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影响伊朗家长式临床环境的因素:一项探索性研究简报。

Factors Influencing Paternalistic Clinical Environment in Iran: An Exploratory Research Brief.

作者信息

Khosravi Mohsen, Shamsi Gooshki Ehsan, Ravangard Ramin, Kavosi Zahra, Shojaei Payam, Ahmadi Marzaleh Milad, Delavari Sajad

机构信息

Student Research Committee, Department of Health Services Management, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.

出版信息

J Patient Exp. 2025 May 30;12:23743735251346665. doi: 10.1177/23743735251346665. eCollection 2025.

Abstract

This study aimed to explore the factors that contribute to the presence of paternalism within the Iranian healthcare system. The study was conducted in 2024, conducting 15 semi-structured interviews. The study sample comprised chronic disease patients discharged from a major public hospital in southwestern region of Iran. The interview sample consisted of approximately 54% males with a mean age of 46 years. About 46% of the participants had diabetes, while the remainder had cardiovascular disorders. After completion of the interviews and the subsequent data gathering, Braun and Clarke's method was utilized in order to conduct a thematic analysis on the acquired data. The thematic analysis presented several themes including 'patient trust in physicians', 'lack of patient empowerment', 'patient psychological and communication barriers', and 'healthcare system and infrastructure limitations'. While, the latter theme was the most frequently addressed theme of factors by the study participants, 'limitations in governmental hospitals' was the most frequently addressed item among the sub-themes of the study findings. The presence of paternalism in Iran's healthcare system was delineated to be primarily influenced by the existing limitations in the Iranian healthcare system and its infrastructure. Further research is necessary to investigate and elaborate on this phenomenon in greater detail.

摘要

本研究旨在探讨伊朗医疗体系中家长式作风存在的影响因素。该研究于2024年开展,进行了15次半结构化访谈。研究样本包括从伊朗西南部一家大型公立医院出院的慢性病患者。访谈样本中约54%为男性,平均年龄46岁。约46%的参与者患有糖尿病,其余患有心血管疾病。在完成访谈及后续数据收集后,采用了布劳恩和克拉克的方法对所获数据进行主题分析。主题分析呈现了几个主题,包括“患者对医生的信任”“患者缺乏自主权”“患者心理和沟通障碍”以及“医疗体系和基础设施限制”。虽然,后一个主题是研究参与者提及最多的影响因素主题,但“政府医院的限制”是研究结果子主题中提及最多的项目。伊朗医疗体系中家长式作风的存在被认为主要受伊朗医疗体系及其基础设施现有限制的影响。有必要开展进一步研究以更详细地调查和阐述这一现象。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b8b/12125512/bbff942e1782/10.1177_23743735251346665-fig1.jpg

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