Brooks A J, Hurlstone D P, Fotheringham J, Gane J, Sanders D S, McAlindon M E
Gastroenterology and Liver Unit, Royal Hallamshire Hospital Teaching Hospitals, National Health Service Trust, Sheffield, United Kingdom.
Endoscopy. 2005 Nov;37(11):1136-9. doi: 10.1055/s-2005-870196.
The aim of this study was to determine how much information patients require about the risk of complications in order to provide informed consent to undergo endoscopy.
Endoscopic complications and their consequences were discussed with consecutive patients who had undergone endoscopy. The patients were asked how common each complication would have to be for them to require information about the complication before providing adequately informed consent.
Data were obtained from 150 gastroscopy patients (51% male, median age 55.5 years) and 150 colonoscopy patients (60% male, median age 54.4 years). Patients in both groups were more likely to want to know about major rather than minor complications at a lower level of risk (P < 0.001 at a risk greater than one in 1000). Similar proportions of gastroscopy patients (n = 29, 19%) and colonoscopy patients (n = 21, 14 %) wanted to know about all possible complications, no matter how inconsequential or rare. Colonoscopy patients were less likely to want no information about any complications than gastroscopy patients (n = 1, 0.7% and n = 15, 10%, respectively; P < 0.001).
The information patients require in order to provide informed consent is very variable. Many appear to make a judgement about the need for information depending on the perceived severity of the complication, but some want information about all complications, irrespective of risk and severity. The level of risk at which they require this information is likely to be higher than the level used by doctors who are obtaining consent from patients. The process may be improved by providing procedure-specific information leaflets that offer information regarding common and serious complications.
本研究旨在确定患者需要多少关于并发症风险的信息,以便在接受内镜检查时能够做出充分知情的同意。
与连续接受内镜检查的患者讨论内镜并发症及其后果。询问患者每种并发症需要多常见,他们才会在充分知情同意前要求了解该并发症。
收集了150例胃镜检查患者(男性占51%,中位年龄55.5岁)和150例结肠镜检查患者(男性占60%,中位年龄54.4岁)的数据。两组患者在较低风险水平下更倾向于了解主要而非次要并发症(风险大于千分之一时,P<0.001)。相似比例的胃镜检查患者(n = 29,19%)和结肠镜检查患者(n = 21,14%)希望了解所有可能的并发症,无论其多么微不足道或罕见。与胃镜检查患者相比,结肠镜检查患者不太可能希望不了解任何并发症(分别为n = 1,0.7%和n = 15,10%;P<0.001)。
患者为做出充分知情同意所需的信息差异很大。许多人似乎根据并发症的感知严重程度来判断是否需要信息,但有些人希望了解所有并发症,无论风险和严重程度如何。他们需要这些信息的风险水平可能高于从患者处获取同意的医生所使用的水平。通过提供针对具体检查的信息手册,提供关于常见和严重并发症的信息,可能会改善这一过程。