Showing 28 results for Hassan
Amirahmad Shojaee, Fereshteh Abolhassani Niyaraki ,
Volume 4, Issue 4 (7-2011)
Abstract
Based on the definition offered by ancient scholars and philosophers, the term “ethics” refers to a certain set of qualities and character traits, and an ethical person is one who possesses those qualities. This definition is still accepted, although it does not undertake the actions of an ethical person, and does not clarify the stance regarding an ethical person who happens to commit an unethical act.
While supporting the definition above, this paper will investigate people’s behaviors individually through an analytical approach, logical arguments, and by applying falsification criticism. It will then proceed to define the term “piety” and provide a comprehensive exposition of an ethical person. The above-mentioned exposition is offered in this paper for the first time and presents a fresh approach to defining morality. It combines the terms piety and ethics to argue that an ethical person is a pious individual who not only possesses ethical characteristics, but also is sensitive to each one of his/her behaviors.
Majid Hassanpoor, Mohammadali Hosseini, Massod Fallahi Khoshknab, Abbas Abbaszadeh,
Volume 4, Issue 5 (10-2011)
Abstract
Making decisions for recipients of health care while offering clinical care is an important part of nurses’ responsibilities. In order to ensure patient satisfaction, nurses are obligated to observe ethical standards in the decision-making process. This paper aimed to determine the effect of teaching professional ethical principles on ethical sensitivity in nurses’ decision-making.
In this semi-empirical study, 80 Social Security nurses were selected through purposive sampling and were then randomly placed in two groups of 40 each, the intervention group and the control group. Research tool was the Ethical Sensitivity Scale Questionnaire for decision-making, the validity of which was assessed using content validity, and whose reliability was confirmed with a Cronbach’s alpha coefficient of 0.83 for internal consistency. At first the ethical sensitivity in decision-making was evaluated in both groups, and then an educational workshop on nursing ethics was held for the intervention group every other week the workshop consisted of 4 three-hour sessions, and upon completion of this workshop, both groups filled in the questionnaire once more, and data were analyzed using SPSS software.
There was no significant difference between the average ethical sensitivity in decision-making of the two groups before the intervention after the intervention, however, the difference was meaningful (P = 0.001). Moreover, the average ethical sensitivity in decision-making of the intervention group was significantly different after the intervention (P = 0.001).
Based on the findings of this study, teaching nursing ethical principles has a positive effect on nurses’ ethical sensitivity in decision-making. It is therefore recommended that this educational program be offered to nursing students and health care staff.
Amir Ahmad Shojaee, Fereshteh Abolhassani Niyaraki,
Volume 4, Issue 6 (12-2011)
Abstract
The definition of disaster is diverse but certainly the similarity between disaster and normal condition is negligible. The most important characteristic of critical condition is the number of human victims. Therefore each critical condition needs medical intervention and the presence of health care providers is necessary.
Health care services are divided into two categories one in normal situation and the other in the critical condition so the ethical considerations and responsibilities of the health care providers will differ accordingly.
Our approach for explaining medical ethics or ethics in health care n critical conditions is two dimensional including the responsibilities of health care providers and ethical problem solving. The second dimension needs systematic approach which is not possible in this article. In the case of the responsibilities of health care providers we may focus on individualized viewpoint or systematic and strategic view point however the later is more complete and acceptable.
From systematic viewpoint three important issues should be considered ethical principles, ethical codes and multi dimensional ethical charter of each organization.
In this review we aimed at describing some ethical principles and codes of conduct and the ethical principles of Red Cross and Red Crescent as well.
In conclusion, critical conditions are far wider and there are full range of special situations in which no unique solution can be followed. It is necessary to determine the diverse fields affecting the condition and solve the resultant ethical issues in a problem oriented manner. In addition medical ethics should be considered as one of the most important priorities of the Ministry of Health and other related organizations.
Abd-Ol-Hassan Kazemi, Mostafa Kazemi, Mahmood Abbasi, Mehrzad Kiyani, Nejat Feyzollahi, Sadyar Ataloo, Mahmood Massodiniya,
Volume 5, Issue 2 (4-2012)
Abstract
End stage patient control and autonomy are core principles in human bio-medical ethics and key components of end-of-life (EOL) care. Albeit, according to modern medical ethics principles the centrality of the patient as decision maker may not be relevant to culturally diverse groups of end stage people. The purpose of this article is to present results of a literature review of end stage patient control and their family position within the context of end of life support. The review revealed that the interaction between medical control and ethical values in end of life support is multifaceted and unpredictable.
According to the recommendations of American College of Physicians/American Society of Internal Medicine End-of-Life Consensus Panel and some other world class medical and ethical societies, culturally effective end of life support includes the following essential elements
• acceptance of and respect for cultural differences among all end stage patients
• willingness to negotiate and compromise when world views differ
• understanding of one's own values and biases
• contact and communication skills that enhance empathy
• information of the cultural practices of patient groups should be seen on a regular basis and
• attention that all patients are individuals and may not share the same views as others within their own ethnic group
According to the above description, applicants identified five domains of quality end of life support:
1. receiving adequate pain control
2. avoiding inappropriate prolongation of the dying process
3. achieving a sense of control
4. relieving burden on loved ones and
5. strengthening relationships
We emphasize that, despite above mentioned points and advices maintaining a sense of control is an essential element in the end of life support for some individuals, further study of the interplay between ethnicity, desire for control, and achieving a good death is needed.
Amirahmad Shojaee, Fereshteh Abolhassani Niaraki,
Volume 5, Issue 4 (1 2012)
Abstract
Trust is a key element in the physician-patient relationship. Imam Jafar Sadiq (A.S.) stated that the proficient and trusted physician is in equal level of a just jurisprudent. Ancient ethical texts put much emphasis on physicians to be trusted. Nowadays, trust is a component of social health we believe that in the physician-patient relationship, trust has a significant impact on the practice, and increases the effectiveness of treatment and the satisfaction of patient and physician? also patient autonomy is preserved, health is positively reinforced, and patients will be more serious and less negligent with expenses, treatment, and follow up. This paper is a review/analytical article, and aims at classifying trust and examining its role in communication between physician and patient. If limited to practice, trust in the physician - patient relationship is divided into two types:
1- Unconditional trust, which means full confidence with no autonomy
2- Conditional trust, which entails maintaining autonomy.
In the first type, where patient's autonomy is foregone, both patient and physician can be blamed. The patient is to blame due to an absence of self confidence and lack of participation in decision making and treatment, and the physician might in his place have the tendency to patronize. In this article we emphasize the importance of trust and warn against paternalism and conclude that if doctors truly comprehend the meaning of trust, they will try to avoid paternalism.
Seyed Mahmoud Tabatabaei, Seyed Hassan Alam-Al-Hoda,
Volume 5, Issue 5 (26 2012)
Abstract
Medicine is a branch of health science with the purpose of maintaining health and health promotion, diagnosis, treatment and prevention of diseases, and rehabilitation of patients. In addition to possessing academic qualifications and legal training, physicians and service providers should be familiar with moral and jurisprudential considerations in their profession, as is rationally and logically expected.Respect for moral values and legal principles is important since on the one hand it gives the service provider a feeling of fulfillment, and on the other hand it causes the patient to feel satisfied with the service offered.Islamic laws must be observed in all aspects of life in our country and medical practices are not an exception. Therefore it is necessary for all practices to be approved by jurists and to comply with the principles of Islamic jurisprudence and ethics. Consequently, practitioners need a thorough understanding of Islamic laws and ethics in order to be considered qualified. In this regard it should be remembered that Islamic jurisprudence, or Sharia refers to a set of laws and rules of life defined by the Quran and its interpretation and explanation by the great Prophet of Islam (SAW) and Imams (AS). In Islamic culture, law and medicine are closely related to each other. Many physicians are staunch followers of the Islamic jurisprudence and try to observe them in their diagnostic and therapeutic approaches, and in cases where they have dilemmas and are not certain what course of action to take, religious standpoint is what guides them to make the right decision. In recent decades, physicians have tried to apply Islamic laws in the context of medical or jurisprudential problems. This article investigates the realm of medical jurisprudence and medical ethics.
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.
Abdolhassan Kazemi, Soraya Mahmoud,
Volume 7, Issue 5 (1-2015)
Abstract
Genes are considered as “green gold” in this era of biotechnology. Currently, multinational companies and governments search continents to find this valuable asset in the hope to discover people with unique genetic characteristics that can be converted into capital and marketed in the future. Modern economy provides the framework to analyze any new technology from the advantage perspective and has vastly transformed the concept of capital and market thus, humans or any organism with specific genetic characteristics can be converted to capital and offered in profitable markets. Patenting and ownership of genetic resources without consideration for principles of inherent human rights will impact the society and result in a violation of these rights, especially those of vulnerable individuals and groups. In spite of the numerous benefits of biotechnology for individuals and the society, the risks to human dignity, equality, health, autonomy and research, as well as the possibility of information abuse should not be ignored, especially considering the alliance between technology and economy. Biotechnology can make claims to ownership of human life and desired genetic traits, and this is a problem caused by the biotechnology revolution in developing countries and consequently, indigenous peoples of these countries have shown different reactions to such issues. This article will discuss “human commodification”, which is a serious concern in the field of biotechnology in our world today
Behzad Foroutan, Moussa Abolhassani, Sajad Salehipour, Adnan Karimi, Fariba Dehghanizadeh, Nastran Rezvani, Mohammad Soltani Beldaji,
Volume 8, Issue 4 (11-2015)
Abstract
Ethics is important in all professions, particularly in nursing, since morality and commitment in nurses can play a significant role in improving patients’ health and recovery. The nursing profession is therefore rooted in ethics, and the observance of nursing ethics is more important than other aspects of health care. This study aimed to determine patient's views on standards of professional ethics in nursing practice in Imam Hussain Hospital during 2015.
This was a cross-sectional study conducted on 575 patients in different wards of Imam Hussein Hospital in Shahroud. Research instrument was a 22-item questionnaire designed by the researchers to evaluate nurses’ observance of professional ethics in the three dimensions of accountability, improvement of care quality, and respect for patients. Data analysis was performed using SPSS 20 software.
The mean age of participants in this study was 51.32 (± 19.03), and 299 participants (52%) were male. The mean total score of professionalism was 18.38 (± 2.74), and the relationship between age and observance of professional ethics was statistically significant (P = 0.006).
According to the subjects of this study, the nurses’ observance of professional ethics was relatively good and at a desirable level. It is recommended to utilize a variety of learning styles and employ the services of professors of nursing ethics in order to enhance the quality of nursing education with respect to professional ethics.
Mahmoud Motavassel Arani, Mohammad Hassan Alamolhoda, Nikzad Easazade, Gholamreza Noormohammadi,
Volume 10, Issue 0 (3-2017)
Abstract
Modern medical ethics, in particular the principle of Non-Maleficent, advises the medical staff to avoid any harm to the patient. Islamic jurists, using religious texts and sources, have introduced rules that are applicable in many areas of life. Among these rules, is the rule Non-Harm, that in this article to review this rule and its applications in medicine. In addition to discussions of the documents, a better understanding of the words "Darar" and "Dirar" and deny or forbid the word "La" at the beginning of the base document, is one of the major issues and disputes. Organ transplants, family planning and birth control, responsibility to protect the health, need to see a doctor for treatment, civil responsibility for doctors in the treatment, responsibility for custodians of society for the control of AIDS, are the problems affecting today's health systems that the rule of No Harm is flowing in them.
Mohammad Hassani, Afsaneh Abbaskhani,
Volume 11, Issue 0 (3-2018)
Abstract
Today, the role of spiritual leaders is to stimulate employees by employing a spiritual perspective and creating cultural backgrounds based on human values to raise capable employees. On the other hand, professional ethics is one of the variables that has a significant impact on individual and group activities and outcomes of the organization. The purpose of this study was to investigate the relationship between spiritual leadership and professional ethics with organizational performance and quality of work life with the intermediate role of organizational learning among employees of Imam Reza Hospital in Urmia. The design of this research was a descriptive-correlational cross-sectional design model of structural equations. The statistical population of this research included 759 employees, 240 of them were selected by random sampling method. For data collection, standard questionnaires were used. Pearson Coefficient and Structural Equation Model Finding were used to analyze and examine the assumptions and the relation between the variants. The results show that there is a significant relationship between spiritual leadership variables and Professional Ethics with organizational performance and quality of life of employees (P<0.01, r=0.42, r=0.51), (P<0.01, r=0.36, r=0.75). Furthermore, the results showed that the intermediate role of organizational learning in the association between spiritual leadership and professional ethics with organizational performance and quality of work life (β = 0.17, β = 0.18, β = 0.16, β = 0.17) ) is confirmed. According to the findings, it can be concluded that paying attention to spiritual leadership and professional ethics can improve the organizational performance and quality of work life, as well as enhance organizational learning among the staff of Imam Reza Hospital.
Hassanali Moazenzadegan, Hamed Rahdarpour,
Volume 11, Issue 0 (3-2018)
Abstract
Since 1984, criminal law more than any other period has been specified under the framework of human rights and consequently limited based on its principal. It was followed by the emergence of a new approach called “quality of law principle”. In criminal law, which was presented by European Court of Human Rights for the first time then in the content of verdicts issued by this international judicial institute and reconsideration of criminal law legality principle, it has developed and become more consistent with social justice and manners. According to this principle, the qualitative law is a law which is consistent with quality elements of law based on human rights and moral principles. It is interesting to note that lack of each requirement voids the related law and according to Court’s case law, the existence of such law would not be different from lack of law. In present paper, through the investigation of physician liability and focus on article 495 of Islamic Penal Code as the key to legislation in this regard, and given the requirements of quality of law principle, it has been concluded that the above mentioned provision and all other articles related to this context are not consistent with elements of “the Quality of Law”, thus with failure to meet the minimum criteria of justice, social morality and human rights, the law fails to have the required quality and consequently, it is recommended to legislate based on the criteria of Quality of Law.
Mohammad Taqi Eslami, Hassan Boosaliki,
Volume 12, Issue 0 (3-2019)
Abstract
The concept of Islamic medicine, which differs from traditional medicine and even Muslims’ medicine, has become more and more popular in recent years in Iran, especially in religious cities. In the present article, we have addressed the extremist approach of the claimants of Islamic medicine (which considers itself a competitor of modern medicine and traditional medicine).Our theoretical basis for the ethical criticism of this approach has been the principlism of "Beauchamp and Childers". Thereby, we have attempted to challenge the clinical position and medical performances of extremists in the Islamic medicine on the basis of four principles of "justice, autonomy, beneficence, and non-maleficence". Then, we have concluded that the claim of the Islamic medicine cannot, in the present circumstances, satisfy the principle of distributive justice. It also violates patients' autonomy by making unfair judgments and fears about modern medicine. It is very prone to harm clients by refusing scientific evaluation of medicines and therapies and lacking a valid certification system. Accordingly, we particularly challenged the attribution of this process to Islam. This attribution may cause serious damage to the religious beliefs of the clients.
Ali Hassan Rahmani, Mina Ranjgaran Alanagh, Farkhondeh Jamshidi,
Volume 13, Issue 0 (3-2020)
Abstract
Increased patient satisfaction can promote patient’s compliance with prescribed treatments and improve patients’ health. The aim of this study was to determine the patients’ satisfaction with nurses in surgical departments of Imam, Razi, and Golestan hospitals of Ahvaz city in 2018. In this descriptive-analytic study, patients over 18 years of age with at least 3 days of hospitalization were studied. Data including age, sex, marriage status, level of education, type of illness, hospitalization time, number of hospital admissions, and health status were collected through a demographic form. Patients’ satisfaction with nurses was obtained by the satisfaction questionnaire of nursing services. Chi-square, one-way analysis of variance, Kruskal-Wallis analysis, Mann-Whitney test, and Spearman correlation coefficient were used to analyze by SPSS software. Patients’ satisfaction in Imam, Razi and Golestan hospitals were 78.25±12.09, 68.30±11.24, and 58.09±17.42, respectively. Highest level of patients’ satisfaction was with Razi hospital nurses (P-value<0.05).There were no significant difference between patients of different hospitals regarding age, marriage status, place of residence, hospitalization history, and education level (P-value>0.05).With increasing age, having a history of admission, an increase in the duration of hospitalization, the patients’ satisfaction score decreased significantly (P-value<0.05), but there was no significant difference between the patients’ satisfaction by marriage status, place of residence and level of education (P-value>0.05). It is suggested that effective strategies for increasing patients’ satisfaction be applied through more care and attention of more sensitive people. Also, increasing awareness of the community about the duties of patients, nurses, and medical staff is recommended.
Kamran Shirbache, Saeed Pourhassan, Ali Shirbacheh,
Volume 14, Issue 0 (3-2021)
Abstract
With the onset of the COVID-19 pandemics, a huge flood of people rushed to medical centers, which severely affected working conditions of the medical staff. In this article, we are going to evaluate the reaction of health care workers to the rise of traffic, social gatherings, non-observance of mask use protocols and physical distance which lead to an increasing number of infected persons and death rate. Here, we address the impact of community’s indifference on medical staff which seems to decrease the quality of medical staff practice gradually
Hadi Jalilvand, Mojtaba Abdi, Matineh Pourrahimi, Alireza Jalilvand , Dorsa Tanharo, Negin Vali, Hamed Abbasi Joshaty , Yaghoob Hassan , Somaye Norouzi , Mohaddeseh Alizadeh, Sahar Aghaee,
Volume 14, Issue 0 (3-2021)
Abstract
Human is spiritual dimensions that has legal status in health and disease. The purpose of this study was to evaluate the knowledge of nursing and midwifery students about patient rights in Iran Universities of Medical Sciences teaching hospitals’ in 2017. This study was a descriptive cross-sectional study in 2017 with convenience sampling method. Data was collected by a three-part questionnaire including demographic information, Knowledge about the Patient Rights Charter, and strategies for student information to deal with patient rights. Mann-Whitney and Spearman tests were used for data analysis. A total of 1219 undergraduate students participated in this study. The mean score of students' awareness of the Patient Rights Charter was 13.54±4.45 out of 29 points. 1007 students (82.61%) reported that education about patient right was sufficient. Direct correlation was between patient knowledge awareness score with pre-internship training (r = 0.461) and learning from instructor information (r = 0.512) and there was a negative correlation between self-education (r = -0.151) and other methods of information acquisition (r = -0.067). Given that most students did not consider the educational content taught in the field of patient rights to be effective, it can be concluded that these methods were ineffective and failed to convey the correct information. Therefore, revising of the Patient Rights Curriculum for Nursing and Midwifery students is recommended
Alireza Monajemi , Amir Hassan Mousavi,
Volume 15, Issue 1 (3-2022)
Abstract
Medicalization, in the sense of expansion of medicine in different aspects of human life and ultimately the transformation of medicine into a tool of social control and domination, is a common interpenetration in the literature. This concept, since its inception in the mid-twentieth century, has been an exclusive critique of modern medicine, meaning that branch of medicine based on biomedical paradigm. In this article, we argue that the conceptual shortcoming of this view and the reduction of medicalization to only one medical paradigm, lead to appear medicalization in the new outfit in the name of demedicalization and with more harmful aspects. By focusing on biomedical paradigm or biomedicalization, we neglected other types of medicalization like paramedicalization or CAMization, meaning expansion of Complementary and Alternative Medicine in different aspects of human life. This negligence makes the space to misuse of medicalization for more medicalizing issues. In the following, Iranian Traditional Medicine has been examined as one of the examples of CAM. By presenting historical examples, in the contrast of common understanding of many medical sociologists, we showed that medicalization is not an exclusive concept around modern medicine and its root go back hundreds of year, not just the last hundred year and not only in the western world.
Abdolhassan Kazemi,
Volume 17, Issue 0 (Supplement of 11th Annual Iranian Congress of Medical Ethics 2024)
Abstract
Journals have begun publishing articles in which chatbots, such as Bard, Bing, and ChatGPT, have been utilized, with some even listing chatbots as co-authors. The legal status of authorship varies by country, but under most jurisdictions, an author must be a legal person. Chatbots do not meet the International Committee of Medical Journal Editors (ICMJE) authorship criteria, particularly requirements such as giving “final approval of the version to be published” and being “accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.” No AI tool can “understand” a conflict-of-interest statement or sign it, nor do chatbots have independent affiliations apart from their developers. Since authors submitting a manuscript must ensure that all listed authors meet the required criteria, chatbots cannot be considered authors. Authors should disclose the use of chatbots and provide detailed information about how they were employed. The extent and type of chatbot usage in journal publications should be clearly indicated, in line with the ICMJE recommendation to acknowledge writing assistance and detail the study's methods and results. When chatbots or AI tools are used to draft new text, authors must note such use in the acknowledgments. All prompts employed to generate text, convert text into tables or illustrations, or draft figures should be specified. If an AI tool was used for analytical work, reporting results (e.g., generating tables or figures), or writing computer codes, this should be explicitly stated in the paper’s Abstract and Methods sections. For transparency and reproducibility, authors should include the complete prompt used to generate results, the query’s time and date, and details of the AI tool, including its version. Authors remain fully responsible for material generated by a chatbot, including its accuracy and the absence of plagiarism. They must also ensure appropriate attribution of all sources, including original sources for content produced by the chatbot. Authors must confirm that the work reflects their data and ideas and is free from plagiarism, fabrication, or falsification. Otherwise, submitting such material for publication constitutes scientific misconduct. Proper attribution of quoted material, with full citations, is essential, and cited sources must align with the chatbot’s claims. Since chatbots may omit sources opposing the viewpoints in their output, it is the author’s responsibility to identify, review, and include such counterviews in their articles. (It is worth noting that biases are not exclusive to AI; human authors are also subject to them.) Editors and peer reviewers should disclose any use of chatbots in manuscript evaluation or correspondence. If they employ chatbots in communications with authors or colleagues, they must clarify how the chatbot was used. Editors and reviewers are responsible for any content and citations generated by chatbots. They should also be mindful that chatbots may retain the prompts and manuscript content provided to them, which could breach the confidentiality of submitted manuscripts. Authors must specify the chatbot used and the exact prompts (query statements) employed. They should detail steps taken to mitigate the risks of plagiarism, provide balanced perspectives, and ensure the accuracy of all references. Editors require effective tools to detect content generated or modified by AI. These tools should be universally accessible, regardless of financial constraints, to uphold scientific integrity and minimize the risk of misinformation that could adversely affect public health. Many medical journal editors currently rely on manuscript evaluation approaches that are not designed to address AI-related challenges, such as manipulated or plagiarized text, fabricated images, and papermill-generated documents. This puts them at a disadvantage when distinguishing legitimate from fabricated content, and the emergence of chatbots exacerbates these challenges. Access to advanced tools that enable efficient and accurate content evaluation is particularly vital for editors of medical journals, where misinformation can have severe consequences, including harm to patients.
Leila Masoudiyekta, Ehsan Hassanpour Pazevar , Alireza Parsapour, Ehsan Shamsi Gooshki, Mohammd Jalili, Amirahmad Shojaei,
Volume 18, Issue 1 (3-2025)
Abstract
Moral distress constitutes a significant challenge for healthcare professionals, arising when individuals find themselves unable to act in accordance with their personal and professional values due to both internal and external pressures. Healthcare professionals may face scenarios that prompt them to question the ethical acceptability of their decisions and treatment practices, often feeling powerless in the face of perceived unethical changes. This study sought to explore the experiences of moral distress encountered by emergency medicine physicians and nurses in the emergency department. This study was conducted using qualitative content analysis. Data were collected through semi-structured interviews with 25 healthcare providers selected via purposive sampling. Data analysis was conducted using MAXQDA 2018 software. The results indicated that the experiences of moral distress among emergency medicine physicians and nurses in the emergency department can be classified into four primary categories including those related to: 1. patient rights, 2. medical staff and colleagues, 3. management, and 4. professionals. Notably, factors such as overcrowding, inadequate staffing, discrepancies between salaries and workloads, and poor management of human and physical resources emerge as significant contributors to moral distress in the emergency department of Imam Khomeini Hospital. To improve patient care quality, it is essential to implement strategies that enhance triage processes, prioritize human resources, align resources with patient needs, monitor patient attendance, and develop a comprehensive protocol for staff.
Hossein Motaarefi, Shahriar Sakhaei, Amin Soheili, Hassan Ebrahimpour Sadagheyani,
Volume 18, Issue 1 (3-2025)
Abstract
Patients’ perceptions of healthcare service quality and satisfaction with their legal rights constitute the primary objective of the care team and should be considered a criterion for accreditation evaluation. In this regard, a thorough examination of healthcare providers’ and patients’ perceptions, emotions, and experiences regarding the reasons for ‘Discharge Against Medical Advice’—as a patient’s legal right—can help identify hidden factors influenced by temporal and spatial conditions. This qualitative study employed a conventional content analysis approach, involving semi-structured interviews with 24 healthcare providers and patients selected purposively. Researchers repeatedly reviewed recorded content and notes to code the data. Subsequently, key codes and themes were clustered, categorized into specific topics, and labeled. Finally, an interpretation of the obtained data reflecting the study’s approach was presented. Through conventional content analysis, 203 codes were extracted. After categorization, four subthemes, including human factors, processes, facilities, and environment, were identified under the core theme of “uncertainty and distrust” as reasons for discharge against medical advice. Discharge against medical advice is recognized as both a challenge for hospital accreditation and an adverse outcome for patients. Addressing uncertainty-related issues and fostering public trust through team collaboration and implementing novel policies can mitigate discharge against medical advice.
