Volume 22, Issue 4 (7-2024)
Nursing and Midwifery Journal 2024, 22(4): 337-340 |
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Amiri E, Galehdarifard A, Baghaei R, Ebrahimi H, Habibzadeh H, Habibpour Z. Revitalizing Open-Door Policies in Psychiatric Institutions: A Strategy for Preserving Patient Dignity – A Letter to the Editor-in-Chief. Nursing and Midwifery Journal 2024; 22 (4) :337-340
URL: http://unmf.umsu.ac.ir/article-1-5198-en.html
URL: http://unmf.umsu.ac.ir/article-1-5198-en.html
Elham Amiri1 
, Atefeh Galehdarifard *2 , Rahim Baghaei3 
, Hossein Ebrahimi4 , Hossein Habibzadeh3 , Zeinab Habibpour5
, Atefeh Galehdarifard *2 , Rahim Baghaei3 , Hossein Ebrahimi4 , Hossein Habibzadeh3 , Zeinab Habibpour5
1- PhD Candidate, Psychiatric Nursing, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
2- PhD Candidate, faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran (Corresponding Author) ,Atefehgalehdarifard@yahoo.com
3- PhD, Professor, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
4- Professor, Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Iran.
5- PhD, Department of Psychiatric Nursing, School of Nursing, Khoy University of Medical Sciences, Khoy, Iran.
2- PhD Candidate, faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran (Corresponding Author) ,
3- PhD, Professor, Faculty of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran.
4- Professor, Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Iran.
5- PhD, Department of Psychiatric Nursing, School of Nursing, Khoy University of Medical Sciences, Khoy, Iran.
Abstract: (917 Views)
To the Editor
Dignity is a fundamental concept in medical ethics. Disruptions in health and the experience of illness pose significant threats to individual dignity (1). This issue becomes even more significant due to the vulnerability of patients with psychiatric disorders (2).
In the healthcare system of Iran, psychiatric centers often expose patients to multiple risks, including loss of personality and disempowerment, rather than providing the care and support they need (3). Patients hospitalized in psychiatric centers feel that they have no control over their lives, are dominated by the staff, and are disregarded by them. These debilitating feelings are likely a result of the staff's separation from the patients and their sole focus on executing routine care (4).
In the healthcare system of Iran, the dominant culture in the patient-nurse relationship is the dominance of the authoritarian relationship over the compassionate relationship in which the medical personnel are in a position of power and the patient is only a pure obeyed (5). This type of caregiving relationship exacerbates the vulnerability of patients and signifies a violation of their dignity. The absence of patient involvement in decision-making is another critical factor that undermines the dignity of individuals with psychiatric disorders. By excluding patients from participation, we further intensify their feelings of being overlooked and disregarded (6). The sensation of being overlooked can be as serious a risk as physical abuse, profoundly affecting a patient's health and overall quality of life (7).
One of the manifestations of the violation of the dignity of psychiatric patients within Iran's healthcare system is the infringement of their independence, which is increasingly evident. Patients in psychiatric facilities in Iran are subjected to care in institutions with locked doors or restricted access to the outside world (8). Although locked wards are associated with a significant reduction in the frequency of patient escapes, they convey a sense of imprisonment and being confined in a cage to the patients (9). In such conditions where patients are kept behind closed doors and their lives are managed by the hospital's routine, the independence of the patient becomes completely meaningless. In such conditions where patients are kept behind closed doors and their lives are managed by the hospital's routine, the independence of the patient becomes completely meaningless. In addition, patients are often deprived of opportunities for education, work, or access to public services and other facilities. Unfortunately, in these locked facilities, there is no rehabilitation treatment available to prepare patients for returning to life outside the hospital and reintegrating with their families (8). This is while implementing open-door policies in institutions can significantly contribute to fostering a sense of independence and involvement in care among patients (10).
In this context, revitalizing and promoting open-door policies in the country’s psychiatric centers can empower patients, nurture their sense of independence, and preserve their dignity. Acknowledging the significant impact that respecting the dignity of psychiatric patients has on enhancing their quality of life, it's crucial to prioritize the foundational structures that support this dignity in clinical environments. Policymakers at all levels must integrate this focus into their agendas while strengthening oversight of healthcare organizations. Moreover, given the pivotal role of nurses in maintaining patient dignity, it is essential that training on this topic is included in both university programs and clinical refresher courses. Nurses should understand that safeguarding the dignity of psychiatric patients does not require extraordinary measures; often, simply being present and engaging in empathetic dialogue can greatly foster a sense of care and mitigate feelings of invisibility.
Dignity is a fundamental concept in medical ethics. Disruptions in health and the experience of illness pose significant threats to individual dignity (1). This issue becomes even more significant due to the vulnerability of patients with psychiatric disorders (2).
In the healthcare system of Iran, psychiatric centers often expose patients to multiple risks, including loss of personality and disempowerment, rather than providing the care and support they need (3). Patients hospitalized in psychiatric centers feel that they have no control over their lives, are dominated by the staff, and are disregarded by them. These debilitating feelings are likely a result of the staff's separation from the patients and their sole focus on executing routine care (4).
In the healthcare system of Iran, the dominant culture in the patient-nurse relationship is the dominance of the authoritarian relationship over the compassionate relationship in which the medical personnel are in a position of power and the patient is only a pure obeyed (5). This type of caregiving relationship exacerbates the vulnerability of patients and signifies a violation of their dignity. The absence of patient involvement in decision-making is another critical factor that undermines the dignity of individuals with psychiatric disorders. By excluding patients from participation, we further intensify their feelings of being overlooked and disregarded (6). The sensation of being overlooked can be as serious a risk as physical abuse, profoundly affecting a patient's health and overall quality of life (7).
One of the manifestations of the violation of the dignity of psychiatric patients within Iran's healthcare system is the infringement of their independence, which is increasingly evident. Patients in psychiatric facilities in Iran are subjected to care in institutions with locked doors or restricted access to the outside world (8). Although locked wards are associated with a significant reduction in the frequency of patient escapes, they convey a sense of imprisonment and being confined in a cage to the patients (9). In such conditions where patients are kept behind closed doors and their lives are managed by the hospital's routine, the independence of the patient becomes completely meaningless. In such conditions where patients are kept behind closed doors and their lives are managed by the hospital's routine, the independence of the patient becomes completely meaningless. In addition, patients are often deprived of opportunities for education, work, or access to public services and other facilities. Unfortunately, in these locked facilities, there is no rehabilitation treatment available to prepare patients for returning to life outside the hospital and reintegrating with their families (8). This is while implementing open-door policies in institutions can significantly contribute to fostering a sense of independence and involvement in care among patients (10).
In this context, revitalizing and promoting open-door policies in the country’s psychiatric centers can empower patients, nurture their sense of independence, and preserve their dignity. Acknowledging the significant impact that respecting the dignity of psychiatric patients has on enhancing their quality of life, it's crucial to prioritize the foundational structures that support this dignity in clinical environments. Policymakers at all levels must integrate this focus into their agendas while strengthening oversight of healthcare organizations. Moreover, given the pivotal role of nurses in maintaining patient dignity, it is essential that training on this topic is included in both university programs and clinical refresher courses. Nurses should understand that safeguarding the dignity of psychiatric patients does not require extraordinary measures; often, simply being present and engaging in empathetic dialogue can greatly foster a sense of care and mitigate feelings of invisibility.
Keywords: Dignity, psychiatric centers, open door policies, closed door policies, psychiatric disorders, patient
Type of Study: Letter to editor |
Subject:
روانپزشکی- روان شناسی
References
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