Nurses' Experiences of Discriminatory Care Towards Vulnerable Patients: A Qualitative Study From Iran

IF 2.2 4区医学 Q4 GERIATRICS & GERONTOLOGY

International Journal of Older People Nursing Pub Date : 2026-07-01 DOI:10.1111/opn.70091

Aram Karimian, Afsaneh Sadooghiasl, Mitra Khoobi, Eesa Mohammadi, Anoshirvan Kazemnejad

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引用次数: 0

Abstract

Background

Discriminatory nursing care endangers patient rights, ethical standards and fair access to treatment—yet the lived experiences of nurses who engage in such practices remain understudied. This study seeks to explore Iranian nurses' personal experiences with their own discriminatory behaviours towards vulnerable patients in everyday clinical settings.

Methods

A qualitative conventional content analysis was conducted in 2024, using in-depth, unstructured interviews with 13 nurses from both public and private hospitals in Iran. Participants were purposefully sampled to ensure maximum variation, and data collection continued until saturation was reached. The interviews were analysed using the five-step framework developed by Graneheim and Lundman.

Results

A central theme, ‘discrimination in service provision for vulnerable patients’, emerged, highlighting two main categories: (1) Professional Shortfalls in the Care of Older Adults and (2) Shortfalls in Care for Persons at the End of Life. Nurses reported prioritizing younger patients, delaying or withholding essential care, reducing therapeutic communication and demonstrating inconsistent adherence to professional standards.

Conclusion

Findings reveal subtle yet widespread discriminatory practices against older adults and end-of-life patients. Combating these disparities requires targeted education, supportive organizational policies and strategies to increase nurses' awareness of unconscious bias.

Implications for Practice

Reducing discriminatory behaviours promotes equitable, person-centred care. Enhancing empathy, prioritizing the needs of vulnerable patients and strengthening adherence to professional standards foster trust, dignity and a more inclusive clinical environment.

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伊朗护士对弱势病人歧视性护理经历的定性研究

背景：歧视性护理危及患者权利、道德标准和公平获得治疗的机会，然而，从事此类实践的护士的生活经历仍未得到充分研究。本研究旨在探讨伊朗护士在日常临床环境中对弱势患者的歧视行为的个人经历。方法：对来自伊朗公立和私立医院的13名护士进行了深入的非结构化访谈，并于2024年进行了定性常规内容分析。参与者有目的地采样，以确保最大的变化，并继续收集数据，直到达到饱和。访谈使用Graneheim和Lundman开发的五步框架进行分析。结果：出现了一个中心主题，“为弱势患者提供服务中的歧视”，突出了两个主要类别：(1)老年人护理专业人员的不足；(2)临终关怀人员的不足。护士报告优先考虑年轻患者，延迟或拒绝基本护理，减少治疗沟通，并表现出不一致的专业标准。结论：研究结果揭示了针对老年人和临终病人的微妙而普遍的歧视做法。消除这些差异需要有针对性的教育、支持性的组织政策和战略，以提高护士对无意识偏见的认识。对实践的影响：减少歧视行为促进公平、以人为本的护理。增强同理心，优先考虑弱势患者的需求，并加强对专业标准的遵守，可促进信任、尊严和更具包容性的临床环境。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Older People Nursing Nursing-Gerontology

CiteScore

3.60

自引率

9.10%

发文量

期刊介绍： International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.