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踝关节骨折手术的知情同意:患者对口头及录像信息的理解

Informed consent for ankle fracture surgery: patient comprehension of verbal and videotaped information.

作者信息

Rossi Michael, McClellan Robert, Chou Loretta, Davis Kristin

机构信息

Wenatchee Valley Medical Center, 820 N. Chelan Avenue, Wenatchee, WA 98801, USA.

出版信息

Foot Ankle Int. 2004 Oct;25(10):756-62. doi: 10.1177/107110070402501011.

Abstract

BACKGROUND

The purpose of our study was to evaluate the effectiveness of using a videotape to give patients information about the risks, benefits, alternatives, and treatment of a common orthopaedic procedure before they sign consent forms.

METHODS

During a 9-month period, 48 patients with isolated closed ankle fractures requiring surgical intervention were randomized into two groups that received either videotaped or conventional verbal information regarding consent for surgery. The study group watched a videotape containing information about the risks, benefits, and treatment alternatives, while the control group obtained this information verbally. To determine comprehension and retention, all patients completed a multiple-choice questionnaire immediately after receiving the information, and 37 patients (77%) were available to complete a questionnaire at an average of 10 weeks later.

RESULTS

The videotape group outperformed the verbal consent group by 40.1% on the initial questionnaire (p = .0002) and by 27.2% on the followup questionnaire (p = 0.0139). Patients with educational levels of less than or equal to the 12th grade performed 67.8% better on the initial questionnaire after watching the video than after receiving the information verbally. (p = .0001).

CONCLUSION

Patients who received information about their surgery on a videotape before giving their consent demonstrated a significant increase in comprehension compared to patients who received this information verbally. The benefit was even greater for patients with lower education levels.

摘要

背景

我们研究的目的是评估在患者签署同意书之前,使用录像带向其提供有关常见骨科手术的风险、益处、替代方案和治疗信息的有效性。

方法

在9个月的时间里,48例需要手术干预的单纯闭合性踝关节骨折患者被随机分为两组,分别接受关于手术同意的录像信息或传统的口头信息。研究组观看了一盘包含风险、益处和治疗替代方案信息的录像带,而对照组则通过口头获得这些信息。为了确定理解和记忆情况,所有患者在收到信息后立即完成一份多项选择题问卷,37例患者(77%)在平均10周后可完成一份问卷。

结果

录像带组在初始问卷上的表现比口头同意组高出40.1%(p = 0.0002),在后续问卷上高出27.2%(p = 0.0139)。教育水平小于或等于12年级的患者在观看视频后,初始问卷上的表现比口头接收信息后高出67.8%(p = 0.0001)。

结论

与通过口头接收手术信息的患者相比,在签署同意书前通过录像带接收手术信息的患者理解能力有显著提高。对于教育水平较低的患者,这种益处更大。

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