Education and Ethics In Nursing ISSN: 2322-5300

چالش‌های اخلاقی مراقبت از سالمندان در ایران: یک مرور روایتی

دوره 14، شماره 1
فروردین 1404
صفحه 99-109

نوع مقاله : مقاله مروری

نویسندگان

1 دانشجوی کارشناسی ارشد پرستاری بهداشت جامعه، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

2 استادیار، مرکز تحقیقات پرستاری جامعه، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران

چکیده
مقدمه: افزایش میانگین سنی جمعیت در سراسر جهان، به طور فزاینده‌ای نیاز به مراقبت از افراد سالمند را افزایش داده است. این بالا رفتن تقاضا، با چالش‌های متعددی از جمله چالش­ های اخلاقی در مراقبت، همراه بوده است. پژوهش حاضر، با هدف تبیین چالش­ های اخلاقی مراقبت از سالمندان در ایران انجام شد.
روش کار: پژوهش حاضر، به صورت مروری - روایتی و با جست­جوی مقالاتی که در ایران، با زبان فارسی یا لاتین و با استفاده از کلید واژه های چالش اخلاقی، پرستار، مراقبت، سالمند و کلمات انگیسی معادل آن­ها شامل: Elderly ,Care,nurse,Ethical Challenges به صورت مجزا و ترکیبی در پایگاه­ های اطلاعاتی PubMed، Scopus، Web of Science، Google Scholar و پایگاه‌ داده‌های فارسی SID، Magiran در فاصلۀ زمانی 2013 تا 2024، انجام گرفته بودند، صورت گرفت؛ سپس مقالات براساس اهداف مطالعه، با استفاده از معیار ارزیابی کیفیت گیفورد، سنجش و تحلیل شدند.
یافته ­ها: پس از ارزیابی نهایی، 18 مقاله شامل چالش­های مرتبط با اصل عدالت (۶ مقاله)، اصل عدم آسیب (۷ مقاله)، اصل سودرسانی (۷ مقاله) و اصل خودمختاری (۵ مقاله) وارد مطالعه شدند. یافته‌ها نشان دادند که نابرابری در دسترسی به خدمات، فناوری‌های نوین و فشارهای اقتصادی بر خانواده‌ها، اصل عدالت را نقض کرده ­اند. تهدید به امنیت و حریم خصوصی سالمندان، پریشانی اخلاقی پرستاران و کمبود منابع، باعث شده است که اصل عدم آسیب، به چالش کشیده شود. کمبود منابع، فقدان مراقبت دلسوزانه و تمرکز ناکافی بر ابعاد انسانی مراقبت، اصل سودمندی را تضعیف کرده است. در تصمیم‌گیری‌های درمانی، کاهش استقلال در محیط زندگی و ملاحظات اخلاقی در استفاده از فناوری‌ها، اصل خودمختاری سالمندان را به مخاطره انداخته ­اند.
نتیجه­ گیری: بر اساس یافته­ ها، مراقبت از سالمندان در ایران، با چالش­ های متعددی مبتنی بر اصول چهارگانۀ اخلاقی روبه ­رو است. نتایج پژوهش حاضر می ­تواند به مدیران و سیاست گذاران حوزۀ سلامت، برای برنامه ­ریزی ارائه مراقبت­ های اخلاقی و حل چالش ­های مرتبط با آن کمک کند.

کلیدواژه‌ها

موضوعات

عنوان مقاله English

Ethical challenges of elderly care in Iran: a narrative review

نویسندگان English

Zahra Khalilzadeh-Farsangi 1
Fereshteh Najafi 2
1 Master of Community Health Nursing, Student Research Committee, Zahedan University of Medical Sciences, Zahedan, Iran
2 Assistant Professor, Community Health Nursing, Zahedan University of Medical Sciences, Zahedan, Iran
چکیده English

Introduction: The increase in the average age of the population around the world has increasingly increased the need to care for the elderly. This increase in demand has been associated with several challenges, including ethical challenges in care. The present study was conducted with the aim of explaining the ethical challenges of caring for the elderly in Iran.
Methods & Materials: The current research, in a review-narrative form and by searching for articles in Iran, in Persian or Latin, using the keywords of ethical challenge, nurse, care, elderly and their equivalent English words, including: Elderly, Care, nurse, Ethical Challenges separately and combined in the databases PubMed, Scopus, Web of Science, Google Scholar and the Persian databases SID, Magiran in the period from 2013 to 2024, had been done, took place; Then, based on the objectives of the study, the articles were assessed and analyzed using Gifford's quality assessment criteria.
Results: After the final evaluation, 18 articles including challenges related to the principle of justice (6 articles), the principle of non-harm (7 articles), the principle of beneficence (7 articles) and the principle of autonomy (5 articles) were included in the study. The findings showed that inequality in access to services, new technologies and economic pressures on families have violated the principle of justice.
The threat to the safety and privacy of the elderly, the moral distress of nurses, and the lack of resources have caused the principle of non-harm to be challenged. Lack of resources, lack of compassionate care, and insufficient focus on the human dimension of care undermine the principle of beneficence. In therapeutic decisions, the reduction of independence in the living environment and ethical considerations in the use of technologies have jeopardized the principle of autonomy of the elderly.
Conclusion: Based on the findings, the care of the elderly in Iran is facing many challenges based on four ethical principles. The results of the present study can help managers and policy makers in the health field to plan the provision of ethical care and solve the challenges related to it.

کلیدواژه‌ها English

  • Ethical challenges
  • nurse
  • care
  • elderly
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