Berry M G, Unwin Jennifer, Ross G L, Peacock Elizabeth, Juma A
Department of Plastic Surgery, Royal Preston Hospital, Preston, UK.
Ann R Coll Surg Engl. 2007 May;89(4):368-73. doi: 10.1308/003588407X183391.
The quality and quantity of information required in the consent process is well documented, but there is little extant literature regarding timing of either information about the proposed procedure or the act of consent itself. With the recent introduction of a new NHS-wide consent form, we wished to determine the preferences of both patients and staff to ascertain whether any concordance of views existed.
A 10-point questionnaire, developed in conjunction with the department of clinical psychology was completed by 242 patients selected for surgery over a 4-month period. Identical questionnaires were completed by local staff (n = 50) and national consultant plastic surgeons (n = 56).
The cumulative majority (61.8%) preferred information at the specialist out-patient appointment (OPA). There was a significant difference (P < 0.001) between patients and staff as to information provision by the specialist as compared to non-specialists; staff indicating it much more strongly. As to the timing of consent form signature, 40.2% preferred signature on admission with no statistically significant difference between subgroups. An additional pre-operative clinic, for consent form signing, was selected by 27.3%. Staff expressed this view more often than patients (P < 0.001).
Patients prefer information about a planned surgical procedure at their specialist OPA and final consent for surgery when admitted to the ward. Staff had quite definite views and felt an additional pre-operative out-patient appointment to be beneficial, more so than the patients themselves.
同意过程所需信息的质量和数量已有充分记录，但关于拟议手术的信息或同意行为本身的时机，现存文献较少。随着最近在国民保健服务体系（NHS）范围内引入新的同意书，我们希望确定患者和工作人员的偏好，以查明是否存在观点上的一致性。
一份与临床心理学系共同制定的10分问卷，由在4个月期间被选定进行手术的242名患者填写。当地工作人员（n = 50）和全国整形外科顾问（n = 56）填写了相同的问卷。
累计多数（61.8%）倾向于在专科门诊预约（OPA）时获取信息。与非专科医生相比，专科医生提供信息时，患者和工作人员之间存在显著差异（P < 0.001）；工作人员的这种倾向更为强烈。关于同意书签署的时机，40.2%的人倾向于入院时签署，各亚组之间无统计学显著差异。27.3%的人选择增设一个术前门诊用于签署同意书。工作人员表达这种观点的频率高于患者（P < 0.001）。
患者倾向于在专科OPA时获取有关计划手术的信息，并在入院时最终同意手术。工作人员有非常明确的观点，认为增设一个术前门诊预约是有益的，比患者自己的感受更强烈。
