Hutson M M, Blaha J D
Section of Arthritis Surgery, West Virginia University, Morgantown 26506.
J Bone Joint Surg Am. 1991 Feb;73(2):160-2.
Thirty-eight consecutive patients who were admitted to the hospital for total joint replacement were studied to determine their understanding of the elements of informed consent at the time when they signed the consent document before the operation and their recall of those elements six months after the operation. All patients received instruction from the same patient-educator before the operation. Each patient was asked to respond verbally to a questionnaire about the preoperative instruction. If a question was not answered correctly, tutoring was given until the patient gave the correct response. The consent document was not presented for signature until the patient could answer all questions correctly. In an interview six months after the operation, thirty-six of the thirty-eight patients were asked the same questions that they had answered before the operation. The recall of risks and benefits six months after the operation was compared with the understanding of risks and benefits that had been demonstrated before the operation by both the verbal questioning and the signed consent document. At six months, the number of patients who recalled the risks ranged from nine (25 per cent) who remembered the risk of infection to only one who remembered the risk of damage to a nerve or artery. More patients recalled the potential benefits: eight (22 per cent) for relief of pain and improved function and five (16 per cent) for improved motion.
对38例因全关节置换入院的连续患者进行了研究，以确定他们在手术前签署同意书时对知情同意要素的理解，以及术后6个月对这些要素的记忆情况。所有患者在手术前均接受了同一名患者教育者的指导。每位患者被要求口头回答一份关于术前指导的问卷。如果问题回答不正确，会给予辅导，直到患者给出正确答案。直到患者能够正确回答所有问题后，才会出示同意书供其签署。在术后6个月的一次访谈中，38例患者中有36例被问及他们在手术前回答过的相同问题。将术后6个月对风险和益处的记忆与术前通过口头询问和签署的同意书所显示的对风险和益处的理解进行了比较。在6个月时，能回忆起风险的患者人数从9人（25%）（记得感染风险）到仅1人（记得神经或动脉损伤风险）不等。更多患者回忆起了潜在益处：8人（22%）提到疼痛缓解和功能改善，5人（16%）提到活动能力改善。
