Inclusion of ethical issues in dementia guidelines: a thematic text analysis.

<h4>Background</h4>Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representatio...

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Autores principales:	Hannes Knüppel, Marcel Mertz, Martina Schmidhuber, Gerald Neitzke, Daniel Strech
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/eeec535da69e4601906d3cf51f880288
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spelling	oai:doaj.org-article:eeec535da69e4601906d3cf51f8802882021-11-18T05:43:10ZInclusion of ethical issues in dementia guidelines: a thematic text analysis.1549-12771549-167610.1371/journal.pmed.1001498https://doaj.org/article/eeec535da69e4601906d3cf51f8802882013-08-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23966839/pdf/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care.<h4>Methods and findings</h4>To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained.<h4>Conclusions</h4>Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors' Summary.Hannes KnüppelMarcel MertzMartina SchmidhuberGerald NeitzkeDaniel StrechPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 10, Iss 8, p e1001498 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Hannes Knüppel Marcel Mertz Martina Schmidhuber Gerald Neitzke Daniel Strech Inclusion of ethical issues in dementia guidelines: a thematic text analysis.
description	<h4>Background</h4>Clinical practice guidelines (CPGs) aim to improve professionalism in health care. However, current CPG development manuals fail to address how to include ethical issues in a systematic and transparent manner. The objective of this study was to assess the representation of ethical issues in general CPGs on dementia care.<h4>Methods and findings</h4>To identify national CPGs on dementia care, five databases of guidelines were searched and national psychiatric associations were contacted in August 2011 and in June 2013. A framework for the assessment of the identified CPGs' ethical content was developed on the basis of a prior systematic review of ethical issues in dementia care. Thematic text analysis and a 4-point rating score were employed to assess how ethical issues were addressed in the identified CPGs. Twelve national CPGs were included. Thirty-one ethical issues in dementia care were identified by the prior systematic review. The proportion of these 31 ethical issues that were explicitly addressed by each CPG ranged from 22% to 77%, with a median of 49.5%. National guidelines differed substantially with respect to (a) which ethical issues were represented, (b) whether ethical recommendations were included, (c) whether justifications or citations were provided to support recommendations, and (d) to what extent the ethical issues were explained.<h4>Conclusions</h4>Ethical issues were inconsistently addressed in national dementia guidelines, with some guidelines including most and some including few ethical issues. Guidelines should address ethical issues and how to deal with them to help the medical profession understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines. There is a need for further research to specify how detailed ethical issues and their respective recommendations can and should be addressed in dementia guidelines. Please see later in the article for the Editors' Summary.
format	article
author	Hannes Knüppel Marcel Mertz Martina Schmidhuber Gerald Neitzke Daniel Strech
author_facet	Hannes Knüppel Marcel Mertz Martina Schmidhuber Gerald Neitzke Daniel Strech
author_sort	Hannes Knüppel
title	Inclusion of ethical issues in dementia guidelines: a thematic text analysis.
title_short	Inclusion of ethical issues in dementia guidelines: a thematic text analysis.
title_full	Inclusion of ethical issues in dementia guidelines: a thematic text analysis.
title_fullStr	Inclusion of ethical issues in dementia guidelines: a thematic text analysis.
title_full_unstemmed	Inclusion of ethical issues in dementia guidelines: a thematic text analysis.
title_sort	inclusion of ethical issues in dementia guidelines: a thematic text analysis.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/eeec535da69e4601906d3cf51f880288
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Inclusion of ethical issues in dementia guidelines: a thematic text analysis.

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