Avoiding Paternalism

Bladon, Henry

doi:10.1080/01612840.2019.1570405

Cited by 8 publications

(9 citation statements)

References 34 publications

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“…One possible explanation lies in paternalism. Mental health professionals work in a system where it is acceptable at times to view people who use services as lacking capacity, and needing to be either protected or controlled in the interest of safety (Bladon 2019).…”

Section: Discussionmentioning

confidence: 99%

There is something about oppression: Allies' perspectives on challenges in relationships with experts by experience

Happell

Gordon

Sharrock

et al. 2023

Int J Mental Health Nurs

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The genuine and meaningful involvement of Experts by Experience in the education of health professionals has consistently demonstrated positive attitudinal change in students. These changes are essential if policy goals for recovery-oriented services and service user participation in mental health services are to be realized. To date academic roles for Experts by Experience have often relied on the support of allies. Despite the important role allies play, research investigating their experiences is limited. The aim of this research was to explore allies' views on supporting implementation of the academic positions for Experts by Experience. A qualitative exploratory study was undertaken involving in-depth interviews with 16 allies. Data were analysed thematically. Challenges that can exist between allies and Experts by Experience was one theme identified from the data. Allies described occasional difficulties in their relationships with Experts by Experience where they felt they were perceived as representative of members of their broader profession with whom Experts by Experience had negative experiences. The perspectives of allies are presented in four subthemes: relationships imbedded in history; consequences of interpersonal stigma; supportive, protective or paternalistic?; and the passion remains, which describes allies'

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Section: Discussionmentioning

confidence: 99%

There is something about oppression: Allies' perspectives on challenges in relationships with experts by experience

Happell

Gordon

Sharrock

et al. 2023

Int J Mental Health Nurs

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“…Improving patient activation widely, and especially amongst people with poor mental health and other chronic conditions can be hindered by a perpetuation of traditional delivery models. 39 However, with an increasingly greater focus on person‐centred care delivery, many providers have risen to the challenge and exploited the potential to harness patient activation to improve health outcomes. 40 , 41 It is critical for health care providers to factor into their treatment plans or prevention strategies, knowledge about the patient's determinants of activation, including understanding their level of psychological distress, their age, and socioeconomic challenges including their ability to pay for needed care in the absence of private health insurance cover.…”

Section: Discussionmentioning

confidence: 99%

“…The paradigm of healthcare delivery remains, in some places, one of professionally‐dominated decision‐making (so‐called ‘paternalism’) rather than one where more emphasis is placed on respecting patient determination, and deploying shared decision‐making models, although this is changing. Improving patient activation widely, and especially amongst people with poor mental health and other chronic conditions can be hindered by a perpetuation of traditional delivery models 39 . However, with an increasingly greater focus on person‐centred care delivery, many providers have risen to the challenge and exploited the potential to harness patient activation to improve health outcomes 40,41 .…”

Section: Discussionmentioning

confidence: 99%

The Patient Activation Measure (PAM) and the pandemic: Predictors of patient activation among Australian health consumers during the COVID‐19 pandemic

Dammery

Vitangcol

Ansell³

et al. 2023

Health Expectations

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Background Preventative healthcare is crucial for improving individual patient outcomes and is integral to sustainable health systems. The effectiveness of prevention programs is enhanced by activated populations who are capable of managing their own health and are proactive to keep themselves well. However, little is known about the level of activation among people drawn from general populations. We used the Patient Activation Measure (PAM) to address this knowledge gap. Methods A representative, population‐based survey of Australian adults was conducted in October 2021 during the Delta strain outbreak of the COVID‐19 pandemic. Comprehensive demographic information was collected, and the participants completed the Kessler‐6 psychological distress scale (K6) and PAM. Multinomial and binomial logistic regression analyses were performed to determine the effect of demographic factors on PAM scores, which are categorised into four levels: 1—participants disengaged with their health; 2—becoming aware of how to manage their health; 3—acting on their health; and 4—engaging with preventative healthcare and advocating for themselves. Results Of 5100 participants, 7.8% scored at PAM level 1; 13.7% level 2, 45.3% level 3, and 33.2% level 4. The mean score was 66.1, corresponding to PAM level 3. More than half of the participants (59.2%) reported having one or more chronic conditions. Respondents aged 18 to 24 years old were twice as likely to score PAM level 1 compared with people aged 25–44 ( p < .001) or people aged over 65 years ( p < .05). Speaking a language other than English at home was significantly associated with having low PAM ( p < .05). Greater psychological distress scores (K6) were significantly predictive of low PAM scores ( p < .001). Conclusion Overall, Australian adults showed high levels of patient activation in 2021. People with lower incomes, of younger age, and those experiencing psychological distress were more likely to have low activation. Understanding the level of activation enables targeting sociodemographic groups for extra support to increase the capacity to engage in prevention activities. Conducted during the COVID‐19 pandemic, our study provides a baseline for comparison as we move out of the pandemic and associated restrictions and lockdowns. Patient or Public Contribution The study and survey questions were co‐designed with consumer researchers from the Consumers Health Forum of Australia (CHF) as equal partners. Researchers from CHF were involved in the analysis of data and production of all publications using data from the consumer sentiment survey.

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“…If it is students' interest then we are being paternalistic, in direct opposition to respecting autonomy, 54 one of the most fundamental principles in healthcare ethics and something that ethical nurses take great care in avoiding. 55 Alternatively, if the beneficiary of these interventions is the university implementing them, they can be regarded as outright authoritarian, and, it must be remembered, this is in the context of students paying tuition fees and incurring large amounts of debt to do so. A paying customer is being coerced and monitored to benefit the merchant.…”

Section: Surveillance: Big Data and Learner Analyticsmentioning

confidence: 99%

Am I my students’ nurse? Reflections on the nursing ethics of nursing education

Snelling

2023

Nurs Ethics

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Despite having worked in higher education for over twenty years, I am still, first and foremost, a practicing nurse. My employer requires me to be a nurse and my regulator regards what I do as nursing. My practice is regulated by the Code and informed by nursing ethics. If I am nurse, practicing nursing, does that mean that my students are my patients? This paper considers how the relationship that I have with my students can be informed by the ethics of the nurse/patient relationship. After some initial theoretical preparation concerning argument from analogy, the paper identifies some areas for comparison between the two relationships. Areas of similarity and difference identify two areas of concern: Nurse education and educators regularly engage in coercion and surveillance in an attempt to increase student success, both of which would be considered outside nursing ethics. It is concluded that these coercive practices are not conducive to an environment where character is cultivated. Despite current financial and workforce pressures, nurse lecturers and more especially their managers would do well to return to the professional ethics of nursing to question and guide their practice.

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Avoiding Paternalism

Cited by 8 publications

References 34 publications

There is something about oppression: Allies' perspectives on challenges in relationships with experts by experience

There is something about oppression: Allies' perspectives on challenges in relationships with experts by experience

The Patient Activation Measure (PAM) and the pandemic: Predictors of patient activation among Australian health consumers during the COVID‐19 pandemic

Am I my students’ nurse? Reflections on the nursing ethics of nursing education

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