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门诊胃镜检查前的知情同意过程有多全面?对英国一家地区医院的实践研究。

How thorough is the process of informed consent prior to outpatient gastroscopy? A study of practice in a United Kingdom District Hospital.

作者信息

Woodrow Susannah R, Jenkins Anthony P

机构信息

Department of Gastroenterology, Princess Royal University Hospital, Farnborough, Kent, UK.

出版信息

Digestion. 2006;73(2-3):189-97. doi: 10.1159/000094528. Epub 2006 Jul 11.

Abstract

BACKGROUND/AIMS: Informed consent for outpatient gastroscopy should involve many elements and many patients may not have spoken to an endoscopist beforehand. The aim was to audit the completeness of the consent process in patients undergoing outpatient gastroscopy.

METHODS

This is a retrospective study in which a 37-point questionnaire was sent to 200 patients who had undergone outpatient gastroscopy. Questions covered information given before and on the day of the procedure.

RESULTS

The response rate was 71.5% (143/200) and 141 questionnaires were analysed. Before the day of the procedure: 92.2% understood why they were having a gastroscopy, 90.8% had the procedure explained to them and of these 96.1% understood the explanation. 48.9% were told the risks of the procedure, 51.8% were given the opportunity to decline, but only 11.3% were told of an alternative to the procedure and 24.1% of possible consequences of not having the test. On arrival at the endoscopy unit: 92.2% of respondents had the procedure explained to them but only 55.4% received an explanation from the endoscopist. 45.4% were told the risks of the procedure, 48.2% were given the opportunity to decline. 39.0% did not read the consent form before signing and, of those that did, 98.7% understood it.

CONCLUSION

Nearly all the patients understood the nature of gastroscopy and the reasons for the test before attending; however, there was poor explanation of the risks of gastroscopy and of its alternatives. Approximately half the patients were not given the opportunity to decline gastroscopy either before or on the day of the procedure.

摘要

背景/目的:门诊胃镜检查的知情同意应涵盖多个要素,且许多患者事先可能未与内镜医师交谈过。本研究旨在审核门诊胃镜检查患者的同意流程完整性。

方法

这是一项回顾性研究,向200例接受门诊胃镜检查的患者发送了一份包含37个问题的问卷。问题涵盖检查前及检查当天所提供的信息。

结果

回复率为71.5%(143/200),共分析了141份问卷。检查前:92.2%的患者明白为何要做胃镜检查,90.8%的患者接受了胃镜检查的相关解释,其中96.1%的患者理解了该解释。48.9%的患者被告知检查风险,51.8%的患者有机会拒绝检查,但仅有11.3%的患者被告知有替代检查方法,24.1%的患者被告知不做该项检查可能产生的后果。到达内镜检查科室时:92.2%的受访者接受了胃镜检查的相关解释,但只有55.4%的患者由内镜医师进行了解释。45.4%的患者被告知检查风险,48.2%的患者有机会拒绝检查。39.0%的患者在签署同意书前未阅读同意书,而阅读的患者中,98.7%的患者理解了同意书内容。

结论

几乎所有患者在就诊前都了解胃镜检查的性质及检查原因;然而,对于胃镜检查的风险及其替代方法的解释不足。约一半的患者在检查前或检查当天没有机会拒绝胃镜检查。

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