Jackson A, Henry R, Avery N, VanDenKerkhof E, Milne B
Department of Anesthesiology, Queen's University, Kingston General Hospital, Ontario, Canada.
Can J Anaesth. 2000 Nov;47(11):1068-73. doi: 10.1007/BF03027957.
To determine A) what a labouring woman expects to hear about epidural analgesia before consenting, B) if she feels able to understand the risks and thereby assess if we are obtaining informed consent.
Sixty actively labouring women were surveyed immediately after requesting an epidural. Demographic, labour, epidural and consent information were included in the questionnaire. Answers were categorical (yes/no, multiple choice) or scored on a scale from 0 to 10 (visual analogue scale).
The majority of parturients wanted all potential epidural complications but not their incidences disclosed in the consent process. However, a discussion of risks would not dissuade women from consenting to an epidural in the majority of cases. Labouring women have a moderate understanding of epidural risks. The ability to understand risks was not affected by labour pain, anxiety, opioid premedication, duration of labour pain, desire for an epidural, previous epidural experience, level of education or age.
This prospective survey characterizes what 60 reasonable labouring women wanted to know about labour epidural analgesia. Parturients wanted all risks of epidural analgesia disclosed in the informed consent process. The majority of women did not want the incidences quoted. This study suggests that labouring patients are as able to give informed consent as are other members of our patient population.
A)确定分娩期妇女在同意使用硬膜外镇痛前希望了解哪些信息;B)确定她是否觉得自己能够理解风险,从而判断我们是否获得了知情同意。
60名正在积极分娩的妇女在请求使用硬膜外麻醉后立即接受调查。问卷中包括人口统计学、分娩、硬膜外麻醉和同意的相关信息。答案为分类(是/否、多项选择)或采用0至10分的评分(视觉模拟评分)。
大多数产妇希望了解所有潜在的硬膜外麻醉并发症,但不希望在同意过程中被告知其发生率。然而,在大多数情况下,讨论风险并不会阻止妇女同意使用硬膜外麻醉。分娩期妇女对硬膜外麻醉风险有一定程度的了解。理解风险的能力不受分娩疼痛、焦虑、阿片类药物术前用药、分娩疼痛持续时间、对硬膜外麻醉的渴望、既往硬膜外麻醉经历、教育程度或年龄的影响。
这项前瞻性调查描述了60名理智的分娩期妇女希望了解的关于分娩期硬膜外镇痛的信息。产妇希望在知情同意过程中了解硬膜外镇痛的所有风险。大多数妇女不希望提及发生率。这项研究表明,分娩期患者与我们患者群体中的其他成员一样能够给予知情同意。