Document Type : Original Article


Nursing and Midwifery Care Research Center, Isfahan University of Medical Science, Isfahan, Iran


CONTEXT: An increasingly common complaint of staff nurses in hospitals is not receiving respect.
One of the strategies to create a healthy and positive work environment is to strengthen the respectful
behaviors among nurses.
AIMS: This study aims to explore the barriers of respect in nursing workplace.
SETTINGS AND DESIGN: This qualitative content analysis was carried out at the School of Nursing
and Midwifery of Golestan University of Medical Sciences.
SUBJECTS AND METHODS: The semi‑structured interview method was employed in this qualitative
study on 14 nursing staff in 2018. We transcribed the interviews verbatim and analyzed them using
the conventional content analysis approach.
RESULTS: Data analysis led to the emergence of 377 primary codes, 13 categories, and 4 themes.
The four themes were as follows: (a) feeling of ignored; (b) socio‑cultural conditions in society;
(c) lack of Support by Managers; (d) poor organizational climate.
CONCLUSIONS: Nursing managers can promote a healthy work environment in the nursing workplace
through recognizing these challenges and applying mitigation strategies and take benefits of their
consequences such as self‑efficacy, self‑confidence, and organizational commitment.


1. Taylor CA. The Development of a Tool to Measure Feelings of
Respect in Nurses [Ph.D. Thesis]. Ann Arbor: George Mason
University; 2014.
2. Duffield CM, Roche MA, Blay N, Stasa H. Nursing unit
managers, staff retention and the work environment. J Clin Nurs
3. Laschinger HK. Job and career satisfaction and turnover intentions
of newly graduated nurses. J Nurs Manag 2012;20:472‑84.
4. Bennett Jacobs B. Respect for human dignity in nursing:
Philosophical and practical perspectives. Can J Nurs Res
5. Price S, Doucet S, Hall LM. The historical social positioning
of nursing and medicine: Implications for career choice, early
socialization and interprofessional collaboration. J Interprof Care
6. Leape LL, Shore MF, Dienstag JL, Mayer RJ, Edgman‑Levitan S,
Meyer GS, et al. Perspective: A culture of respect, part 1: The
nature and causes of disrespectful behavior by physicians. Acad
Med 2012;87:845‑52.
7. Varaei S, Vaismoradi M, Jasper M, Faghihzadeh S. Iranian nurses
self‑perception – Factors influencing nursing image. J Nurs Manag
8. Emeghebo L. The image of nursing as perceived by nurses. Nurse
Educ Today 2012;32:e49‑53.
9. Bhargava P, Bansod S, Mohammed TL. Fostering a culture of
respect. Curr Prob Diagn Radiol 2016;45:159‑60.
10. Lee YW, Dai YT, Park CG, McCreary LL. Predicting quality
of work life on nurses’ intention to leave. J Nurs Scholarsh
11. Khademian Z, Moattari M, Khademian F. Iranian nursing
students’ perceptions of nursing and the ideal career: A descriptive
comparative study. Nurs Midwifery Stud 2016;5:e33113.
12. Browne A. A conceptual clarification of respect. J Adv Nurs
13. National Institutes of Health. What is Cultural Respect? Bethesda,
Maryland: National Institutes of Health; 2016. Available from: [Last accessed on 2019 Mar 09; Last
updated 2017 Feb 15].
14. D’Ambra AM, Andrews DR. Incivility, retention and new
graduate nurses: An integrated review of the literature. J Nurs
Manag 2014;22:735‑42.
15. Weaver KB. The effects of horizontal violence and bullying on
new nurse retention. J Nurses Prof Dev 2013;29:138‑42.
16. Smith LM, Andrusyszyn MA, Spence Laschinger HK. Effects
of workplace incivility and empowerment on newly‑graduated
nurses’ organizational commitment. JNurs Manag 2010;18:1004‑15.
17. Augsberger A, Schudrich W, McGowan BG, Auerbach C. Respect
in the workplace: A mixed methods study of retention and
turnover in the voluntary child welfare sector. Child Youth Serv
Rev 2012;34:1222‑9.
18. Beach MC, Branyon E, Saha S. Diverse patient perspectives on
respect in healthcare: A qualitative study. Patient Educ Couns
19. Nouri A, Jouybari L, Sanagoo A. Nurses’ perception of factors
influencing professional autonommy in nursing: A qualitative
study. J Urmia Univ Med Sci 2017;28:469‑77.[Persian]
20. McMahon SA, George AS, Chebet JJ, Mosha IH, Mpembeni RN,
Winch PJ. Experiences of and responses to disrespectful maternity
care and abuse during childbirth; a qualitative study with
women and men in Morogoro region, Tanzania. BMC Pregnancy
Childbirth 2014;14:268.
21. Araghian Mojarad F, Nouri A, Sanagoo A, Jouybari L. Improving
the public image of the nursing profession: An enduring challenge
for nurses. NHJ 2017;1:46‑9.
22. Farsi Z, Dehghan‑Nayeri N, Negarandeh R, Broomand S. Nursing
profession in Iran: An overview of opportunities and challenges.
Jpn J Nurs Sci 2010;7:9‑18.
23. ten Hoeve Y, Jansen G, Roodbol P. The nursing profession: Public
image, self‑concept and professional identity. A discussion paper.
J Adv Nurs 2014;70:295‑309.
24. Sodeify R, Vanaki Z, Mohammadi E. Nurses’experiences of
perceived support and their contributing factors: A qualitative
content analysis. Iran J Nurs Midwifery Res 2013;18:191‑7.
25. Spence Laschinger HK, Gilbert S, Smith LM, Leslie K. Towards a
comprehensive theory of nurse/patient empowerment: Applying
Kanter’s empowerment theory to patient care. J Nurs Manag