Patient rights and their repercussions on the nurse-patient relationship: a scoping review
DOI:
https://doi.org/10.5216/ree.v27.78263Keywords:
Patient Rights, Patient Advocacy, Nurse-Patient Relations, Ethics, Nursing, ReviewAbstract
Objective: to map formally produced content on patient rights that have an impact on the nurse-patient relationship. Methods: a scoping review that followed recommendations from the JBI and PRISMA Extension for Scoping Reviews. It involved searching for articles in four databases and an electronic library, texts obtained from the references of selected articles, documents from national and international organizations related to the protection of patient rights and nursing entities and autarchies. Results: thirty-four articles, published between 2002 and 2022, and 11 documents, published between 1974 and 2022, were selected. The topics were grouped into four classes: patient rights - meaning of the concept; tools that materialize patient rights (informed consent and advance directives); characteristics of nurses and the nurse-patient relationship that indicate that these professionals respect patient rights; theoretical framework, currents and ethical principles that support nurses’ work. Conclusion: respect for patient rights materializes in actions to defend patients by nurses and in the use of informed consent and advance directives, based on human dignity, theoretical and legal frameworks of human rights and the ethical currents and principles that permeate the profession.
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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
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