Iranian Journal of Medical Ethics and History of Medicine

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Breaking bad news is one of the most difficult tasks an emergency physician has to perform and unfortunately it is not well studied. Almost all of the original studies for compilation of the guidelines of breaking bad news have been conducted in a non-emergent situation and were physician-oriented. In this study and by reviewing related articles in medical databases, the authors try to show the necessity of adapting these guidelines into the situation of the emergency departments and indigenizing them for non-Western countries. This can be the first step to design a guideline for the emergency department.The different nature of bad news and the chaotic situation in the emergency departments are the two most important points that may prevent using these guidelines in the emergency departments. On the other hand, breaking bad news guidelines are designed based on Western cultures and their application in a non-Western country may decrease their effectiveness.To the best of our knowledge, there is no national guideline for breaking bad news in Iran. There is a long way to go before we can suggest a national guideline for emergency departments, so we recommend using one of the Western guidelines and indigenizing it according to the Iranian culture and emergency situations.

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Observation of patients’ rights as a major component in defining the standards of clinical services can increase patient satisfaction and is an important indicator of health care quality. Since most hospital patients are admitted through the emergency department, this study was conducted to investigate the observance of patients’ rights in the emergency department of Nemazee Hospital during 2015.

This cross-sectional study was performed on 100 patients over a period of one month. Data were collected by a questionnaire and analyzed using SPSS version 21 and statistical tests including descriptive statistics and inferential analysis.

The mean of the patients’ age in this study was 54.4 ± 19.35. Based on our findings, the overall level of observing patients’ rights was 51%, while patients’ expectations were 93%. Moreover, there was a meaningful difference between observance of the patients’ rights and their expectations in all aspects based on the paired sample t-test (P<0.05). It was also established that age was one of the factors affecting observance of patients’rights (P<0.05).

In this study, observation of patients’ rights in the emergency department was at the intermediate level, while patients’ expectations were higher in comparison.

In order to promote patient satisfaction, it seems necessary to educate the personnel and medical students on patients’ rights by holding workshops, reducing the waiting time for receiving services, and establishing an order in the system based on the patient’s condition.