Iranian stroke patient’s perception of dignity, autonomy and privacy: a questionnaire survey


  • Behnam Sadeghzadeh Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
  • Ghasem Fattahzadeh-Ardalani Ardabil University of Medical Sciences, Iran
  • Azad Rahmani Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
  • Vahid Zamanzadeh Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
  • Mojgan Behshid Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
  • Arman Azadi Ilam University of Medical Sciences, Iran



Dignity, Autonomy, Privacy, Stroke


Background: Patients with stroke have many problems which may have adverse effects on opportunities for dignified care. So, any plans to improve the providing of dignified care in these patients need to identify the level of maintaining their dignity in hospital settings and its related factors in particular privacy and autonomy. Accordingly, the aim of this study was to recognize the level of self-perceived dignity and its relationships with the perception of respected autonomy and privacy among Iranian stroke patients.

Methods: This descriptive-correlational study was undertaken among 166 patients with stroke admitted to a public educational centre affiliated to Ardebil University of Medical Sciences, Ardebil/Iran. They were selected using convenience sampling method. Patients’ levels of self-perceived dignity, autonomy and privacy were assessed using valid questionnaires.  

Results: The study findings showed a significant negative correlation between patients’ self-perceived dignity and autonomy. Also there was no significant relationship between patients’ self-perceived dignity and patients’ perception of protected privacy.

Conclusions: According to the findings of this study respect to autonomy of patient increases the amount of patient dignity. But there isn’t this relationship about respect to the privacy of patient.


Metrics Loading ...


Organization WH. WHO STEPS Stroke Manual: The WHO STEP wise approach to stroke surveillance. 2005.

Brunner LS, Smeltzer SCC, Bare BG, Hinkle JL, Cheever KH. In: Brunner & Suddarth's textbook of medical-surgical nursing. Lippincott Williams & Wilkins; 2010.

Hankey GJ. Preventable stroke and stroke prevention. Journal of thrombosis and haemostasis. JTH. 2005;3(8):1638-45.

Xiong L, Leung H, Chen XY, Han JH, Leung T, Soo Y, et al. Preliminary findings of the effects of autonomic dysfunction on functional outcome after acute ischemic stroke. Clinical neurology and neurosurgery. 2012;114(4):316-20.

Seshadri S, Beiser A, Kelly-Hayes M, Kase CS, Au R, Kannel WB, et al. The lifetime risk of stroke: estimates from the Framingham Study. Stroke a journal of cerebral circulation. 2006;37(2):345-50.

Turin TC, Kokubo Y, Murakami Y, Higashiyama A, Rumana N, Watanabe M, et al. Lifetime risk of stroke in Japan. Stroke a journal of cerebral circulation. 2010;41(7):1552-4.

Borhani-Haghighi A, Safari R, Heydari ST, Soleimani F, Sharifian M, Yektaparast Kashkuli S, et al. Hospital mortality associated with stroke in southern iran. Iranian journal of medical sciences. 2013;38(4):314-20.

Azarpazhooh MR, Etemadi MM, Donnan GA, Mokhber N, Majdi MR, Ghayour-Mobarhan M, et al. Excessive incidence of stroke in Iran: evidence from the Mashhad Stroke Incidence Study (MSIS), a population-based study of stroke in the Middle East. Stroke a journal of cerebral circulation. 2010;41(1):3-10.

Stinear C. Prediction of recovery of motor function after stroke. The Lancet Neurology. 2010;9(12):1228-32.

Lewkonia R. Patient rights and medical education: clinical principles. Medical teacher. 2011;33(5):392-6.

Matiti MR, Trorey G. Perceptual adjustment levels: patients' perception of their dignity in the hospital setting. International journal of nursing studies. 2004;41(7):735-44.

Stevenson A. Oxford dictionary of English. Oxford University Press; 2010.

Fletcher-Smith J, Walker MF, Drummond A. The influence of hand use on dressing outcome in cognitively impaired stroke survivors. The British Journal of Occupational Therapy. 2012;75(1):2-9

Nayeri ND, Aghajani M. Patients' privacy and satisfaction in the emergency department: a descriptive analytical study. Nursing ethics. 2010;17(2):167-77.

Torabizadeh C, Ebrahimi H, Mohamadi E. The Relationship between Patients' Privacy and Dignity. Medical Ethics. 2012;1(19):121-33.

Ebrahimi H, Torabizadeh C, Mohammadi E, Valizadeh S. Patients' perception of dignity in Iranian healthcare settings: a qualitative content analysis. Journal of medical ethics. 2012;38(12):723-8.

Vlug MG, De-Vet HC, Pasman HR, Rurup ML, Onwuteaka-Philipsen BD. The development of an instrument to measure factors that influence self-perceived dignity. Journal of palliative medicine. 2011;14(5):578-86.

Cairns D, Williams V, Victor C, Richards S, Le May A, Martin W, et al. The meaning and importance of dignified care: findings from a survey of health and social care professionals. BMC geriatrics. 2013;13:28.

Whitehead J, Wheeler H. Patients' experience of privacy and dignity. Part 2: An empirical study. British journal of nursing. 2008;17(7):458-64.

Delmar C, Alenius-Karlsson N, Mikkelsen AH. The implications of autonomy: Viewed in the light of efforts to uphold patients dignity and integrity. International journal of qualitative studies on health and well-being. 2011;6(2):6045.

Delmar C, Boje T, Dylmer D, Forup L, Jakobsen C, Moller M, Sonder H. Independence/dependence--a contradictory relationship? Life with a chronic illness. Scandinavian journal of caring sciences. 2006;20(3):261-8.

Kozier B. Fundamentals of nursing, concepts, process and practice. Pearson Education; 2008.

Chaichana KL, Halthore AN, Parker SL, Olivi A, Weingart JD, Brem H, et al. Factors involved in maintaining prolonged functional independence following supratentorial glioblastoma resection. Clinical article. Journal of neurosurgery. 2011;114(3):604-12.

Stiggelbout AM, Molewijk AC, Otten W, Timmermans DR, van Bockel JH, Kievit J. Ideals of patient autonomy in clinical decision making: a study on the developmentof a scale to assess patients' and physicians' views. Journal of medical ethics. 2004;30(3):268-74.

Back E, Wikblad K. Privacy in hospital. Journal of advanced nursing. 1998;27(5):940-5.

Birrell J, Thomas D, Jones CA. Promoting privacy and dignity for older patients in hospital. Nursing standard. 2006;20(18):41-6.

Avestan Z, Rahmani A, Heshmati-Nabavi F, Mogadasian S, Faghani S, Azadi A, et al. Perceptions of Iranian Cancer Patients Regarding Respecting their Dignity in Hospital Settings. Asian Pacificjournal of cancer prevention. APJCP. 2015;16(13):5453-8.

Woogara J. Patients' privacy of the person and human rights. Nursing ethics. 2005;12(3):273-87.

Karro J, Dent AW, Farish S. Patient perceptions of privacy infringements in an emergency department. Emergency medicine Australasia. EMA. 2005;17(2):117-23.

Barlas D, Sama AE, Ward MF, Lesser ML. Comparison of the auditory and visual privacy of emergency department treatment areas with curtains versus those with solid walls. Annals of emergency medicine. 2001;38(2):135-9.

Akyuz E, Erdemir F. Surgical patients' and nurses' opinions and expectations about privacy in care. Nursing ethics. 2013;20(6):660-71.

Suhonen R, Valimaki M, Dassen T, Gasull M, Lemonidou C, Scott PA, et al. Patients' autonomy in surgical care: a comparison of nurses' perceptions in five European countries. International nursing review. 2003;50(2):85-94.

Moser A, Houtepen R, Widdershoven G. Patient autonomy in nurse-led shared care: a review of theoretical and empirical literature. Journal of advanced nursing. 2007;57(4):357-65.

Rahmani A, Ghahramanian A, Alahbakhshian A. Respecting to patients' autonomy in viewpoint of nurses and patients in medical-surgical wards. Iranian journal of nursing and midwifery research. 2010;15(1):14-9.

Ebrahimi H, Sadeghian E, Seyedfatemi N, Mohammadi E. Challenges associated with patient autonomy in Iranian hospitals: a qualitative study. Iranian Journal of Medical Ethics and History of Medicine. 2014;7(4):92-103.

Akbari S, AshayeriH, Fahimi MA, Kamali M, Lyden PD. The correlation of independency in activities of daily living performance with cognitive status and the intensity of neurological impairment in right-handed stroke patients. Neuro Rehabilitation. 2010;29(3):311-6.






Original Research Articles