Abstract:
INTRODUCTION:General Practitioners (GPs) and allied healthcare professionals working in primary care are regularly required to make decisions with, for and on behalf of patients who lack capacity. In England and Wales, these decisions are made for incapacitated adult patients under the Mental Capacity Act 2005, which primarily requires that decisions are made in the patient's 'best interests'. Regarding children, decisions are also made in their best interests but are done so under the Children Act 1989, which places paramount importance on the welfare of the child. Decisions for children are usually made by parents, but a GP may become involved if he or she feels a parent is not acting in the best interests of the child. Internationally, including elsewhere in the UK, different approaches are taken. We hypothesise that, despite the legislation and professional guidelines, there are many different approaches taken by GPs and allied healthcare professionals in England and Wales when making these complex decisions with, for and on behalf of patients who lack capacity. To better understand what is known about how these decisions are made, we plan to undertake a scoping review and directed content analysis of the literature. While the majority of decisions made in primary care are made by GPs, for completeness, this review will include all allied healthcare professionals working in primary care. METHODS AND ANALYSIS:To ensure a wide breadth of literature is captured, a scoping review will be undertaken as described by Arksey and O'Malley (2005). A five-stage approach will be taken when conducting this review: (1) identifying the research question; (2) identifying relevant papers; (3) study selection; (4) data extraction and (5) summarising and synthesis. The final stage will include a directed content analysis of the data to help establish the cross-cutting themes. ETHICS AND DISSEMINATION:The scoping review will be disseminated through conferences and peer-reviewed publications. This scoping review is the first (mapping) phase in a proposed larger study to explore how GPs make decisions with, for and on behalf of those who lack capacity. Qualitative research with GPs, patients and their families will follow, before all the results are synthesised using an 'empirical bioethics' methodology.
journal_name
BMJ Openjournal_title
BMJ openauthors
Ogden SJ,Huxtable R,Ives Jdoi
10.1136/bmjopen-2020-038032subject
Has Abstractpub_date
2020-10-20 00:00:00pages
e038032issue
10issn
2044-6055pii
bmjopen-2020-038032journal_volume
10pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVE:To examine consumers' confidence in their own, and also in other people's, over-the-counter (OTC) skills and to describe their attitude towards the availability of OTC painkillers. Moreover we examined the association between confidence in OTC skills and attitudes. DESIGN:Cross-sectional survey. Mixed method...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003455
更新日期:2013-09-25 00:00:00
abstract:OBJECTIVE:This study examined the association of initial provider treatment with early and long-term opioid use in a national sample of patients with new-onset low back pain (LBP). DESIGN:A retrospective cohort study of patients with new-onset LBP from 2008 to 2013. SETTING:The study evaluated outpatient and inpatien...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028633
更新日期:2019-09-20 00:00:00
abstract:INTRODUCTION:Hamstring injury among athletes often results in significant morbidity. Currently, there are controversies regarding the clinical use of platelet-rich plasma (PRP) for the treatment of acute hamstring injury. METHODS AND ANALYSIS:This study is a single-centre double-blind randomised placebo-controlled tri...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-039105
更新日期:2020-08-20 00:00:00
abstract:OBJECTIVE:Outpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019099
更新日期:2018-01-10 00:00:00
abstract:OBJECTIVES:To investigate the impact of first eye and second eye cataract surgery on the level of physical activity undertaken by older adults with bilateral cataract. DESIGN:Prospective cohort study. SETTING:Three public ophthalmology clinics in Western Australia. PARTICIPANTS:Fifty-five older adults with bilateral...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-024491
更新日期:2019-03-20 00:00:00
abstract:OBJECTIVE:Cardiac disease in pregnancy is a leading cause of maternal death in high-income countries. Evidence-based guidelines to assist in planning and managing the healthcare of affected women is lacking. The objective of this research was to produce the first qualitative metasynthesis of the experiences of pregnant...
journal_title:BMJ open
pub_type: 杂志文章,meta分析
doi:10.1136/bmjopen-2018-022755
更新日期:2018-09-28 00:00:00
abstract:OBJECTIVES:This evidence review was conducted to understand how and why workforce development interventions can improve the skills and care standards of support workers in older people's services. DESIGN:Following recognised realist synthesis principles, the review was completed by (1) development of an initial progra...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011964
更新日期:2016-08-26 00:00:00
abstract:OBJECTIVE:We aimed to adapt, translate and validate the Chronic Liver Disease Questionnaire (CLDQ) in Malaysian patients with chronic liver diseases of various aetiologies. SETTING:Tertiary level teaching institution in Malaysia. PARTICIPANTS:The validation process involved 211 adult patients (English language n=101,...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013873
更新日期:2017-05-25 00:00:00
abstract:OBJECTIVE:To develop a novel sex independent anthropometric index, termed as angle index, related to type 2 diabetes. DESIGN:Case-control. PARTICIPANTS:The study comprised 121 participants and were divided into two groups. One group had no form of diabetes and served as controls (n=50). The other group had the condit...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024029
更新日期:2019-02-19 00:00:00
abstract:OBJECTIVES:Inspired by the James Lind Alliance (JLA) user involvement approach, the aim of the present study was to identify the top 10 uncertainties for sleep research raised by students in higher education, and to discuss our experiences with adapting the JLA method to a student population. DESIGN:The study design i...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-043697
更新日期:2021-01-26 00:00:00
abstract:INTRODUCTION:Systematic reviews of high-quality randomised controlled trials are necessary to identify effective interventions to impact burn wound infection (BWI) outcomes. Evidence synthesis requires that BWI is reported in a consistent manner. Cochrane reviews investigating interventions for burns report that the in...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026056
更新日期:2019-05-14 00:00:00
abstract:OBJECTIVES:Mental health problems and hazardous alcohol consumption often co-exist. Hazardous drinking could have a negative impact on different aspects of health and also negatively influence the effect of mental health treatment. The aims of this study were to examine if alcohol consumption patterns changed after tre...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2018-028236
更新日期:2019-11-10 00:00:00
abstract:OBJECTIVES:Isoniazid preventive therapy (IPT), for people living with HIV (PLHIV) is the proven and recommended intervention to avert tuberculosis (TB). In 2015, Nepal implemented 6 months of IPT for all PLHIV registered for HIV care in antiretroviral therapy (ART) centres. After programmatic implementation, there has ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2019-029058
更新日期:2019-05-29 00:00:00
abstract:INTRODUCTION:Discharge documents are important for transferring information from hospitals to the referring clinician; in the UK and many countries, this is often the patient's general practitioner or family physician. However, patients may or may not receive their discharge letters, and whether patients should routine...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2017-018353
更新日期:2017-11-12 00:00:00
abstract:INTRODUCTION:Idiopathic nephrotic syndrome (INS) is the most common glomerulopathy that results in childhood chronic kidney disease in China, but the relationships between different clinical phenotypes and immunological genetic variants observed in patients with INS are ambiguous and have not been well studied. A cohor...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028717
更新日期:2019-08-28 00:00:00
abstract:OBJECTIVE:To identify what women report influences their preferred mode of birth after caesarean section. DESIGN:Systematic review of qualitative literature using meta-ethnography. DATA SOURCES:Medline, EMBASE, ASSIA, CINAHL and PsycINFO (1996 until April 2013; updated September 2015). Hand-searched journals, referen...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2015-008881
更新日期:2016-01-08 00:00:00
abstract:INTRODUCTION:Subjective tinnitus is very common and has a number of comorbid associations including depression, sleep disturbance and concentration difficulties. Concentration difficulties may be observable in people with tinnitus through poorer behavioural performance in tasks thought to measure specific cognitive dom...
journal_title:BMJ open
pub_type: 杂志文章,meta分析
doi:10.1136/bmjopen-2018-023700
更新日期:2018-08-13 00:00:00
abstract:OBJECTIVE:To provide insight into the motives for hospital self-referral during office hours and the barriers deterring general practitioner (GP) consultation with a primary care request. SETTING:People who self-referred at a Daytime General Practice Cooperative (GPC) in two hospitals in The Hague, The Netherlands. P...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029853
更新日期:2019-06-06 00:00:00
abstract:OBJECTIVE:To evaluate the evidence on the efficacy of psychosocial interventions for improving pregnancy rates and reducing distress for couples in treatment with assisted reproductive technology (ART). DESIGN:Systematic review and meta-analysis. DATA SOURCES:PsycINFO, PubMed, EMBASE, CINAHL, Web of Science and The C...
journal_title:BMJ open
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmjopen-2014-006592
更新日期:2015-01-28 00:00:00
abstract:OBJECTIVES:Current clinical guidelines discourage long-term prescription of benzodiazepines and Z-drugs (BZD); however, the practice continues to exist. The aim of this study was to investigate the proportion of long-term BZD prescriptions and its risk factors. DESIGN:Retrospective cohort study using a health insuranc...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029641
更新日期:2019-07-26 00:00:00
abstract:BACKGROUND:According to new Norwegian laws, mental healthcare for adults are obligated to assess all patients who are parents and to act on their children's needs. This article describes the study protocol of implementing the interventions Family Assessment and Child Talks for children of patients in the adult psychiat...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2011-000709
更新日期:2012-05-03 00:00:00
abstract:OBJECTIVE:To report on the relative cost-effectiveness of total hip arthroplasty and resurfacing arthroplasty (replacement of articular surface of femoral head only) in patients with severe arthritis suitable for hip joint resurfacing arthroplasty. DESIGN:Cost-effectiveness analysis on an intention-to-treat basis of a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001162
更新日期:2012-10-12 00:00:00
abstract:INTRODUCTION:Reducing length of hospital stay for stroke survivors often creates a shift in the responsibility of care towards informal carers. Adjustment to the caregiving process is experienced by many carers as overwhelming, complex and demanding and can have a detrimental impact on mental and physical health and we...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-018309
更新日期:2017-10-22 00:00:00
abstract:OBJECTIVES:This study aimed to investigate if the use of a transition team was feasible for patients with diabetes being discharged from hospital on injectable diabetes therapies. DESIGN:Pilot, randomised controlled trial. SETTING:The trial was conducted between 2014 and 2016 conjointly by a tertiary referral hospita...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2018-023583
更新日期:2019-09-20 00:00:00
abstract:PURPOSE:The Buffalo Osteoporosis and Periodontal Disease (OsteoPerio) study is a prospective cohort study focused on the relationship between the microbiome and oral and systemic health outcomes in postmenopausal women. The cohort was established to examine how the oral microbiome is affected by (and how it affects) pe...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024263
更新日期:2018-12-04 00:00:00
abstract:OBJECTIVES:Estimate the prevalence of genital warts (GW) and GW-related healthcare resource use and costs among male and female patients seeking treatment in South Korea. DESIGN:To estimate GW prevalence, physicians in five major South Korean regions recorded daily logs of patients (n=71 655) seeking care between July...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-014217
更新日期:2017-07-02 00:00:00
abstract:INTRODUCTION:Sepsis is defined as detrimental immune response to an infection. This overwhelming reaction often abolishes a normal reconstitution of the immune cell homeostasis that in turn increases the risk for further complications. Recent studies revealed a favourable impact of ketone bodies on resolution of inflam...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038532
更新日期:2020-07-08 00:00:00
abstract:OBJECTIVE:In recent years, quality of life (QoL) in multiple sclerosis (MS) has been gaining considerable importance in clinical research and practice. Against this backdrop, this systematic review aimed to provide a broad overview of clinical, sociodemographic and psychosocial risk and protective factors for QoL in ad...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-041249
更新日期:2020-11-30 00:00:00
abstract:INTRODUCTION:Current international guidelines recommend non-vitamin K oral anticoagulants (NOACs) for stroke prevention among patients with non-valvular atrial fibrillation (AF) at significant ischaemic stroke risk given the superior safety and comparable efficacy of NOACs over warfarin. Nonetheless, the safety and eff...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038194
更新日期:2020-09-25 00:00:00
abstract:OBJECTIVES:To examine the association between women's autonomy and the utilisation of maternal healthcare services across 31 Sub-Saharan African countries. DESIGN, SETTING AND PARTICIPANTS:We analysed the Demographic and Health Survey (DHS) (2010-2016) data collected from married women aged 15-49 years. We used four D...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023128
更新日期:2019-03-13 00:00:00