Repository of colleges and higher education institutions

Show document
A+ | A- | Help | SLO | ENG

Title:Etične dileme pri zdravstveni oskrbi marginalnih skupin
Authors:ID Bradeško, Ina (Author)
ID Rakuša Krašovec, Kristina (Mentor) More about this mentor... New window
Files:.pdf DIP_Bradesko_Ina_2026.pdf (1,04 MB)
MD5: F7344550D07EF36CC448C5765368A645
 
Language:Slovenian
Work type:Bachelor thesis/paper
Typology:2.11 - Undergraduate Thesis
Organization:UNM FZV - University of Novo mesto - Faculty of Health Sciences
Abstract:Teoretična izhodišča: Etične dileme v zdravstveni oskrbi marginalnih skupin predstavljajo pomemben izziv sodobne zdravstvene prakse. Temelj razumevanja teh dilem predstavljajo štiri osnovna bioetična načela, in sicer avtonomija, neškodovanje, dobrobit in pravičnost, ki usmerjajo strokovno ravnanje zdravstvenih delavcev. Marginalne skupine, kot so priseljenci, brezdomci, osebe z duševnimi motnjami, starejši s socialnimi težavami in pripadniki LGBTQ+ skupnosti, se pogosto soočajo z omejenim dostopom do zdravstvenih storitev, kar povečuje tveganje za pojav etičnih dilem. Ključni dejavniki, ki vplivajo na njihovo obravnavo, so jezikovne ovire, kulturne razlike, stigmatizacija in sistemske omejitve. Namen raziskave je preučiti etične dileme, s katerimi se zdravstveni delavci soočajo pri oskrbi marginaliziranih skupin. Metoda: Raziskava je temeljila na kvantitativni metodi dela. Podatki so bili zbrani s pomočjo anonimnega spletnega anketnega vprašalnika (1KA), ki je vseboval 15 vprašanj. V raziskavi je sodelovalo 106 zdravstvenih delavcev, zaposlenih na primarni in sekundarni ravni zdravstvene dejavnosti. Vzorec je bil oblikovan po metodi snežne kepe, sodelovanje je bilo prostovoljno in anonimno. Podatki so bili računalniško obdelani s programom 1KA in MS Excel ter prikazani v tabelah in grafih. Rezultati: Anketiranci poročajo, da se z etičnimi dilemami srečujejo v 52 % občasno, medtem ko jih približno četrtina navaja pogostejše pojavljanje. Dileme se v 26,9 % najpogosteje pojavljajo v komunikaciji z bolniki, kjer se pojavi približno četrtina vseh dilem, ter v odnosih z družinskimi člani. Pomemben delež je povezan tudi s kadrovsko podhranjenostjo, ki predstavlja 17,2 % zaznanih dilem. Vpliv etičnih dilem večina anketirancev ocenjuje kot nevtralen, medtem ko jih približno tretjina poroča o negativnem vplivu. Pri oskrbi marginalnih skupin se dileme najpogosteje kažejo v komunikaciji s pacientom 35,2 % in v odnosu osebja do pacientov 30 %. Manj pogosto vplivajo na kakovost nege, dostopnost storitev in odločanje o zdravljenju. Med dejavniki, ki prispevajo k nastanku dilem, so anketiranci najpogosteje navedli jezikovne ovire 28,8 %, kulturne razlike in stigmatizacijo 23,3 % ter pomanjkanje kadra 16,0 %. Podpora, ki jo imajo pri reševanju etičnih dilem zdravstveni delavci v ustanovah, je bila ocenjena kot zadostna (37 %) ali delno zadostna (35 %), nekateri menijo, da je podpora povsem nezadostna, le redki pa jo doživljajo kot zelo dobro. Izobraževanja s področja etike so po mnenju večine dostopna le občasno (42 %), redna vključitev pa je redka (9 %). Samoocena usposobljenosti zdravstvenih delavcev kaže, da se večina počuti vsaj delno pripravljene (35 %) na soočanje z etičnimi dilemami, le manjši del pa svojo usposobljenost ocenjuje kot zelo dobro (3 %) ali povsem nezadostno (7 %). Odprti odgovori razkrivajo dodatne dileme, povezane z jezikovnimi in kulturnimi razlikami, zavračanjem zdravljenja, vprašanji ob koncu življenja, obravnavo socialno ogroženih skupin ter zapornikov. Razprava: Rezultati kažejo, da so etične dileme v zdravstveni oskrbi marginalnih skupin pogost pojav, ki se največkrat izraža v komunikaciji med pacientom in zdravstvenim osebjem. Jezikovne ovire in kulturne razlike predstavljajo ključne izzive, ki otežujejo enakovredno obravnavo. Poleg tega se dileme pojavljajo v povezavi s socialnimi stiskami, stigmatizacijo in vprašanji ob koncu življenja. Podpora v ustanovah je pogosto ocenjena kot zgolj delno zadostna, kar nakazuje na potrebo po sistematičnem razvoju etičnih komisij, svetovalnih služb in kontinuiranem izobraževanju. Samoocena usposobljenosti zdravstvenih delavcev kaže na vrzeli v znanju, kar potrjuje nujnost krepitve etične kompetentnosti. Raziskava potrjuje, da etične dileme niso zgolj individualni problem, temveč odsev sistemskih omejitev v slovenskem zdravstvenem sistemu. Njihovo reševanje zahteva kombinacijo etične občutljivosti, kulturne kompetentnosti in institucionalne podpore.
Keywords:Etične dileme, zdravstvena nega, marginalne skupine, zdravstveni sistem, etična načela.
Year of publishing:2026
PID:20.500.12556/ReVIS-13154 New window
COBISS.SI-ID:267224835 New window
Publication date in ReVIS:05.02.2026
Views:351
Downloads:4
Metadata:XML DC-XML DC-RDF
:
Copy citation
  
Share:Bookmark and Share


Hover the mouse pointer over a document title to show the abstract or click on the title to get all document metadata.

Secondary language

Language:English
Title:Echical Dilemmas in Health Care of Marginal Groups
Abstract:Theoretical background: Ethical dilemmas in the medical care of marginalized groups represent a significant challenge in contemporary medical practice. The foundation for understanding these dilemmas lies in the four basic bioethical principles - autonomy, non-maleficence, beneficence, and justice - which guide the professional conduct of healthcare workers. Marginalized groups, such as immigrants, homeless people, individuals with mental health disorders, elderly persons with social difficulties, and members of the LGBTQ+ community, often face limited access to healthcare services, which increases the risk of ethical dilemmas. Key factors influencing their treatment include language barriers, cultural differences, stigmatization, and system limitations. The purpose of the study is to examine the ethical dilemmas faced by healthcare professionals in the care of marginalized groups. Method: The research was based on a quantitative approach. Data were collected through an anonymous online survey (1KA), which consisted of 15 questions. A total of 117 healthcare professionals working at the primary and secondary levels of healthcare participated. The sample was obtained using the snowball method, with voluntary and anonymous participation. Data were processed using 1KA and MS Excel and presented in tables and graphs. Results: Respondents report that they encounter ethical dilemmas occasionally in 52%, while approximately a quarter indicate more frequent occurrence. Dilemmas most commonly arise in communication with patients in 26.9%, representing about a quarter of all dilemmas, as well as in interactions with family members. A significant share is also associated with staff shortages, which account for 17.2% of the identified dilemmas. Most respondents assess the impact of ethical dilemmas as neutral, while approximately one third report a negative impact. In the care of marginalised groups, dilemmas most frequently appear in communication with patients 35.2% and in staff attitudes towards patients 30%. They less frequently affect the quality of care, access to services, and treatment decision making. Among the factors contributing to the emergence of dilemmas, respondents most often cited language barriers 28.8%, cultural differences and stigmatisation 23.3%, and staff shortages 16.0%. The support available to healthcare workers in resolving ethical dilemmas in institutions was assessed as adequate (37%) or partially adequate (35%), while some consider the support entirely insufficient and only a few perceive it as very good. Ethics related training is, according to most respondents, available only occasionally (42%), while regular inclusion is rare (9%). The self assessment of healthcare workers’ competence shows that most feel at least partially prepared (35%) to face ethical dilemmas, while a smaller proportion rate their competence as very good (3%) or entirely insufficient (7%). Open ended responses reveal additional dilemmas related to language and cultural differences, refusal of treatment, end of life issues, and the care of socially disadvantaged groups and prisoners. Discussion: The findings indicate that ethical dilemmas in the medical care of marginalized groups are a frequent occurrence, most commonly expressed in communication between patients and healthcare staff. Language barriers and cultural differences represent key challenges that hinder equal treatment. In addition, dilemmas arise in connection with social hardships, stigmatization, and end-of-life issues. Institutional support is often perceived as only partially adequate, highlighting the need for systematic development of ethics committees, counseling services, and continuous education. Self-assessment of healthcare workers’ competence reveals gaps in knowledge, confirming the necessity of strengthening ethical competence. The study demonstrates that ethical dilemmas are not merely an individual problem but reflect systemic limitations within the Slovenian healthcare system. Their resolution requires a combination of ethical sensitivity, cultural competence, and institutional support.
Keywords:Ethical dilemmas, nursing care, marginalized groups, healthcare system, bioethical principles.


Back