Angelos Peter, DaRosa Debra A, Bentram David, Sherman Heather
Department of Surgery, Northwestern University Medical School, Chicago, Illinois, USA.
Curr Surg. 2002 Jan-Feb;59(1):115-8. doi: 10.1016/s0149-7944(01)00591-8.
The purpose of this study was to determine the extent to which first-year surgical residents are prepared to obtain informed consent from patients. The study was designed to answer the following research questions: 1) Are first-year residents who are asked to obtain informed consent sufficiently knowledgeable about the risks, benefits, and alternatives of the procedures? 2) Can first-year residents accurately answer the questions patients may pose about these procedures?
First-year residents (n = 18) were asked to list the risks, benefits, and alternatives for open inguinal hernia repair, laparoscopic cholecystectomy, total thyroidectomy, esophagogastrectomy, and abdominal aortic aneurysm repair, assuming the procedures were elective on otherwise healthy individuals. Residents were also asked to answer questions that patients may pose about each of the procedures. The basic minimum risks, benefits, and alternatives to be listed and answers to the questions were validated by asking faculty representing general (n = 6) and vascular (n = 3) surgery to complete the questionnaires.
Few residents were able to correctly list all risks, benefits, and alternatives of any of the procedures. Less than one-half of the questions that patients may ask about the procedures were correctly answered.
Even though first-year residents are commonly obtaining consent for surgical procedures, many are unable to provide patients with the correct descriptions of the risks, benefits, and alternatives. Nor were they able to correctly answer common questions. Surgical faculty must take more time to educate first-year residents on the appropriate issues in informed consent for the procedures being performed.
本研究旨在确定一年级外科住院医师在获取患者知情同意方面的准备程度。该研究旨在回答以下研究问题:1)被要求获取知情同意的一年级住院医师对手术的风险、益处和替代方案是否有足够的了解?2)一年级住院医师能否准确回答患者可能提出的关于这些手术的问题?
假设这些手术针对其他方面健康的个体为择期手术,要求18名一年级住院医师列出开放式腹股沟疝修补术、腹腔镜胆囊切除术、全甲状腺切除术、食管胃切除术和腹主动脉瘤修复术的风险、益处和替代方案。还要求住院医师回答患者可能针对每种手术提出的问题。通过让代表普通外科(6名)和血管外科(3名)的教员填写问卷,对需列出的基本最低风险、益处和替代方案以及问题的答案进行了验证。
很少有住院医师能够正确列出任何一种手术的所有风险、益处和替代方案。患者可能提出的关于手术的问题中,不到一半得到了正确回答。
尽管一年级住院医师通常在获取手术同意书,但许多人无法向患者正确描述风险、益处和替代方案。他们也不能正确回答常见问题。外科教员必须花更多时间就正在进行的手术的知情同意相关适当问题对一年级住院医师进行教育。