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Patient-Centered Care in Chronic Diseases Among Iranian Patients: The Acceptability of Paternalism As a Distinctive Feature Publisher Pubmed



Khosravi M1, 2 ; Shojaei P3 ; Kavosi Z4 ; Ravangard R4 ; Gooshki ES5, 6 ; Marzaleh MA7 ; Delavari S4
Authors
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Authors Affiliations
  1. 1. Student Research Committee, Department of Health Services Management, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Fars Province, Shiraz, Iran
  2. 2. Social Determinants of Health Research Center, Birjand University of Medical Sciences, South Khorasan Province, Birjand, Iran
  3. 3. Department of Management, Shiraz University, Fars Province, Shiraz, Iran
  4. 4. Health Human Resources Research Center, Department of Health Services Management, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Fars Province, Shiraz, Iran
  5. 5. Monash Bioethics Center, Monash University, Melbourne, VIC, Australia
  6. 6. Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran Province, Tehran, Iran
  7. 7. Department of Health in Disasters and Emergencies, Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Fars Province, Shiraz, Iran

Source: Journal of Evaluation in Clinical Practice Published:2025


Abstract

Rationale: Research on patient-centeredness in managing chronic diseases like cancer, diabetes, stroke, and heart disorders is gaining prominence. This approach in chronic disease management involves various dimensions and elements, the importance of which has been presented to differ. Aims and Objectives: The present research, carried out in the year 2023, aimed to identify and prioritize existing dimensions and elements of patient-centered care for chronic diseases. Methods: Firstly, multiple databases including the Cochrane Database of Systematic Reviews, Scopus, PubMed and ProQuest were searched. Secondly, 35 chronic patients were interviewed; Finally, a sample of 30 experts familiar with the context was asked to rank the dimensions and elements of patient-centered care using Best-Worst method. Results: The study identified 6 dimensions and 13 elements of patient-centered care in chronic diseases. The findings indicated that accessibility, quality, education, timeliness and affordability were the five elements that ranked highest in importance for designing and implementing patient-centered care interventions for chronic diseases. Conclusion: The results presented that Iranian patients with chronic diseases exhibit a positive attitude towards paternalistic behavior and often prefer others to make the best therapeutic decisions on their behalf. Our research revealed that the concept of patient-centered care differs across regions and cultures, highlighting the need for policymakers and researchers to adapt strategies to the specific characteristics of local populations around the globe. © 2025 John Wiley & Sons Ltd.
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