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INTRODUCTION: The quality of care and patient satisfaction is closely linked with dignity, which is a crucial component of therapy and care. However, there is very little study on dignity in the context of mental health care. Planning for ongoing patient care might benefit from an understanding of the notion of dignity by exploring the experiences of patients, caregivers and companions of patients who have a history of hospitalization in mental health institutions. To retain patients' dignity while they were being treated in mental wards, this study sought to understand the experiences of patients, caregivers and companions of patients. MATERIALS AND METHODS: This investigation was qualitative. Semistructured interviews and focus groups were utilized to collect the data. The purposeful sampling method was employed for participant recruitment, which continued until data saturation. Two focus group discussions and 27 interviews were conducted. Participants included 8 patients, 2 patients' family members (companions), 3 psychologists, 4 nurses and 11 psychiatrists. Two focus group discussions were held with seven family members or companions of patients. Thematic analysis was used for data analysis. RESULTS: The primary theme that emerged was the infringement of patients' dignity, through negative guardianship, dehumanization and violations of their rights. Subthemes included dehumanization, worthlessness and namelessness, patient rights violations and stripping patients of authority. CONCLUSION: Our results suggest that, regardless of the severity of the illness, the nature of psychiatric illness significantly compromises patients' dignity. Mental health practitioners, due to their sense of guardianship, may unintentionally treat patients with mental health disorders, thus compromising the patient's dignity. PATIENT OR PUBLIC CONTRIBUTION: The research team's experiences as a psychiatrist, doctor and nurse informed the study's objectives. Nurses and psychiatrists who work in the healthcare industry designed and conducted the study. The primary authors, who are healthcare providers, collected and analysed the required data. Furthermore, the entire study team contributed to the writing of the manuscript. Study participants were involved in the data collection and analysis.
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Caregivers , Respect , Humans , Friends , Qualitative Research , HospitalizationABSTRACT
To deliver effective medical services and establish trust and psychological security in patients, care providers must prioritize ethical principles. Developing a comprehensive clinical education program for learners, along with specific ethical guidelines, and implementing managerial and executive interventions necessitates a thorough understanding of the ethical challenges within this field. This qualitative study aimed to elucidate the ethical issues faced by otolaryngologists. Sixteen otolaryngologists participated in the study, selected through purposive sampling. Data were gathered through semi-structured interviews, and the analysis, conducted through conventional content analysis, revealed eight main categories and 38 subcategories encapsulating the identified ethical issues. The primary categories encompassed ethical issues faced by otolaryngologists concerning patients and companions, education, communication with the treatment team, physicians' rights, medical tourism, medical advertising, cultural considerations, and managerial challenges. resources and treatment approaches in alignment with Iranian cultural norms, address conflicts between treatment and education, and implement sound management plans to uphold rights of the treatment team. Additionally, the study suggests the necessity of ethical advertising programs and the strategic promotion of therapeutic tourism.
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One critical tactic that leads to a better understanding of the ethical status of dentists is to assess their ethical attitude by using an appropriate scale. This study aimed to design and evaluate the validity and reliability of the ethical attitude of dentists scale (EADS). This study was conducted based on a mixed-method design. The first qualitative part of the study was conducted in 2019 and the items of the scale were produced from the ethical codes compiled in a previous study. In this part, the psychometric analysis was conducted. The reliability was evaluated by Cronbach's alpha coefficient and intraclass correlation coefficient. Factor analysis was used to assess the construct validity (n = 511), and the following three factors were extracted with a total variance of 48.03. 1) Maintaining the standing of the profession in relationships. 2) Providing dental services while maintaining trust in the profession, and 3) Providing information for the benefit of the patient. In confirmatory factor analysis, appropriate values were obtained for the goodness of fit indices, and Cronbach's alpha was 0.68 - 0.84 for the various factors. Based on the results mentioned above, this scale showed an appropriate validity and reliability for measuring the ethical attitude of dentists.
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A key element in therapeutic communication is trust and it needs to be created and maintained between health care providers and recipients reciprocally. This study aimed to identify the factors that can enhance and improve trust between pharmacists and patients. This study was a qualitative study consisting of an in-depth semi-structured interview followed by a focus group discussion. In the first phase of the study, a semi-structured open-ended interview was conducted with patients, pharmacists, and pharmacy technicians. The interview phase was followed by transcribing verbatim and content analysis and a focus group discussion. Finally, 49 items of trust-building factors between the patient and the pharmacists were obtained. A questionnaire was designed and distributed among 80 people for transparency and relevance, similar to the participants. The necessary corrections and changes were made in the items after collecting the answers. The study achieved two main themes; external and internal trust-building factors. Internal factors include the category of the factors related to human resources and managerial factors. Finally, 49 trust-building factors were developed. Internal factors are those factors in which the pharmacist, the pharmacy technician, and the pharmacy's management system play a key role in building trust between pharmacists and patients.
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BACKGROUND: Facing a devastating infectious outbreak like COVID-19, the command of "stay at home" was recommended by some officials as a self-voluntary quarantine strategy for controlling the outbreak, but the people perceived and act differently. In this study, we aimed at ethnographic evaluation of public response to this command. MATERIALS AND METHODS: This research used ethnography for observing the public response to the recommendation of "stay at home" in the COVID-19 outbreak. Data were collected via observing public behavior and documentation; then, the data were qualitatively analyzed. RESULTS: Our findings showed 10 different ignored dimensions in this moral statement including lack of legal and administrative support, diverse perception and contradictory reactions of the people to the epidemiological forecasting and recommendations, different response to moral statements, various perceptions of the people about health and wellbeing, feeling exhausted of staying at home, not including justice and fairness in the moral statement, not clarifying the meaning of necessary matters, not considering the COVID-19 infected patients and their requirements, assigning the responsibility of government to the public, and halting other scientific activities and investigations in charge of COVID-19. CONCLUSIONS: Taken together, the officials should take an active role in implementing this moral statement by strict regulations, public education about the disease, its control, and the importance of quarantine, considering justice and fairness in implementation.
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BACKGROUND: The COVID-19 outbreak is rapidly spread over the world and kills infected patients. There is no proven medication for its treatment, so, all of the medications used for treatment are considered to be off-label. Off-label uses are not under regulation in the outbreak because there is no specific regulation for this condition. OBJECTIVES: In this short communication we aim at describing two ways of off-label use as clinical practice or investigational use. Further, we will describe the third way of off-label use, we named it pseudo-research and then we will state the most possible ethical challenges of off-label use for better perceptions and responsibility. RESULTS: The WHO considers off-label uses as country-specific. All international regulatory bodies consider off-label prescription as the physician's responsibility and legal by necessitating some requirements. There is no international guideline for regulating investigational off-label uses as clinical practice. CONCLUSION: There are different types of approaches, none of them is comprehensive and conclusive. Furthermore, respecting the four ethical principles necessitates codification and strict regulation of off-label uses either as clinical practice or investigational. Besides, compilation of a special guideline based on ethical principles especially non-maleficence and autonomy for investigational off-label uses in disasters is highly recommended.
