The Effect of Patient Rights Charter Education on Satisfaction with Healthcare Services and Awareness of the Charter Among Hospitalized Patients
akhlāq-i pizishkī i.e., Medical Ethics,
Vol. 19 (1404),
25 September 2025
,
Page 1-15
https://doi.org/10.22037/mej.v19i-.50881
Abstract
Background and Aim: Patient satisfaction is a key indicator of the quality of hospital services. Awareness of patient rights may contribute to increased satisfaction; however, unmet expectations arising from such awareness may conversely lead to dissatisfaction. This study aimed to examine the effect of education on the Patient Rights Charter on awareness and satisfaction among hospitalized patients.
Methods: This quasi-experimental, two-group study was conducted among 28 hospitalized patients admitted to the internal medicine and surgical wards of Allameh Bohlool Hospital in Gonabad, Iran. A two-stage cluster sampling method was used, and participants were randomly assigned to either the intervention or control group. At baseline, all participants completed questionnaires assessing awareness of the Patient Rights Charter and satisfaction with medical and non-medical services. The intervention group received face-to-face education on the Patient Rights Charter over three sessions. At discharge, both questionnaires were re-administered in the two groups. Data were analyzed using SPSS 19, employing independent and paired t-tests, with the level of statistical significance set at p<0.05.
Ethical Considerations: Informed consent was obtained from all participants. Confidentiality of data, safety of the intervention, voluntary participation, and the right to withdraw from the study at any time were ensured.
Results: Before the intervention, no statistically significant difference was observed between the two groups regarding satisfaction with medical and non-medical services (p=0.16). After the intervention, patient satisfaction in the intervention group was significantly lower compared with the control group (p<0.001). Awareness of the Patient Rights Charter did not differ significantly between the two groups at baseline (p=0.265); however, a significant increase in awareness was observed in the intervention group following the educational program (p<0.001).
Conclusion: Education on the Patient Rights Charter increases patients’ awareness of their rights and subsequently raises their expectations of healthcare services. When these expectations are not adequately met by the healthcare team, patient satisfaction may decline. Therefore, strengthening adherence to patient rights and improving service quality through managerial and staff-level interventions are essential for enhancing patient satisfaction.
Keywords: Education; Patient Rights Charter; Patient Satisfaction; Hospitalized Patients
- Education
- Patient Rights Charter
- Patient satisfaction
- Hospitalized Patients
How to Cite
References
1. Taghavi Larijani T, Najafi F. Patient Satisfaction Survey of Nursing Care and Services in Iran: A systematic review. Journal of Education and Ethics in Nursing. 2019;8(1):54-65. [Persian]
2. Farajzadeh MA, Vahedian Azimi A, Mir Javadi S A, Karimi L. Survey of the Patients' Satisfaction with Services provided in an Iranian Naval Hospital in 2019: A Cross-sectional Study. Journal of Marine Medicine. 2019;1(3):170-9. [Persian]
3. Safa A, Rayat F, Arbabi Z, Abedzadeh MR, Gholami MS. The Relationship between Nurses' Care Behaviors and Patients' Satisfaction in Public Hospitals of Kashan. Quarterly Journal of Nursing Management. 2022;10(3):1-10. [Persian]
4. Heravi-Karimooi M, Javanmardnejad S, Rejeh N, Tabe V, Rezaei F. Patients' satisfaction with the services provided for Covid-19 in Ilam, Iran. Journal of the Iranian Institute for Health Sciences Research. 2022;21(4):356-66. [Persian]
5. Ariffin AAM, Zain NM, Menon BV, Aziz NA. The customer satisfaction index model: An empirical study of the private healthcare sector in Malaysia. Journal of Asian Finance, Economics and Business. 2022;9(1):93-103.
6. Shafiei F, Zarei B, Tabiei Sh. The Effect of Primary Nursing Care on Patient Satisfaction after Coronary Angioplasty. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2019;5(3):43-53. [Persian]
7. Graham B. Defining and Measuring Patient Satisfaction. The Journal of Hand Surgery. 2016;41(1):929-31.
8. Batbaatar E, Dorjdagva J, Luvsannyam A, Savino MM, Amenta P. Determinants of patient satisfaction: a systematic review. Perspectives in Public Health. 2017;137(2):89-101.
9. Xesfingi S, Vozikis A. Patient satisfaction with the healthcare system: Assessing the impact of socioeconomic and healthcare provision factors. BMC Health Services Research. 2016;16(1):1-7.
10. Farahani MF, Shamsikhani S, Hezaveh MS. Patient satisfaction with nursing and medical care in hospitals affiliated to Arak university of medical sciences in 2009. Nursing and Midwifery Studies. 2014;3(3):6-11. [Persian]
11. Khezri L, Ravanipour M, Jahanpour F, Mirzaee K. Assessment of patient satisfaction with nursing services provided in general wards of university hospitals in Bushehr 2012. Nursing Journal of the Vulnerable. 2015;2(2):36-46. [Persian]
12. Zolhavarieh SM, Rezaee M, Rassoli P. Evaluation of Satisfaction in Hospitalized Patients in Urology Ward at the Hamedan Medical Sciences University, Shahid Beheshti Hospital during First and Second Half Year of 2013. Journal of Research in Urology. 2017;2(1):15-22. [Persian]
13. Raesi R, Bokaie S, Hushmandi K, Raei M. Evaluation of Patients' Satisfaction with the Diagnosis of COVID-19 from the Quality of Nursing Services in Corona Ward: A Cross-sectional Study. Journal of Critical Care Nursing. 2022; 15(1):25-33. [Persian]
14. Kalhor M, Kaveii B, Samii-Rad F. Evaluation Patients awareness and satisfaction of implementing Patients' Rights Charter at Kowsar Hospital in Qazvin. Research in Medical Science Education. 2017;9(3):29-37. [Persian]
15. Rostami-Moez M, Oshvandi K, Niazy Z, Shayan A, Masoumi SZ. The Effect of Teaching Patients’ Rights to Midwifery Students on Their Compliance with Patients’ Rights at Fatemieh Hospital, Hamadan, Iran. Journal of Medical Education. 2021;20(3): e116707.
16. Kazemi S, Gholizadeh M, Rajaee M, Yousefnezhad M, Khayat Kakhki S. Presenteeism, moral courage, and moral disengagement among nurses: a cross-sectional structural equation modeling study. BMC Nursing. 2025;24(1):1126.
17. Mortazavi Z, Hosseini SA, Jafari V, Heshmati B, Mortazavi SS. The survey Awareness of Students in Hamadan School of Rehabilitation about Patients’ Rights Charter. Journal of Medical Education and Development. 2020;15(2):141-50. [Persian]
18. Mousavi SN, Yaghobian M, Ranjbar M. Awareness of Cancer Patients about Patient Bill of Rights and its Administration in Hospitals. Journal of Mazandaran University of Medical Sciences. 2016;26(140):167-74. [Persian]
19. Ezzati N, Ezzati N, Ezzati M. Effective factors on the satisfaction of female patients with the performance of medical personnel in line with the implementation of the patient's rights charter in selected hospitals of Tabriz in 2013-2014. Woman and Family Studies. 2016;6(32):77-98. [Persian]
20. Mohammadipour F, Sahraeibeiranvand M, Beiranvand S, Beiranvand S. Investigating the relationship between mental welfare of nurses and patient satisfaction with mediating role of Job burnout. Scientific Journal of Nursing, Midwifery and Paramedical Faculty. 2018;3(4):46-57. [Persian]
21. Mehrtak M, Ebrahimi K, Mahdavi A, Ravaghi H. The effectiveness of Patient Bill of Rights education on patients' satisfaction. Test Engineering and Management. 2021;83(May-June 2020):14653-60.
22. Mohammed ES, Seedhom AE, Ghazawy ER. Awareness and practice of patient rights from a patient perspective: an insight from Upper Egypt. International Journal for Quality in Health Care. 2018;30(2):145-51.
23. Fouad ER, Abdelrahman SM, Mohamed EA. Nurses Compliance Toward Patients' Rights and its Relation to Patients Satisfaction. Minia Scientific Nursing Journal. 2020;7(1):44-53.
24. Farzianpour F, Rahimi Foroushani A, Shahidi Sadeghi N, Ansari Nosrati S. Relationship between' patient's rights charter' and patients' satisfaction in gynecological hospitals. BMC Health Services Research. 2016;16(1):476.
25. Habibi M. Investigating the effect of teaching nurses the charter of patients' rights on the satisfaction and anxiety reduction of patients hospitalized in Amir Shiraz Oncology Hospital in 2016 [master's thesis on the Internet]. Islamic Azad University: Maroodasht Branch; 2016 [cited 2026 February 1]. Available from: https://ganj.irandoc.ac.ir. [Persian]
26. Niyazi Z, Shayan A, Bakht R, Roshanayi Gh, Masumi Z. The effect of teaching the Charter of Rights of Pregnant Women on the performance of midwives and the satisfaction of pregnant women referring to Imam Reza (AS) hospital in Kabudar Ahang, 2014. Journal of Midwifery and Infertility Women of Iran. 2017;20(2):50-9. [Persian]
27. Ameryoun A, Ebrahimnia M, Soltani Zarandi MR, Aghighi A, Jafarzadeh A. Localization of patients' satisfaction questionnaire hospitalized at a military hospital. Nurse and Physician Within War. 2017;4(13):187-95. [Persian]
28. Basirimoghadam K, basirimoghadam M, Moslem A, ajamzibad H, Jamal F. Health providers and patients' awareness on patient bill of rights and its observing rate in an educational hospital in Gonabad. Internal Medicine Today. 2011;11(2):45-54. [Persian]
29. Fruzannezhad F. Designing and evaluating a multimedia educational program based on the pre-organizer teaching model and its effect on the motivation of academic progress in social studies [master's thesis on the Internet]. Allameh Tabatabai University; 2014 [cited 2026 February 1]. Available from: https://ganj.irandoc.ac.ir. [Persian]
30. Nemati F, Mohammadnejad E, Tabatabaei A, Ehsani S, Sajjadi A, Hajiesmaeilpoor A. Satisfaction rate of hospitalized patients in teaching hospitals with presented services. Journal of Medical Ethics and History. 2014;8(28):29-50. [Persian]
31. Nekoii-Moghadam M, Amir Esmaiili M, Ghorbaninia R, Sharifi T, Tabatabi S. Awareness of patients' rights and their observance from the perspective of patients and nurses: a study in limited surgical centers in Kerman city in 2013. Bioethics Journal. 2016;4(11):1-12. [Persian].
32. Thornton RD, Nurse N, Snavely L, Hackett-Zahler S, Frank K, Ditomasso RA. Influences on patient satisfaction in healthcare centers: a semi-quantitative study over 5 years. BMC Health Services Research. 2017;17(1):361.
33. Farajzadeh Z, Nakhaei Z, Mohammadi S. Patients' Satisfaction from Nursing Care in Hospitals of Birjand University of Medical Sciences in 2019. Journal of Nursing Education. 2021;10(5):22-31. [Persian]
34. Rouhafza M, Adhami Moghadam F, Sahebalzamani M, Ariffin AA. Assessment the relationship between patient satisfaction and quality of hospital services based on SERVQUAL Model in the hospitals related to Islamic Azad University, Tehran Medical Sciences Branch in 2015. Medical Sciences. 2016; 26(3):173-9. [Persian]
35. Rahmani AH, Ranjgaran Alanagh M, Jamshidi F. Evaluation of patient’s satisfaction with nurses in surgical departments of Ahvaz teaching hospital in 2018. Medical Ethic and History of Medicine. 2020; 13:329-349. [Persian]
- Abstract Viewed: 60 times