Fayez R, Nawwab A, Al-Jahdali H, Baharoon S, Binsalih S, Al Sayyari A
Department of Psychiatry, Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia.
Avicenna J Med. 2013 Jul;3(3):57-62. doi: 10.4103/2231-0770.118458.
There is limited information about the prevalence of unethical behavior and how is perceived among health care providers. The aim of this study is to assess such behavior and how is perceived.
This is a cross-sectional study among three groups of professionals. Total participants were 370 and included medical staff, medical residents, and nurses in five medical specialties in four tertiary hospitals in Saudi Arabia (two Ministry of Health Hospitals and two military Hospitals). Participants were asked to rate their agreement with occurrence of 15 "negative" unethical behavior scenarios in their workplace. The scenarios covered areas of "respect for persons", "interprofessional relationships", and "empathy with patients".
Majority of respondents agreed that "unethical" behavior occurred in their workplace, including confidentiality being compromised (36.3%), informed consent not taken properly (60.2%), and bad news not well-delivered (62.2%). Other significant area agreement included doctors lacking empathy (47.8%), patient autonomy not fully respected (42.5%), discrimination (41.2%), and being pressurized to write inaccurate reports (31.2%). Respondents in medicine had the lowest rate of agreement and those in psychiatry had the highest (mean of 49.8% and 82.3%, respectively). Respondents with length of employment of less than 6 years had significantly higher agreement that unethical behavior occurs compared to those with length of employment of more than 6 years. Males were more likely than females to agree that unethical behavior occurs. The biggest difference was seen in the behavior of "informed consent not properly taken" with a gender margin of 18.7% (P = 0.001).
There is high prevalence of behavior that is considered unethical as perceived by various health care workers at Saudi hospitals.
关于不道德行为的发生率以及医护人员如何看待这些行为的信息有限。本研究的目的是评估此类行为及其认知情况。
这是一项针对三组专业人员的横断面研究。总共有370名参与者,包括沙特阿拉伯四家三级医院(两家卫生部医院和两家军事医院)五个医学专科的医务人员、实习医生和护士。参与者被要求对其工作场所中15种“负面”不道德行为场景的发生情况表示同意程度。这些场景涵盖了“尊重他人”“跨专业关系”和“对患者的同理心”等领域。
大多数受访者同意其工作场所存在“不道德”行为,包括保密性受到损害(36.3%)、未妥善获得知情同意(60.2%)以及坏消息传达不佳(62.2%)。其他达成显著共识的领域包括医生缺乏同理心(47.8%)、患者自主权未得到充分尊重(42.5%)、歧视(41.2%)以及被迫撰写不准确报告(31.2%)。医学专业的受访者同意率最低,而精神科的受访者同意率最高(分别为49.8%和82.3%)。工作年限少于6年的受访者比工作年限超过6年的受访者更认同不道德行为的发生。男性比女性更倾向于认同存在不道德行为。在“未妥善获得知情同意”行为方面差异最大,性别差异幅度为18.7%(P = 0.001)。
沙特医院的各类医护人员认为,被视为不道德的行为普遍存在。