Showing 18 results for Ebrahimi
Marjan Mardani Hamooleh, Ehteram Ebrahimi, Mehrdad Mostaghasi, Taraneh Taghavi Larijani,
Volume 6, Issue 3 (8-2013)
Abstract
Organizational justice is of great importance particularly for hospital personnel, and job stress has the potential to put their health at risk. The purpose of this study was to determine the relationship between organizational justice and job stress among the personnel of a hospital in Isfahan.
In this correlation study, the samples consisted of 150 personnel that were working in a governmental hospital in Isfahan. Samples were selected through convenience sampling in 2012. Data were gathered by personal data questionnaire, Niehoff organizational justice questionnaire and job stress questionnaire. Data were analyzed by descriptive and analytical statistics.
Results showed that job stress among hospital personnel varied from 48.6% (moderate) to 39.4% (mild) and 12% (severe). Moreover, findings showed there was a relationship between organizational justice in the domain of interactional justice and job stress among hospital personnel (r = - 0.18, P = 0.03).
According to the findings, it is essential to pay attention to the concept of organizational justice in hospitals in order to decrease job stress among the personnel.
Hossein Ebrahimi, Abdolhassan Kazemi, Mohammad Asghari Jafarabadi, Arezo Azarm,
Volume 6, Issue 4 (10-2013)
Abstract
One of the most important issues in nursing ethics is moral distress, which is a severe psychological problem among nurses. The purpose of this study was to determine the nurses’ moral distress in the hospitals of the northwest of Iran.This was a cross-sectional study in which 418 nurses were selected by randomized multistep sampling method in the northwest of Iran in 2012. Data collection was done using the moral distress standard scale with high reliability and validity. In order to analyze data, descriptive (mean, standard deviation, frequency and percent) and inferential statistics (independent t-test and one way ANOVA) were used.The mean score of nurses’ moral distress was 148.49 ± 32.93, and 222 nurses (53%) suffered from severe moral distress. Of the three provinces under study, Zanjan (152.46 ± 35.88) and intensive care units (152.72 ± 33.36) had the highest moral distress scores. Among the respondents’ demographic characteristics, province (P < 0.01), education (P < 0.05), type of shift (P < 0.05) and job status (P < 0.05) were significantly related to the level of moral distress experienced by the nurses.Due to the high level of moral distress in the nursing profession, dealing with it requires a lot of attention. Studies on casual and predictive factors in different wards and teaching coping strategies to nurses appear to be necessary in order to address this issue.
Omid Asemani, Sedigheh Ebrahimi,
Volume 6, Issue 6 (2-2014)
Abstract
Confidentiality is an inevitable pillar of the history of the physician-patient relationship. Misunderstanding of this principle not only causes harm to sanctity of the medical profession, but also can damage the quality of the therapeutic relationship, and more broadly public health. The keystone of this negative effect is the potential harm to the patients’ trust and confidence. Generally, the Western school tends to agree that respecting patient confidentiality is essentially desirable. Islam also respects and emphasizes confidentiality, and has general and some specific recommendations about the importance of secrecy and concealment of people’s secrets. Overall, despite strong agreement about the importance of the principle, some ethical theories do not insist on maintaining confidentiality under any circumstance. This paper is an attempt to describe the importance of confidentiality in the medical profession considering the approach of both absolutists and relativists in practice.Absolutists believe that the intrinsic desirability of implementing the principle of confidentiality in all cases is the same and without any exception, but the issue is about not giving just priority to other conflicting moral values.Additionally, the absolutists believe that breaching this principle in practice cannot be permissible due to some serious long-term and mostly hidden complications such as patients’ failure or delay to seek medical assistance or advice and/or withholding important information and so forth. Overall, according to empirical evidence and rational considerations, adherence to absolute confidentiality seems more desirable to absolutists. Unlike absolutists, in relativists’ concept of confidentiality, insisting on maintaining the secret will not be allowed in certain cases, and those cases are considered exceptions of the rule of confidentiality.The most important reasons for falling into the wrong orientation of relative confidentiality seem to be precipitance to attain the desired result, poor communication skills, ignorance of the consequences, and being headstrong.
Omid Asmeni, Sedeghe Ebrahimi,
Volume 7, Issue 1 (5-2014)
Abstract
Hossein Ebrahimi, Effat Sadeghian, Naeimeh Seyedfatemi, Eesa Mohammadi,
Volume 7, Issue 4 (11-2014)
Abstract
Patient autonomy is the opposite of paternalism and an essential element in individualised, patient-centred, ethical care. Challenges associated with patient autonomy are culture-related and have not been fully investigated in Iran so far. The aim of this study was to explore the challenges to the autonomy of patients in Iranian hospitals.This was a qualitative study using conventional content analysis methods. In 2013 13 patients, 7 nurses and 1 doctor were selected from three Tabriz and Hamadan teaching hospitals using purposive sampling to participate in semi-structured interviews. The interviews were subjected to qualitative content analysis and analysed using the MAXQD10 software.Fifteen categories and three themes were identified. The three main themes related to challenges associated with patient autonomy were: interpersonal factors, altered relationships, and organisational constraints. In summary, this study revealed some challenges associated with patient autonomy that the treatment team, managers and planners in the health care system should target in order to improve patient autonomy.
Shahin Reisnejadian, Sedigheh Ebrahimi, Shiva Hemmati,
Volume 8, Issue 5 (2-2016)
Abstract
Pharmacists serve as members of both the society and the health care team, which may involve them in activities that could be the subject of ethical query. They can face issues and problems in the workplace that may raise questions as to whether their acts are appropriate, right, just or legal.
This study aims to explore ethical issues from the perspective of pharmacists and to examine their reasoning processes regarding social phenomena such as ethical challenges. Moreover, it explores the ethical decision-making strategies that pharmacists employ when dealing with such problems in pharmacies and in their interactions with people.
This was a qualitative content analysis study. The participants were chosen using purposeful sampling from community pharmacists and the academic staff of the School of Pharmacy at Shiraz University of Medical Sciences. The data were obtained through semi-structured interviews with 20 individuals and analyzed using content analysis approach.
Analysis of the interviews led to extraction of the following six categories: pharmacists' understanding of key ethical concepts; pharmacists' experiences and duties; relationship with other health professionals; the pharmacy as a commercial setting; the difference between the practice of ethics in pharmacy, medicine and nursing from the perspective of pharmacists; and the actual response of pharmacists in confronting ethical problems. Each of the above-mentioned categories were further divided into sub-classifications describing specific ethical challenges in pharmacy practice
Awareness of ethical issues and professional guidelines is a fundamental part of the education of health care professionals and provides a structure that will enable them to assess ethical problems and make appropriate, justifiable decisions. The findings of this study indicate the need for implementation of professional guidelines and codes of ethics in pharmacy practice to cover all ethical issues
Leily Keyvanloo, Tayebe Rahimi Pordanjani, Ali Mohamadzade Ebrahimi,
Volume 8, Issue 6 (3-2016)
Abstract
The present study tests a model of the relationship between Islamic work ethics and job satisfaction and organizational commitment with mediation of intrinsic motivation. Research design was correlation through structural equation modeling (SEM) and the sample consisted of 203 employees of Sabzevar University of Medical Sciences selected by census sampling method. Participants in this study completed questionnaires on Islamic work ethics, job satisfaction, organizational commitment and intrinsic motivation. Reliability and validity of all questionnaires were reported to be at an acceptable level. Data were analyzed through structural equation modeling (SEM) using AMOS-21 and SPSS-19 software packages. In addition, Preacher and Hayes’ SPSS macro program was used for testing mediation. The results showed that the proposed model fit the data properly, and that Islamic work ethics directly affected job satisfaction and organizational commitment. Moreover, the mediating effect of intrinsic motivation on the relationship between Islamic work ethics and job satisfaction and organizational commitment was confirmed. Employers can therefore rely on Islamic work ethics and training the employees and supervisors to reinforce intrinsic motivation, and thus promote job satisfaction and organizational commitment
Mojtaba Parsa, Bagher Larijani, Kiarash Aramesh, Saharnaz Nedjat, Akbar Fotouhi, Mir Saeid Yekaninejad, Nedjatollah Ebrahimian,
Volume 9, Issue 6 (3-2017)
Abstract
Informal payments in clinics raise ethical concerns in healthcare delivery. This cross-sectional questioner survey aims to evaluate the prevalence and related factors of informal payment in healthcare system in Iran.
The study was carried out in 2013, prior to the implementation of the government' Health System Reform among physicians with different specialties. The questionnaire were distributed among the participants during the congresses and continuing medical education programs.
In results; of the total specialist physicians, 276 returned the questionnaires. The response rate was 81.17%. and out of 276 returned questionnaires 257 fulfilled the inclusion criteria. The prevalence of informal payments, among the physicians who were susceptible to receiving informal payments, was relatively high (63.8%). The physicians who practiced in the private sector, as well as physicians who practiced in Tehran and those who had a positive attitude towards the informal payments, received more informal payments. From the viewpoint of the respondents, the main cause of informal payments was unrealistic/unfair tariffs and the main consequence of informal payments was the rising costs of patient care.
This study showed that, unfortunately, more than half of the participants did not believe or did not decisively consider informal payments as unethical. This confirms the importance of physicians’ education about the unethical practice of informal payments. However, compare to private sectors, more supervision in public sector may be the main cause of less prevalence of informal payments in public hospitals.
In conclusion: Developing ethical guidelines to prevent informal payments as well as more realistic and fair tariffs would help to decrease the incidence of informal payments.
Sedigheh Ebrahimi , Nasrin Alinejad,
Volume 10, Issue 0 (3-2017)
Abstract
Today, due to the highlighted the importance of respect for the human dignity, and increasing awareness of patients, traditional methods of ethics training cannot meet the educational needs. In this cross-sectional study, the effect of medical ethics workshops on knowledge and attitudes of 40 fourth years medical students was studied. A pre-post questionnaire on the measurement of the importance of the medical ethics components, the self-assessment of ethical knowledge, behavior and professional ethics was presented. There was a significant difference between the mean score of the importance of the medical ethics components (questionnaire number 1) before and after the workshop (p = 0.002); but in the case of self-assessment of moral behavior (P = 0.64) and self-assessment of professional ethics compliance (p = 0.48), there was no significant difference between the mean score of students before and after the workshop. The analysis of log-books indicated that students understand, topics of confidentiality, informed consent, and breaking bad news; but issues such as empathy, respect for the patient's emotional state, interaction with a patient suffering from AIDS, informing the patient about the disease and the course of the treatment, accepting a mistake from the doctor, and apologizing to the patient were inadequately addressed by the students. Ethics training is not sufficient just at the beginning of the clinical course; it must also be trained actively in the hospital and on the patient's bedside.
Masoumeh Hasanlo, Arezo Azarm, Parvaneh Asadi, Azar Avazeh, Mitra Hojt Ansari, Hossein Ebrahimi, Mohammad Asghari Jafarabadi,
Volume 10, Issue 0 (3-2017)
Abstract
Stressful ethical situations are considered as one of the problems of nursing profession, which disrupts the competence of simultaneous application of knowledge, skills, attitudes, and values in patient care. Since clinical nurses are more exposed to ethical distress due to their nature of job, especially in in critical care and psychiatric wards, this study was conducted to analyze the relationship between three dimensions of moral distress. In this descriptive-correlational study 545 nurses from Tabriz educational centers were selected by census method in 2013-2014. The moral distress scale (MDS) questionnaire was distributed among partcipants and data was collected during nine months. Data were analyzed by SPSS V13, descriptive statistics, Chi-square test, and Kendall's tau-b correlation coefficient. According to the findings, the mean of moral distress was 141.89 ± 29.6 (in the intermediate range). Chi-square test showed the relationship between the dimensions of moral distress (the relation between patient's ignorance, decision-making power, and professional competence) (P <0.05). According to the Kendall's tau-b correlation coefficient test, there was a direct and significant correlation between the dimensions of moral distress (P <0.05). There was a meaningful correlation between the moral distress and the demographic characteristic of the educational level (P <0.05). Considering the direct and meaningful relationship between three dimensions of moral distress (patient's ignorance, decision-making power, and professional competence), each dimension of moral distress affects another as aggravating or modifying factor. Therefore, it is recommended that planners and health care administrators at the macro level provide appropriate programs to increase the nurse's attention and support to patients and reinforce decision-making power and professional competence by increasing the number of nurses and other controlling programs.
Roghayeh Zare, Sedigheh Ebrahimi,
Volume 11, Issue 0 (3-2018)
Abstract
Involving children in their own treatment decision-making improves their abilities. Factors such as the ability to reason, previous children's experiences in relation to the subject as well as information, and their general understanding of the subject affect the child's ability to make decisions. The current laws of informed consent in children allow alternate decision makers to decide on their own. Our goal in this study was to examine the current conditions for the informed consent of children in to provide appropriate guidelines in this regard. In this qualitative study, participants were selected through targeted sampling. The data were collected by semi-structured interview with open questions. Coding and classification was carried out using continuous comparative analysis. Participants included 6 admitted children, 15 parents of children, and 4 pediatricians. Three general categories of "satisfaction culture", "environmental conditions", and "child world" were extracted. Parents and children were not clear about the purpose of obtaining consent. The gender of children was not significantly affected by the process of obtaining formal consent in medical settings. The existing conditions have created a non-appropriate balance in the expectations of parents regarding the treatment decisions and giving vital information and treating the child by doctors disregarding child’s competency. This defective balance can, in the meantime, cause instability and harm to human dignity and autonomy of parents and children, waste of resources, challenging the sense of trust in the community towards doctors and the lack of growth in child’s decision-making power.
Mohammad Hossein Asgardoon, Sepehr Azizi, Azin Ebrahimi, Mohammad Hossein Ahmadian,
Volume 12, Issue 0 (3-2019)
Abstract
Several definitions for medical futility has been proposed in the literature. Medical futility is defined as the condition in which an intervention, either for diagnosis, prevention, treatment, rehabilitation or other medical goals, has no benefit for the individual patient. This critical review aimed to increase the understanding of physicians and other healthcare providers on the issue of futility in complementary and alternative medicine (CAM). Our comprehensive search resulted in more than 1000 studies; unrelated studies were excluded by title and abstract screening, then 219 full-texts were read and finally, 118 studies were included. The conclusion concerning whether or not it is morally acceptable to provide a futile treatment in CAM, becomes a controversial issue based on different approaches. Using futile treatments is not acceptable according to the duty-based approach, and the principle of justice. In contrast, the case-based approach and the principle of autonomy of the patient, hold that such treatments could be morally acceptable. Based on utilitarianism, only evidence-based treatments can be morally discussed, and those CAM therapies that have been shown to be futile, should be prohibited; thus health care providers must not offer them to patients since it would be a kind of deceit. We suggest that more comprehensive studies should be performed to clarify the boundary between placebo, nocebo, and futility.
Sedigheh Ebrahimi, Reza Mohammadi, Seyed Ziaedin Tabei,
Volume 12, Issue 0 (3-2019)
Abstract
The white coat ceremonies are a recent phenomenon in medical education at the first steps of their education, that use as a symbol to impress upon medical students the importance of professionalism in medicine. This ceremony is known as one of the primary preparations for entrance of medical students to clinical courses. This study aims to investigate the effect of white coat ceremonies on professional ethics and student familiarity with their professional tasks in clinical departments. The present study is a qualitative study on the students' viewpoints regarding white coat ceremony and based on goal-based sampling. The statistical population included 4th-year medical students of Shiraz University of Medical Sciences in 1394. Data collection was done by a mixed method which one part of it was the half structural interview and another part by answering the open questions. Data collection continued to the saturation phase, furthermore; the data were analyzed by content analysis method according to the instructions. Most of the participants in this study considered holding a ceremony before entering the hospital as an important event for the readiness of students to go through a clinical course. The most important positive effects of white coat ceremony were increased students' commitment and accountability, improved interactions with patients, increased motivation and self-confidence, and familiarity with some of the basic principles of professional ethics. A white coat celebration can enhance the students' familiarity with their professional duties and motivations. More studies are needed to better understand the strengths, weaknesses, and shortcomings of this ritual.
Sedigheh Ebrahimi, Zahra Hemmati,
Volume 12, Issue 0 (3-2019)
Abstract
Medical error is one of the most important ethical and legal issues that sometimes occur when a variety of health care practices are provided by healthcare professionals. Due to the necessity of medical error disclosure and lack of adequate personal and organizational support in this field, this study investigates strategies for facilitating error disclosure as well as increasing the variety of supportive measures from the perspective of residents. This was a descriptive cross-sectional study with statistical population including all residents of Shiraz University of Medical Sciences. The sample size was obtained using Morgan table as 248 participants. Data were collected using a researcher-made questionnaire (with descriptive and valid reliability) and analyzed by SPSS software using descriptive and inferential statistics. In this study, increasing support facilities for medical error disclosure (mean 4.38) was the most important factor, and increasing the lawfulness and transparency of activities in the medical setting (mean 4.32) was the second factor affecting the promotion of medical error disclosure. Also, medical liability insurance (mean 4.80) was the most important supportive measure. The fear of legal and judicial consequences was reported as the most effective factors on the error concealment and having experienced lawyers and cultivation effects of mass media declared as the way out. In the present study, although most residents agreed with medical error disclosure, but due to the wide range of risk management problems that affect error disclosure, they found it necessary to establish a support system. Given the teamwork in health-care delivery, support should be given to all members of the treatment team.
Sedigheh Ebrahimi, Azadeh Mohammad Rezaee, Omid Asemani,
Volume 12, Issue 0 (3-2019)
Abstract
Medical errors in pediatrics if different from adults. This study aimed to investigate type and frequency of medical errors and the related contributing factors from pediatric residents' point of view. This descriptive and cross sectional study was done in 2016. After determining validity (face and content) and reliability the final questionnaire with 17 questions categorized in six parts was used for data collection. Data were analyzed descriptively using SPSS v.22. ''Errors of diagnosis or delay in diagnosis' (8.6)', ''choosing appropriate dose (8.3) and medication (8.2)'' had the highest average weights. Fellows of pediatrics (12.6) and pediatrics’ professors (12.1) with the highest average weights had the most dominant role in diagnosis and prevention of errors. The most and the least average weights of the errors was reported for urban general physicians and pediatrics’ professors, respectively. Errors could occur at 2-8 AM more likely. Junior residents were the ones with the most chance of doing errors. Medical errors were mostly reported to occur in the group of children (70.6%) than neonates (29.4%). Reconstruction and strengthening educational and supervision role of pediatric fellowships and attending with the aim of in time diagnosis and then prevention of medical errors could be considered as a must in teaching hospitals. Holding purposeful educational courses and control of contributing factors like workload, exhaustion, inexperience, etc. are among duties of educational and executive managers.
Omid Asemani, Maryam Shabani Abadeh, Sedigheh Ebrahimi,
Volume 12, Issue 0 (3-2019)
Abstract
Obtaining informed consent is for protection of patients' rights. The aim of informed consent is not decreasing physicians' responsibility.Informed consent assists the patient in making a decision concerning their care, improve their satisfaction, and decrease legal litigations. This study examined patients' attitude toward the quality of informed consent and its challenges in educational -clinical settings. Current qualitative research was simple content analysis. Semi-structured interviews were conducted with 15 hospitalized patients who were selected by purposeful sampling method considering type and severity of the disease, gender, age, and satisfaction or dissatisfaction from the management. The data was analyzed using MAXQDA 2007 software. Primary codes and categories were extracted then the findings were presented based on the main. Five themes were extracted from the data: "meaning, importance and status of consent in medicine", "consequences of obtaining consent", "the role of patient and therapist in the process of informed consent", "challenges of making informed consents" and "facilitators in the process of informed consent"; all could define and compile the main theme “doctor, patient, and procedural elements, three pillars of informed consent”. Inadequate explanation to the patient, signing the form prior to read it, lack of trust to the practitioner, disregarding patients' psychologic needs and stress and obtaining the consent by someone other than the physician was among the main reported challenges of informed consent. Correction and standardization of obtaining informed consent's culture requires knowledge about current situation followed by training, enforcement, supervision, encouragement, and punishment. Collaboration of health care team needs comprehension of necessity and importance of this issue and its consequences.
Omid Asemani, Zahra Javadi, Seddigheh Ebrahimi,
Volume 13, Issue 0 (3-2020)
Abstract
Regarding how to make decisions on the revelation of medical errors done by colleagues, investigation of physicians' points of view particularly those in educational settings could help the improvement of circumstances to which we encounter medical errors and thus respecting patient's rights. This cross-sectional descriptive study was conducted through a researcher-made questionnaire after performing face and content validaty and determination of internal and external reliability. The viewpoint of 40 attending physicians and 112 medical residents from different specialties about their inclination to disclose errors, the results of disclosure, the factors influencing on nondisclosure, and the factors decreasing medical errors were asked. Data were analyzed using SPSS v.21. Mean scores of 15.2±1.3 for attending and 12.56±2.05 for residents regarding the dimension of "inclination to disclose others' medical error"; and mean scores of 7.55±0.677 for attending and 9.09±2.01 for residents in terms of "inclination to NOT disclose" were differed significantly (p<0.001). Participants declared the head of medical department/ward as the best authority for managing and dealing with medical errors as the best approach for disclosure of the errors through attendance of the senior physician accompanied by the physician who has made the error. Urban general physicians, nurses, and first-year residents were reported with the most frequency of the errors. The data can be used for the promotion of the patient's rights and the perspective of the medical team when encountering errors done by a colleague, rightfully, and protectively. Building cultural, legal, and social contexts will be the mission of the educational-medical settings aimed at making possible a scientific and skillful error disclosure.
Nehleh Zarei-Fard, Sedigheh Ebrahimi,
Volume 17, Issue 1 (3-2024)
Abstract
Medical science and ethics form an integral part of medical curricula. Cadaver dissection is the preferred educational tool in the early stages of medical education which provides a suitable opportunity to sow the seeds of medical ethics in the minds of future physicians. This review study aimed to investigate unethical events in the history of dissection and subsequent ethical evolutions in human dissection to highlight the need to uphold the ethical values related to donor bodies in the dissection hall. To find and evaluate related documents, the articles published from 2005 to 2023 were searched in Scopus, PubMed, Google Scholar, and Research Gate databases using relevant keywords. The results indicated that in the past, cadaver dissection was performed on the bodies of executed criminals or through illegal methods, and until the early 1960s, the ethical principle of respect for autonomy was overlooked. However, from the 20th century onwards, the use of donated bodies with informed consent became prominent, allowing universities in the 21st century to utilize this resource for education, thereby providing an acceptable solution to fill the ethical gaps in dissection. Clarifying the ethical standards associated with the use of donated bodies is essential for medical students. The human body represents a valuable scientific resource that warrants respectful treatment following established ethical guidelines and laws. Adhering to the highest ethical standards within educational institutions is necessary to ensure donors feel confident in their decisions.
