Development of a nursing model to assist Japanese patients and family with health care decision making
Japan Society for the Promotion of Science:Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)
Date (from‐to) : 2009 -2012
Author : ITO Misae; HATTORI Keiko; KAKEDA Takahiro; MURAKAMI Kyoko; TURALE Susan; HAYASHI Shinpei; TANIDA Noritoshi; MARIE T Nolan
The reigning principle in health care ethics has been emphasized respect for patient autonomy. Nurses experience a family request not to inform a patient of a diagnosis and prognosis. The healthy adults desire the involvement of their family in health care decision making, and that the extents of physician’s opinion for the life style are lower than those for examination and treatment style. The extents of own opinion for the treatment decision and of family’s opinion for the life-prolonging treatment in the terminal stage tend to be taken by the adults. The most common decision-making preference desired by patients and their families are to make their own decisions after consultation with the physician and the family. However, preferences regarding the decision making process for competent patients are diverse among them. Few pairs of the adults/patients and their family members matched on desire for making decision in health care. It is necessary for nurse to assess the competency for decision making and autonomy preference of a patient and substitute judgment by family. Nurses are in the ideal role to facilitate discussions of preferences between patients and their family members.