Professional Documents
Culture Documents
Abstract ref
ﻣﻘﺎﻟﻪﻱ ﭘﮋﻭﻫﺸ ﻲ
ﺑﺮرﺳﯽ ﻣﻮاﻧﻊ رﻋﺎﯾﺖ اﺧﻼق ﺣﺮﻓﻪاي در ﻣﺮاﻗﺒﺖﻫﺎي ﺑﺎﻟﯿﻨﯽ ﻣﺎﻣﺎﯾﯽ ،از دﯾﺪﮔﺎه ﻣﺎﻣﺎﻫﺎي
ﺑﯿﻤﺎرﺳﺘﺎنﻫﺎي ﺗﺨﺼﺼﯽ زﻧﺎن و زاﯾﻤﺎن اﺳﺘﺎن ﺧﺮاﺳﺎن ﺷﻤﺎﻟﯽ ،در ﺳﺎل 1397
Downloaded from ijme.tums.ac.ir at 11:22 IRST on Friday October 29th 2021
ﭼﻬﺮ ۶ ﺳﻴﺪﻩ ﻣﺤﺒﻮﺑﻪ ﺭﺿﺎﺋﻴﺎﻥ ،۱ﺯﻫﺮﺍ ﮐﺎﻇﻤﻲ ﮔﻠﻴﺎﻥ* ،۲ﻗﺎﺳﻢ ﮐﺎﻇﻤﻲ ﮔﻠﻴﺎﻥ ،۳ﺯﻫﺮﻩ ﻋﺒﺎﺳﻲ ،۴ﺍﻟﻬﻪ ﺳﺎﻻﺭﻱ ،۵ﻣﺤﺒﻮﺑﻪ ﻃﺒﺎﻃﺒﺎﻳﻲ
.1ﻣﺮﺑﯽ ،ﮔﺮوه ﻣﺎﻣﺎﯾﯽ ،داﻧﺸﮑﺪهي ﭘﺰﺷﮑﯽ ،داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﺧﺮاﺳﺎن ﺷﻤﺎﻟﯽ ،ﺑﺠﻨﻮرد ،اﯾﺮان.
.2ﮐﺎرﺷﻨﺎس ﻣﺎﻣﺎﯾﯽ ،داﻧﺸﮑﺪهي ﭘﺰﺷﮑﯽ ،داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﺧﺮاﺳﺎن ﺷﻤﺎﻟﯽ ،ﺑﺠﻨﻮرد ،اﯾﺮان.
.3اﺳﺘﺎدﯾﺎر رﯾﺎﺿﯽ ﮐﺎرﺑﺮدي ،داﻧﺸﮕﺎه آزاد اﺳﻼﻣﯽ واﺣﺪ ﺷﯿﺮوان ،ﺷﯿﺮوان ،اﯾﺮان.
.4اﺳﺘﺎدﯾﺎر ،ﮔﺮوه ﻣﺎﻣﺎﯾﯽ ،داﻧﺸﮑﺪهي ﭘﺰﺷﮑﯽ ،داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﺧﺮاﺳﺎن ﺷﻤﺎﻟﯽ ،ﺑﺠﻨﻮرد ،اﯾﺮان.
.5ﻣﺮﺑﯽ ،ﮔﺮوه ﻣﺎﻣﺎﯾﯽ ،داﻧﺸﮑﺪهي ﭘﺰﺷﮑﯽ ،داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﺧﺮاﺳﺎن ﺷﻤﺎﻟﯽ ،ﺑﺠﻨﻮرد ،اﯾﺮان.
.6ﻣﺮﺑﯽ ،ﻣﺮﮐﺰ ﺗﺤﻘﯿﻘﺎت ﻣﺮاﻗﺒﺖ ﺳﺎﻟﻤﻨﺪي ،داﻧﺸﮑﺪهي ﭘﺰﺷﮑﯽ ،داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ ﺧﺮاﺳﺎن ﺷﻤﺎﻟﯽ ،ﺑﺠﻨﻮرد ،اﯾﺮان.
ﭼﮑﯿﺪه
* ﻧﻮﯾﺴﻨﺪهي ﻃﺮف ﻣﮑﺎﺗﺒﻪ:
ﺭﻋﺎﻳﺖﻧ ﺸﺪﻥ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺎﻣﺎﻳﻲ ،ﺧﻄﺮﺍﺗﻲ ﺯﻳﺎﻥﺑﺎﺭ ،ﺍﺯﺟﻤﻠﻪ ﺍﻓﺰﺍﻳﺶ ﻣﺮﮒﻭﻣﻴﺮ زﻫﺮا ﮐﺎﻇﻤﯽ ﮔﻠﯿﺎن
ﻣﺎﺩﺭﺍﻥ ﻭ ﻧﻮﺯﺍﺩﺍﻥ ﺭﺍ ﺑﻪ ﺩﻧﺒﺎﻝ ﺧﻮﺍﻫﺪ ﺩﺍ ﺷﺖ .ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎ ﺿﺮ ،ﺑﺎ ﻫﺪﻑ ﺑﺮﺭ ﺳﻲ ﻣﻮﺍﻧﻊ آدرس :ﺑﺠﻨﻮرد ،ﺑﻠﻮار دوﻟﺖ ،داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ
ﺧﺮاﺳﺎن ﺷﻤﺎﻟﯽ.
ﺭ ﻋﺎ ﻳﺖ ﺍﺧﻼﻕ ﺣﺮ ﻓﻪ ﺍﻱ ﺩﺭ ﻣﺮﺍﻗ ﺒﺖ ﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﻣﺎ ﻣﺎﻳﻲ ،ﺍﺯ ﺩ ﻳﺪ ﮔﺎﻩ ﻣﺎ ﻣﺎ ﻫﺎﻱ ﮐﺪ ﭘﺴﺘﯽ7487794149 :
ﺑﻴﻤﺎﺭﺳــﺘﺎﻥﻫﺎﻱ ﺍﺳــﺘﺎﻥ ﺧﺮﺍﺳــﺎﻥ ﺷــﻤﺎﻟﻲ ،ﺩﺭ ﺳــﺎﻝ ،۱۳۹۷ﺍﻧﺠﺎﻡ ﺷــﺪ .ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪﻱ ﺗﻠﻔﻦ09388469427 :
ﺗﻮ ﺻﻴﻔﻲﻣﻘﻄﻌﻲ ،ﺑﺎ ﻣ ﺸﺎﺭﮐﺖ ۱۴۱ﻣﺎﻣﺎﻱ ﺷﺎﻏﻞ ﺩﺭ ﺑﻴﻤﺎﺭ ﺳﺘﺎﻥﻫﺎﻱ ﺗﺨ ﺼ ﺼﻲ ﺯﻧﺎﻥ ﻭ Email: Zkazemy75@gmail.com
ﺯﺍﻳﻤﺎﻥ ﺍﺳﺘﺎﻥ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ،ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻧﻤﻮﻧﻪﮔﻴﺮﻱ ﻃﺒﻘﻪﺑﻨﺪﻱﺷﺪﻩ ،ﺻﻮﺭﺕ ﮔﺮﻓﺖ.
ﺍﺑﺰﺍﺭ ﺟﻤﻊﺁﻭﺭﻱ ﺍﻃﻼﻋﺎﺕ ،ﭘﺮﺳﺶﻧﺎﻣﻪﺍﻱ ﺷﺎﻣﻞ ﺩﻭ ﺑﺨﺶ ﺑﻮﺩ :ﺍﻃﻼﻋﺎﺕ ﺩﻣﻮﮔﺮﺍﻓﻴﮏ ﻭ ﺗﺎرﯾﺦ درﯾﺎﻓﺖ1399/6/5 :
ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ،ﺩﺭ ﺳــﻪ ﺣﻴﻄﻪﻱ ﻣﺤﻴﻄﻲ ﻭ ﻣﺪﻳﺮﻳﺘﻲ ﻭ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ. ﺗﺎرﯾﺦ ﭘﺬﯾﺮش1399/12/17
ﺗﺎرﯾﺦ اﻧﺘﺸﺎر1400/7/11 :
ﺩﺍﺩﻩﻫﺎ ،ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻧﺮﻡﺍﻓﺰﺍﺭ ،SPSSﻧﺴﺨﻪﻱ ۲۲ﻭ ﺁﻣﺎﺭ ﺗﻮﺻﻴﻔﻲ ﻭ ﺍﺳﺘﻨﺒﺎﻃﻲ ،ﺗﺠﺰﻳﻪ
.
ﻭ ﺗﺤﻠﻴﻞ ﺷـــﺪ .ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎ ،ﻫﺮ ﺳـــﻪ ﺩﺳـــﺘﻪﻱ ﻋﻮﺍﻣﻞ ﻣﺤﻴﻄﻲ )،(% ۷۳,۹۴
ﻓﺮﺩﻱ ﻣﺮﺍﻗﺒﺘﻲ ) (% ٦٤,٦٦ﻭ ﻣﺪﻳﺮﻳﺘﻲ ) ،(% ٦٤,٩٧ﺍﺯﺟﻤ ﻠﻪ ﻣﻮﺍﻧﻊ ﺭ ﻋﺎ ﻳﺖ ﺍﺧﻼﻕ
ﺣﺮﻓﻪﺍﻱ ﺑﻮﺩﻧﺪ .ﻣﻬﻢﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﺑﻌﺪ ﻣﺪﻳﺮﻳﺘﻲ ،ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ
) ،(% ۸۰ﺩﺭ ﺑﻌﺪ ﻣﺤﻴﻄﻲ ،ﺗﻐﻴﻴﺮﺍﺕ ﺑﻴﻮﻟﻮﮊﻳﮑﻲ ﺑﺪﻥ ﺩﺭ ﺷﻴﻔﺖ ﮐﺎﺭﻱ ) (% ۸۵,۲ﻭ ﺩﺭ ﺑﻌﺪ
ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ،ﺭ ﺿﺎﻳﺖﻧﺪﺍ ﺷﺘﻦ ﺍﺯ ﻧﻴﺎﺯﻫﺎﻱ ﭘﺎﻳﻪ ،ﻣﺎﻧﻨﺪ ﻣﮑﻔﻲﺑﻮﺩﻥ ﺩﺭﺁﻣﺪ ﻳﺎ ﺍ ﺳﺘﺮﺍﺣﺖ ﮐﺎﻓﻲ ﺩﺭ ﭘﺮ ﺳﻨﻞ ﻣﺎﻣﺎﻳﻲ ) ،(% ۸۰,۹ﺑﻮﺩ .ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ
ﺍﻫﻤﻴﺖ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﻭ ﻣ ﺴﺎﺋﻞ ﻭ ﻣ ﺸﮑﻼﺕ ﻧﺎ ﺷﻲ ﺍﺯ ﺭﻋﺎﻳﺖﻧ ﺸﺪﻥ ﺁﻥ ،ﭘﻴ ﺸﻨﻬﺎﺩ ﻣﻲ ﺷﻮﺩ ﻣﺪﻳﺮﺍﻥ ﻭ ﻣ ﺴﺌﻮﻻﻥ ،ﺑﺮﻧﺎﻣﻪﺭﻳﺰﻱﻫﺎﻱ
ﻻﺯﻡ ﻭ ﺿﺮﻭﺭﻱ ﺭﺍ ﺗﻮﺳﻂ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎ ،ﺑﺮﺍﻱ ﺭﻓﻊ ﻣﻮﺍﻧﻊ ﺫﮐﺮﺷﺪﻩ ﺍﺯ ﺳﻮﻱ ﻣﺎﻣﺎﻫﺎ ﺍﻧﺠﺎﻡ ﺩﻫﻨﺪ.
واژﮔﺎن ﮐﻠﯿﺪي :ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ،ﻣﺮﺍﻗﺒﺖ ﺑﺎﻟﻴﻨﻲ ،ﻣﺎﻣﺎ ،ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺗﺨﺼﺼﻲ ﺯﻧﺎﻥ ﻭ ﺯﺍﻳﻤﺎﻥ.
ﺭﺿﺎﻳﻴﺎﻥ ﻭ ﻫﻤﮑﺎﺭﺍﻥ :ﺑﺮﺭﺳﻲ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﻣﺎﻣﺎﻳﻲ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺗﺨﺼﺼﻲ ... 2
ﺁﻥ ﻣﻮﺍﺟﻪ ﻣﻲﺷﻮﻧﺪ ) (۱۰ﻭ ﺣﺴﺎﺳﻴﺖ ﺍﺧﻼﻗﻲ ﻭ ﻣﻌﻨﻮﻱ ﺧﺎﺻﻲ ﭘﺰﺷﮑﻲ ،ﺳﻌﻲ ﺩﺍﺭﺩ ﺍﺧﻼﻗﻴﺎﺕ ﺭﺍ ﺑﻪﺻﻮﺭﺕ ﮐﺎﺭﺑﺮﺩﻱ ،ﺩﺭ ﺣﻴﻄﻪﻱ
ﮐﻪ ﺩﺭ ﺍﻳﻦ ﺣﺮﻓﻪ ﻭﺟﻮﺩ ﺩﺍﺭﺩ ) ،(۱۱ﺭﻋﺎﻳﺖ ﺍﺻﻮﻝ ﺍﺧﻼﻗﻲ ،ﺑﺴﻴﺎﺭ ﻋﻤﻞ ﭘﺰﺷﮑﺎﻥ ﻭ ﮐﺎﺩﺭ ﺩﺭﻣﺎﻧﻲ ﻭ ﺩﺭ ﺣﻮﺯﻩﻱ ﺗﺼﻤﻴﻢﮔﻴﺮﻱﻫﺎﻱ
ﺩﺭ ﮐﺎﻧﻮﻥ ﺗﻮﺟﻪ ﺍﺳﺖ ) .(۱۲ﺗﺤﻘﻴﻘﺎﺕ ﺍﻧﺠﺎﻡﺷﺪﻩ ﺩﺭ ﺯﻣﻴﻨﻪﻱ ﺍﺧﻼﻗﻲ ،ﺩﺭ ﻃﺐ ،ﻭﺍﺭﺩ ﻭ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺭﺍ
ﻋﻤﻠﮑﺮﺩ ﺍﺧﻼﻗﻲ ﺩﺭ ﻣﺎﻣﺎﻳﻲ ،ﺣﺎﮐﻲ ﺍﺯ ﺍﻫﻤﻴﺖ ﺍﻳﻦ ﻣﻮﺿﻮﻉ ﻭ ﺑﺮﺭﺳﻲ ﮐﻨﺪ؛ ﺑﻪﻋﻨﻮﺍﻥ ﻣﺜﺎﻝ ،ﺍﻳﻦ ﻣﻮﺍﻧﻊ ﻣﻲﺗﻮﺍﻧﺪ ﺩﺭ ﺣﻮﺯﻩﻫﺎﻱ
ﺗﻼﺵ ﺑﺮﺍﻱ ﺁﻣﻮﺯﺵ ﺑﻴﺸﺘﺮ ﺩﺭ ﺍﻳﻦ ﺯﻣﻴﻨﻪ ﺍﺳﺖ )۱۳ﻭ .(۱۴ﺍﺯ ﻣﺪﻳﺮﻳﺘﻲ ،ﻣﺤﻴﻄﻲ ،ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ﻭ ﻫﺮ ﻋﺎﻣﻠﻲ ﮐﻪ ﻣﺎﻧﻊ ﺭﻋﺎﻳﺖ
ﻃﺮﻓﻲ ،ﻫﺮ ﮔﻮﻧﻪ ﺧﻠﻞ ﺩﺭ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎ ،ﻣﻲﺗﻮﺍﻧﺪ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﻣﻲﺷﻮﺩ ،ﻗﺮﺍﺭ ﮔﻴﺮﺩ ).(۲
ﻧﺘﻴﺠﻪﻱ ﻋﻠﻤﻲﺗﺮﻳﻦ ﻭ ﺑﻬﺘﺮﻳﻦ ﻣﺮﺍﻗﺒﺖﻫﺎ ﺭﺍ ﺗﺤﺖﺍﻟﺸﻌﺎﻉ ﻗﺮﺍﺭ ﺩﻫﺪ ﻣﺎﻣﺎﻳﻲ ،ﺣﺮﻓﻪﺍﻱ ﺍﺳﺖ ﮐﻪ ﻗﺪﻣﺘﻲ ﺑﺮﺍﺑﺮ ﺑﺎ ﺗﺎﺭﻳﺦ ﺑﺸﺮ ﺩﺍﺭﺩ ﻭ ﺩﺭ
)(۱۴؛ ﺑﻨﺎﺑﺮﺍﻳﻦ ،ﺑﺎﻳﺪ ﻫﺮ ﻣﺎﻧﻌﻲ ﮐﻪ ﺑﻪﻧﻮﻋﻲ ،ﺩﺭ ﺭﻋﺎﻳﺖﻧﺸﺪﻥ ﻋﺮﺻﻪﻱ ﺑﻴﻦﺍﻟﻤﻠﻠﻲ ،ﮐﺎﻣﻼﹰ ،ﺷﻨﺎﺧﺘﻪﺷﺪﻩ ﺍﺳﺖ ) .(۳ﺍﻳﻦ ﺣﺮﻓﻪ ،ﺑﻪ
ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖ ﺍﺯ ﺑﻴﻤﺎﺭﺍﻥ ﺍﺛﺮﮔﺬﺍﺭ ﺍﺳﺖ، ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺟﺴﻤﻲ ﻭ ﺭﻭﺍﻧﻲ ﻭ ﺍﺟﺘﻤﺎﻋﻲ ﺯﻧﺎﻥ ﺩﺭ ﺩﻭﺭﺍﻥ
ﺑﺮﻃﺮﻑ ﺷﻮﺩ ﺗﺎ ﻣﺮﺍﻗﺒﺖ ﺍﺯ ﺑﻴﻤﺎﺭﺍﻥ ﻧﻴﺰ ،ﺑﺎ ﺭﻋﺎﻳﺖ ﺣﺪﺍﮐﺜﺮ ﺑﺎﺭﺩﺍﺭﻱ ،ﺯﺍﻳﻤﺎﻥ ﻭ ﭘﺲ ﺍﺯ ﺯﺍﻳﻤﺎﻥ ﻭ ﻧﻴﺰ ،ﻧﻮﺯﺍﺩﺍﻥ ﻣﺮﺑﻮﻁ ﻣﻲﺷﻮﺩ
ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺻﻮﺭﺕ ﮔﻴﺮﺩ ) .(۱۵ﺗﺤﻘﻴﻘﺎﺕ ﺩﺭ ) .(۴ﻣﺎﻣﺎﻫﺎ ﻭﻇﻴﻔﻪﻱ ﻣﺮﺍﻗﺒﺖ ﺍﺯ ﺳﻼﻣﺖ ﺯﻧﺎﻥ ﻭ ﺣﻤﺎﻳﺖ ﺍﺯ
ﺯﻣﻴﻨﻪﻱ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ،ﺣﺎﮐﻲ ﺍﺯ ﻋﻤﻠﮑﺮﺩ ﺍﺧﻼﻗﻲ ﺗﻮﺍﻧﻤﻨﺪﺳﺎﺯﻱ ﻭﺿﻌﻴﺖ ﺍﺟﺘﻤﺎﻋﻲ ﺁﻧﺎﻥ ﺭﺍ ﺑﺮ ﻋﻬﺪﻩ ﺩﺍﺭﻧﺪ ) (۵ﻭ
ﻧﺎﻣﻄﻠﻮﺏ ﺑﻮﺩﻩ ﺍﺳﺖ؛ ﻧﺘﺎﻳﺞ ﭘﮋﻭﻫﺶ ﺷﻬﺮﻳﺎﺭﻱ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ﺗﻮﺟﻪ ﺑﻪ ﻣﺒﺎﻧﻲ ﺍﺧﻼﻗﻲ ﺩﺭ ﺍﻳﻦ ﺣﻴﻄﻪ ،ﺿﺮﻭﺭﻱ ﺑﻪ ﻧﻈﺮ ﻣﻲﺭﺳﺪ
) (۱۳۹۵ﻧﺸﺎﻥ ﺩﺍﺩ ﻣﻴﺎﻧﮕﻴﻦ ﻧﻤﺮﻩﻱ ﮐﻞ ﺭﻋﺎﻳﺖ ﮐﺪﻫﺎﻱ ﺍﺧﻼﻕ )۶ﻭ .(۷ﺭﻋﺎﻳﺖﻧﺸﺪﻥ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺎﻣﺎﻳﻲ ،ﺧﻄﺮﻫﺎﻳﻲ
ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺎﻣﺎﻫﺎﻱ ﺷﺎﻏﻞ ﺩﺭ ﺯﺍﻳﺸﮕﺎﻩ ۸۰/۵±۱۴/۷ ،ﻭ ﺩﺭ ﺯﻳﺎﻥﺑﺎﺭ ،ﺍﺯﺟﻤﻠﻪ ﺍﻓﺰﺍﻳﺶ ﻣﺮﮒﻭﻣﻴﺮ ﻣﺎﺩﺭﺍﻥ ﻭ ﻧﻮﺯﺍﺩﺍﻥ ،ﮐﺎﻫﺶ
ﻣﺎﻣﺎﻫﺎﻱ ﺷﺎﻏﻞ ﺩﺭ ﺑﺨﺶ ﺯﻧﺎﻥ ۸۵/۱±۱۲/۰۲ ،ﺍﺳﺖ ﮐﻪ ﺍﺯﺟﻤﻠﻪ ﺭﺿﺎﻳﺖ ﺍﺯ ﺟﺎﻣﻌﻪﻱ ﻣﺎﻣﺎﻳﻲ ،ﮐﺎﻫﺶ ﺍﻋﺘﻤﺎﺩ ﻋﻤﻮﻡ ﺑﻪ ﺁﻧﺎﻥ ﻭ
ﻋﻮﺍﻣﻞ ﻣﺮﺗﺒﻂ ﺑﺎ ﺑﺨﺶﻫﺎﻱ ﺯﻧﺎﻥ ﻭ ﺯﺍﻳﺸﮕﺎﻩﻫﺎ ،ﻣﻲﺗﻮﺍﻥ ﺑﻪ ﭘﺮﺳﻨﻞ ﮐﺎﻫﺶ ﻣﻮﻓﻘﻴﺖ ﺩﺭ ﺯﺍﻳﻤﺎﻥ ﻭ ﻣﺮﺍﻗﺒﺖ ﺍﺯ ﻧﻮﺯﺍﺩ ﺭﺍ ﺑﻪ ﺩﻧﺒﺎﻝ ﺧﻮﺍﻫﺪ
ﻭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﻭﺍﺑﺴﺘﻪ ﻭ ﺯﻳﺮﹺﻧﻈﺮ ﺩﺍﻧﺸﮕﺎﻩ ﻭ ﻣﺮﺗﺒﻂ ﺑﺎ ﺑﺨﺶ ﺩﺍﺷﺖ ) .(۸ﺑﺎ ﭘﻴﺸﺮﻓﺖ ﺭﻭﺯﺍﻓﺰﻭﻥ ﺍﻃﻼﻋﺎﺕ ﻭ ﺗﮑﻨﻮﻟﻮﮊﻱ
ﺯﻧﺎﻥ ﻭ ﺯﺍﻳﺸﮕﺎﻩﻫﺎ ﺍﺷﺎﺭﻩ ﮐﺮﺩ ) .(۱۶ﺩﺭ ﺗﺤﻘﻴﻘﻲ ﺩﻳﮕﺮ ،ﺑﻪ ﻣﻨﻈﻮﺭ ﭘﺰﺷﮑﻲ ،ﻣﺸﮑﻼﺕ ﺍﺧﻼﻗﻲ ﻫﻤﺮﺍﻩ ﺑﺎ ﺁﻥ ﻧﻴﺰ ،ﺭﻭ ﺑﻪ ﺍﻓﺰﺍﻳﺶ ﺍﺳﺖ؛
ﺑﺮﺭﺳﻲ ﻣﻴﺰﺍﻥ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﺍﻣﺮ ﺍﺟﺮﺍﻱ ﺩﺳﺘﻮﺭﺍﺕ ﺍﺯﺍﻳﻦﺭﻭ ،ﺭﺍﻫﻨﻤﺎﻫﺎﻳﻲ ﺍﺧﻼﻗﻲ ﻻﺯﻡ ﺍﺳﺖ ﺗﺎ ﺑﺎ ﮐﺎﺳﺘﻦ ﺍﺯ ﺍﻳﻦ
ﺩﺍﺭﻭﻳﻲ ﺗﻮﺳﻂ ﭘﺮﺳﺘﺎﺭﺍﻥ ،ﻳﺎﻓﺘﻪﻫﺎ ﻧﺸﺎﻥ ﺩﺍﺩ %ﻱ ﭼﺸﻤﮕﻴﺮ ﺍﺯ ﻣﺸﮑﻼﺕ ،ﺍﺯ ﺳﻼﻣﺖ ﺍﻧﺴﺎﻥﻫﺎ ﺣﻔﺎﻇﺖ ﮐﻨﺪ .ﺍﻳﻦ ﺍﻣﺮ ،ﺑﻪﺧﺼﻮﺹ
ﭘﺮﺳﺘﺎﺭﺍﻥ ،ﺩﺭ ﻓﺮﺍﻳﻨﺪ ﺩﺍﺩﻥ ﺩﺍﺭﻭ ،ﻋﻤﻠﮑﺮﺩﻱ ﻧﺎﻣﻄﻠﻮﺏ ﺩﺍﺷﺘﻪﺍﻧﺪ؛ ﺩﺭ ﺣﺮﻓﻪﻱ ﻣﺎﻣﺎﻳﻲ ،ﺿﺮﻭﺭﻱ ﺑﻪ ﻧﻈﺮ ﻣﻲﺭﺳﺪ؛ ﭼﺮﺍﮐﻪ ﻣﺎﻣﺎ ﺩﺭ
ﺑﻪﻃﻮﺭﻱﮐﻪ ﺍﺻﻮﻝ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺭﺍ ﺭﻋﺎﻳﺖ ﻧﮑﺮﺩﻩﺍﻧﺪ؛ ﭘﺲ ،ﺑﺎ ﺣﺮﻓﻪﻱ ﺧﻮﺩ ،ﻫﻢﺯﻣﺎﻥ ،ﺑﺎ ﺩﻭ ﺍﻧﺴﺎﻥ ﺳﺮﻭﮐﺎﺭ ﺩﺍﺭﺩ ﮐﻪ ﻫﺮ ﮐﺪﺍﻡ،
ﺗﻮﺟﻪ ﺑﻪ ﺷﻮﺍﻫﺪ ﻣﻲﺗﻮﺍﻥ ﮔﻔﺖ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﺁﻥﭼﻨﺎﻥﮐﻪ ﺩﺍﺭﺍﻱ ﺣﻘﻮﻕ ﺍﻧﺴﺎﻧﻲ ﻣﺸﺨﺼﻲ ﻫﺴﺘﻨﺪ ) .(۶ﺑﻪﻃﻮﺭ ﮐﻠﻲ ،ﻣﺎﻣﺎ ﺑﺎﻳﺪ
ﺷﺎﻳﺴﺘﻪﻱ ﺑﻴﻤﺎﺭﺍﻥ ﻭ ﻓﺮﻫﻨﮓ ﻣﺎﺳﺖ ،ﺭﻋﺎﻳﺖ ﻧﻤﻲﺷﻮﺩ ﻭ ﻧﺴﺒﺖ
Website: http://ijme.tums.ac.ir
3 ﺍﺧﻼﻕ ﻭ ﺗﺎﺭﻳﺦ ﭘﺰﺷﻜﻲ ،ﺳﺎﻝ ،١٤٠٠ﺩﻭﺭﻩ ١٤
ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ﺑﻮﺩﻧﺪ؛ ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺩﺍﻳﺮﺑﻮﺩﻥ ﻫﻔﺖ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺑﺎ ﺑﻪ ﺍﻳﻦ ﻣﻮﺿﻮﻉ ،ﺳﻬﻞﺍﻧﮕﺎﺭﻱ ﺷﺪﻩ ﺍﺳﺖ ) .(۱۵ﺑﻪﻃﻮﺭ ﮐﻠﻲ،
ﺗﺨﺼﺺ ﺯﻧﺎﻥ ﻭ ﺯﺍﻳﻤﺎﻥ ،ﺩﺭ ﺷﺶ ﺷﻬﺮ ﺍﻳﻦ ﺍﺳﺘﺎﻥ ﻭ ﻃﺒﻖ ﻓﺮﻫﻨﮓ ﻣﺎ ﺍﻳﺠﺎﺏ ﻣﻲﮐﻨﺪ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ،
ﺍﻃﻼﻋﺎﺕ ﺍﺧﺬﺷﺪﻩ ﺍﺯ ﻣﺪﻳﺮﻳﺖ ﻫﺮ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ،ﺗﻌﺪﺍﺩ ﻣﺎﻣﺎﻫﺎﻱ ﺑﻪﻧﺤﻮ ﺍﺣﺴﻦ ﺍﻧﺠﺎﻡ ﮔﻴﺮﺩ ﻭ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ،
ﺷﺎﻏﻞ ﺩﺭ ﺍﻳﻦ ﺑﺨﺶﻫﺎ ٢٢٢ﻧﻔﺮ ﺑﻮﺩﻧﺪ .ﺭﻭﺵ ﻧﻤﻮﻧﻪﮔﻴﺮﻱ ﺩﺭ ﺍﻳﻦ ﺷﻨﺎﺳﺎﻳﻲ ﻭ ﺑﺮﺍﻱ ﺭﻓﻊ ﺁﻥ ﮐﻮﺷﺶ ﺷﻮﺩ )۱۷ﻭ(۱۸؛ ﺑﺎﺍﻳﻦﺣﺎﻝ،
Downloaded from ijme.tums.ac.ir at 11:22 IRST on Friday October 29th 2021
ﭘﮋﻭﻫﺶ ،ﻧﻤﻮﻧﻪﮔﻴﺮﻱ ﻃﺒﻘﻪﺑﻨﺪﻱﺷﺪﻩ ،ﺑﺎ ﺗﺨﺼﻴﺺ ﻣﺘﻨﺎﺳﺐ ﺑﺎ ﺩﻫﻘﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ) ،(۱۳۹۲ﺑﻪ ﺑﺮﺭﺳﻲ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ
ﺣﺠﻢ ﺍﺳﺖ .ﺍﺳﺘﺎﻥ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ،ﺷﺶ ﺷﻬﺮﺳﺘﺎﻥ ﻣﺠﻬﺰ ﺑﻪ ﺍﺳﺘﺎﻧﺪﺍﺭﺩﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ
ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺗﺨﺼﺼﻲ ﺯﻧﺎﻥ ﻭ ﺯﺍﻳﻤﺎﻥ ﺩﺍﺭﺩ ﮐﻪ ﻋﺒﺎﺭﺕﺍﻧﺪ ﺍﺯ.۱ : ﭘﺮﺳﺘﺎﺭﺍﻥ ،ﭘﺮﺩﺍﺧﺘﻨﺪ ﻭ ﻣﻮﺍﻧﻊ ﻣﻮﺟﻮﺩ ﺩﺭ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺭﺍ ﺩﺭ
ﺑﺠﻨﻮﺭﺩ )ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ »ﺑﻨﺖﺍﻟﻬﺪﻱ« ﻭ »ﺛﺎﻣﻦﺍﻻﺋﻤﻪ«(؛ .۲ﺷﻴﺮﻭﺍﻥ ﺳﻪ ﺣﻴﻄﻪﻱ ﻣﺪﻳﺮﻳﺘﻲ ﻭ ﻣﺤﻴﻄﻲ ﻭ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ﻧﺸﺎﻥ ﺩﺍﺩﻧﺪ.
)ﺑﻴﻤﺎﺭﺳﺘﺎﻥ »ﺍﻣﺎﻡﺧﻤﻴﻨﻲ)ﺭﻩ(«(؛ .۳ﻓﺎﺭﻭﺝ )ﺑﻴﻤﺎﺭﺳﺘﺎﻥ »ﺷﻬﺪﺍﻱ ﻋﻤﺪﻩﻱ ﻣﻮﺍﻧﻊ ،ﻣﺮﺑﻮﻁ ﺑﻪ ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ ،ﺍﺯﺩﺣﺎﻡ ﺑﺨﺶ ﻭ
ﻓﺎﺭﻭﺝ«(؛ .۴ﺍﺳﻔﺮﺍﻳﻦ )ﺑﻴﻤﺎﺭﺳﺘﺎﻥ »ﺍﻣﺎﻡﺧﻤﻴﻨﻲ)ﺭﻩ(«(؛ .۵ﻣﺎﻧﻪ ﻭ ﺭﺍﺿﻲﻧﺒﻮﺩﻥ ﭘﺮﺳﻨﻞ ﺍﺯ ﻧﻴﺎﺯﻫﺎﻱ ﭘﺎﻳﻪ ،ﺍﺯﺟﻤﻠﻪ ﺍﻣﮑﺎﻧﺎﺕ ﺑﺨﺶﻫﺎ،
ﺳﻤﻠﻘﺎﻥ )ﺑﻴﻤﺎﺭﺳﺘﺎﻥ »ﭘﻮﺭﺳﻴﻨﺎﻱ ﺍﺷﺨﺎﻧﻪ«(؛ .۶ﺟﺎﺟﺮﻡ )ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﻭﺳﺎﻳﻞ ﻣﺠﻬﺰﺗﺮ ﺑﺮﺍﻱ ﻣﺮﺍﻗﺒﺖ ﺍﺯ ﻣﺎﺩﺭ ﻭ ﻧﻮﺯﺍﺩ ﻭ ﺍﻳﺠﺎﺩ ﻣﺤﻴﻂ
»ﺟﻮﺍﺩﺍﻻﺋﻤﻪ)ﻉ(«( .ﺍﻳﻦ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎ ،ﺑﻪﻋﻨﻮﺍﻥ ﻃﺒﻘﺎﺕ ،ﺩﺭ ﻧﻈﺮ ﺷﺎﺩﺗﺮ ﺑﺮﺍﻱ ﻣﺎﺩﺭ ﺑﻮﺩ ) .(۱۹ﺑﻪ ﺩﻧﺒﺎﻝ ﻧﺘﺎﻳﺞ ﻓﻮﻕ ﻭ ﺳﺎﻳﺮ ﻣﻄﺎﻟﻌﺎﺕ،
ﮔﺮﻓﺘﻪ ﺷﺪﻧﺪ ﻭ ﺳﭙﺲ ،ﺍﺯ ﻫﺮ ﻃﺒﻘﻪ ،ﻣﺘﻨﺎﺳﺐ ﺑﺎ ﺣﺠﻢ ﺁﻥ، ﺍﻏﻠﺐ ﭘﺮﺳﺘﺎﺭﺍﻥ ﺑﺎ ﻫﻢ ﺗﻮﺍﻓﻖ ﺩﺍﺭﻧﺪ ﻭ ﻧﻈﺮﺷﺎﻥ ﺍﻳﻦ ﺍﺳﺖ ﮐﻪ
ﻧﻤﻮﻧﻪﮔﻴﺮﻱ ﺷﺪ .ﺍﺑﺰﺍﺭ ﺟﻤﻊﺁﻭﺭﻱ ﺍﻃﻼﻋﺎﺕ ،ﭘﺮﺳﺶﻧﺎﻣﻪﺍﻱ ﺷﺎﻣﻞ ﻣﻮﺍﻧﻌﻲ ﺑﺮﺍﻱ ﻋﻤﻠﮑﺮﺩ ﺍﺧﻼﻗﻲ ﺩﺭ ﻣﺤﻴﻂ ﮐﺎﺭﻱﺷﺎﻥ ﻭﺟﻮﺩ ﺩﺍﺭﺩ
ﺩﻭ ﺑﺨﺶ ﺍﻃﻼﻋﺎﺕ ﺩﻣﻮﮔﺮﺍﻓﻴﮏ ﻭ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﮐﻪ ﺗﻮﺍﻧﺎﻳﻲ ﺁﻥﻫﺎ ﺭﺍ ﺑﺮﺍﻱ ﻓﺮﺍﻫﻢﮐﺮﺩﻥ ﻣﺮﺍﻗﺒﺖ ﺷﺎﻳﺴﺘﻪ ﻭ ﺩﻟﺴﻮﺯﺍﻧﻪ
ﺩﺭ ﺳﻪ ﺣﻴﻄﻪﻱ ﻣﺤﻴﻄﻲ ﻭ ﻣﺪﻳﺮﻳﺘﻲ ﻭ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ﺑﻮﺩ .ﺍﻃﻼﻋﺎﺕ ﻣﺨﺘﻞ ﻣﻲﮐﻨﺪ ) .(۲۰ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺍﻫﻤﻴﺖ ﺷﻨﺎﺧﺖ ﻋﻠﻞ ﻭ ﻣﻮﺍﻧﻊ ﻭ
ﺩﻣﻮﮔﺮﺍﻓﻴﮏ ،ﺩﺭﺑﺮﮔﻴﺮﻧﺪﻩﻱ ﻣﺘﻐﻴﺮﻫﺎﻱ ﺳﻦ ،ﺗﺤﺼﻴﻼﺕ ،ﺳﺎﺑﻘﻪﻱ ﺍﺭﺍﺋﻪﻱ ﺭﺍﻫﮑﺎﺭ ﺑﺮ ﺍﺳﺎﺱ ﻣﻮﺍﻧﻊ ﻣﻮﺟﻮﺩ ،ﺑﺮﺭﺳﻲ ﺩﻳﺪﮔﺎﻩﻫﺎﻱ
ﮐﺎﺭ ،ﻭﺿﻌﻴﺖ ﺗﺄﻫﻞ ،ﻧﻮﻉ ﺍﺳﺘﺨﺪﺍﻣﻲ ﻭ ﻣﺤﻞ ﺧﺪﻣﺖ ﺍﺳﺖ. ﻣﺘﻔﺎﻭﺕ ،ﺑﻪ ﺑﺮﻧﺎﻣﻪﺭﻳﺰﻱ ﻭ ﺗﺼﻤﻴﻢﮔﻴﺮﻱ ﺩﺭﺧﺼﻮﺹ ﺭﻓﻊ ﺍﻳﻦ
ﭘﺮﺳﺶﻧﺎﻣﻪﻱ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ،ﺷﺎﻣﻞ ٣٣ﺳﺆﺍﻝ ﻣﺸﮑﻞ ﺑﺴﻴﺎﺭ ﮐﻤﮏ ﻣﻲﮐﻨﺪ .ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﮐﻤﺒﻮﺩ ﻣﻄﺎﻟﻌﺎﺕ ﺩﺭ ﺍﻳﻦ
)ﭼﻬﺎﺭﺩﻩ ﺳﺆﺍﻝ ،ﻣﺮﺑﻮﻁ ﺑﻪ ﺣﻴﻄﻪﻱ ﻣﺪﻳﺮﻳﺘﻲ ،ﭘﻨﺞ ﺳﺆﺍﻝ ،ﻣﺮﺑﻮﻁ ﺯﻣﻴﻨﻪ ،ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪﻑ ﺗﻌﻴﻴﻦ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ
ﺑﻪ ﺣﻴﻄﻪﻱ ﻣﺤﻴﻄﻲ ﻭ ﭼﻬﺎﺭﺩﻩ ﺳﺆﺍﻝ ،ﻣﺮﺑﻮﻁ ﺑﻪ ﺣﻴﻄﻪﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎﻱ ﺷﺎﻏﻞ ﺩﺭ
ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ( .ﮔﻮﻳﻪﻫﺎ ﺑﺎ ﻣﻘﻴﺎﺱ ﭘﻨﺞﺩﺭﺟﻪﺍﻱ ﭘﺎﺳﺦ ﺩﺍﺩﻩ ﺷﺪ. ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺍﺳﺘﺎﻥ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ﺍﻧﺠﺎﻡ ﮔﺮﻓﺖ.
ﺍﻧﺘﺨﺎﺏ ﮔﺰﻳﻨﻪﻱ »ﮐﺎﻣﻼﹰ ﻣﻮﺍﻓﻘﻢ« ﻳﺎ »ﻣﻮﺍﻓﻘﻢ« ،ﻧﺸﺎﻥﺩﻫﻨﺪﻩﻱ ﺍﻳﻦ ﺭﻭﺵ ﮐﺎﺭ
ﺍﺳﺖ ﮐﻪ ﺁﻳﺘﻢ ﻣﻄﺮﺡﺷﺪﻩ ،ﻣﺎﻧﻌﻲ ﺑﺮﺍﻱ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺍﻳﻦ ﭘﮋﻭﻫﺶ ،ﻣﻄﺎﻟﻌﻪﺍﻱ ﺍﺯ ﻧﻮﻉ ﺗﻮﺻﻴﻔﻲﻣﻘﻄﻌﻲ ﺍﺳﺖ .ﻫﺪﻑ
ﺍﺳﺖ .ﮔﺰﻳﻨﻪﻱ »ﻣﺨﺎﻟﻔﻢ« ،ﻧﺸﺎﻥﺩﻫﻨﺪﻩﻱ ﺍﻳﻦ ﺍﺳﺖ ﮐﻪ ﺁﻳﺘﻢ ﺍﺯ ﺁﻥ ،ﺑﺮﺭﺳﻲ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ،ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ
ﻣﻄﺮﺡﺷﺪﻩ ،ﻣﺎﻧﻌﻲ ﺑﺮ ﺳﺮ ﺭﺍﻩ ﺭﻋﺎﻳﺖ ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺑﺎﻟﻴﻨﻲ ﻣﺎﻣﺎﻳﻲ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺗﺨﺼﺼﻲ ﺯﻧﺎﻥ
ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎ ﻧﻴﺴﺖ .ﺍﻧﺘﺨﺎﺏ ﮔﺰﻳﻨﻪﻱ »ﻧﻈﺮﻱ ﻧﺪﺍﺭﻡ« ﻧﻴﺰ، ﻭ ﺯﺍﻳﻤﺎﻥ ﺩﺭ ﺍﺳﺘﺎﻥ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ،ﺩﺭ ﺳﺎﻝ ۱۳۹۷ﺑﻮﺩ .ﺟﺎﻣﻌﻪﻱ
ﮔﻮﻳﺎﻱ ﻧﺎﺁﮔﺎﻫﻲ ﺍﺯ ﺍﺛﺮ ﻣﺘﻐﻴﺮ ﭘﺮﺳﺶﺷﺪﻩ ﺩﺭ ﺭﻋﺎﻳﺖﻧﮑﺮﺩﻥ ﭘﮋﻭﻫﺶ ،ﻫﻤﻪﻱ ﻣﺎﻣﺎﻫﺎﻱ ﺷﺎﻏﻞ ﺩﺭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺍﺳﺘﺎﻥ
Website: http://ijme.tums.ac.ir
ﺭﺿﺎﻳﻴﺎﻥ ﻭ ﻫﻤﮑﺎﺭﺍﻥ :ﺑﺮﺭﺳﻲ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﻣﺎﻣﺎﻳﻲ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺗﺨﺼﺼﻲ ... 4
ﺳﻦ ﻣﺎﻣﺎﻫﺎﻱ ﻣﻮﺭﺩ ﭘﮋﻭﻫﺶ ۳۰/۸۹ ،ﻭ ﺳﺎﺑﻘﻪﻱ ﺧﺪﻣﺖ ﺁﻥﻫﺎ ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺍﺳﺖ .ﺭﻭﺍﻳﻲ ﭘﺮﺳﺶﻧﺎﻣﻪﻱ ﻣﻮﺍﻧﻊ
۶/۲۴ﺳﺎﻝ ﺍﺳﺖ .ﺑﻪ ﻋﻼﻭﻩ ،ﻣﻴﺎﻧﮕﻴﻦ ﺩﺭﺁﻣﺪ ﻣﺎﻣﺎﻫﺎﻱ ﻣﻮﺭﺩ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ،ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ
ﭘﮋﻭﻫﺶ ۲/۲۱ ،ﻣﻴﻠﻴﻮﻥ ﺗﻮﻣﺎﻥ ﺑﻮﺩ؛ ﻫﻤﭽﻨﻴﻦ ،ﺍﺯ ﻣﺠﻤﻮﻉ ۱۴۱ ﺩﻫﻘﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ﺗﺄﻳﻴﺪ ﺷﺪﻩ ﺍﺳﺖ ) .(١٩ﺍﻳﻦ ﭘﺮﺳﺶﻧﺎﻣﻪ،
ﻣﺎﻣﺎﻱ ﺷﺮﮐﺖﮐﻨﻨﺪﻩ ﺩﺭ ﭘﮋﻭﻫﺶ ،% ۶۳/۴ ،ﻣﺘﺄﻫﻞ ﻭ % ۳۳/۱ﻣﺠﺮﺩ ﻣﺠﺪﺩﺍﹰ ،ﺍﺯ ﻧﻈﺮ ﻣﺤﺘﻮﺍﻳﻲ ،ﺍﺭﺯﻳﺎﺑﻲ ﺭﻭﺍﻳﻲ ﺷﺪ؛ ﺑﻪ ﺍﻳﻦ ﺗﺮﺗﻴﺐ ﮐﻪ
Downloaded from ijme.tums.ac.ir at 11:22 IRST on Friday October 29th 2021
ﺑﻮﺩﻧﺪ .ﺩﺭ ﺭﺍﺑﻄﻪ ﺑﺎ ﺗﺤﺼﻴﻼﺕ ﻣﺎﻣﺎﻫﺎ % ۸۵/۹ ،ﺩﺍﺭﺍﻱ ﻣﺪﺭﮎ ﺍﻳﻦ ﭘﺮﺳﺶﻧﺎﻣﻪ ﻭ ﻫﻤﭽﻨﻴﻦ ،ﺑﺨﺶ ﺍﻃﻼﻋﺎﺕ ﺩﻣﻮﮔﺮﺍﻓﻴﮏ ،ﺩﺭ
ﮐﺎﺭﺷﻨﺎﺳﻲ ﻭ % ۱۰/۶ﺩﺍﺭﺍﻱ ﻣﺪﺭﮎ ﮐﺎﺭﺷﻨﺎﺳﻲ ﺍﺭﺷﺪ ﺑﻮﺩﻧﺪ .ﺩﺭ ﺍﺧﺘﻴﺎﺭ ﺩﻩ ﻧﻔﺮ ﺍﺯ ﺍﻋﻀﺎﻱ ﻫﻴﺌﺖ ﻋﻠﻤﻲ ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﮑﻲ
ﺍﻳﻦ ﭘﮋﻭﻫﺶ % ۵۸/۵ ،ﻣﺎﻣﺎﻫﺎ ﺑﺪﻭﻥ ﻓﺮﺯﻧﺪ % ۱۸/۳ ،ﺩﺍﺭﺍﻱ ﻳﮏ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ﻗﺮﺍﺭ ﮔﺮﻓﺖ ﻭ ﭘﺲ ﺍﺯ ﺍﺻﻼﺣﺎﺕ ﻭ ﭘﻴﺸﻨﻬﺎﺩﺍﺕ
ﻓﺮﺯﻧﺪ % ۱۷/۶ ،ﺩﺍﺭﺍﻱ ﺩﻭ ﻓﺮﺯﻧﺪ ﻭ % ۵/۶ﺩﺍﺭﺍﻱ ﺳﻪ ﻓﺮﺯﻧﺪ ﺑﻮﺩﻧﺪ. ﻻﺯﻡ ،ﺍﺑﺰﺍﺭ ﻧﻬﺎﻳﻲ ﺍﺳﺘﻔﺎﺩﻩ ﺷﺪ؛ ﻫﻤﭽﻨﻴﻦ ،ﭘﺎﻳﺎﻳﻲ ﭘﺮﺳﺶﻧﺎﻣﻪ ﺭﺍ،
ﺩﻳﮕﺮ ﺍﻃﻼﻋﺎﺕ ﺩﻣﻮﮔﺮﺍﻓﻴﮏ ،ﺩﺭ ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩﻱ ﻳﮏ ﻧﻤﺎﻳﺶ ﺩﺍﺩﻩ ﻣﻄﺎﻟﻌﻪﻱ ﺩﻫﻘﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ،ﺑﺎ ﺁﻟﻔﺎﻱ ﮐﺮﻭﻧﺒﺎﺥ ۰/۸۹ﺗﺄﻳﻴﺪ ﮐﺮﺩ
ﺷﺪﻩ ﺍﺳﺖ. ) .(۱۹ﺑﺨﺶ ﺍﻃﻼﻋﺎﺕ ﺩﻣﻮﮔﺮﺍﻓﻴﮏ ،ﺷﺎﻣﻞ ﻋﺒﺎﺭﺕﻫﺎﻱ ﻭﺍﺿﺢ
ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩﻱ -۱ﻣﺸﺨﺼﺎﺕ ﺩﻣﻮﮔﺮﺍﻓﻴﮏ ﻭﺍﺣﺪﻫﺎﻱ ﻣﻮﺭﺩ ﭘﮋﻭﻫﺶ ﺍﺳﺖ ﮐﻪ ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻣﻄﺎﻟﻌﺎﺕ ﻣﺸﺎﺑﻪ ،ﻣﺸﺎﻭﺭﻩ ﺑﺎ ﺍﺳﺘﺎﺩﺍﻥ ﺭﺍﻫﻨﻤﺎ
ﺗﻌﺪﺍﺩ )(% ﻣﺸﺨﺼﺎﺕ ﺩﻣﻮﮔﺮﺍﻓﻴﮏ ﻭ ﺍﺳﺘﻔﺎﺩﻩ ﺩﺭ ﺗﺤﻘﻴﻘﺎﺕ ﻣﺨﺘﻠﻒ ،ﭘﺎﻳﺎﻳﻲ ﺁﻥ ﺗﺄﻳﻴﺪ ﺷﺪﻩ ﺍﺳﺖ.
(٥٧/٧) ۸۲ ﺑﻴﺴﺖ ﺗﺎ ﺳﻲ ﺳﺎﻝ ﭘﺎﻳﺎﻳﻲ ﭘﺮﺳﺶﻧﺎﻣﻪﻱ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ
(٢٨/٢) ۴۰ ﺳﻲ ﺗﺎ ﭼﻬﻞ ﺳﺎﻝ ﺳﻦ
ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ،ﻣﺠﺪﺩﺍﹰ ،ﺑﺎ ﺁﻟﻔﺎﻱ ﮐﺮﻭﻧﺒﺎﺥ ۰/۸۴ﺗﺄﻳﻴﺪ ﺷﺪ.
(٨/٥) ۱۲ ﭼﻬﻞ ﺗﺎ ﭘﻨﺠﺎﻩ ﺳﺎﻝ
ﭘﺲ ﺍﺯ ﺍﺧﺬ ﻣﺠﻮﺯ ﺍﺯ ﮐﻤﻴﺘﻪﻱ ﺍﺧﻼﻕ ﭘﮋﻭﻫﺶ ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ
(١١/٣) ۱۶ ﺯﻳﺮ ﺳﻪ ﻣﻴﻠﻴﻮﻥ ﺗﻮﻣﺎﻥ
(٥٢/٨) ۷۵ ﺑﻴﻦ ﺳﻪ ﺗﺎ ﺷﺶ ﻣﻴﻠﻴﻮﻥ ﺗﻮﻣﺎﻥ ﻣﻴﺰﺍﻥ ﺩﺭﺁﻣﺪ ﭘﺰﺷﮑﻲ ﺑﺠﻨﻮﺭﺩ ﻭ ﺍﺭﺍﺋﻪﻱ ﻣﻌﺮﻓﻲﻧﺎﻣﻪ ﺍﺯ ﻣﺪﻳﺮﻳﺖ ﭘﮋﻭﻫﺸﻲ
(٣١/٧) ۴۵ ﺑﺎﻻﻱ ﺷﺶ ﻣﻴﻠﻴﻮﻥ ﺗﻮﻣﺎﻥ ﺩﺍﻧﺸﮕﺎﻩ ﺑﻪ ﻣﺴﺌﻮﻻﻥ ﺫﻱﺭﺑﻂ ،ﭘﮋﻭﻫﺸﮕﺮ ﺑﺎ ﻣﺮﺍﺟﻌﻪﻱ ﻣﮑﺮﺭ ﺑﻪ
(٦٠/٦) ۸۶ ﺯﻳﺮ ٥ﺳﺎﻝ ﺑﺨﺶﻫﺎﻱ ﻣﺨﺘﻠﻒ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺍﺳﺘﺎﻥ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ،ﺍﺑﺘﺪﺍ،
(١٤/١) ۲۰ ٥ﺗﺎ١١ﺳﺎﻝ
ﺍﻫﺪﺍﻑ ،ﺭﻭﺵ ﻣﻄﺎﻟﻌﻪ ﻭ ﻣﺤﺮﻣﺎﻧﻪﻣﺎﻧﺪﻥ ﺍﻃﻼﻋﺎﺕ ﺭﺍ ﺑﺮﺍﻱ
(١٣/٤) ۱۹ ١١ﺗﺎ١٧ﺳﺎﻝ ﺳﺎﺑﻘﻪﻱ ﮐﺎﺭ
ﻭﺍﺣﺪﻫﺎﻱ ﭘﮋﻭﻫﺶ ﺗﻮﺿﻴﺢ ﺩﺍﺩ ﻭ ﺍﺯ ﺁﻥﻫﺎ ﺭﺿﺎﻳﺖﻧﺎﻣﻪﻱ ﮐﺘﺒﻲ
(٥/٦) ۸ ١٧ﺗﺎ٢٣ﺳﺎﻝ
(٢ /١) ۳ ٢٣ﺗﺎ٢٩ﺳﺎﻝ ﮔﺮﻓﺖ ﻭ ﺳﭙﺲ ،ﭘﺮﺳﺶﻧﺎﻣﻪﻫﺎ ﺭﺍ ﺩﺭ ﺯﻣﺎﻥ ﻣﻨﺎﺳﺐ ،ﺑﻴﻦ ﻣﺎﻣﺎﻫﺎ
(٣/۶) ٥ ﻃﺮﺣﻲ ﺗﻮﺯﻳﻊ ﻭ ﭘﺲ ﺍﺯ ﭘﺎﺳﺦﺩﻫﻲ ،ﺟﻤﻊﺁﻭﺭﻱ ﮐﺮﺩ .ﺩﺍﺩﻩﻫﺎ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ
ﻭﺿﻌﻴﺖ
(٧٤/۶)٠٥ ﭘﻴﻤﺎﻧﻲ ﻧﺮﻡﺍﻓﺰﺍﺭ ،SPSSﻧﺴﺨﻪﻱ ۲۲ﻭ ﺁﻣﺎﺭ ﺗﻮﺻﻴﻔﻲ )ﻓﺮﺍﻭﺍﻧﻲ% ،
ﺍﺳﺘﺨﺪﺍﻣﻲ
(٢١/۸) ٣١ ﺭﺳﻤﻲ
ﻓﺮﺍﻭﺍﻧﻲ ،ﻣﻴﺎﻧﮕﻴﻦ ﻭ ﺍﻧﺤﺮﺍﻑ ﻣﻌﻴﺎﺭ( ﻭ ﺁﻣﺎﺭ ﺍﺳﺘﻨﺒﺎﻃﻲ )ﻫﻢﺑﺴﺘﮕﻲ
١٠٢
ﺑﺨﺶ ﺯﺍﻳﻤﺎﻥ ﭘﻴﺮﺳﻮﻥ( ﺗﺠﺰﻳﻪ ﻭ ﺗﺤﻠﻴﻞ ﺷﺪ.
)(٧٢/۵
ﺍﻭﺭﮊﺍﻧﺲ
(١٢)١٧ ﻣﺤﻞ ﺧﺪﻣﺖ ﻳﺎﻓﺘﻪﻫﺎ
ﺯﻧﺎﻥ
(٥/۶) ٨ ﺍﺯ ﺑﻴﻦ ۱۵۰ﭘﺮﺳﺶﻧﺎﻣﻪﻱ ﺗﻮﺯﻳﻊﺷﺪﻩ ۱۴۱ ،ﭘﺮﺳﺶﻧﺎﻣﻪ،
ﺟﺮﺍﺣﻲ
(٦/۳) ٩ ﺗﮑﻤﻴﻞ ﻭ ﺑﺮﮔﺮﺩﺍﻧﺪﻩ ﺷﺪ .ﻳﺎﻓﺘﻪﻫﺎﻱ ﭘﮋﻭﻫﺶ ﻧﺸﺎﻥ ﺩﺍﺩ ﻣﻴﺎﻧﮕﻴﻦ
ﻃﺒﻖ ﻳﺎﻓﺘﻪﻫﺎ ،ﺍﻏﻠﺐ ﭘﺎﺳﺦﺩﻫﻨﺪﮔﺎﻥ ﺑﺎ ﻧﻘﺶ ﺑﺎﺯﺩﺍﺭﻧﺪﻩﻱ ﻫﺮ
Website: http://ijme.tums.ac.ir
5 ﺍﺧﻼﻕ ﻭ ﺗﺎﺭﻳﺦ ﭘﺰﺷﻜﻲ ،ﺳﺎﻝ ،١٤٠٠ﺩﻭﺭﻩ ١٤
ﺷﺎﻣﻞ ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ ) ،(% ٨٨ﺳﺎﻋﺎﺕ ﮐﺎﺭﻱ ﻃﻮﻻﻧﻲ ) (% ٨١ﻭ ﺳﻪ ﺩﺳﺘﻪﻱ ﻋﻮﺍﻣﻞ ﻣﺤﻴﻄﻲ ) ،(% ۷۳,۹۴ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ )(% ۶۴,۶۶
ﺭﻋﺎﻳﺖﻧﺸﺪﻥ ﺗﻨﺎﺳﺐ ﺳﺎﻋﺎﺕ ﮐﺎﺭﻱ ﭘﺮﺳﻨﻞ ) (% ٧٦/٨ﺑﻮﺩ .ﺩﺭ ﻭ ﻣﺪﻳﺮﻳﺘﻲ ) ،(% ۶۴,۹۷ﺩﺭ ﺭﻋﺎﻳﺖ ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ
ﺑﻌﺪ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ،ﺗﺄﻣﻴﻦﻧﺸﺪﻥ ﻧﻴﺎﺯﻫﺎﻱ ﭘﺎﻳﻪ ،ﻣﺎﻧﻨﺪ ﻣﮑﻔﻲﺑﻮﺩﻥ ﻣﻮﺍﻓﻖ ﺑﻮﺩﻧﺪ؛ ﻫﻤﭽﻨﻴﻦ ،ﻣﻬﻢﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ
ﺩﺭﺁﻣﺪ ﻳﺎ ﺍﺳﺘﺮﺍﺣﺖ ﮐﺎﻓﻲ ) ،(% ٨٠/٩ﮐﻤﺒﻮﺩ ﺩﺍﻧﺶ ﻭ ﺁﮔﺎﻫﻲ ﺩﺭ ﺑﻌﺪ ﻣﺪﻳﺮﻳﺘﻲ ،ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ )(% ۸۸؛ ﺩﺭ ﺑﻌﺪ ﻣﺤﻴﻄﻲ ،ﺗﻐﻴﻴﺮﺍﺕ
Downloaded from ijme.tums.ac.ir at 11:22 IRST on Friday October 29th 2021
ﺩﺭﺑﺎﺭﻩﻱ ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ) (% ٧٦/٨ﻭﺑﻲﺗﻮﺟﻬﻲ ﻭ ﺑﻴﻮﻟﻮﮊﻳﮑﻲ ﺑﺪﻥ ﺩﺭ ﺷﻴﻔﺖ ﮐﺎﺭﻱ ) (% ۸۵,۲ﻭ ﺩﺭ ﺑﻌﺪ
ﮐﻢﺩﻗﺘﻲ ﭘﺮﺳﻨﻞ ﺑﻪ ﺩﻟﻴﻞ ﺣﺠﻢ ﺯﻳﺎﺩ ﮐﺎﺭ ﻭ ،(% ۶۹/۷) ...ﺭﺗﺒﻪﻫﺎﻱ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ،ﺗﺄﻣﻴﻦﻧﺸﺪﻥ ﻧﻴﺎﺯﻫﺎﻱ ﭘﺎﻳﻪ ،ﻣﺎﻧﻨﺪ ﻣﮑﻔﻲﺑﻮﺩﻥ ﺩﺭﺁﻣﺪ
ﺍﻭﻝ ﺗﺎ ﺳﻮﻡ ﺭﺍ ﺷﺎﻣﻞ ﺷﺪﻧﺪ )ﻧﮏ :ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩﻱ ﺩﻭ(؛ ﻫﻤﭽﻨﻴﻦ، ﻳﺎ ﺍﺳﺘﺮﺍﺣﺖ ﮐﺎﻓﻲ ) (% ٨٠/٩ﺑﻮﺩ .ﺩﺭ ﺑﻌﺪ ﻣﺤﻴﻄﻲ ،ﺗﻐﻴﻴﺮﺍﺕ
ﺁﺯﻣﻮﻥ ﻫﻢﺑﺴﺘﮕﻲ ﭘﻴﺮﺳﻮﻥ ﻧﺸﺎﻥ ﺩﺍﺩ ﺑﻴﻦ ﻣﺘﻐﻴﺮﻫﺎﻱ ﺩﻣﻮﮔﺮﺍﻓﻴﮏ ﺑﻴﻮﻟﻮﮊﻳﮏ ﺑﺪﻥ ﺩﺭ ﺷﻴﻔﺖ ﮐﺎﺭﻱ ﺷﺒﺎﻧﻪ ) ،(% ٨٥/٢ﺍﺯﺩﺣﺎﻡ ﺑﺨﺶ
ﻭﺍﺣﺪﻫﺎﻱ ﭘﮋﻭﻫﺶ ﺑﺎ ﻣﻮﺍﻧﻊ ﻣﺤﻴﻄﻲ ﻭ ﻣﺪﻳﺮﻳﺘﻲ ﻭ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ، ) (% ۸۳/۱ﻭ ﮐﻤﺒﻮﺩ ﺍﻣﮑﺎﻧﺎﺕ ﻭ ﺗﺠﻬﻴﺰﺍﺕ ﻣﻨﺎﺳﺐ ﺩﺭ ﺑﺨﺶ
ﺍﺭﺗﺒﺎﻁ ﺁﻣﺎﺭﻱ ﻣﻌﻨﺎﺩﺍﺭﻱ ﻭﺟﻮﺩ ﻧﺪﺍﺭﺩ ).(P> ۰/۰۵ )ﻓﻘﺪﺍﻥ ﻳﺎ ﺧﺮﺍﺑﻲ ﺩﺳﺘﮕﺎﻩﻫﺎ( ) ،(% ٧٤/٦ﺭﺗﺒﻪﻫﺎﻱ ﺍﻭﻝ ﺗﺎ ﺳﻮﻡ ﺭﺍ
ﺑﻪ ﺧﻮﺩ ﺍﺧﺘﺼﺎﺹ ﺩﺍﺩﻧﺪ .ﺩﺭ ﺑﻌﺪ ﻣﺪﻳﺮﻳﺘﻲ ،ﺭﺗﺒﻪﻫﺎﻱ ﺍﻭﻝ ﺗﺎ ﺳﻮﻡ،
ﺟﺪﻭﻝ ﺷﻤﺎﺭﻩﻱ :۲ﺗﻮﺯﻳﻊ ﻓﺮﺍﻭﺍﻧﻲ ﻧﺴﺒﻲ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎ
)٢٢ (% ١٥ /٥ )١٩ (% ١٣/٤ )١٠٠ (% ٧٠/٤ ﺑﻲﺗﻮﺟﻬﻲ ﺑﻪ ﺗﻮﺍﻧﺎﻳﻲ ﻭ ﻣﻬﺎﺭﺕ ﭘﺮﺳﻨﻞ ،ﺣﻴﻦ ﺗﻘﺴﻴﻢ ﮐﺎﺭ ١
)٣٣ (% ٢٣/٢ )٣٣ (% ٢٣/٢ )٧٤ (% ٥٢/١ ﻧﺒﻮﺩ ﮐﻨﺘﺮﻝ ﻭ ﻧﻈﺎﺭﺕ ﻣﺆﺛﺮ ،ﺗﻮﺳﻂ ﻣﺪﻳﺮﺍﻥ ﻣﺎﻣﺎﻳﻲ ٢
)٢٤ (% ١٦/٩ )٣٠ (% ٢١/١ )٨٧ (% ٦١/٢ ﺑﻲﺗﻮﺟﻬﻲ ﺑﻪ ﻧﻴﺎﺯﻫﺎﻱ ﺁﻣﻮﺯﺷﻲ ﭘﺮﺳﻨﻞ ﻭ ﺑﺮﻧﺎﻣﻪﺭﻳﺰﻱ ﺑﺮﺍﻱ ﺭﻓﻊ ﻧﻴﺎﺯﻫﺎ ٣
)٢٦ (% ١٨/٣ )٥٠ (% ٣٥/٢ )٦٣ (% ٤٤/٤ ﻓﻘﺪﺍﻥ ﮐﺪﻫﺎﻱ ﺍﺧﻼﻗﻲ ﺩﺭ ﻣﺎﻣﺎﻳﻲ ٤
)٢٧ (% ١٩ )٤٢ (% ٢٩/٦ )٦٩ (% ٤٨/٥ ﻣﺪﻳﺮﻳﺖ ﻏﻴﺮﻣﺆﺛﺮ ﺑﺤﺮﺍﻥ ﺩﺭ ﺑﺨﺶ ٥
)١٦ (% ١١/٣ )١٤ (% ٩/٩ )١٠٩ (% ٧٦/٨ ﺭﻋﺎﻳﺖﻧﺸﺪﻥ ﺗﻨﺎﺳﺐ ﺳﺎﻋﺎﺕ ﮐﺎﺭﻱ ﭘﺮﺳﻨﻞ ٦
)٤ (% ٢/٨ )١٢ (% ٨/٥ )١٢٥ (% ٨٨ ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ ٧
ﻣﺪﻳﺮﻳﺘﻲ
)١٥ (% ١٠/٦ )٩ (% ٦/٣ )١١٥ (% ٨١ ﺳﺎﻋﺎﺕ ﮐﺎﺭﻱ ﻃﻮﻻﻧﻲ ٨
)١١ (% ٧/٧ )٣٢ (% ٢٢/٥ )٩٧ (% ٦٨/٣ ﺍﺭﺗﺒﺎﻁ ﻧﺎﻣﻨﺎﺳﺐ ﻣﺪﻳﺮﺍﻥ ﻣﺎﻣﺎﻳﻲ ﺑﺎ ﭘﺮﺳﻨﻞ )ﺑﻲﺍﻋﺘﻤﺎﺩﻱ( ٩
Website: http://ijme.tums.ac.ir
ﺭﺿﺎﻳﻴﺎﻥ ﻭ ﻫﻤﮑﺎﺭﺍﻥ :ﺑﺮﺭﺳﻲ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﻣﺎﻣﺎﻳﻲ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺗﺨﺼﺼﻲ ... 6
)١٠ (% ٧ )٢١ (% ١٤/٨ )١٠٩ (% ٧٦/٧ ﮐﺎﻓﻲﻧﺒﻮﺩﻥ ﺣﻤﺎﻳﺖ ﺍﺧﻼﻗﻲ ﻭ ﺣﻘﻮﻗﻲ ﻣﺪﻳﺮﺍﻥ ١٤
ﮐﻤﺒﻮﺩ ﺍﻣﮑﺎﻧﺎﺕ ﻭ ﺗﺠﻬﻴﺰﺍﺕ ﻣﻨﺎﺳﺐ ﺩﺭ ﺑﺨﺶ )ﻓﻘﺪﺍﻥ ﻳﺎ ﺧﺮﺍﺑﻲ
)٢٢ (% ١٥/٥ )١١ (% ٧/٧ )١٠٦ (% ٧٤/٦ ١٥
ﺩﺳﺘﮕﺎﻩﻫﺎ(
)٤ (% ٣/٥ )١٥ (% ١٠/٦ )١٢١ (% ٨٥/٢ ﺗﻐﻴﻴﺮﺍﺕ ﺑﻴﻮﻟﻮﮊﻳﮏ ﺑﺪﻥ ﺩﺭ ﺷﻴﻔﺖ ﮐﺎﺭﻱ ﺷﺒﺎﻧﻪ ١٦
ﻣﺤﻴﻄﻲ
)١٠ (% ٧ )١٢ (% ٨/٥ )١١٨ (% ٨٣/١ ﺍﺯﺩﺣﺎﻡ ﺑﺨﺶ ١٧
)٢٥ (% ١٧/٦ )٢٨ (% ١٩/٧ )٨٧ (% ٦١/٣ ﺷﻴﻔﺖ ﺩﺭ ﮔﺮﺩﺵ ١٨
)١١ (% ٧/٧ )٣٧ (% ٢٦/١ )٨٨ (% ٦٥/٥ ﺗﻮﻗﻌﺎﺕ ﻧﺎﺑﻪﺟﺎﻱ ﺑﻴﻤﺎﺭﺍﻥ ﻭ ﻫﻤﺮﺍﻫﺎﻧﺸﺎﻥ ﺍﺯ ﭘﺮﺳﻨﻞ ﻣﺎﻣﺎﻳﻲ ١٩
)١٣ (% ٩/٢ )١٦ (% ١١/٣ )١٠٩ (% ٧٦/٨ ﮐﻤﺒﻮﺩ ﺩﺍﻧﺶ ﻭ ﺁﮔﺎﻫﻲ ﺩﺭﺑﺎﺭﻩﻱ ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ٢٠
)١٩ (% ١٣/٤ )٢٥ (% ١٧/٦ )٩٧ (% ٦٨/٣ ﮐﻤﺒﻮﺩ ﻭﻗﺖ ٢١
)١٨ (% ١٢/٧ )٢٣ (% ١٦/٢ )٩٩ (% ٦٩/٧ ﺑﻲﺗﻮﺟﻬﻲ ﻭ ﮐﻢﺩﻗﺘﻲ ﭘﺮﺳﻨﻞ ،ﺑﻪ ﺩﻟﻴﻞ ﺣﺠﻢ ﺯﻳﺎﺩ ﮐﺎﺭﻱ ﻭ... ٢٣
)٢٦ (% ١٨/٣ )٣٨ (% ٢٦/٨ )٧٧ (% ٥٤/٢ ﻧﮕﺮﺵ ﻣﻨﻔﻲ ﺑﻪ ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺎﻣﺎﻳﻲ ٢٥
)٢٧ (% ١٩ )٢٩ (% ٢٠/٤ )٨١ (% ٥٧/١ ﺑﻲﺍﻧﮕﻴﺰﮔﻲ ﻭ ﺑﻲﻋﻼﻗﮕﻲ ﺩﺭ ﭘﺮﺳﻨﻞ ﻣﺎﻣﺎﻳﻲ ٢٧
)١٤ (% ٩/٩ )٩ (% ٦/٣ )١١٥ (% ٨٠/٩ ﺗﺄﻣﻴﻦﻧﺸﺪﻥ ﻧﻴﺎﺯﻫﺎﻱ ﭘﺎﻳﻪ ،ﻣﺎﻧﻨﺪ ﻣﮑﻔﻲﺑﻮﺩﻥ ﺩﺭﺁﻣﺪ ﻳﺎ ﺍﺳﺘﺮﺍﺣﺖ ﮐﺎﻓﻲ ٢٨
)۱۵ (% ١٠/٦ )٣٣ (% ٢٣/٢ )٩٢ (% ٦٤/٨ ﻧﺎﺭﺿﺎﻳﺘﻲ ﺩﺭ ﺑﺨﺶ ﻣﺤﻞ ﺧﺪﻣﺖ ٢٩
)٣٢ (% ٢٢/٥ )٥٧ (% ٤٠/١ )٤٩ (% ٣٤/٥ ﮐﻤﺒﻮﺩ ﻣﻬﺎﺭﺕ ﻓﻨﻲ ﻣﺎﻣﺎﻳﻲ ٣٠
)١٢ (% ٨/٤ )٥٨ (% ٤٠/٨ )٧٠ (% ٤٩/٣ ﮐﻤﺒﻮﺩ ﺗﻮﺍﻧﺎﻳﻲ ﺗﻔﮑﺮ ﺍﻧﺘﻘﺎﺩﻱ ﻳﺎ ﺗﻮﺍﻥ ﺗﺼﻤﻴﻢﮔﻴﺮﻱ ﺍﺧﻼﻕ ﻣﺎﻣﺎﻳﻲ ٣١
)٣٥ (% ٢٤/٦ )٣٧ (% ٢٦/١ )٦٩ (% ٤٨/٦ ﻧﻘﺺ ﺩﺭ ﺑﺮﻗﺮﺍﺭﻱ ﺍﺭﺗﺒﺎﻁ ﻣﺆﺛﺮ ﻭ ﻣﻨﺎﺳﺐ ﺑﺎ ﺑﻴﻤﺎﺭﺍﻥ ٣٢
)٣٦ (% ٢٥/٣ )٢٨ (% ١٩/٧ )٧٥ (% ٥٢/٨ ﺿﻌﻒ ﺍﻋﺘﻘﺎﺩﻱ ﻧﺴﺒﺖ ﺑﻪ ﺭﻋﺎﻳﺖ ﻣﻮﺍﺯﻳﻦ ﺍﺧﻼﻗﻲ ٣٣
Website: http://ijme.tums.ac.ir
7 ﺍﺧﻼﻕ ﻭ ﺗﺎﺭﻳﺦ ﭘﺰﺷﻜﻲ ،ﺳﺎﻝ ،١٤٠٠ﺩﻭﺭﻩ ١٤
ﺑﻮﺩ ) .(۲۳ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺸﻤﺘﻲﻓﺮ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ) (۱۳۹۳ﻧﻴﺰ ﮐﻪ ﺑﺎ ﺣﺮﻓﻪﻱ ﻣﺎﻣﺎﻳﻲ ﮐﻪ ﻫﻢﺯﻣﺎﻥ ،ﺑﺎ ﺳﻼﻣﺖ ﻣﺎﺩﺭ ﻭ ﻧﻮﺯﺍﺩ ﻭﻱ ﺩﺭ
ﻫﺪﻑ ﺑﺮﺭﺳﻲ ﻣﻮﺍﻧﻊ ﺣﺴﺎﺳﻴﺖ ﺍﺧﻼﻗﻲ ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﭘﺮﺳﺘﺎﺭﺍﻥ ﺍﺭﺗﺒﺎﻁ ﺍﺳﺖ ،ﻣﺘﺄﺳﻔﺎﻧﻪ ،ﻣﻄﺎﻟﻌﺎﺗﻲ ﺍﻧﺪﮎ ﺩﺭ ﺍﺭﺗﺒﺎﻁ ﺑﺎ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ
ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺁﻣﻮﺯﺷﻲ ﺳﺒﺰﻭﺍﺭ ﺍﻧﺠﺎﻡ ﮔﺮﻓﺖ ،ﺑﺮ ﺍﻫﻤﻴﺖ ﺗﻮﺟﻪ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﺳﻪ ﺣﻴﻄﻪﻱ ﻣﺤﻴﻄﻲ ،ﻣﺪﻳﺮﻳﺘﻲ ﻭ
ﺑﻪ ﻫﺮ ﭼﻬﺎﺭ ﺣﻴﻄﻪﻱ ﻣﺤﻴﻄﻲ ،ﻣﺪﻳﺮﻳﺘﻲ ،ﻣﻮﺍﻧﻊ ﻣﺮﺑﻮﻁ ﺑﻪ ﭘﺮﺳﺘﺎﺭ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺍﺳﺖ ﮐﻪ ﺑﺎﻋﺚ
ﻭ ﺑﻴﻤﺎﺭ ﺗﺄﮐﻴﺪ ﺷﺪ ) .(٢٤ﻣﻄﺎﻟﻌﺎﺕ ﺫﮐﺮﺷﺪﻩ ،ﺍﺯ ﺍﻳﻦ ﻧﻈﺮ ،ﺑﺎ ﻣﻲﺷﻮﺩ ﺍﺭﺯﻳﺎﺑﻲ ﻧﺘﺎﻳﺞ ﺑﺎ ﻣﺮﻭﺭ ﻣﻄﺎﻟﻌﺎﺕ ﻣﻮﺍﻓﻖ ﻭ ﻣﺨﺎﻟﻒ ،ﺩﺷﻮﺍﺭ
ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ﻫﻤﺴﻮﺳﺖ؛ ﺩﺭ ﻧﺘﻴﺠﻪ ،ﺑﻪ ﻧﻈﺮ ﻣﻲﺭﺳﺪ ﺷﻨﺎﺧﺖ ﺑﺎﺷﺪ .ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ،ﺑﻪﺗﺮﺗﻴﺐ ،ﻫﺮ ﺳﻪ ﺣﻴﻄﻪﻱ ﻋﻮﺍﻣﻞ
ﻭ ﺑﻪ ﺩﻧﺒﺎﻝ ﺁﻥ ،ﺑﺮﻃﺮﻑﮐﺮﺩﻥ ﻣﻮﺍﻧﻊ ﻣﺮﺑﻮﻁ ﺑﻪ ﺣﻴﻄﻪﻱ ﻣﺤﻴﻄﻲ، ﻣﺤﻴﻄﻲ ﻭ ﻣﺪﻳﺮﻳﺘﻲ ﻭ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ،ﺍﺯﺟﻤﻠﻪ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ
ﺑﺴﻴﺎﺭ ﺣﺎﺋﺰ ﺍﻫﻤﻴﺖ ﺍﺳﺖ. ﺣﺮﻓﻪﺍﻱ ﺍﺳﺖ .ﺍﺯ ﺑﻴﻦ ﺍﻳﻦ ﺳﻪ ﺣﻴﻄﻪ ،ﺩﺳﺘﻪﻱ ﻋﻮﺍﻣﻞ ﻣﺤﻴﻄﻲ،
ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ،ﺩﺭ ﺑﻌﺪ ﻣﺤﻴﻄﻲ ،ﺗﻐﻴﻴﺮﺍﺕ ﺑﻴﻮﻟﻮﮊﻳﮏ ﺑﺪﻥ ﻧﺴﺒﺖ ﺑﻪ ﺳﺎﻳﺮ ﻋﻮﺍﻣﻞ ،ﻣﺆﺛﺮﺗﺮ ﺑﻪ ﻧﻈﺮ ﻣﻲﺭﺳﺪ.
ﺩﺭ ﺷﻴﻔﺖ ﮐﺎﺭﻱ ﺷﺒﺎﻧﻪ ،ﺍﺯﺩﺣﺎﻡ ﺑﺨﺶ ﻭ ﮐﻤﺒﻮﺩ ﺍﻣﮑﺎﻧﺎﺕ ﻭ ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﻗﻤﺮﻱ ﺯﺍﺭﻉ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ) (۱۳۹۳ﮐﻪ ﺑﺎ ﻫﺪﻑ
ﺗﺠﻬﻴﺰﺍﺕ ﻣﻨﺎﺳﺐ ﺩﺭ ﺑﺨﺶ )ﻓﻘﺪﺍﻥ ﻳﺎ ﺧﺮﺍﺑﻲ ﺩﺳﺘﮕﺎﻩﻫﺎ(، ﺗﻌﻴﻴﻦ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻋﻤﻠﮑﺮﺩ ﭘﺮﺳﺘﺎﺭﺍﻥ ﺍﺯ
ﺑﻪﺗﺮﺗﻴﺐ ،ﺭﺗﺒﻪﻫﺎﻱ ﺍﻭﻝ ﺗﺎ ﺳﻮﻡ ﺭﺍ ﺑﻪ ﺧﻮﺩ ﺍﺧﺘﺼﺎﺹ ﺩﺍﺩﻧﺪ .ﺩﺭ ﺩﻳﺪﮔﺎﻩ ﻣﺪﻳﺮﺍﻥ ﭘﺮﺳﺘﺎﺭﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺷﻬﺮ ﻗﻢ ﺍﻧﺠﺎﻡ ﮔﺮﻓﺖ،
ﻣﻄﺎﻟﻌﻪﻱ ﻣﺤﻤﺪﻱ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ،ﻣﻬﻢﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ﻣﺤﻴﻄﻲ ﺩﺭ ﺍﺟﺮﺍﻱ ﻫﻤﻪﻱ ﻋﻮﺍﻣﻞ ﻣﺤﻴﻄﻲ ﻭ ﻣﺪﻳﺮﻳﺘﻲ ﻭ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ،ﺑﻪﺗﺮﺗﻴﺐ ،ﺩﺭ
ﺍﺻﻮﻝ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ،ﺍﺯﺩﺣﺎﻡ ﺑﺨﺶ ،ﺗﻐﻴﻴﺮﺍﺕ ﺑﻴﻮﻟﻮﮊﻳﮏ ﺑﺪﻥ ﺭﻋﺎﻳﺖﻧﺸﺪﻥ ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﻧﻘﺸﻲ ﺑﺴﺰﺍ ﺩﺍﺷﺘﻨﺪ؛
ﺩﺭ ﺷﻴﻔﺖﻫﺎﻱ ﺷﺒﺎﻧﻪ ﻭ ﺗﻮﻗﻌﺎﺕ ﻧﺎﺑﻪﺟﺎﻱ ﺑﻴﻤﺎﺭﺍﻥ ﻭ ﻫﻤﺮﺍﻫﺎﻧﺸﺎﻥ ﺑﺎﺍﻳﻦﺣﺎﻝ ،ﻧﻘﺶ ﻋﻮﺍﻣﻞ ﻣﺤﻴﻄﻲ ،ﻣﺆﺛﺮﺗﺮ ﺑﻮﺩ ) .(۲۱ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ
ﺍﺯ ﭘﺮﺳﻨﻞ ﭘﺮﺳﺘﺎﺭﻱ ،ﮔﺰﺍﺭﺵ ﺷﺪ ) .(۲۳ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺩﻫﻘﺎﻧﻲ ﻭ ﺩﻫﻘﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ﻧﻴﺰ ﮐﻪ ﺑﺎ ﻫﺪﻑ ﺗﻌﻴﻴﻦ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ
ﻫﻤﮑﺎﺭﺍﻥ ،ﻣﻬﻢﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ﻣﺤﻴﻄﻲ ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﭘﺮﺳﺘﺎﺭﺍﻥ ،ﺑﻪﺗﺮﺗﻴﺐ، ﺍﺳﺘﺎﻧﺪﺍﺭﺩﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﺍﺯ ﺩﻳﺪﮔﺎﻩ
ﺍﺯﺩﺣﺎﻡ ﺑﺨﺶ ،ﺗﻮﻗﻌﺎﺕ ﻧﺎﺑﻪﺟﺎﻱ ﺑﻴﻤﺎﺭﺍﻥ ﻭ ﻫﻤﺮﺍﻫﺎﻥ ﺍﻳﺸﺎﻥ ﺍﺯ ﭘﺮﺳﺘﺎﺭﺍﻥ ﺍﻧﺠﺎﻡ ﮔﺮﻓﺖ ،ﺑﻪﺗﺮﺗﻴﺐ ،ﻫﺮ ﺳﻪ ﺩﺳﺘﻪﻱ ﻋﻮﺍﻣﻞ ﻣﺤﻴﻄﻲ
ﭘﺮﺳﻨﻞ ﭘﺮﺳﺘﺎﺭﻱ ﻭ ﺗﻐﻴﻴﺮﺍﺕ ﺑﻴﻮﻟﻮﮊﻳﻚ ﺑﺪﻥ ﺩﺭ ﺷﻴﻔﺖ ﻛﺎﺭﻱ ﻭ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ﻭ ﻣﺪﻳﺮﻳﺘﻲ ،ﺩﺭ ﺭﻋﺎﻳﺖﻧﮑﺮﺩﻥ ﺍﺳﺘﺎﻧﺪﺍﺭﺩﻫﺎﻱ
ﺷﺒﺎﻧﻪ ،ﺭﺗﺒﻪﻫﺎﻱ ﺍﻭﻝ ﺗﺎ ﺳﻮﻡ ﺭﺍ ﻛﺴﺐ ﮐﺮﺩﻧﺪ ) .(۱۹ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﻣﺆﺛﺮ ﺑﻮﺩﻧﺪ ﮐﻪ ﻣﻬﻢﺗﺮﻳﻦ ﻋﺎﻣﻞ ،ﺣﻴﻄﻪﻱ ﻋﻮﺍﻣﻞ
ﻗﻤﺮﻱ ﺯﺍﺭﻉ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ﻧﻴﺰ ،ﺍﺯﺩﺣﺎﻡ ﺑﺨﺶ ،ﺗﻮﻗﻌﺎﺕ ﻧﺎﺑﻪﺟﺎﻱ ﻣﺤﻴﻄﻲ ﺑﻮﺩ ) .(۱۹ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺑﺮﻫﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ) (۱۳۹۰ﮐﻪ
ﺑﻴﻤﺎﺭﺍﻥ ﻭ ﻫﻤﺮﺍﻫﺎﻧﺸﺎﻥ ﺍﺯ ﭘﺮﺳﻨﻞ ﭘﺮﺳﺘﺎﺭﻱ ﻭ ﺗﻐﻴﻴﺮﺍﺕ ﺑﻴﻮﻟﻮﮊﻳﮏ ﺑﺎ ﻫﺪﻑ ﺩﺭﮎ ﺩﺍﻧﺸﺠﻮﻳﺎﻥ ﭘﺮﺳﺘﺎﺭﻱ ﺍﺯ ﻣﻮﺍﻧﻊ ﺣﺴﺎﺳﻴﺖ ﺍﺧﻼﻕ
ﺩﺭ ﺷﻴﻔﺖ ﮐﺎﺭﻱ ﺷﺒﺎﻧﻪ ،ﻣﻬﻢﺗﺮﻳﻦ ﻋﻮﺍﻣﻞ ﺩﺭ ﺑﻌﺪ ﻣﺤﻴﻄﻲ ﺍﺳﺖ ﺣﺮﻓﻪﺍﻱ ﺍﻧﺠﺎﻡ ﺷﺪ ،ﻭﻳﮋﮔﻲﻫﺎﻱ ﺷﺨﺼﻲ ،ﺑﺮﻧﺎﻣﻪﻱ ﺁﻣﻮﺯﺷﻲ ﻭ
) .(۲۱ﻣﻄﺎﻟﻌﺎﺕ ﺫﮐﺮﺷﺪﻩ ،ﺍﺯ ﻧﻈﺮ ﻣﻬﻢﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ﻣﺤﻴﻄﻲ ،ﺷﺎﻣﻞ ﻣﺤﻴﻂ ﺑﺎﻟﻴﻨﻲ ﺭﺍ ﺑﺮ ﺣﺴﺎﺳﻴﺖ ﺍﺧﻼﻗﻲ ﻣﺆﺛﺮ ﺩﺍﻧﺴﺘﻨﺪ )(۲۲؛
ﺗﻐﻴﻴﺮﺍﺕ ﺑﻴﻮﻟﻮﮊﻳﮏ ﺑﺪﻥ ﺩﺭ ﺷﻴﻔﺖ ﮐﺎﺭﻱ ﺷﺒﺎﻧﻪ ﻭ ﺍﺯﺩﺣﺎﻡ ﺑﺨﺶ، ﻫﻤﭽﻨﻴﻦ ،ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﻣﺤﻤﺪﻱ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ) ،(۱۳۹۴ﻫﺮ ﺳﻪ
Website: http://ijme.tums.ac.ir
ﺭﺿﺎﻳﻴﺎﻥ ﻭ ﻫﻤﮑﺎﺭﺍﻥ :ﺑﺮﺭﺳﻲ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﻣﺎﻣﺎﻳﻲ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺗﺨﺼﺼﻲ ... 8
ﻣﻬﻢﺗﺮﻳﻦ ﻋﻮﺍﻣﻞ ﺍﺳﺘﺮﺱﺯﺍﻱ ﺷﻐﻠﻲ ﻣﺤﺴﻮﺏ ﻣﻲﺷﻮﻧﺪ ) .(۲۷ﺍﺯ ﻫﻤﺨﻮﺍﻥ ﺑﺎ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ﺍﺳﺖ؛ ﺍﻣﺎ ﺍﺯ ﻧﻈﺮ ﺗﻮﻗﻌﺎﺕ ﻧﺎﺑﻪﺟﺎﻱ
ﻃﺮﻓﻲ ،ﺧﻮﺩ ﺍﺳﺘﺮﺱ ﺷﻐﻠﻲ ،ﻣﻲﺗﻮﺍﻧﺪ ﺑﺮ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺍﺛﺮ ﻣﻨﻔﻲ ﺑﻴﻤﺎﺭﺍﻥ ﻭ ﻫﻤﺮﺍﻫﺎﻧﺸﺎﻥ ﺍﺯ ﭘﺮﺳﻨﻞ ،ﺑﺎ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ﻫﻤﺨﻮﺍﻧﻲ
ﺑﮕﺬﺍﺭﺩ؛ ﺑﻪﻃﻮﺭﻱﮐﻪ ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺴﻨﻲ ) ،(۱۳۹۵ﻧﺸﺎﻥ ﺩﺍﺩﻩ ﺷﺪ ﻧﺪﺍﺭﺩ .ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﭘﻴﺶ ﺭﻭ ،ﺗﻮﻗﻌﺎﺕ ﻧﺎﺑﻪﺟﺎﻱ ﺑﻴﻤﺎﺭﺍﻥ ﻭ
ﺑﻴﻦ ﺟﻮ ﺍﺧﻼﻗﻲ ﻭ ﺍﺳﺘﺮﺱ ﺷﻐﻠﻲ ،ﻫﻢﺑﺴﺘﮕﻲ ﻣﻌﮑﻮﺱ ﻣﻌﻨﺎﺩﺍﺭ ﻫﻤﺮﺍﻫﺎﻧﺸﺎﻥ ﺍﺯ ﭘﺮﺳﻨﻞ ،ﺟﺰﺀ ﺭﺗﺒﻪﻫﺎﻱ ﺍﻭﻝ ﺗﺎ ﺳﻮﻡ ﻣﻮﺍﻧﻊ ﻣﺤﻴﻄﻲ
Downloaded from ijme.tums.ac.ir at 11:22 IRST on Friday October 29th 2021
ﻭﺟﻮﺩ ﺩﺍﺭﺩ )(۲۸؛ ﺑﻨﺎﺑﺮﺍﻳﻦ ،ﻋﻮﺍﻣﻠﻲ ﮐﻪ ﻣﻨﺠﺮ ﺑﻪ ﺍﻓﺰﺍﻳﺶ ﺍﺳﺘﺮﺱ ﺩﺭ ﺍﺟﺮﺍﻱ ﺍﺻﻮﻝ ﺍﺧﻼﻗﻲ ﺫﮐﺮ ﻧﺸﺪ .ﺷﺎﻳﺪ ،ﺍﺯ ﺩﻻﻳﻞ ﺁﻥ ،ﺗﻔﺎﻭﺕ
ﺷﻐﻠﻲ ﻣﻲﺷﻮﺩ ،ﺍﺯﺟﻤﻠﻪ ﻓﻀﺎﻱ ﺑﺨﺶ ،ﻧﻮﺑﺖ ﮐﺎﺭﻱ ﻭ ﺣﺠﻢ ﺯﻳﺎﺩ ﺩﺭ ﺟﺎﻣﻌﻪ ﻭ ﻣﺤﻴﻂ ﭘﮋﻭﻫﺶ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻣﻄﺎﻟﻌﺎﺕ ﺫﮐﺮﺷﺪﻩ
ﮐﺎﺭ ،ﻣﻲﺗﻮﺍﻧﺪ ﻣﺎﻧﻌﻲ ﺑﺮﺍﻱ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺑﺎﺷﺪ .ﺑﺎ ﺗﻮﺟﻪ ﺑﺎﺷﺪ؛ ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ،ﺟﺎﻣﻌﻪﻱ ﭘﮋﻭﻫﺶ ،ﻣﺎﻣﺎﻫﺎ ﻫﺴﺘﻨﺪ؛ ﺍﻣﺎ
ﺑﻪ ﺍﻳﻦ ﻋﻮﺍﻣﻞ ﮐﻪ ﻣﺎﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﺣﻴﻄﻪﻱ ﺩﺭ ﻣﻄﺎﻟﻌﺎﺕ ﺫﮐﺮﺷﺪﻩ ،ﺟﺎﻣﻌﻪﻱ ﭘﮋﻭﻫﺶ ،ﭘﺮﺳﺘﺎﺭﺍﻥﺍﻧﺪ؛ ﻫﻤﭽﻨﻴﻦ،
ﻋﻤﻠﮑﺮﺩ ﻣﺎﻣﺎﻫﺎ ﺷﺪﻩ ﺍﺳﺖ ،ﺑﻪ ﻧﻈﺮ ﻣﻲﺭﺳﺪ ﺑﺮﮔﺰﺍﺭﻱ ﺟﻠﺴﺎﺕ ﻭ ﺍﺯﺁﻧﺠﺎﮐﻪ ﻣﺤﻞ ﺧﺪﻣﺖ ﺍﮐﺜﺮ ﺟﺎﻣﻌﻪﻱ ﭘﮋﻭﻫﺶ ﻣﻄﺎﻟﻌﻪﻱ ﭘﻴﺶ ﺭﻭ
ﺍﻧﺠﺎﻡ ﻫﻤﺎﻫﻨﮕﻲﻫﺎﻱ ﻻﺯﻡ ﺑﺎ ﻣﺪﻳﺮﺍﻥ ﻭ ﻣﺴﺌﻮﻻﻥ ﺫﻱﺭﺑﻂ ،ﺑﺮﺍﻱ ) ،(% ۷۲/۵ﺑﺨﺶ ﺯﺍﻳﻤﺎﻥ ﺍﺳﺖ ﻭ ﺑﻪ ﺩﻟﻴﻞ ﺷﺮﺍﻳﻂ ﺧﺎﺹ ﺑﺨﺶ
ﺭﻓﻊ ﺍﻳﻦ ﻣﻮﺍﻧﻊ ﻣﺤﻴﻄﻲ ﺿﺮﻭﺭﻱ ﺍﺳﺖ؛ ﻫﻤﭽﻨﻴﻦ ،ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺯﺍﻳﻤﺎﻥ ،ﺍﺟﺎﺯﻩﻱ ﺣﻀﻮﺭ ﻫﻤﺮﺍﻩ ﺩﺭ ﺍﻳﻦ ﺑﺨﺶ ،ﻣﺸﺎﺑﻪ ﺳﺎﻳﺮ
ﺍﻫﺪﺍﻑ ﻭ ﺭﺳﺎﻟﺖ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺩﻭﺳﺘﺪﺍﺭ ﻣﺎﺩﺭ ﻭ ﮐﻮﺩﮎ ،ﺿﺮﻭﺭﻱ ﺑﺨﺶﻫﺎﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ،ﻧﻴﺴﺖ ،ﺣﻀﻮﺭ ﻫﻤﺮﺍﻩ ﻭ ﺑﻪﺗﺒﻊ ﺁﻥ ،ﺗﻮﻗﻌﺎﺕ
ﺍﺳﺖ ﻣﺤﻴﻂ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﻣﺎ ﺑﻪ ﺳﻤﺖ ﺗﺠﻬﻴﺰﮐﺮﺩﻥ ﺍﻣﮑﺎﻧﺎﺕ ﻭ ﻧﺎﺑﻪﺟﺎﻱ ﻫﻤﺮﺍﻫﺎﻥ ﺑﻴﻤﺎﺭﺍﻥ ﺩﺭ ﺍﻳﻦ ﺑﺨﺶ ،ﺑﺴﻴﺎﺭ ﮐﻤﺘﺮ ﺍﺯ
ﻭﺳﺎﻳﻞ ﻣﻮﺭﺩ ﻧﻴﺎﺯ ﻭ ﺍﻳﺠﺎﺩ ﺍﺗﺎﻕﻫﺎﻱ LDRﺑﺮﺍﻱ ﻣﺎﺩﺭﺍﻥ ،ﭘﻴﺶ ﺑﺨﺶﻫﺎﻱ ﺩﻳﮕﺮ ﺍﺳﺖ .ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺑﺮﻫﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ﻧﻴﺰ،
ﺭﻭﺩ ﺗﺎ ﺑﺎ ﺍﻧﺠﺎﻡ ﺍﻳﻦ ﺍﻗﺪﺍﻣﺎﺕ ،ﺑﺨﺸﻲ ﺍﺯ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺯﻳﺎﺩﺑﻮﺩﻥ ﺑﺎﺭﹺ ﻛﺎﺭﻱ ﻭ ﮐﺎﻓﻲﻧﺒﻮﺩﻥ ﺍﻣﻜﺎﻧﺎﺕ ،ﺍﺯﺟﻤﻠﻪ ﻣﻮﺍﻧﻊ
ﺣﺮﻓﻪﺍﻱ ،ﺍﺯﺟﻤﻠﻪ ﺍﺯﺩﺣﺎﻡ ﺑﺨﺶ ﻭ ﮐﻤﺒﻮﺩ ﺍﻣﮑﺎﻧﺎﺕ ﻭ ﺗﺠﻬﻴﺰﺍﺕ ﺣﺴﺎﺳﻴﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﻣﻌﺮﻓﻲ ﺷﺪﻩ ﺍﺳﺖ ) .(٢٢ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ
ﻣﻨﺎﺳﺐ ﺩﺭ ﺑﺨﺶ ،ﺑﺮﻃﺮﻑ ﺷﻮﺩ؛ ﺍﻓﺰﻭﻥﺑﺮﺍﻳﻦ ،ﭘﻴﺸﻨﻬﺎﺩ ﻣﻲﺷﻮﺩ ﺑﺎ ﺣﺸﻤﺘﻲﻓﺮ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ﻫﻢ ،ﻣﻬﻢﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ﺣﺴﺎﺳﻴﺖ ﺍﺧﻼﻗﻲ
ﺑﺮﻧﺎﻣﻪﺭﻳﺰﻱﻫﺎﻱ ﻻﺯﻡ ،ﺷﻴﻔﺖﻫﺎﻳﻲ ﺛﺎﺑﺖﺗﺮ ،ﺩﺭ ﻣﺎﻩ ،ﺑﺮﺍﻱ ﻫﻤﻪﻱ ﺩﺭ ﺑﻌﺪ ﻣﺤﻴﻄﻲ ،ﺷﻠﻮﻏﻲ ﺑﺨﺶ ﻭ ﮐﻤﺒﻮﺩ ﺍﻣﮑﺎﻧﺎﺕ ﻭ ﺗﺠﻬﻴﺰﺍﺕ
ﮐﺎﺩﺭ ﺩﺭﻣﺎﻥ ،ﺍﺯﺟﻤﻠﻪ ﻣﺎﻣﺎﻫﺎ ،ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﻮﺩ. ﻋﻨﻮﺍﻥ ﺷﺪﻩ ﺍﺳﺖ ) (۲۴ﮐﻪ ﺑﺎ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ﻫﻤﺨﻮﺍﻧﻲ ﺩﺍﺭﺩ .ﺩﺭ
ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ،ﺩﺭ ﺑﻌﺪ ﻣﺪﻳﺮﻳﺘﻲ ،ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ ،ﺳﺎﻋﺖ ﻣﻄﺎﻟﻌﻪﻱ ﺳﻠﻴﻤﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ) (۱۳۸۶ﻧﻴﺰ ،ﮔﺰﺍﺭﺵ ﺷﺪ ﺳﻄﺢ
ﮐﺎﺭﻱ ﻃﻮﻻﻧﻲ ﻭ ﺷﻴﻔﺖﻫﺎﻱ ﻧﺎﻣﻨﺎﺳﺐ ﮐﺎﺭﻱ )ﺭﻋﺎﻳﺖﻧﺸﺪﻥ ﺳﻼﻣﺖ ﻋﻤﻮﻣﻲ ﭘﺮﺳﺘﺎﺭﺍﻧﻲ ﮐﻪ ﺩﺭ ﺷﻴﻔﺖﻫﺎﻱ ﮐﺎﺭﻱ ﺩﺭ ﮔﺮﺩﺵ
ﺗﻨﺎﺳﺐ ﺳﺎﻋﺖ ﮐﺎﺭﻱ ﭘﺮﺳﻨﻞ( ،ﺟﺰﺀ ﻣﻬﻢﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﻫﺴﺘﻨﺪ ،ﺩﺭ ﻣﻘﺎﻳﺴﻪ ﺑﺎ ﭘﺮﺳﺘﺎﺭﺍﻧﻲ ﮐﻪ ﺩﺭ ﺷﻴﻔﺖﻫﺎﻱ ﺛﺎﺑﺖﺍﻧﺪ،
ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﮔﺰﺍﺭﺵ ﺷﺪﻩ ﺍﺳﺖ ﮐﻪ ﺍﺯ ﺍﻳﻦ ﻧﻈﺮ ،ﺑﺎ ﻣﻄﺎﻟﻌﻪﻱ ﻧﺎﻣﻄﻠﻮﺏﺗﺮ ﺍﺳﺖ )(۲۵؛ ﻫﻤﭽﻨﻴﻦ ،ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺧﺎﻗﺎﻧﻲﺯﺍﺩﻩ ﻭ
ﺩﻫﻘﺎﻧﻲ ) (۱۹ﻭ ﻗﻤﺮﻱ ﺯﺍﺭﻉ ) ،(۲۱ﻫﻤﺴﻮﺳﺖ )۱۹ﻭ(۲۱؛ ﻫﻤﮑﺎﺭﺍﻥ ) ،(۱۳۸۷ﻧﻮﺑﺖ ﮐﺎﺭﻱ ،ﺑﻪﻋﻨﻮﺍﻥ ﻳﮑﻲ ﺍﺯ ﻋﻮﺍﻣﻞ ﻣﺆﺛﺮ ﺑﺮ
ﻫﻤﭽﻨﻴﻦ ،ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﻣﺤﻤﺪﻱ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ،ﻣﻬﻢﺗﺮﻳﻦ ﻋﻮﺍﻣﻞ، ﺑﺮﻭﺯ ﺍﺳﺘﺮﺱ ﺩﺭ ﺍﻓﺮﺍﺩ ﺷﺎﻏﻞ ﺩﺭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎ ﺑﻴﺎﻥ ﺷﺪ ).(۲۶
ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ ﻭ ﺁﻣﻮﺯﺵﻫﺎﻱ ﻻﺯﻡ ﺩﺭ ﺯﻣﻴﻨﻪﻱ ﻣﻮﺿﻮﻋﺎﺕ ﻧﺘﺎﻳﺞ ﺗﺤﻘﻴﻖ ﺳﺎﻭﺍﺗﺰﮐﻲ (۱۹۹۶) ١ﺭﻭﻱ ﭘﺮﺳﺘﺎﺭﺍﻥ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ
ﺍﺧﻼﻗﻲ ،ﺩﺭ ﺩﻭﺭﺍﻥ ﺗﺤﺼﻴﻞ ﺩﺍﻧﺸﺠﻮﻳﺎﻥ ﭘﺮﺳﺘﺎﺭﻱ ﮔﺰﺍﺭﺵ ﺷﺪﻩ ﮐﺎﻧﺎﺩﺍ ﻧﻴﺰ ،ﺑﻴﺎﻧﮕﺮ ﺍﻳﻦ ﺍﺳﺖ ﮐﻪ ﻓﻀﺎﻱ ﺑﺨﺶ ﻭ ﺣﺠﻢ ﺯﻳﺎﺩ ﮐﺎﺭ ،ﺍﺯ
1. Sawatzky
Website: http://ijme.tums.ac.ir
9 ﺍﺧﻼﻕ ﻭ ﺗﺎﺭﻳﺦ ﭘﺰﺷﻜﻲ ،ﺳﺎﻝ ،١٤٠٠ﺩﻭﺭﻩ ١٤
ﺑﺎ ﻫﺪﻑ ﺗﻌﻴﻴﻦ ﻋﻮﺍﻣﻞ ﻣﺮﺗﺒﻂ ﺑﺎ ﺗﺴﻬﻴﻞ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺍﺳﺖ ) .(۲۳ﻧﺘﺎﻳﺞ ﻣﻄﺎﻟﻌﻪﻱ ﻣﺤﻤﺪﻱ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ،ﺍﺯ ﻧﻈﺮ ﮐﻤﺒﻮﺩ
ﭘﺮﺳﺘﺎﺭﺍﻥ ﺍﻧﺠﺎﻡ ﮔﺮﻓﺖ ،ﻧﺘﺎﻳﺞ ﻧﺸﺎﻥ ﺩﺍﺩ ﺭﺍﺿﻲﺑﻮﺩﻥ ﭘﺮﺳﻨﻞ ﺍﺯ ﭘﺮﺳﻨﻞ ،ﻫﻤﺨﻮﺍﻥ ﺑﺎ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ﺍﺳﺖ؛ ﺍﻣﺎ ﺍﺯ ﻧﻈﺮ ﮐﻤﺒﻮﺩ
ﻧﻴﺎﺯﻫﺎﻱ ﭘﺎﻳﻪ ،ﻣﺎﻧﻨﺪ ﻣﮑﻔﻲﺑﻮﺩﻥ ﺩﺭﺁﻣﺪ ﻳﺎ ﺍﺳﺘﺮﺍﺣﺖ ،ﻋﺎﻣﻠﻲ ﺑﺴﻴﺎﺭ ﺁﻣﻮﺯﺵﻫﺎﻱ ﻻﺯﻡ ﺩﺭ ﺯﻣﻴﻨﻪﻱ ﻣﻮﺿﻮﻋﺎﺕ ﺍﺧﻼﻗﻲ ﺩﺭ ﺩﻭﺭﺍﻥ
ﻣﻬﻢ ﺍﺯ ﻣﻴﺎﻥ ﻋﻮﺍﻣﻞ ﺗﺴﻬﻴﻞﮐﻨﻨﺪﻩﻱ ﺭﻋﺎﻳﺖ ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺗﺤﺼﻴﻞ ،ﺑﺎ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ،ﻫﻤﺨﻮﺍﻧﻲ ﻧﺪﺍﺭﺩ ﮐﻪ ﻋﻠﺖ ﺁﻥ ﺭﺍ ﻣﻲﺗﻮﺍﻥ
Downloaded from ijme.tums.ac.ir at 11:22 IRST on Friday October 29th 2021
ﺣﺮﻓﻪﺍﻱ ﭘﺮﺳﺘﺎﺭﺍﻥ ﺍﺳﺖ ) .(۳۰ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﻗﻤﺮﻱ ﺯﺍﺭﻉ ﻭ ﺗﻔﺎﻭﺕ ﺩﺭ ﻭﺍﺣﺪﻫﺎﻱ ﭘﮋﻭﻫﺶ ﺩﺍﻧﺴﺖ؛ ﭼﺮﺍﮐﻪ ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ
ﻫﻤﮑﺎﺭﺍﻥ ﻧﻴﺰ ،ﻧﺪﺍﺷﺘﻦ ﺭﺿﺎﻳﺖ ﺍﺯ ﻧﻴﺎﺯﻫﺎﻱ ﭘﺎﻳﻪ ،ﻣﺎﻧﻨﺪ ﻣﮑﻔﻲﺑﻮﺩﻥ ﻣﺤﻤﺪﻱ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ،ﮐﻤﺒﻮﺩ ﺁﻣﻮﺯﺵﻫﺎﻱ ﻻﺯﻡ ﺩﺭ ﺯﻣﻴﻨﻪﻱ
ﺩﺭﺁﻣﺪ ﻳﺎ ﺍﺳﺘﺮﺍﺣﺖ ﮐﺎﻓﻲ ﭘﺮﺳﻨﻞ ﻭ ﮐﻤﺒﻮﺩ ﺩﺍﻧﺶ ﻭ ﺁﮔﺎﻫﻲ ﻣﻮﺿﻮﻋﺎﺕ ﺍﺧﻼﻗﻲ ،ﺩﺭ ﺩﻭﺭﺍﻥ ﺗﺤﺼﻴﻞ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺪﺭﺳﺎﻥ
ﺩﺭﺑﺎﺭﻩﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ،ﻣﻬﻢﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ،ﺑﻴﺎﻥ ﺷﺪﻩ ﺍﺳﺖ ).(۲۱ ﭘﺮﺳﺘﺎﺭﻱ ﺍﺳﺖ؛ ﻭﻟﻲ ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﭘﺮﺳﺘﺎﺭﺍﻥ )ﭘﺮﺳﻨﻞ
ﺍﺯﺩﻳﺪﮔﺎﻩ ﻣﺤﻤﺪﻱ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ﻭ ﺩﻫﻘﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ﻧﻴﺰ، ﺑﻴﻤﺎﺭﺳﺘﺎﻥ( ﺍﺳﺖ ) .(۲۴ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﭘﻴﺶ ﺭﻭ ﻧﻴﺰ ،ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ،
ﻣﻬﻢﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ،ﮐﻤﺒﻮﺩ ﻭﻗﺖ ﻭ ﺑﻲﺗﻮﺟﻬﻲ ﻭ ﮐﻢﺩﻗﺘﻲ ﮐﺎﻓﻲ ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎ )ﭘﺮﺳﻨﻞ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ( ﺍﺳﺖ .ﻧﺼﻴﺮﻳﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ
ﭘﺮﺳﻨﻞ ﺑﻪ ﺩﻟﻴﻞ ﺣﺠﻢ ﺯﻳﺎﺩ ﮐﺎﺭ ﺑﻮﺩ )۱۹ﻭ .(۲۳ﺍﺯ ﻃﺮﻓﻲ ،ﺩﺭ ) (۱۳۸۱ﻣﻌﺘﻘﺪﻧﺪ ﻳﮑﻲ ﺍﺯ ﻋﻮﺍﻣﻠﻲ ﮐﻪ ﺑﺮ ﺭﻋﺎﻳﺖ ﺣﻘﻮﻕ ﺑﻴﻤﺎﺭﺍﻥ
ﻣﻄﺎﻟﻌﻪﻱ ﺍﻣﻴﺪﻱ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ) (۱۳۹۹ﮐﻪ ﺑﺎ ﻫﺪﻑ ﺗﻌﻴﻴﻦ ﻣﻴﺰﺍﻥ ﻣﺆﺛﺮ ﺍﺳﺖ ،ﺩﺭﻧﻈﺮﮔﺮﻓﺘﻦ ﺣﻘﻮﻕ ﭘﺮﺳﺘﺎﺭﺍﻥ ﺍﺳﺖ .ﺷﻴﻔﺖﻫﺎﻱ
ﺁﮔﺎﻫﻲ ﻣﺎﻣﺎﻫﺎ ﺍﺯ ﻗﻮﺍﻧﻴﻦ ﻭ ﻣﻘﺮﺭﺍﺕ ﻣﺎﻣﺎﻳﻲ ﻭ ﮐﺪﻫﺎﻱ ﺍﺧﻼﻕ ﮐﺎﺭﻱ ﺯﻳﺎﺩ ،ﮐﻤﺒﻮﺩ ﭘﺮﺳﻨﻞ ﻭ ﮐﻤﺒﻮﺩ ﺩﺳﺘﻤﺰﺩﻫﺎﻱ ﭘﺮﺳﺘﺎﺭﻱ ،ﺟﺰﺀ
ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺗﺎﺑﻊ ﺍﺳﺘﺎﻥ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ﺍﻧﺠﺎﻡ ﺣﻘﻮﻕ ﭘﺮﺳﺘﺎﺭﺍﻥ ﺗﻠﻘﻲ ﻣﻲﺷﻮﺩ )(۲۹؛ ﺩﺭ ﻧﺘﻴﺠﻪ ،ﺿﺮﻭﺭﻱ ﺑﻪ ﻧﻈﺮ
ﮔﺮﻓﺖ ،ﻧﺘﺎﻳﺞ ﻧﺸﺎﻥ ﺩﺍﺩ ﺁﮔﺎﻫﻲ ﺍﮐﺜﺮ ﻣﺎﻣﺎﻫﺎ ) ،(% ۷۸/۶ﺍﺯ ﮐﺪﻫﺎﻱ ﻣﻲﺭﺳﺪ ﺑﻪ ﻣﻨﻈﻮﺭ ﺑﺮﻃﺮﻑﺷﺪﻥ ﺍﻳﻦ ﻣﻮﺍﻧﻊ ﺩﺭ ﺑﻌﺪ ﻣﺪﻳﺮﻳﺘﻲ،
ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ،ﻣﺘﻮﺳﻂ ﺑﻮﺩ ﻭ ،% ۱۱/۹ﺁﮔﺎﻫﻲ ﺿﻌﻴﻒ ﻭ ﺗﻨﻬﺎ، ﻣﺪﻳﺮﺍﻥ ﺍﺭﺷﺪ ﺩﺭ ﺣﻴﻄﻪﻱ ﺑﻬﺪﺍﺷﺖ ﻭ ﺩﺭﻣﺎﻥ ،ﺑﺮﻧﺎﻣﻪﺭﻳﺰﻱﻫﺎ ﻭ
% ۹/۵ﺍﺯ ﺁﻥﻫﺎ ،ﺁﮔﺎﻫﻲ ﺧﻮﺑﻲ ﺩﺭ ﺍﻳﻦ ﺯﻣﻴﻨﻪ ﺩﺍﺷﺘﻨﺪ؛ ﻫﻤﭽﻨﻴﻦ، ﺍﻗﺪﺍﻣﺎﺕ ﻻﺯﻡ ﺭﺍ ﺑﺮﺍﻱ ﺭﻓﻊ ﺍﻳﻦ ﻣﻮﺍﻧﻊ ﺍﻧﺠﺎﻡ ﺩﻫﻨﺪ .ﺩﺭ ﺻﻮﺭﺕ
ﺳﻄﺢ ﺁﮔﺎﻫﻲ ﻣﺎﻣﺎﻫﺎ ﺍﺯ ﻗﻮﺍﻧﻴﻦ ﻭ ﻣﻘﺮﺭﺍﺕ ﻣﺎﻣﺎﻳﻲ ،% ۴۷/۶ ،ﺁﮔﺎﻫﻲ ﺍﻓﺰﺍﻳﺶ ﺗﻌﺪﺍﺩ ﭘﺮﺳﻨﻞ ،ﻣﻲﺗﻮﺍﻥ ﻣﺸﮑﻞ ﺷﻴﻔﺖﻫﺎﻱ ﻧﺎﻣﻨﺎﺳﺐ ﮐﺎﺭﻱ
ﺿﻌﻴﻒ ،% ۴۷/۶ ،ﺁﮔﺎﻫﻲ ﻣﺘﻮﺳﻂ ﻭ ﺗﻨﻬﺎ % ۴/۸ ،ﺍﺯ ﺁﻥﻫﺎ ﺁﮔﺎﻫﻲ ﻭ ﺳﺎﻋﺎﺕ ﮐﺎﺭﻱ ﻃﻮﻻﻧﻲ ﭘﺮﺳﻨﻞ ﺩﺭ ﻣﺎﻩ ﺭﺍ ﮐﺎﻫﺶ ﺩﺍﺩ ﮐﻪ ﻫﻤﻪﻱ
ﺧﻮﺑﻲ ﺩﺍﺷﺘﻨﺪ )(۳۱؛ ﻟﺬﺍ ،ﺑﻪ ﻧﻈﺮ ﻣﻲﺭﺳﺪ ﻳﮑﻲ ﺍﺯ ﺍﺻﻠﻲﺗﺮﻳﻦ ﻣﻮﺍﻧﻊ ﺍﻳﻦ ﻋﻮﺍﻣﻞ ،ﻣﻨﺠﺮ ﺑﻪ ﺭﻋﺎﻳﺖ ﺑﻬﺘﺮ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﺑﻴﻦ ﻣﺎﻣﺎﻫﺎﻱ
ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ،ﮐﻤﺒﻮﺩ ﺩﺍﻧﺶ ﻭ ﺁﮔﺎﻫﻲ ﻣﺎﻣﺎﻫﺎﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺷﺎﻏﻞ ﺩﺭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺧﻮﺍﻫﺪ ﺷﺪ.
ﺍﺳﺘﺎﻥ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ﺍﺳﺖ .ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺑﺮﻫﺎﻧﻲ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ،ﺩﺭ ﺣﻴﻄﻪﻱ ﻋﻮﺍﻣﻞ ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ،
) (١٣٩٠ﻧﻴﺰ ،ﺑﻴﺎﻥ ﺷﺪ ﺁﮔﺎﻫﻲ ﺍﺯ ﺩﺍﻧﺶ ﺣﺮﻓﻪﺍﻱ ﻭ ﻗﻮﺍﻧﻴﻦ ﻣﻮﺟﻮﺩ، ﺭﺿﺎﻳﺖﻧﺪﺍﺷﺘﻦ ﺍﺯ ﻧﻴﺎﺯﻫﺎﻱ ﭘﺎﻳﻪ ،ﻣﺎﻧﻨﺪ ﻣﮑﻔﻲﻧﺒﻮﺩﻥ ﺩﺭﺁﻣﺪ ﻳﺎ
ﻣﻲﺗﻮﺍﻧﺪ ﺩﺭ ﻛﻨﺎﺭ ﺁﮔﺎﻫﻲ ﺍﺯ ﻣﻮﻗﻌﻴﺖ ﺍﺧﻼﻗﻲ ،ﻣﻨﺠﺮ ﺑﻪ ﺣﺴﺎﺳﻴﺖ ﺍﺳﺘﺮﺍﺣﺖ ﮐﺎﻓﻲ ﭘﺮﺳﻨﻞ ،ﮐﻤﺒﻮﺩ ﺩﺍﻧﺶ ﻭ ﺁﮔﺎﻫﻲ ﺩﺭﺑﺎﺭﻩﻱ
ﺍﺧﻼﻗﻲ ﺷﻮﺩ )(٢٣؛ ﻫﻤﭽﻨﻴﻦ ،ﺩﺭ ﺑﺴﻴﺎﺭﻱ ﺍﺯ ﻣﻄﺎﻟﻌﺎﺕ ،ﺍﺯﺟﻤﻠﻪ ﻣﻌﻴﺎﺭﻫﺎﻱ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﻭ ﺑﻲﺗﻮﺟﻬﻲ ﻭ ﮐﻢﺩﻗﺘﻲ ﮐﺎﻓﻲ ﭘﺮﺳﻨﻞ
ﻣﻄﺎﻟﻌﻪﻱ ﮐﻴﻢ ٢ﻭ ﻫﻤﮑﺎﺭﺍﻥ ) ،(۲۰۰۵ﺑﺮ ﺗﺄﺛﻴﺮ ﺁﻣﻮﺯﺵ ﺩﺭ ﺍﻓﺰﺍﻳﺶ ﺑﻪ ﺩﻟﻴﻞ ﺣﺠﻢ ﺯﻳﺎﺩ ﮐﺎﺭ ،ﺍﺯﺟﻤﻠﻪ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ
ﺣﺴﺎﺳﻴﺖ ﺍﺧﻼﻗﻲ ،ﺗﺄﻛﻴﺪ ﺷﺪﻩ ﺍﺳﺖ )(٣٢؛ ﺑﻨﺎﺑﺮﺍﻳﻦ، ﮔﺰﺍﺭﺵ ﺷﺪﻩ ﺍﺳﺖ .ﺩﺭ ﻣﻄﺎﻟﻌﻪﻱ ﻃﺎﻫﺮﻱ ﻭ ﻫﻤﮑﺎﺭﺍﻥ ) (۲۰۱۵ﮐﻪ
2. Kim
Website: http://ijme.tums.ac.ir
ﺭﺿﺎﻳﻴﺎﻥ ﻭ ﻫﻤﮑﺎﺭﺍﻥ :ﺑﺮﺭﺳﻲ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﻣﺎﻣﺎﻳﻲ ،ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺗﺨﺼﺼﻲ ... 10
ﻟﺬﺍ ،ﺷﻨﺎﺧﺖ ﻭ ﺭﻓﻊ ﻣﻮﺍﻧﻌﻲ ﮐﻪ ﻣﻨﺠﺮ ﺑﻪ ﺭﻋﺎﻳﺖﻧﺸﺪﻥ ﺍﺧﻼﻕ ﺍﺯﺟﻤﻠﻪ ﻣﺤﺪﻭﺩﻳﺖﻫﺎﻱ ﺍﻳﻦ ﭘﮋﻭﻫﺶ ،ﻣﺤﺪﻭﺩﻳﺖ ﺑﺨﺶﻫﺎﻱ
ﺣﺮﻓﻪﺍﻱ ﺍﺳﺖ ،ﺑﺴﻴﺎﺭ ﺣﺎﺋﺰ ﺍﻫﻤﻴﺖ ﺍﺳﺖ .ﺑﺮ ﺍﺳﺎﺱ ﻧﺘﺎﻳﺞ ﻣﻮﺭﺩ ﻧﻤﻮﻧﻪﮔﻴﺮﻱ ﻭ ﻣﺤﺪﻭﺩﺑﻮﺩﻥ ﻣﻄﺎﻟﻌﻪ ﺑﻪ ﻧﻈﺮﺍﺕ ﻣﺎﻣﺎﻫﺎﻱ
ﻣﻄﺎﻟﻌﻪﻱ ﺣﺎﺿﺮ ،ﻫﺮ ﺳﻪ ﺩﺳﺘﻪﻱ ﻋﻮﺍﻣﻞ ﻣﺤﻴﻄﻲ ﻭ ﻣﺪﻳﺮﻳﺘﻲ ﻭ ﺷﺎﻏﻞ ﺩﺭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺑﺎ ﺗﺨﺼﺺ ﺯﻧﺎﻥ ﻭ ﺯﺍﻳﻤﺎﻥ ﺍﺳﺘﺎﻥ
ﻓﺮﺩﻱﻣﺮﺍﻗﺒﺘﻲ ،ﺑﻪﺗﺮﺗﻴﺐ ،ﺑﻴﺸﺘﺮﻳﻦ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ﺍﺳﺖ؛ ﻟﺬﺍ ،ﺩﺭ ﺗﻌﻤﻴﻢ ﻧﺘﺎﻳﺞ ﺑﺎﻳﺪ ﺍﺣﺘﻴﺎﻁ ﮐﺮﺩ.
ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎﻱ ﺷﺎﻏﻞ ﺩﺭ
ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺍﺳﺘﺎﻥ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ﺍﺳﺖ؛ ﺑﻨﺎﺑﺮﺍﻳﻦ ،ﭘﻴﺸﻨﻬﺎﺩ
ﻣﻲﺷﻮﺩ ﻣﺪﻳﺮﺍﻥ ﻭ ﻣﺴﺌﻮﻻﻥ ﺫﻱﺭﺑﻂ ،ﺑﺎ ﺍﻧﺠﺎﻡ ﻫﻤﺎﻫﻨﮕﻲﻫﺎ ﻭ
ﺑﺮﻧﺎﻣﻪﺭﻳﺰﻱﻫﺎﻱ ﻻﺯﻡ ﺑﺮﺍﻱ ﺭﻓﻊ ﺍﻳﻦ ﻣﻮﺍﻧﻊ ،ﺑﺮﺍﻱ ﺭﻋﺎﻳﺖ ﻫﺮﭼﻪ
ﺑﻴﺸﺘﺮ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ،ﺗﻼﺵ ﮐﻨﻨﺪ.
ﺗﺸﮑﺮ ﻭ ﻗﺪﺭﺩﺍﻧﻲ
ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ،ﻧﺘﻴﺠﻪﻱ ﻃﺮﺡ ﺗﺤﻘﻴﻘﺎﺗﻲ ﻣﺼﻮﺏ ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ
ﭘﺰﺷﮑﻲ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ،ﺑﺎ ﮐﺪ ۹۸۰۱۴۳ﺍﺳﺖ .ﺍﺯ ﻫﻤﻪﻱ
ﻣﺎﻣﺎﻫﺎﻱ ﻣﺸﺎﺭﮐﺖﮐﻨﻨﺪﻩ ﺩﺭ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﮐﻪ ﻣﺎ ﺭﺍ ﺩﺭ ﺍﻧﺠﺎﻡ ﺍﻳﻦ
ﻃﺮﺡ ﻳﺎﺭﻱ ﮐﺮﺩﻧﺪ ﻭ ﻫﻤﭽﻨﻴﻦ ،ﻣﻌﺎﻭﻧﺖ ﭘﮋﻭﻫﺸﻲ ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ
ﭘﺰﺷﮑﻲ ﺧﺮﺍﺳﺎﻥ ﺷﻤﺎﻟﻲ ،ﺑﺮﺍﻱ ﺣﻤﺎﻳﺖ ﻣﺎﻟﻲ ،ﺗﺸﮑﺮ ﻭ ﻗﺪﺭﺩﺍﻧﻲ
ﻣﻲﺷﻮﺩ.
Website: http://ijme.tums.ac.ir
11 ١٤ ﺩﻭﺭﻩ،١٤٠٠ ﺳﺎﻝ،ﺍﺧﻼﻕ ﻭ ﺗﺎﺭﻳﺦ ﭘﺰﺷﻜﻲ
ﻣﻨﺎﺑﻊ
1- Larijani B. Physicion and Ethical 12- Fisher C, Hauck Y, Fenwick J. How social
Consideration. Tehran: Baraye Farda; 2003. context impact on women‘s fear of child
[in Persian] birth; a Western Australian example. Soc
2- Hosseini A, Aghazade G. The principles Sci Med. 2006; 63(1): 64-75.
Downloaded from ijme.tums.ac.ir at 11:22 IRST on Friday October 29th 2021
and measures of medical ethics and the 13- Shaali M, Shahriari M, Abdishahshahani
quantity of their consistency with Islamic M. Assessing the codes of ethics of
ethics. J Urmia Univ Med Sci. 2008; 18(4): midwifery ethics by midwives working in
652-6. [in Persian] maternity wards and some related factors in
3- Varney HK, Kriebs JM, Gegor CL. hospitals affiliated to Isfahan University of
Varney’s midwifery. Massachusetts: Jones Medical Sciences. Iranian Journal of
& Bartlett Learning; 2006. Obstetrics, Gynecology and Infertility.
4- Shariati M. History of ethics midwifery and 2016; 21(3): 54-63.
regulation. Tehran: City Firoozeh; 2013. 14- Shah Hossini Z, Rashidi S, Abedian K.
p.155. [in Persian] Assessing midwives’awareness of legal
5- Faraj Khoda T, Latifnejad R, Abbasi M. rules and drug use in midwifery. J Forensic
Developing the professional codes of ethics Med; 2005; 39: 154-57. [in Persian]
forreproductive health care provider and 15- Saharkhiz H. Effect group discussions
it’s assessmentfrom their viewpoints in about professional ethics with nursing
Yazd health care centers. [ Dissertation]. student on promoting of them professional
Tehran(Iran), Shahid Beheshti University ethics. [Dissertation]. Tehran(Iran), Tarbiat
of Medical Sciences; 2012. [in Persian] Modares University; 2008. [in Persian]
6- Mohammadi M, Mohammadi S. Ethics in 16- Tefagh MR, Nikbakht Nasrabadi A,
midwifery. J Navido. 2008; 13(42); 25-30. Mehran A, Dinmohammadi N.
[in Persian] Investigation of the ethical practice in
7- Rahimparvar V, Fatemeh S, Nasirian L, medication process among nurse. Heyat.
Khoda TF, Bahrani N. Compliance rate of 2005; 10(23): 77-85. [in Persian]
midwifves with the professional codes of 17- Dehghani A, Ordoubadi N, Parvinian
ethics in maternal child health centers in Nasab A, Talebi M, Shamsizadeh M.
Tehran. Medical Ethics and History of Perspective of patients about complains
Medicine. 2014; 7(2): 46 -56. [in Persian] with standard of professional ethics in
8- Ghobadifar MA, Mosalanejad L. nursing practice.Journal of Nursing
Evaluation of staff adherence to Education. 2014; 3(2): 76-84.
professionalism in Jahrom university of 18- Dehghani A, Islamiakbar R, Parvinian
medical sciences. J Educ Ethics Nurs. Nasab A, Shamsizadeh M, Shamsi A. The
2013; 2(2); 1-7. [in Persian] determination of I factors related to
9- Larijani B, Malek Afzali HO, Zahedi F, professional ethics in nurse practice.
Motevaseli E. Strengthening medical ethics Journal of Ethics in Education. 2013; 2(3):
by strategic planning in the Islamic 53-60.
Republic of Iran. Dev World Bioethics. 19- Dehghani A, Dast Pak M, Gharib AR.
2006; 6(2):106-10. Barriers to respect professional ethics
10- Mahmoodi Shan G, Alhani F, Ahmadi F, standard in clinical care; viewpoint of
Kazemnejad A. Ethics in nurses’ lifestyle; a nurses. Iranian Journai of Medical
qualitative study. Medical Ethics and Education. 2013; 13(5): 421-30. [in
History of Medicine. 2009; 2(4): 63-78. [in Persian]
Persian] 20- Dierckx de Casterle B, Shigeko I, Godfrey
11- 11. Butts J, Rich K. Nursing ethics. NS, Denhaerynck. Nurses responses to
London: Jones & Bartlett; 2011. ethical dilemmas in nursing practice: meta-
Website: http://ijme.tums.ac.ir
... ﺍﺯ ﺩﻳﺪﮔﺎﻩ ﻣﺎﻣﺎﻫﺎﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥﻫﺎﻱ ﺗﺨﺼﺼﻲ، ﺑﺮﺭﺳﻲ ﻣﻮﺍﻧﻊ ﺭﻋﺎﻳﺖ ﺍﺧﻼﻕ ﺣﺮﻓﻪﺍﻱ ﺩﺭ ﻣﺮﺍﻗﺒﺖﻫﺎﻱ ﺑﺎﻟﻴﻨﻲ ﻣﺎﻣﺎﻳﻲ: ﺭﺿﺎﻳﻴﺎﻥ ﻭ ﻫﻤﮑﺎﺭﺍﻥ 12
Website: http://ijme.tums.ac.ir
Medical
13 Ethics and History of Medicine ١٤ ﺩﻭﺭﻩ،١٤٠٠ ﺳﺎﻝ،ﺍﺧﻼﻕ ﻭ ﺗﺎﺭﻳﺦ ﭘﺰﺷﻜﻲ 2021, Volume 14
Original Article
Study of Barriers to Professional Ethics in Midwifery Clinical Care from Midwives’
Viewpoints in Hospitals Specializing in Obstetrics and Gynecology in North Khorasan
Province in 2018
Downloaded from ijme.tums.ac.ir at 11:22 IRST on Friday October 29th 2021
Seyedeh Mahboobeh Rezaeean1, Zahra Kazemi Gelian2*, Ghasem Kazemi Gelian3, Zohreh Abbasi4,
Elahe Salari5, Mahboobe Tabatabayi Chehr6
1. Instructor, Department of Midwifery, Medical Faculty, North Khorasan University of Medical Sciences, Bojnurd, Iran.
2. BSc in midwifery, Department of Midwifery, Medical Faculty, North Khorasan University of Medical Sciences,
Bojnurd, Iran.
3. Assistant Professor, Department of Mathematics, Islamic Azad University, Shirvan Branch, Shirvan, Iran
4. Assistant Professor, Department of Midwifery, Medical Faculty, North Khorasan University of Medical Sciences,
Bojnurd, Iran.
5. Instructor, Department of Midwifery, Medical Faculty, North Khorasan University of Medical Sciences, Bojnurd, Iran.
6. Instructor, Geriatric Care Research Center, Department of Midwifery, Medical Faculty, North Khorasan University
of Medical Sciences, Bojnurd, Iran.
Abstract
Received: 26 August 2020 Failure to follow professional ethics in midwifery will lead to harmful risks,
Accepted: 7 March 2021 including an increase in maternal and infant mortality. The aim of this study
Published: 3 October 2021
was to investigate the barriers to professional ethics in midwifery clinical
* Corresponding Author care from midwives ’viewpoints in hospitals specializing in obstetrics and
Zahra Kazemi Gelian gynecology in North Khorasan province in 2018. This cross-sectional
Address: North Khorasan University of descriptive study was performed with the participation of 141 midwives
Medical Sciences, Dowlat Blv., Bojnurd, working in specialized obstetrics and gynecology hospitals in North
Iran.
Postal Code: 7487794149 Khorasan province, using classified sampling. The data collection tool was
Tel: (+ 98) 09388469427 a questionnaire consisting of two parts: demographic information and
Email: Zkazemy75@gmail.com barriers to professional ethics, in three areas: environmental and managerial
and personal care. Data were analyzed using SPSS software version 22 and
Citation to this article:
Rezaeean SM, Kazemi Gelian Z, Kazemi descriptive and inferential statistics. From the perspective of midwives, all
Gelian G, Abbasi Z, Salari E, Tabatabayi three categories of environmental factors (73.94%), personal care (64.66%)
Chehr M. Study of barriers to professional and management (64.97%) were among the barriers to professional ethics.
ethics in midwifery clinical care from
midwives’ viewpoints in hospitals The most important barriers to professional ethics in the managerial
specializing in obstetrics and gynecology in dimension are staff shortages (80%), in the environmental dimension,
North Khorasan Province in 2018. Medical
Ethics and History of Medicine. 2021; 14:
biological changes in the body during work shifts (85.2%) and in the
1-13. personal dimension, dissatisfaction with basic needs, such as insufficient
income or adequate rest in midwifery (80.9%), was. Given the importance
of observing professional ethics and the issues and problems arising from non-compliance, it is suggested that
managers and officials make the necessary planning by hospitals to remove the barriers mentioned by
midwives.
Keywords: Professional ethics, Clinical care, Midwife, hospitals specializing in obstetrics and gynecology.
Copyright © 2021 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license
https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.
Website: http://ijme.tums.ac.ir