Losanoff Julian E, Litwinczuk Kathleen M, Ranella Michael J, Basson Marc D
Department of Surgery, John D. Dingell Veterans' Affairs Medical Center, USA.
Am Surg. 2009 Apr;75(4):296-300.
Informed consent is increasingly being standardized. We sought to evaluate variability in the amount and quality of information desired by patients in choosing whether to undergo elective surgical hernia repair, a prototypical low- to moderate-risk common procedure. Consecutive stable outpatients were asked to assume that they were considering hernia repair and interviewed with a standard questionnaire that asked them to rate their interest in learning about the natural history, pathology, and management of inguinal hernia as well as herniorrhaphy complications and postoperative recovery. Ninety-eight consecutive patients exhibited substantial interpersonal variability in their level of interest in receiving information. Although interest in some types of information tended to correlate with interest in other types of information, patients' degree of interest in receiving information about anesthesia during the procedure was independent of other variables. Education and previous exposure to individuals with hernias also affected interest in receiving potentially important information before deciding whether to consent to hernia surgery. Patients may vary with regard to the information they want to receive when deciding whether to consent to an invasive procedure. It may be preferable to individualize the consent process to patients' preferences rather than adhering to standardized content.
知情同意正日益标准化。我们试图评估患者在选择是否接受择期手术疝修补术(一种典型的低至中度风险的常见手术)时所需信息的数量和质量的变异性。连续的稳定门诊患者被要求假设他们正在考虑疝修补术,并使用一份标准问卷进行访谈,该问卷要求他们对了解腹股沟疝的自然病史、病理学、治疗方法以及疝修补术并发症和术后恢复的兴趣程度进行评分。98名连续患者在接受信息的兴趣水平上表现出显著的人际变异性。虽然对某些类型信息的兴趣往往与对其他类型信息的兴趣相关,但患者对术中麻醉信息的兴趣程度与其他变量无关。教育程度和以前接触过疝气患者的经历也会影响在决定是否同意进行疝气手术之前对接收潜在重要信息的兴趣。在决定是否同意进行侵入性手术时,患者想要接收的信息可能会有所不同。根据患者的偏好对同意过程进行个性化处理,而不是坚持标准化内容,可能会更好。