fa چالش‌های حرفه‌ای مددکاری اجتماعی ‌پزشکی در ترخیص ایمن بیماران؛ یک مطالعه کیفی کیفیت خدمات و ایمنی بیمار در بیمارستان کیفیت خدمات و ایمنی بیمار در بیمارستان مقاله ی اصیل Original Article <span style="font-size:10pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Arial,sans-serif"><b><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">زمینه و هدف</span></span></span></span></b><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">:</span></span></span></span></b><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt"> برنامه‌ریزی‌ ترخیص به عنوان فرایندی جهت انتقال امن بیمار، با مداخلات مددکاران اجتماعی ‌پزشکی همواره‌ با چالش مواجه بوده است</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">. </span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">‌شناسایی ‌این چالش‌ها از اختلال در برنامه‌ریزی مؤثر جلوگیری می</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">‌</span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">کند</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">. </span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">‌هدف ‌این پژوهش بررسی چالش‌‌های مددکاران اجتماعی</span></span></span></span> <span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">‌پزشکی در برنامه‌ریزی‌</span></span></span></span> <span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">ترخیص است</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">. ‌</span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt"></span></span></span></span></span></span></span></span></span><br> <span style="font-size:10pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Arial,sans-serif"><b><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">مواد و روش‌ها</span></span></span></span></b><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">:</span></span></span></span></b> <span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">این مقاله یک مطالعه کیفی است که در سال </span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">1402 </span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">در سطح کشور</span></span></span></span> <span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">‌ایران انجام گرفت</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">. </span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">‌داده‌ها از طریق مصاحبه‌ی نیمه ساختاریافته به صورت حضوری و تلفنی، با ۱</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">6 </span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">نفر از مددکاران اجتماعی شاغل در بیمارستان، جمع‌آوری و با روش تحلیل مضمون، به صورت دستی تحلیل گردید</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">. </span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt">‌</span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.3pt"></span></span></span></span></span></span></span></span></span><br> <span style="font-size:10pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Arial,sans-serif"><b><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">نتایج</span></span></span></b><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">:</span></span></span></b><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> یافته‌‌های</span></span></span> <span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">‌این پژوهش نشان داد که مددکاران اجتماعی</span></span></span> <span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">‌بیمارستان در طی برنامه‌ریزی‌</span></span></span> <span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">ترخیص با چالش‌های ساختاری و حرفه‌ای مواجه هستند</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">.</span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"> در نتیجه انجام این پژوهش، مضامینی با عناوین انزوای حرفه‌ای، محیط فرساینده، هزینه‌های کمرشکن، ساختار‌‌های ناکارآمد و فشار‌های حرفه‌ای و مضمون اصلی ترخیص مراقبت نشده، استخراج گردید</span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:">. ‌</span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br> <span style="font-size:10pt"><span style="line-height:150%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:Arial,sans-serif"><b><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">نتیجه‌گیری</span></span></span></span></b><b><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">:</span></span></span></span></b><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt"> نتایج حاصل از</span></span></span></span> <span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">‌این پژوهش حاکی از آن است که مددکاران اجتماعی در بیمارستان با همکاری و مشارکت ضعیف، کمبود امکانات و تجهیزات و در سطح جامعه با موانع اقتصادی</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">-</span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">اجتماعی روبه‌رو می‌باشند. </span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">آنان با چالش‌‌های حرفه‌ای در جهت رعایت اصول و ارزش‌‌های حرفه‌ای و حفظ کیفیت خدمات مددکاری اجتماعی در برنامه‌ریزی‌</span></span></span></span> <span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">ترخیص مواجه هستند</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">. </span></span></span></span><span lang="fa" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">با توجه به اهمیت مداخلات پس از ترخیص انجام اصلاحات سازمانی، ساختاری جامعه و اصلاحات حرفه‌ای در سطح خرد و کلان توصیه ‌می‌گردد</span></span></span></span><span lang="FA" style="font-size:14.0pt"><span style="line-height:150%"><span b="" nazanin="" style="font-family:"><span style="letter-spacing:-.2pt">.</span></span></span></span></span></span></span></span></span> <span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt"><span arial="" style="font-family:"><span style="letter-spacing:-.3pt">Background and Purpose</span></span></span></b><span style="font-size:11.0pt"><span arial="" style="font-family:"><span style="letter-spacing:-.3pt">: Discharge planning, as a process for the safe transfer of patients, has always been challenged by the interventions of medical social workers. Identifying these challenges prevents disruptions in effective planning. This research aims to explore the challenges faced by medical social workers in discharge planning.</span></span></span></span></span></span></span></span></span><br> <span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt"><span arial="" style="font-family:">Materials and Methods</span></span></b><span style="font-size:11.0pt"><span arial="" style="font-family:">: This is a qualitative study conducted in Iran in 2023. Data were collected through semi-structured face-to-face and telephone interviews with 16 social workers working in hospitals and were manually analyzed using thematic analysis.</span></span></span></span></span></span></span></span><br> <span style="font-size:10pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="line-height:normal"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:11.0pt"><span arial="" style="font-family:">Results</span></span></b><span style="font-size:11.0pt"><span arial="" style="font-family:">: The findings of this study revealed that hospital social workers encounter structural and professional challenges during discharge planning. As a result, themes such as professional isolation, erosive environment, back-breaking costs, inefficient structures, and professional pressures were identified, with the main theme being unattended discharge.</span></span></span></span></span></span></span></span><br> <b><span style="font-size:11.0pt"><span arial="" style="font-family:">Conclusion</span></span></b><span style="font-size:11.0pt"><span arial="" style="font-family:">: The results indicate that social workers in hospitals are faced with poor cooperation and participation, a lack of facilities and equipment, and socio-economic barriers at the community level. They encounter professional challenges in adhering to professional principles and values and in maintaining the quality of social work services in discharge planning. Given the importance of post-discharge interventions, organizational, structural, and professional reforms at both the micro and macro levels are recommended.</span></span> برنامه‌ریزی ‌ترخیص, مداخلات مددکاری اجتماعی, چالش‌های ترخیص ایمن, ترخیص مراقبت نشده. Discharge Planning, Social Work Interventions, Safe Discharge Challenges, Unattended Discharge. 219 232 http://jhosp.tums.ac.ir/browse.php?a_code=A-10-1852-1&slc_lang=fa&sid=1 Ahmad Kalateh Sadati احمد کلاته ساداتی Yes Associate Professor, Department of Sociology, Faculty of Social Sciences, Yazd University Yazd, Iran. Corresponding Author Email: asadati@yazd.ac.ir دانشیار،گروه جامعه شناسی، دانشکده علوم اجتماعی، دانشگاه یزد، یزد، ‌ایران. * نویسنده مسئول مقاله: asadati@yazd.ac.ir Seyed Reza Javadian سید رضا جوادیان srj699@gmail.com No Associate Professor, Department of Social work and social policy, Faculty of Social Sciences, Yazd University, Yazd Iran. دانشیار،گروه جامعه شناسی، دانشکده علوم اجتماعی، دانشگاه یزد، یزد، ‌ایران. Marzieh Sadeghi Hardangi مرضیه صادقی هاردنگی marziyehsadeghi5@gmail.com No Master of Social Work, Department of Social work and social policy, Faculty of Social Sciences, Yazd University Yazd Iran. کارشناس ارشد مددکاری‌اجتماعی، گروه جامعه شناسی، دانشکده علوم اجتماعی، دانشگاه یزد، یزد،‌ ایران.