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临床环境中患者伦理治疗的障碍:系统叙述性综述。

Barriers to ethical treatment of patients in clinical environments: A systematic narrative review.

作者信息

Dehkordi Fatemeh Ghani, Torabizadeh Camellia, Rakhshan Mahnaz, Vizeshfar Fatemeh

机构信息

Student Research Committee of Nursing and Midwifery School Shiraz University of Medical Sciences Shiraz Iran.

School of Nursing and Midwifery Shiraz University of Medical Sciences Shiraz Iran.

出版信息

Health Sci Rep. 2024 May 1;7(5):e2008. doi: 10.1002/hsr2.2008. eCollection 2024 May.

Abstract

BACKGROUND AND AIM

It is essential that healthcare providers display ethical behavior toward their patients. Despite development of codes of ethics for clinical practice, the occurrence of unethical behaviors toward patients is alarmingly high. The present study was conducted to identify the barriers to ethical treatment of patients in clinical environments.

METHODS

Through systematic narrative review, the present study investigated the barriers to ethical treatment of patients. This study was carried out in line with Assessment of Multiple Systematic Reviews 2 and Preferred Reporting Items of Systematic reviews and Meta-Analyses guidelines.

RESULTS

Ethical challenges in clinical environments can be classified into two categories: "organizational factors" and "personal factors." Organizational factors consist of three domains: managers and regulations, organizational environment, and human resources. Personal factors consist of two domains: factors related to patients and their families and factors related to care providers.

CONCLUSION

Research shows that encouraging healthcare teams to adopt ethical behaviors through education and having them persistently observe ethics in their clinical practice will not completely bridge the gap between theory and practice: it seems that the clinical environment, the personal characteristics of healthcare team members and patients, and the organizational values of the healthcare system pose the greatest barrier to bridging this gap. Accordingly, in addition to raising healthcare providers' awareness of the existing issues in clinical ethics, measures should be taken to improve organizational culture and atmosphere.

摘要

背景与目的

医疗服务提供者对患者展现出符合道德规范的行为至关重要。尽管已经制定了临床实践伦理准则,但针对患者的不道德行为发生率却高得惊人。本研究旨在确定临床环境中患者接受符合伦理治疗的障碍。

方法

通过系统的叙述性综述,本研究调查了患者接受符合伦理治疗的障碍。本研究是按照《多重系统评价评估2》以及《系统评价与Meta分析的首选报告项目》指南进行的。

结果

临床环境中的伦理挑战可分为两类:“组织因素”和“个人因素”。组织因素包括三个领域:管理人员与规章制度、组织环境和人力资源。个人因素包括两个领域:与患者及其家属相关的因素以及与护理人员相关的因素。

结论

研究表明,通过教育鼓励医疗团队采取符合伦理的行为,并让他们在临床实践中始终遵守伦理规范,并不会完全弥合理论与实践之间的差距:似乎临床环境、医疗团队成员和患者的个人特征以及医疗系统的组织价值观是弥合这一差距的最大障碍。因此,除了提高医疗服务提供者对临床伦理中现有问题的认识外,还应采取措施改善组织文化和氛围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6268/11063269/ab3648cfd2cd/HSR2-7-e2008-g001.jpg

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