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探索医学伦理的实施挑战:一项定性研究。

Exploring medical ethics' implementation challenges: A qualitative study.

作者信息

Mashayekhi Jannat, Mafinejad Mahboobeh Khabaz, Changiz Tahereh, Moosapour Hamideh, Salari Pooneh, Nedjat Saharnaz, Larijani Bagher

机构信息

Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Medical Ethics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Educ Health Promot. 2021 Feb 27;10:66. doi: 10.4103/jehp.jehp_766_20. eCollection 2021.

Abstract

BACKGROUND

Adherence to medical ethics principles by medical professionals is required to improve health-care system's quality. Recognizing medical ethics' challenges and attempting to resolve them are important in the implementation of medical ethics in practice. This study aimed to explore such challenges at Iran's medical sciences universities in 2018.

MATERIALS AND METHODS

This descriptive, qualitative study utilized a conventional content analysis approach for data analysis. This study was conducted using purposeful sampling from participants with experience in teaching or practicing of medical ethics field, and by considering maximum variety of disciplines (e.g., gynecology, internal medicine, surgery, and medical ethics). The data were gathered using semi-structured interviews. The interview guide was designed based on previous research findings by two members of the research team and contained the main interview questions and participants had the opportunity to express their perspectives in detail. Participants were chosen from clinical and ethical faculty members as well as managers. The data collection process continued until the data saturation stage, beyond which no new information or concept achieved by continuing interviews.

RESULTS

After interviewing 14 faculty members and managers, findings were classified into 4 themes, 9 categories, and 42 sub-categories; four main categories of medical ethics challenges are affected by cognitive, educational, practical, and structural factors, respectively.

CONCLUSION

This study suggested that medical ethics' cognitive and educational challenges can alleviate using educational programs intended for improving qualitative and quantitative aspects of medical ethics teaching for medical professionals ranging from students to faculty members. Medical ethics' structural and practical challenges are within policymaking and scheduling activities dealt with through future researches by health-care system's managers and planners.

摘要

背景

医疗专业人员遵守医学伦理原则对于提高医疗保健系统质量至关重要。认识到医学伦理面临的挑战并努力解决这些挑战对于在实践中实施医学伦理至关重要。本研究旨在探讨2018年伊朗医学科学大学面临的此类挑战。

材料与方法

本描述性定性研究采用传统内容分析法进行数据分析。本研究通过有目的地从具有医学伦理领域教学或实践经验的参与者中抽样,并考虑最大程度的学科多样性(如妇科、内科、外科和医学伦理学)来开展。数据通过半结构化访谈收集。访谈指南基于研究团队两名成员先前的研究结果设计,包含主要访谈问题,参与者有机会详细表达他们的观点。参与者选自临床和伦理教员以及管理人员。数据收集过程持续到数据饱和阶段,超过该阶段后,继续访谈不会获得新的信息或概念。

结果

在采访了14名教员和管理人员后,研究结果被分为4个主题、9个类别和42个子类别;医学伦理挑战的四个主要类别分别受到认知、教育、实践和结构因素的影响。

结论

本研究表明,医学伦理的认知和教育挑战可以通过旨在从学生到教员等医疗专业人员改善医学伦理教学的质量和数量方面的教育计划来缓解。医学伦理的结构和实践挑战属于医疗保健系统管理人员和规划者未来研究应对的政策制定和规划活动范畴。

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