This article focuses on the reasons for using physical restraints, their prevalence and nurses’ experiences of their use. The data were collected by means of a questionnaire from nurses, trained nurse’s aids and auxiliary staff ( n = 173) in seven Swiss nursing homes. The results showed that physical restraints are used in nursing units, the mean number of restrained residents in each being 3.7 (SD 3.9). However, nursing staff did not necessarily understand and consider the term ‘restraint’ as a (...) restrictive device in its negative sense. The most common reasons indicated for the use of restraint were related to the protection and safety of the residents themselves, the prevention of disturbance of other residents, and the residents’ restlessness and aggressiveness. As for the reasons related to staffing, reference was made to understaffing, a lack of competence on the part of nurses, and the demands of residents, their next of kin and doctors. It was not common practice to inform the elderly residents that they would be restrained, and therefore they were not always aware of what was happening to them and why. Twenty-nine per cent of the respondents reported that the flexibility of their work was affected by the use of physical restraint. (shrink)

BACKGROUND: It can be argued that the ethical conduct of research involves achieving a balance between the rights and needs of three parties-potential research participants, society, and researchers. Local Research Ethics Committees (LRECs) have a number of roles and functions in the research enterprise, but there have been some indications that LREC members, researchers and the public can have different views about these responsibilities. Any such differences are potential sources of disagreement and misunderstanding. OBJECTIVES: To compare the views of LREC (...) members, researchers and the public towards the roles and functions of LRECs. DESIGN: A questionnaire that contained items concerned with a variety of such roles was distributed to general practice patients (as proxies for potential research participants), researchers and LREC members. FINDINGS: While general practice patients believed that the main function of LRECs is to ensure that research participants come to no harm, LREC members were more concerned with the protection of participants' rights. There was also some disagreement between members and researchers with regard to the consideration of proposals on the grounds of scientific merit. CONCLUSIONS: Local Research Ethics Committee members need to be aware of potential differences in views, that they ought to make their priorities clear, and that membership of LRECs ought to reflect the views of both researchers and potential research participants. (shrink)

The issues discussed in this article concern the process of interviewing the bereaved relatives of organ donors, the personal impact, and the potentially painful nature of such research. Narrative interviews were carried out with 24 donor relatives. The relatively small number of donating families and their anonymity mean that little is understood about the experience of having a relative in a critical care situation that ends in donation. The purpose of this study was to develop a theory that explained the (...) organ donation process for relatives of ‘major organ’ donors. A central concern of implementing the investigation was the possible threat it posed to the participants and myself. The sensitive nature of the research made access to relatives difficult. Undoubtedly, my nursing background and personal attributes had an impact on interactions with participants and the pursuance of the research agenda. (shrink)

This paper draws on research undertaken by the authors in community well woman clinics and hospital settings. Discussion focuses on issues around informed consent and participant observation. The authors are concerned to highlight the complexity of decision-making where researchers hold dual or multiple agendas, which are sometimes in conflict. Further situational factors which affect decision-making in research settings are explored. In particular, the complexity of gaining informed consent throughout the research process is addressed. The intention is not to point to (...) definitive resolutions to the problems posed, but rather to prompt debate about the often taken for granted meaning of 'informed' consent in relationship to participant observation. Cet article est basé sur les recherches que les auteurs avaient entrepris dans des polycliniques de santé de femmes et des hôpitaux. La discussion est concentré sur les thèmes du consentement informé et l'observation participante. Les auteurs sont inquiets de montrer la complexité du processus de se décider quant les chercheurs ont un rôle double ou multiple qui peut être en conflit. D'autres éléments qui influencent la prise de décisions dans des cadres de recherche sont aussi étudiés. En particulier, la compléxité de l'acquisition du consentement informé est adressée. L'intention n'est pas d'amener à une résolution définitive du problème posé, mais plutôt d'inviter á une discussion sur le sens (trop souvent pris pour réalité) du consentment 'informé' quant il s'agit de l'observation participante. Dieser Artikel stützt auf Forschungen, die die Autoren in Frauengesundheits-Kliniken und Spitälern unternommen hatten. Die Diskussion ist hier über die Themen Informierte Zustimmung und Mitteilende Beobachtung. Die Autoren befassen sich mit der Vielschichtigkeit der Entscheidungskräfte wenn die Forscher doppelte oder mehrfache Rollen haben, die manchmal im Konflikt sein können. Andere Faktoren, die die Entscheidungsmöglichkeit beeinflussen, sind auch untersucht. Besonders wird hier die Komplexität des erhalten von informierter Zustimmungung während des Forschungsprozesses angesprochen. Die Absicht ist nicht, eine definitive Lösung des Problems zu finden, sondern eher zu einer Debatte einzuladen über die zu oft als selbstverständlich betrachtete Bedeutung der 'informierten' Zustimmung auf der Ebene der mitteilenden Beobachtung. (shrink)

Child abuse within the family is a highly sensitive issue and therefore difficult to research. This article is based on our experiences of a child abuse research project in Finland. Special attention is given to ethical considerations during the initiation of the study, and in the sampling procedures, data collection and reporting. Most importantly, all those taking part in studies on sensitive issues must be guaranteed full confidentiality and anonymity. There are also other ethical considerations that go beyond the usual (...) concerns in the research process. (shrink)

It is rare to find honest accounts of the difficulties and dilemmas encountered when conducting sensitive research with vulnerable research populations. This account explores some of the ethical issues raised by a qualitative interview study with lesbians and gay men about their experiences of nursing care. There is tension between the moral duty to conduct research with vulnerable and stigmatized groups in order to improve care, and the inevitable lack of resources that go with such a venture. This increases the (...) risk of harm during the process of research. The risk of harm to both the researchers and the researched is explored and the need for a support structure for both groups is raised. There is a pressing need to develop further understanding about the ways in which the dissemination of research can potentially harm already vulnerable research populations. (shrink)