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| کلمات کلیدی | A Survey on Nurses' Attitude and Practice in Respecting Clients' Rights in the Emam–Reza Hospital in Kermanshah (Iran) in 2008. Katayon Esmaeili, Sina Ganji-Morad (Kermanshah University of Medical Sciences. Kermanshah, Iran) Human rights are the most important ethical rights should be equally considered for every human being. Managers of medical health centers are responsible for the patients’ and clients’ rights protection. Respecting the individual's rights is one of a nurse’s responsibilities in addition to the basic responsibility to provide the patients with health care. The purpose of this research was to determine the nurses' attitude and practice on respecting patients' rights in Emam-Reza hospital in Kermanshah (Iran). Material and Methods: It was a descriptive study. Random sampling was used and 92 nurses of Emam-Reza hospital were selected. Data was gathered with a questionnaire that was designed in three sections. The first part was about personal and demographic characteristics (age, sex, marital status, level of literacy, occupation). The second part included 28 question regarding attitude, and the third part consisted of 18 questions regarding the practice of staff dealing with respecting patients' rights. Reliability and validity of the questionnaire was also measured. The SPSS software was used for data collection and also descriptive statistics (chi-square test) for analyzing data. Results: Most of research units were clinical nurses, with the mean age as 33.3 (22-47 years old), and having between 1-26 years of work experiences. The nurses' attitude toward the patient in regards to respect was positive in 94.6% cases, 5.4% was weak, and there was no report of negative attitude. Over all, there was 96.7% with positive practice, 3.3% with weak practice, and there was no one with negative practice. The highest score was given to the nurses whose attitudes engaged the patients to the medical techniques and medication, and the lowest score was given to nurses who introduced their physicians to the patients. The best score for the practice of the nurses were to introduce themselves to the patients. The lowest score of the nurses was taken about to respect the territory and privacy of patients. Discussion: In recent years, Emam-Reza hospital was announced as the main center for training of medical students. Crowded of the students, visitors and patients cause the decrease of availability of patients' rights. Regarding the findings, increasing patients’ trust and satisfaction can come true through promotion of nursing care quality and nurses' better function regarding clients' rights respect. Key word: Nurse, attitude, practice, patient and client rights. Introduction: Human rights are the most important ethical rights should be equally considered for every human being. Today, ethic is defined as principles and standards that govern “right” from “wrong” behaviors (1). To discuss ethics, it is helpful to establish a basic vocabulary. Although the term may have a certain meaning in a large context, it provides a specific meaning within the context of ethic that furthers the understanding and discussion about ethical matters. The basic terms include autonomy, beneficence, nonmaleficence, justice, and fidelity (2). Nurses’ professional values are acquired during socialization into nursing from codes of ethic, nursing experience, teachers and peers. The American Association of College of Nursing (1998) identified five values essential for the professional nurse: altruism, autonomy, human dignity, integrity, and social justice. Altruism is reflected by the nurse’s concern for the welfare of patients, other nurses, and other health care providers. Professional practice reflected autonomy when the nurse respects patients’ rights to make decision about their health care. Human dignity is reflected when the nurse values and respects all patients and colleagues. Integrity is reflected in professional practice when the nurse is honest and provides care based on ethical framework that is accepted within the profession social justice. This value is reflected in professional practice when the nurse works to ensure equal treatment under the law and equal access to quality health care (3). The purpose of standards of care is to protect the consumer. Standards of care are the skill and learning commonly processed by members of profession (4). Every patient expects something when they stay in hospital, as such as high quality hospital care, a clean and safe environment, involvement in their care, protection of their privacy, preparing them and their family for when they leave the hospital, and help with their bill and filing insurance claims (k). A patient’s bill of rights is the following items: 1- patients have the right to considerate and respectful care, 2- to obtain from his physician complete current information concerning his diagnosis treatment, and prognosis, 3- to receive from his physician information necessary to give informed consents prior to the start of procedure and for treatment, 4- to refuse treatment to the permitted by law and to be informed of the medical consequences of his action, 5- to every consideration of his privacy concerning his own medical care program, 6 – to expect that all communications and records pertaining to his care should be treated as confidential, 7- to expect that within its capacity a hospital must make reasonable response to the request of patients for services, 8 - to obtain information as to any relationship of his hospital to other health care and educational institutions insofar as his care is concerned, 9 – to be advised if the hospital proposes to engage in or perform human experimentation affecting his care or treatment; the patient has the right to refuse to participate in such research project, 10 – to expect reasonable continuity of care; the right to know in advance what appointment times and physician are available and where, 11 – to examine and receive an explanation of his bill regardless of source of payment, 12 – to know what hospital rules and regulations apply to his conduct as a patient (5 , 6). In Iran, some studies showed that high percentage of the patients=2 0were not satisfied from physicians and nurses about status of territory and patients rights (7, 8). Managers of medical health centers are responsible for patient and client rights protection. Respecting the individual's rights is another responsibility of a nurse in addition to their basic responsibility to providetheir patients with health care.The purpose of this research was to determine the nurses’ attitudes and practice on respecting patients' rights in Emam-Reza hospital in Kermanshah (Iran). Material and Methods: It was a descriptive study. Random sampling was used and 92 nurses of Emam-Reza hospital were selected. Data was gathered with a questionnaire that was designed in three sections. The first part was about personal and demographic characteristics (age, sex, marital status, level of literacy, occupation). The second part included 28 question regarding attitude, and the third part consisted of 18 questions regarding the practice of staff dealing with respecting patients' rights. For scoring the answers, grading was done in the following format: “always” 5 points, “often” 4 points, “sometimes” 3 points, “seldom” 2 points, “never”1 point. Finally, all of the scoring was added up and then analyzed. Reliability and validity of questionnaire was measured. This questionnaire was created according to the texts and studies on this field and member of faculty of Kermanshah’s school of nursing. To determine scientific validity, a pilot study was used. An Alph-coronbach test was used for data analysis. The SPSS software was used for data collection and also descriptive statistics (chi-square test) for analyzing data. Results: Most of research units were clinical nurses, with the mean age as 33.3 (22-47 years old), and having between 1-26 years of work experiences. The nurses' attitude toward the patient in regards to respect was positive in 94.6% cases, 5.4% was weak, and there was no report of negative attitude. Over all, there was 96.7% with positive practice, 3.3% with weak practice, and there was no one with negative practice. The highest score was given to the nurses whose attitudes engaged the patients to the medical techniques and medication, and the lowest score was given to nurses who introduced their physicians to the patients. The best score for the practice of the nurses were to introduce themselves to the patients. The lowest score of the nurses was taken about to respect the territory and privacy of patients. Hasanian found that nurses’ attitudes about patients’ rights were positive with respect (58 %), confidentiality (60.3 %), keeping secret of personal patient information in researches (60.7%). Yet the findings of Vashany indicate that 32.3% of patients said that their territory and privacy were not protected. Also 47.9% contended that nurses did not introduce themselves before care-giving as for the physical aspect of territory and rights, the findings revealed that a high percentage (42.2%) of patients insisted that clinical staff entered their rooms without their leave, and that 43.4% expressed that the clinical staff did not familiarize them with new environment, and 28% expressed the need to facilities for prayers. 31.3% said that clinical staff responded to their bell on time. However, 24.6% expressed the opposite. Discussion: In recent years, Emam-Reza hospital was announced as the main center for training of medical students. Crowded of the students, visitors and patients cause the decrease of availability of patients' rights. Regarding the findings, increasing patients’ trust and satisfaction can come true through promotion of nursing care quality and nurses' better function regarding clients' rights respect. References: 1- Cole,G . Fundamental of Nursing. Concepts and Skills. Second edition. 1996 . Mosby Company. Denison. Texas. 2- Potter, P.A. Perry, A.G. Fundamental of Nursing. 6th edition. 2005. Mosby Company. Missouri. 3- American Hospital Association: a patients’ bill of rights, Chicago. 1992. The association. 4- Guido, G.W. legal and Ethical Issues in Nursing. 4th edition. Upper saddle River, NJ. Prentice hall. 2006. 5- Berman, Synder, Kozier, Erb. Kozier and Erb Fundamental of Nursing. Vol: 1. 8th edition. Upper saddle River. New Jersey. 2008. 6- Esmaeili, k. Ghafary, p. Legal and Ethical Issues in Health care Management. Taghbostan Publish ar. Karmanshah. Iran. 2004. 7- Vashany , H.R. survey on rate of respect for patient’s territory and rights in Sabzevar Hospital. ASRAR. Journal of Sabzevar School of medical sciences. Vol: 10. No: 1. spring 2005. 8- Esmaeili, K. and et all. View point patients about situation of territory and personal space in hospital. Kermanshah university of medical sciences . Iran .2004. 9- Hasanian, M A survey on Nurses; attitude in respecting clients ’right in Hospital of Hamadan. Tehran . Iran . journal of nursing and midwifery research . No: 27 . Spring 2005. |
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