RESUMO
Advances in chronic and genetic disease management and technology create new challenges for healthcare professionals and patients in making informed decisions. The growing interest in children's involvement in their own healthcare decisions and a rebalancing of child and adolescent rights and responsibilities compounds these challenges. This article presents an overview of research and standards of practice regarding children's participation in research and healthcare decisions. Further research on children's competence to participate in healthcare decisions is recommended. Reasons for and against children's increased involvement in healthcare decisions are included. There is a preponderance of support for involving children in the process, and a dearth of well-articulated reasons to exclude them.
Assuntos
Defesa da Criança e do Adolescente , Proteção da Criança , Consentimento Livre e Esclarecido , Competência Mental , Participação do Paciente , Adolescente , Criança , Humanos , Autonomia Pessoal , Sujeitos da Pesquisa , Estados UnidosRESUMO
Rural health care is hampered by uneven development of services and multiple definitions of rurality. One of the most vulnerable populations in this setting is older residents. This article explores existing models of long-term care for the older population and proposes a model for rural community-based care. This model emphasizes the contributions of advanced practice nurses as coordinators of a collaborative system of care for the targeted population. Issues of cost and quality, as well as the strengths and limitations of the model, are addressed.
