Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Intern Med. 2010 Mar;25(1):36-43. doi: 10.3904/kjim.2010.25.1.36. Epub 2010 Feb 26.
BACKGROUND/AIMS: Only a few reports have examined informed consent for gastrointestinal endoscopy in Korea. The aim of this study was to evaluate the appropriateness of the informed consent procedure in Korea.
A total of 209 patients who underwent endoscopy were asked to answer a self-administered structured questionnaire on the informed consent procedure for gastrointestinal endoscopy.
One hundred thirteen patients completed questionnaires and were enrolled. In the survey, 91.2% answered that they understood the procedure, and the degree of understanding decreased with age; 85.8% were informed of the risks of the procedure, and the proportion was higher for inpatients and for those receiving therapeutic endoscopy or endoscopic retrograde cholangiopancreatography; 60.2% were informed of alternative methods, and the proportion was higher in older patients; 76.1% had the opportunity to ask questions during the informed consent procedure, and the proportion was higher in inpatients. The understanding of the risks of the endoscopic procedure was better in the younger and more highly educated groups. About 80% had sedation before endoscopy, and only 56% were informed of the risks of sedation during endoscopy.
The current informed consent process may be reasonably acceptable and understandable to the patients. However, the understanding of the risks of endoscopy was insufficient especially in the cases of older, poorly educated patients and outpatients. The information about alternatives, the opportunity to ask for additional information, and the information about the risks of sedation during endoscopy were also insufficient in the current consent process.
背景/目的:仅有少数研究报告检查了韩国胃肠道内镜检查的知情同意情况。本研究旨在评估韩国知情同意程序的适当性。
共有 209 名接受内镜检查的患者被要求回答一份关于胃肠道内镜检查知情同意程序的自我管理结构问卷。
共有 113 名患者完成了问卷调查并被纳入研究。在调查中,91.2%的患者回答他们理解该程序,理解程度随年龄增长而降低;85.8%的患者被告知该程序的风险,住院患者和接受治疗性内镜检查或内镜逆行胰胆管造影术的患者比例更高;60.2%的患者被告知替代方法,年龄较大的患者比例更高;76.1%的患者有机会在知情同意过程中提问,住院患者的比例更高。年轻和受教育程度较高的患者对内镜检查风险的理解更好。约 80%的患者在内镜检查前接受镇静,只有 56%的患者被告知镇静期间的风险。
目前的知情同意过程可能对患者来说是合理可接受且易于理解的。然而,特别是对于年龄较大、教育程度较低的患者和门诊患者,他们对内镜检查风险的理解不足。目前的同意过程中,关于替代方案、询问额外信息的机会以及关于内镜检查期间镇静风险的信息也不足。