Gender and Family Studies

Gender and Family Studies

The Lived Experiences of Hospitalized Women Regarding the Violation of Body Boundaries

Document Type : Original Article

Authors
asieh shariatmadar 1
hadi mohammadlo 2
reihane pahlavani 3
sedigheh bagheri 3
behina akbari 3
1 Department of Counsulting, Faculty of Psychology & Educational Sciences, Univercity of Allameh Tabatabaii Tehran
2 Department of Counsulting, Faculty of Psychology & Educational Sciences, Univercity of Allameh Tabatabaii, Tehran
3 Department of Counsulting, Faculty of Psychology & Educational Sciences, Univercity of Allameh Tabatabaii, Tehran
Abstract
Preserving bodily privacy is one of the foundational principles of ethics in medical sciences and a key pillar in delivering humane and dignified healthcare services. This concept not only pertains to physical aspects such as bodily coverage and personal space, but also includes respect for individual autonomy, informed consent, and the preservation of human dignity. In healthcare systems, observing bodily privacy plays a crucial role in fostering trust between patients and medical staff, reducing anxiety, and enhancing the quality of medical care. In the cultural and social context of Iran—where religious, ethical, and customary values strongly influence social interactions—bodily privacy holds particular sensitivity and significance. Many Iranian women, especially during hospitalization and surgical procedures, face challenges arising from the conflict between medical requirements and cultural expectations regarding privacy. Accordingly, this study was conducted using a qualitative approach to examine the lived experiences of women regarding violations of bodily privacy in Iranian hospitals. By exploring their personal and concrete experiences, the study aims to reveal hidden dimensions of this issue and provide a foundation for policy reform and the advancement of professional ethics. This study employed a qualitative research method with a phenomenological approach. The participants included 13 married women, aged 25 to 60, residing in Tehran, who had experienced hospitalization and surgery within the past five years. Participants were selected purposefully, based on inclusion criteria. Data were collected through semi-structured interviews and analyzed using thematic analysis. The analysis showed that women’s experiences of bodily privacy violations in hospitals are multifaceted and complex. Inappropriate behaviors by some healthcare staff—such as disregard for verbal and behavioral boundaries, unauthorized entry into patient rooms, and neglect of patients’ bodily coverage and physical condition—were identified as significant human factors. Additionally, hospital infrastructure—such as shared rooms, lack of curtains or proper partitions, and insufficient facilities for maintaining privacy—were recognized as physical factors that exacerbate these violations. On the other hand, some patients accepted these violations due to fear of being denied medical services, lack of awareness of their rights, or normalization of privacy breaches. Nevertheless, some participants adopted strategies to confront these violations, including direct protest, requesting behavioral changes from staff, and using positive self-talk to reduce anxiety. Suggestions for external guarantees of bodily privacy included professional ethics training for healthcare personnel, development of operational guidelines, and continuous monitoring of patient rights compliance. The results of this study indicate that bodily privacy violations in hospitals are a serious and multilayered issue influenced by both human and structural factors. The lived experiences of hospitalized women reveal that such violations not only lead to feelings of shame, anxiety, and mistrust, but can also negatively affect the treatment and recovery process. Therefore, educating healthcare staff in professional ethics, raising patients’ awareness of their rights, and improving the physical infrastructure of medical facilities are essential measures for preserving human dignity and enhancing the quality of medical care. This study can serve as a basis for developing policies and practical programs in the field of medical ethics and patient rights.
Keywords
Aristotle
Misogyny
Hylomorphism
Myth
1. Akyüz, E. & Erdemir, F. (2013). Surgical Patients’ and Nurses’ Ipinions and Expectations about Privacy in Care. Nursing Ethics, 20 (6), 660-671. DOI: 10.1177/0969733012468931
2. Baillie, L. (2008). Mixed-sex Wards and Patient Dignity: Nurses’ and Patients’ Perspectives. British Journal of Nursing, 17 (19), 1220-1225.  DOI: 10.12968/bjon.2008.17.19.31461
3. Barati, F., Atarodi, A., Asghari, B. A. & Atarodi, A. (2019). Awareness and Observation of Patients’ Rights from the Perspective of Patients and Nurses. Journal of Research and Health, 9 (4), 315-323. DOI: 10.29252/jrh.9.4.315. (In Persian).
4. Braun, V. & Clarke, V. (2006), Using Thematic Analysis in Psychology. Qualitative Research in Psychology, (3), 77-101. DOI:10.1191/1478088706qp063oa
5. Brunner, L. S. (2010). Brunner & Suddarth's Textbook of Medical-Surgical Nursing (v.1). Lippincott Williams & Wilkins.
6. Carew, P. J. & Stapleton, L. (2005). Towards a Privacy Framework for Information Systems Development. In Information Systems Development: Advances in Theory, Practice, and Education. Boston, MA: Springer US. (pp. 77-88).
7. Crigger, N. J. & Holcomb, L. (2007). Practical Strategies for Providing Culturally Sensitive, Ethical Care in Developing Nations. Journal Transcult Nurs, 18 (1), 70-76. DOI: 10.1177/1043659606294198
8. Değirmen, N. & Şaylıgil, Ö. (2020). Body Privacy in Gynecology Obstetrics. Acta Bioethica, 26 (2), 225-235. DOI:10.4067/S1726-569X2020000200225
9. Fuseini, A. G., Rawson, H., Ley, L. & Kerr, D. (2023). Patient Dignity and Dignified Care: A Qualitative Description of Hospitalised Older Adults Perspectives. Journal of Clinical Nursing, 32 (7-8), 1286-1302. DOI: 10.1111/jocn.16286
10. Gutierrez-Puertas, L., Marquez-Hernandez, V. V., Gutierrez-Puertas, V., Granados-Gamez, G. & Aguilera-Manrique, G. (2020). Educational Interventions for Nursing Students to Develop Communication Skills with Patients: a Systematic Review. International Journal of Environmental Research and Public Health, 17 (7), 2241. DOI: 10.3390/ijerph17072241.
11. Hatzigeorgiadis, A. & Galanis, E. (2017). Self-Talk Effectiveness and Attention. Current Opinion in Psychology, (16), 138-142.  DOI: 10.1016/j.copsyc.2017.05.014
12. Heijkenskjöld, K. B., Ekstedt, M. & Lindwall, L. (2010). The Patient’s Dignity from the Nurse’s Perspective. Nursing Ethics, 17 (3), 313-324. DOI: 10.1177/0969733010361444
13. Hemsley, B., Balandin, S. & Worrall, L. (2012). Nursing the Patient with Complex Communication Needs: Time as a Barrier and a Facilitator to Successful Communication in Hospital. Journal of Advanced Nursing, 68 (1), 116-126. DOI: 10.1111/j.1365-2648.2011.05722.x
14. Hongladarom, S. (2016). The Online Self: Externalism, Friendship and Games. Springer (v. 25).
15. Joolaee, S., Tschudin, V. Nikbakht‐Nasrabadi, A. & Parsa‐Yekta, Z. (2008). Factors Affecting Patients' Rghts Practice: the Lived Experiences of Iranian Nurses and Physicians. International Nursing Review 55, (1), 55-61. DOI: 10.1111/j.1466-7657.2007.00584.x
16. Karro, J., Dent, A. W. & Farish, S. (2005). Patient Perceptions of Privacy Infringements in an Emergency Department. Emergency Medicine Australasia, 17 (2), 117-123. DOI: 10.1111/j.1742-6723.2005.00702.x
17. Latour, J. M. & Albarran, J. W. (2012). Privacy, Dignity and Confidentiality: a Time to Reflect on Practice. Nursing in Critical Care, 17 (3), 109-111. DOI: 10.1111/j.1478-5153.2012.00508.x
18. Lin, Y. P. & Tsai, Y. F. (2011). Maintaining Patients’ Dignity During Clinical Care: a Qualitative Interview Study. Journal of Advanced Nursing, 67 (2), 340-348. DOI: 10.1111/j.1365-2648.2010.05498.x
19. Mema, A., Bressan, V., Stevanin, S. & Cadorin, L. (2025). The Perception of Dignity in the Hospitalized Patient: Findings from a Meta-Synthesis. Nursing Ethics, 32 (1), 19-41. ‏DOI: 10.1177/09697330241238339
20. Moore, M. & Chaudhary, R. (2013). Patients’ Attitudes Towards Privacy in a Nepalese Public Hospital: a Cross-Sectional Survey. BMC Research Notes, (6), 1-5. DOI: 10.1186/1756-0500-6-31
21. Nayeri, N. D., Aghajani, M. (2010). Patients’ Privacy and Satisfaction in the Emergency Department: a Descriptive Analytical Study. Nursing Ethics, 17 (2), 34–42. DOI: 10.1177/0969733009355377
22. Ohl, M., Schweizer, M., Graham, M., Heilmann, K., Boyken, L. & Diekema, D. (2012). Hospital Privacy Curtains are Frequently and Rapidly Contaminated with Potentially Pathogenic Bacteria. American Journal of Infection Control, 40 (10), 904-906.  DOI: 10.1016/j.ajic.2011.12.017
23. Özturk, H., Bahçecik, N. & Özçelik, K. S. (2014). The Development of the Patient Privacy Scale in Nursing. Nursing Ethics, 21 (7), 812-828.  DOI: 10.1177/0969733013515489
24. Parsapoor, A., Bagheri, A. & Larijani, B. (2014). Patient's Rights Charter in Iran. Acta Medica Iranica, 24-28. DOI: acta.tums.ac.ir/index.php/acta/article/view/4746
25. Scott, P. A., Välimäki, M., Leino-Kilpi, H., Dassen, T., Gasull, M., Lemonidou, C., ... & Kaljonen, A. (2003). Perceptions of Autonomy in the Care of Elderly People in Five European Countries. Nursing Ethics, 10 (1), 28-38. DOI: 10.1191/0969733003ne572oa
26. Serenko, N. & Fan, L. (2013). Patients’ Perceptions of Privacy and their Outcomes in healthcare. International Journal of Behavioural and Healthcare Research, 4 (2), 101-122. DOI:10.1504/IJBHR.2013.057359
27. Speziale, H. S., Streubert, H. J. & Carpenter, D. R. (2011). Qualitative Research in Nursing: Advancing the Humanistic Imperative. Lippincott Williams & Wilkins.
28. Stephen Ekpenyong, M., Nyashanu, M., Ossey-Nweze, C. & Serrant, L. (2021). Exploring the Perceptions of Dignity Among Patients and Nurses in Hospital and Community Settings: An Integrative Review. Journal of Research in Nursing, 26 (6), 517-537. DOI: 10.1177/1744987121997890
29. Swan, M. (2009). Emerging Patient-Driven Health Care Models: an Examination of Health Social Networks, Consumer Personalized Medicine and Quantified Self-Tracking. International Journal of Environmental Research and Public Health, 6 (2), 492-525. DOI: 10.3390/ijerph6020492
30. Tajdari, S., Irajpour, A., Shahriari, M. & Saghaei, M. (2022). Identifying the Dimensions of Patient Privacy in Intensive Care Units: a Qualitative Content Analysis Study. Journal of Medical Ethics and History of Medicine, 15. doi.org/10.18502/jmehm.v15i6.11048. (in Persion).
31. Tehrani, H., Fallahi-Khoshknab, M., Ebadi, A. & Gillespie, M. (2018). Respecting the Privacy of Hospitalized Patients: An Integrative Review. Nursing Ethics, 969733018759832-969733018759832. DOI: 10.1177/0969733018759832
32. Turban, E., King, D., Lee, J. & Viehland, D. (2006). Electronic Commerce A Managerial Perspective Prentice Hall. New Jersey.
33. Valentine, N., Darby, C. & Bonsel, G. J. (2008). Which Aspects of Non-Clinical Quality of Care are Most Important? Results from WHO's General Population Surveys of "Health Systems Responsiveness" in 41 Countries. Social Science & Medicine, 66 (9), 1939-1950. DOI: 10.1016/j.socscimed.2007.12.002
34. Van Raalte, J. L., Vincent, A. & Brewer, B. W. (2016). Self-Talk: Review and Sport-Specific Model. Psychology of Sport and Exercise, (22), 139-148. doi.org/10.1016/j.psychsport.2015.08.004
35. Walsh, K. & Kowanko, I. (2002). Nurses’ and Patients’ Perceptions of Dignity. International Journal of Nursing Practice, 8 (3), 143-151. DOI: 10.1046/j.1440-172x.2002.00355.x
36. Yilmaz, F. T. & Demirel, G. (2021). The Relationship Between Body Privacy and Anxiety in Women Having Gynecological Examination. Journal of Obstetrics and Gynaecology, 41 (7), 1112-1115. DOI: 10.1080/01443615.2020.1835845
37. Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., ... & Dastgerdi, M. V. (2013). The Code of Ethics for Nurses. Iranian Journal of Public Health, (42), 1. DOI: ijph.tums.ac.ir/index.php/ijph/article/view/4718. (in Persion).
38. Zakaria, N. & Ramli, R. (2017). Physical Factors that Influence Patients’ Privacy Perception Toward a Psychiatric Behavioral Monitoring System: a Qualitative Study. Neuropsychiatric Disease and Treatment, 117-128. DOI: 10.2147/NDT.S115261.