Tehran University of Medical Sciences, Iran.
Nurs Ethics. 2018 Aug;25(5):591-600. doi: 10.1177/0969733016664973. Epub 2016 Sep 21.
Rationing of various needed services, for example, nursing care, is inevitable due to unlimited needs and limited resources. Rationing of nursing care is considered an ethical issue since it requires judgment about potential conflicts between personal and professional values.
The present research sought to explore aspects of rationing nursing care in Iran.
This study applied qualitative content analysis, a method to explore people's perceptions of everyday life phenomena and interpret the subjective content of text data. Data collection was performed through in-depth, unstructured, face-to-face interviews with open-ended questions. Participants and research context: The study population included Iranian nurses of all nursing positions, from clinical nurses to nurse managers. Purposive sampling was employed to select 15 female and 3 male nurses (11 clinical nurses, 3 supervisors, 1 matron, 1 nurse, and 2 members of the Nursing Council) working in hospitals of three cities in Iran. Ethical considerations: The study protocol was approved by Tehran University of Medical Sciences (91D1302870). Written informed consent was also obtained from all participants.
According to the participants, rationing of nursing care consisted of two categories, that is, causes of rationing and consequences of rationing. The first category comprised three subcategories, namely, patient needs and demands, routinism, and VIP patients. The three subcategories forming the second category were missed nursing care, patient dissatisfaction, and nurses' feeling of guilt.
Levels at which healthcare practices are rationed and clarity of the rationing are important structural considerations in the development of an equal, appropriate, and ethical healthcare system. Moreover, the procedure of rationing is critical as it not only influences people's lives but also reflects the values that dominate in the society. Therefore, in order to minimize the negative consequences of rationing of nursing care, further studies on the ethical dimensions of this phenomenon are warranted.
由于无限的需求和有限的资源，各种必要服务（例如护理）的配给是不可避免的。护理配给被认为是一个伦理问题，因为它需要对个人和专业价值观之间潜在的冲突进行判断。
本研究旨在探讨伊朗护理配给的各个方面。
本研究采用定性内容分析法，这是一种探索人们对日常生活现象的看法并解释文本数据主观内容的方法。通过深入、非结构化、面对面的访谈，采用开放式问题收集数据。
研究人群包括所有护理岗位的伊朗护士，从临床护士到护士长。采用目的抽样法选择了 15 名女性和 3 名男性护士（11 名临床护士、3 名主管、1 名护士长、1 名护士和 2 名护理委员会成员），他们在伊朗三个城市的医院工作。
该研究方案得到了德黑兰医科大学（91D1302870）的批准。所有参与者均获得书面知情同意。
根据参与者的说法，护理配给包括两个类别，即配给的原因和配给的后果。第一类包括三个亚类，即患者需求和要求、例行公事和 VIP 患者。第二类包括三个亚类，即护理缺失、患者不满和护士的内疚感。
医疗实践配给的水平和配给的明确性是建立公平、适当和符合伦理的医疗保健系统的重要结构考虑因素。此外，配给程序至关重要，因为它不仅影响人们的生活，而且反映了主导社会的价值观。因此，为了最大限度地减少护理配给的负面影响，有必要进一步研究这一现象的伦理维度。
