The purpose of this paper is to analyse the concept of 'best interest' in order to give nurses, who use it to justify their actions, a clear picture of what this means, and to identify the skills needed for doing so. The process for concept analysis developed by Walker and Avant was used in the analysis of data generated from the literature. Themes were identified from which the defining attributes, antecedents and consequences emerged. The congruence of the findings with current values in nursing, such as promotion of patient autonomy, and the nurse as advocate, are discussed, together with the underpinning ethics theory. The skills needed for nursing practice are identified and recommendations for nurse education are made.
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References
1.
United Kingdom Central Council for Nursing, Midwifery and Health Visiting.Code of professional conduct, third edition, London: UKCC, 1992.
2.
Tribe D., Korgaonkar G.Withdrawing medical treatment: implications of the Bland case. Br J Nurs1993; 2: 84-86.
3.
Lansdown G.Children's status in the UK. PrimHealth Care1993; 3 (10): 12-13.
4.
Kitson A.Nursing: art and science. London: Chapman and Hall, 1993.
5.
Walker LO, Avant KCStrategies for theory construction in nursing, second edition. Norwalk, CT: Appleton and Lange, 1988.
6.
Allen RE ed. Concise Oxford dictionary, eighth edition. Oxford: Oxford University Press, 1991.
7.
McPherson B.In whose best interests? Soc Work Today1988; 20 (4): 12-13.
8.
Males J.Safeguarding the rights and interests of mentally handicapped people. Nursing (Add-on J Clin Nurs)1985; 2: 1101-103.
9.
Goldstein J., Freud A., Solnit AJBefore the best interests of the child. London: Burnett, 1979.
10.
Hope T., Sprigings D., Crisp R.'Not clinically indicated': patients' interests or resource allocation. Br Med J1993; 306: 379-81.
11.
Cowles KV, Rodgers BLThe concept of grief: an evolutionary perspective. In: Rodgers BL, Knafl KA eds. Concept development in nursing: foundations, techniques, and applications . London: Saunders, 1993: 93-106.
12.
Langslow A.In the best interests of the child. Aust Nurs J1991; 21 (4): 28-29.
13.
Young I.The child client. Child Soc1992; 6: 187-203.
14.
Bruce N.On the importance of genetic knowledge. Child Soc1990; 4: 183-96.
15.
Lepping G.Mentorship in occupational health nursing. Occup Health Nurs1985; 33: 547-51.
16.
Mackay R., Storey R., Maclean LC, Misick JD, Glube RH, Pereira L.Job design matching jobs to staff nurses' interests. Nurs Manage1987; 18: 76-80.
17.
Owen M.The notion of justice in social workers' decisions about children. Child Soc1992; 6: 212-24.
18.
Papadakis E.Class interests, class politics and welfare state regime. Br J Sociol1993; 44: 249-70.
Fry A.Conflict of interest. Nurs Times1992; 88 (26): 20.
30.
Edwards BSWhen the physician won't give up. Am J Nurs1993; 93 (9): 34-37.
31.
Jones IHHuman folly. Nurs Times1987; 83 (49): 34-36.
32.
Nord E.An alternative to QALYs: the saved young life equivalent (SAVE). Br Med J1992; 305: 865-77.
33.
Strain M.Evaluating the practice of care: interests and methods. Nurse Educ Today1987; 7: 253-57.
34.
Beattie J.The nature of professional child abuse [Editorial]. Br J Nurs1992; 1: 432.
35.
Bullock A, Stallybrass O, Trombley S eds. The Fontana dictionary of modern thought . London: Fontana, 1988.
36.
Light K., Connelly R.Is the ANA guilty of paternalism in its guidelines on withdrawing or withholding food and fluids? Nurs Forum1989; 24 (3/4): 19-23.
37.
Bandman EL, Bandman B.Nursing ethics through the life span. London: Prentice-Hall, 1990.
38.
McCormack B.How to promote quality of care and preserve patient autonomy. Br J Nurs1993; 2: 338-41.
39.
O'Donnell M.How to enable staff to empower patients. Nurs Stand1993; 8 (12): 36-38.
40.
Seedhouse D.The autonomy test: a guide for decision-making . Senior Nurse1992; 12 (2): 37-40.
41.
Lee T.Patient information; the key to increased autonomy. Prof Nurse1989; 5 (1): 43-47.
Segesten B.Patient advocacy - an important part of the daily work of the expert nurse. Scholarly Inqiry Nurs Pract1993; 7: 129-35.
44.
Royal College of Nursing.Advocacy and the nurse. (Issues in nursing and health series.)London: RCN, (undated).
45.
Bristow Ott B., Nieswiadomy RMSupport of patient autonomy in the 'do not resuscitate' decision. Heart Lung1991; 20: 66-74.
46.
Neighbour R.Paternalism or autonomy. Practitioner1992; 236: 860-64.
47.
Wreen MJAutonomy, religious values, and refusal of life-saving medical treatment. J Med Ethics1991; 17: 124-30.
48.
Bramlett MH , Gueldner SH, Sowell RLConsumer-centric advocacy: its connection to nursing frameworks. Nurs Sci Q1990; 3: 156-61.
49.
Beauchamp TLPhilosophic ethics: an introduction to moral philosophy, second edition, New York: McGraw-Hill, 1991.
50.
Berger PL, Luckmann T.The social construction of reality. Harmondsworth: Penguin, 1966.
51.
Rodgers BLPhilosophical foundations of concept development. In: Rodgers BL, Knafl KA. eds. Concept development in nursing: foundations, techniques, and applications . London: Saunders, 1993: 7-33. 52 Rodgers BLConcept analysis: an evolutionary view. In: Rodgers BL, Knafl KA eds.
52.
Concept development in nursing: foundations, techniques, and applications . London: Saunders, 1993: 73-92.
53.
Smith MCFacts about phenomenology in nursing. (Phenomenological research in nursing: commentary and response.)Nurs Sci Q1989; 2: 9-19.
54.
Boyd COClarifying the issues. (Phenomenological research in nursing: commentary and response.)Nurs Sci Q1989; 2: 9-19.
55.
Adam E.Nursing theory: what it is and what it is not. Nurs PaplPerspect Nurs1987; 19 (1): 5-14.
56.
Clarke M.Memories of breathing: a phenomenological dialogue: asthma as a way of becoming . In: Morse JM ed. Qualitative health research. London: Sage, 1992: 123-40.
57.
Forrest D.The experience of caring. J Adv Nurs1989; 14: 815-23.
58.
Hasse JEComponents of courage in chronically ill adolescents: a phenomenological study . Adv Nurs Sci1987; 9 (2): 64-80.
59.
Kelpin V.Birthing pain. In: Morse JM ed. Qualitative health research. London: Sage, 1992: 93-103.
60.
Kretlow F.A phenomenological view of illness. Aust J Adv Nurs1990; 7 (2): 8-10.
