto-code-of-ethics.pdf
Bak R. Patient advocacy from a perioperative nurse perspective. Tennessee Nurse. 2021;84(1):12. Available from: https://www.proquest.com/docview/2501512790?accountid=26644&sourcetype=Trade%20Journals
Neves FB, Vargas MAO, Zilli F, Trentin D, Huhn A, Brehmer LCF. Advocacia em saúde na enfermagem oncológica: revisão integrativa da literatura. Esc Anna Nery. 2021;25(1):e20200106. https://doi.org/10.1590/2177-9465-ean-2020-0106
Moreno-Poyato AR, Abidi KE, Rodríguez-Nogueira Ó, Lluch-Canut T, Puig-Llobet M. A qualitative study exploring the patients' perspective from the reserved therapeutic space nursing intervention in acute mental health units. Int J Ment Health Nurs. 2021 Feb 17;30(3):783-97. https://doi.org/10.1111/inm.12848
Vilela GS, Ferraz CMLC, Moreira DA, Brito MJM. Expressões da ética e do distresse moral na prática do enfermeiro intensivista. Acta Paul Enferm. 2021;34:eAPE01661. https://doi.org/10.37689/acta-ape/2021AO01661
International Council of Nurses. The ICN code of ethics for nurses. Revised 2021 [Internet]. Geneva: International Council of Nurses; 2021 [cited 2022 Aug 7]. Available from: https://www.icn.ch/resources/publications-and-reports/icn-code-ethics-nurses
Tomaschewski-Barlem JG, Lunardi VL, Barlem ELD, Silveira RS, Ramos AM, Piexak DR. Advocacia do paciente na enfermagem: barreiras, facilitadores e possíveis implicações. Texto contexto - enferm. 2017 Sept 28;26(3):e0100014. https://doi.org/10.1590/0104-0707201700010001
Warner SL. Getting political about patient advocacy. Nursing. 2017 Nov;47(11):47-9. https://doi.org/10.1097/01.nurse.0000525989.51732.b6
Rasheed SP, Younas A, Mehdi F. Challenges, extent of involvement and the impact of nurses' involvement in politics and policy making in last two decades: an integrative review. J Nurs Scholarsh. 2020 May 25;52(4):446-55. https://doi.org/10.1111/jnu.12567
Sharpnack PA. Overview and summary: nurses' impact on advocay and policy. OIJN. 2022 May 31;27(2). https://doi.org/10.3912/OJIN.Vol27No02ManOS
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2025 Revista Eletrônica de Enfermagem
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
