The 'Mental Health and Justice Project': Using interdisciplinarity to move beyond impasse in disability rights

Expert patients leading activities on social justice: towards patient-centered education

BACKGROUND

Social justice is recognized by reputable international organizations as a professional nursing value. However, there are serious doubts as to whether it is embodied in Catalan nursing education.

OBJECTIVES

To explore what nursing students take away from two teaching activities led by expert patients (one presentation and three expert patient illness narratives) on the topics of social justice, patient rights, and person-centered care.

RESEARCH DESIGN

Qualitative study using a content analysis approach. The research plan included (1) think-pair-share activities (additional faculty-assisted presentation and three faculty-assisted, semi-structured scripted narratives); (2) paired reflections; (3) focus groups; and (4) content analysis of paired reflections and focus groups.

PARTICIPANTS AND RESEARCH CONTEXT

Fourth-year nursing degree students at the Autonomous University of Barcelona (UAB), Spain. Convenience sampling was used.

ETHICAL CONSIDERATIONS

The UAB Research Ethics Committee did not deem it necessary to apply any specific measures. We fully explained to patients that they could decide what medical information they would share with the students that was relevant to their learning, and we provided students with guidelines about patient confidentiality, dignity, and respect.

FINDINGS/RESULTS

The students engaged in reflection about their education (recognizing that it had been centered on the professional and not the patient) and their relationship with the patient, in which they reproduced low-involvement patient care by modeling behaviors of their nurse educator. Moreover, they valued a person-centered care model with an emphasis on the emotional part but left out decision-making as an individual right of people.

CONCLUSIONS

The think-pair-share activities were useful to spark self-reflection among students, who identified aspects to change in their own practice, and reflected about their own education process, both of which promote change.

Decision-making by and for adults with impaired capacity: The potential of the Dutch levenstestament

Anticipatory decision-making instruments - continuing powers of attorney and advance directives - are increasingly seen as a promising way forward to enhance the autonomy of adults with impaired capacity by making the adult's voice an influential component of future decisions. However, little is known about the experiences with these instruments in practice. This article presents the findings of an interview study looking at the expectations and experiences of both adults and attorneys with a Dutch anticipatory decision-making instrument, the so-called levenstestament. In order to realise its full potential, anticipatory decision-making instruments, such as the levenstestament, should be embedded in robust, timely and ongoing conversations between adults and attorneys about the adult's (changing) wishes and preferences and the role of the attorney.