Patientsa€? Description of Unexpected Interactions: A Critical Ethnography of the Quality of Doctor-Patient Interactions in One Educational Hospital in Shiraz, Iran

摘要

Background:Sociologistsregularlycriticizetheunbalanceddoctor-patientinteraction(DPI).AfewpreviousstudieshaveinvestigatedDPIindevelopingcountries.Objectives:ThisstudyaimedtoexplorethenatureofDPIinoneeducationalhospitalinShiraz,Iran,accordingtotheviewsofpatientsandtheirrelatives.Methods:Thisisacriticalethnographystudythatwasconductedusingatriangulationstrategyin2014,including156clinicalconsultations,920hoursofparticipantobservations,and6focusgroupswith51patientsandtheirfamiliesusingacriticalethnographymethod.Samplingwaspurposeful,andthedatawereinterpretedaccordingtoanexplorationofthepowerrelationshipbetweenthedoctorandthepatientinthecontextofthestudyaccordingtotheopinionsofpatientsandtheirrelatives.Results:Thestudyshowedthatparticipantsfacedunexpectedinteractions,whichincludedfourfeatures:unequal,unprofessional,instrumental,andnon-cooperative.Althoughthisformofinteractionwasexploredtoexaminethestrugglebetweenthevoiceofmedicineandthevoiceofthelifeworld,theresultsshowedthattheDPIinthecontextofourstudycontainshegemonicfeatures,whicharerelatedtophysiciansa€?autonomy.Conclusions:Thesefourthemesrevealedthatpatientsarecriticizedaboutthisformofinteraction.Thesethemesnotonlyarenotinlinewiththeresponsibilitiesandethicsofmedicinebutalsoareincontrasttoit.Itseemsthatpatient-centeredapproachescanhelpsolvetheproblem.Inaddition,thehealthsystemshouldmonitorDPIsandpromotethembyreformingtheirstructure.