Dr Aram Karimian1, Dr afsaneh SadooghiasL2, Dr mitra khoobi3, Dr Easa Mohammadi4, Dr Anoshirvan Kazemnejad5
1Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. https://orcid.org/0000-0001-8705-325X, tehran, Iran, 2PhD, Assistant Professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. , tehran, iran, 3PhD, Assistant Professor, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. , tehran, iran, 4PhD, Professor of Nursing, Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. , tehran, iran, 5PhD, Professor of Biostatistics, Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. , tehran, iran
Biography:
I am a doctoral student in nursing. I have experience of 13 years of clinical work in emergency and special departments as a clinical nurse in Iranian hospitals. I have been a member of the faculty of nursing for 5 years. One of my interests is research in the field of medical ethics and I have several articles in this field. One of the important issues in the field of nursing is the ethical issues related to patients in the last stages of life. In this research work, we tried to examine the discrimination against these patients as a moral challenge.
Abstract:
Introduction:
End-of-life patients may experience the negative impact of discrimination more than other patients. Discrimination against these patients in nursing care is an important ethical challenge that can harm patient outcomes. Due to the necessity of fully understanding this phenomenon, this study was conducted to determine the examples of discrimination towards the patients on stage from the point of view of clinical nurses.
Methods:
The study used qualitative content analysis, collecting data through in-depth and unstructured interviews with 13 clinical nurses. Participants were chosen through purposive sampling, and data collection continued until saturation was reached. Data analysis followed Granheim and Lundman's five-step approach. The validity, reliability, stability, and transferability of the data were evaluated using Lincoln and Guba's (2004) method.
Results:
The main theme identified from the data analysis was "Discrimination in providing services to end-of-life patients," which comprised two categories: "depriving end-of-life patients of receiving care" and "non-observance of professional principles in providing care to end-of-life patients." The first category included failure to provide nursing care, allocate time, administer drugs, provide nutrition, communicate, offer training, and follow up on paraclinical tests. The second category included failure to observe sterile procedures, improper drug administration, and improper care performance.
Conclusion:
The study revealed that discrimination against end-of-life patients extends across all aspects of nursing care, from basic routines to communication and education. Addressing this issue requires a comprehensive approach involving long-term and short-term policies, nurse education on discriminatory behaviors and their consequences.
Keywords: clinical ethics, discrimination, end-of-life patients, nursing care.