Vohra H A, Ledsham J, Vohra H, Patel R L
University Hospitals, Coventry & Warwickshire Hospitals NHS Trust, Walsgrave Hospital, Coventry, UK.
Cardiovasc Surg. 2003 Feb;11(1):64-9. doi: 10.1016/s0967-2109(02)00057-1.
To determine the extent to which informed patient consent for cardiac surgery corresponds with standard guidelines and to assess patient satisfaction with the consent process.
A questionnaire developed in accordance with consent guidelines published by the Medical Defence Union (MDU) and the Practicalities Of Producing Patient information (POPPi) Guide was administered to 82 patients after they were consented for cardiac surgery.
Patients were informed about i) type of operation [n=80, 97.5%] ii) reason for surgery [n=78, 95%] iii) surgical procedure [n=77, 94%] iv) length of hospital stay [n=73, 89%] and v) post-surgical care [n=79, 96.3%]. However, a decreasing number of patients were notified about i) possible risks of surgery [n=64, 78%] and ii) consequences of no surgery [n=62, 75.6%]. Interestingly, patients received less adequate information about i) alternative methods of treatment (n=34, 41.4%], ii) future lifestyle (n=55, 67%] and iii) medications following surgery [n=40, 48.7%]. 81% (n=67) were overall 'satisfied' with the information provided. More than 95% (n=78) patients were invited to ask questions. The most commonly asked questions were about i) quality of life ii) length of operation and hospital stay iii) surgical procedure iv) consequences of no surgery.
The study has highlighted areas of informed consent in cardiac surgical patients that need attention. Although, patients were generally satisfied and well informed about the procedure, less information was presented covering alternative treatments, future lifestyle and medications. This was reflected in the questions asked by patients and their suggested improvements for the consent procedure.
确定心脏手术患者的知情同意程度与标准指南的符合情况,并评估患者对同意过程的满意度。
根据医学防护联盟(MDU)和患者信息生成实用指南(POPPi)发布的同意指南制定问卷,在82例心脏手术患者签署同意书后进行调查。
患者了解到:i)手术类型[n = 80,97.5%];ii)手术原因[n = 78,95%];iii)手术步骤[n = 77,94%];iv)住院时间[n = 73,89%];v)术后护理[n = 79,96.3%]。然而,了解以下信息的患者数量逐渐减少:i)手术可能的风险[n = 64,78%];ii)不进行手术的后果[n = 62,75.6%]。有趣的是,患者获得的关于以下方面的信息不足:i)替代治疗方法(n = 34,41.4%);ii)未来生活方式(n = 55,67%);iii)术后用药(n = 40,48.7%)。81%(n = 67)的患者总体上对所提供的信息“满意”。超过95%(n = 78)的患者被邀请提问。最常问的问题是关于:i)生活质量;ii)手术和住院时间;iii)手术步骤;iv)不进行手术的后果。
该研究突出了心脏手术患者知情同意中需要关注的领域。虽然患者总体上对手术过程满意且了解充分,但关于替代治疗、未来生活方式和药物的信息较少。这反映在患者提出的问题以及他们对同意过程的改进建议中。