College of Nursing, Eulji University, Republic of Korea.
Int J Nurs Stud. 2009 Dec;46(12):1580-4. doi: 10.1016/j.ijnurstu.2009.05.011. Epub 2009 Jun 25.
Informed consent is based on the Western notion of autonomy that patients have the right to know about their illnesses and make decisions about their health. However, there may be difficulty in accepting informed consent in Eastern cultures based on Confucianism, such as Korea. Even though nurses have no legal binds to informed consent, they have participated in the process of obtaining informed consent as an administrative assistant in Korea and then have had moral distress.
The purpose of this study was to investigate nurses' perception of informed consent and their role in establishing a better process of informed consent in Korea.
This exploratory study employed in-depth interviews with nurses. Participants were 12 nurses from selected departments (orthopedics surgery, cardiac surgery, and obstetrics & gynecology) from two university hospitals in Seoul and Kwang-ju, Korea. A semi-structured interview guide was constructed from the literature and used to elicit responses.
Content analysis showed that nurses perceived a lot of problems in the process of obtaining informed consent and noted the need to modify this process. Although the role of nurses was found to be insignificant in the process of obtaining informed consent, some nurses wanted to participate in the process in order to advocate for patients and to verify if patients had received the information they needed.
Nurses can take a proactive role in the process of informed consent, as advocator as well as witness. This may be influential in balancing patient autonomy with paternalism, changing the skewed patient-physician relationship to one of mutual respect.
知情同意基于西方自主的概念,即患者有权了解自己的疾病并对自己的健康做出决定。然而,在以儒家思想为基础的东方文化中,如韩国,接受知情同意可能存在困难。尽管护士在法律上没有告知同意的义务,但他们在韩国作为行政助理参与了获得知情同意的过程,然后感到了道德上的困扰。
本研究旨在调查韩国护士对知情同意的看法以及他们在建立更好的知情同意过程中的作用。
本探索性研究采用深度访谈的方法,对来自首尔和光州两所大学医院选定科室(骨科手术、心脏手术和妇产科)的 12 名护士进行了访谈。半结构化访谈指南是根据文献构建的,并用于引出回答。
内容分析表明,护士在获得知情同意的过程中发现了很多问题,并指出需要修改这一过程。尽管护士在获得知情同意的过程中作用不明显,但有些护士希望参与这一过程,为患者辩护,并核实患者是否收到了他们所需的信息。
护士可以在知情同意过程中发挥积极主动的作用,作为倡导者和见证者。这可能会对平衡患者自主权与家长主义、将医患关系从单向尊重转变为相互尊重产生影响。