Barriers to adopt the Health Promoting Hospitals (HPH) initiative in Iran: The Q method derived perspectives of front line practitioners.

Abstract

This study aimed to investigate prospects of a sample of Iranian front line health care professionals about their perceived barriers to implement the HPH initiative. The six stages Q methodology was applied to systematically envisage divergent perspectives of the 33 health professionals (7 physicians, 2 managerial and 24 nurses) working in the 10 educational hospitals in Iran. Analysis of the study participants' viewpoints (the Q-sorts) resulted in a five factor solution (accounted for 48% of the total variance) to endorse main barriers of the HPH implementation in the typical Iranian hospitals. The health professionals' dominant biomedical approach and their deficit commitment to health promotion programs, inappropriate decision-making mechanisms and insufficiency of the organizational infrastructure in the Iranian national health system (INHS) were among the important emanated factors to sustainably maintain the HPH program. The identified barriers reflect the spheres that need to be focused in interventions to facilitate the successful implementation of the HPH initiative in Iran and other developing countries. Despite the existent consensus about overall merits of the HPH to fulfill best interests of hospitalized patients, major challenges deems to exist for operability of this beneficial undertaking in Iran.