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一项评估心脏手术中录音咨询对知情同意质量影响的随机对照试验。

A randomized controlled trial to assess the effect of audiotaped consultations on the quality of informed consent in cardiac surgery.

作者信息

Mishra Pankaj Kumar, Mathias Helen, Millar Keith, Nagrajan Kumaresan, Murday Andrew

机构信息

Department of Cardiothoracic Surgery, Glasgow Royal Infirmary, Glasgow, Scotland.

出版信息

Arch Surg. 2010 Apr;145(4):383-8. doi: 10.1001/archsurg.2010.45.

Abstract

OBJECTIVE

To evaluate the effect of audiotaping outpatient consultations on informed consent for cardiac surgery.

DESIGN

Randomized controlled trial.

SETTING

Tertiary health care center in Scotland.

PARTICIPANTS

Eighty-four patients who had first-time coronary artery surgery conducted by 1 surgeon from February 10, 2005, through March 15, 2006, whose consultations before surgery were audiotaped.

INTERVENTION

Randomization to 3 trial arms. The control group (n = 29) received no tape. The generic group (n = 25) received a tape about coronary artery surgery, which we scripted to include information covering the domains described by the General Medical Council. The consultation group (n = 30) received a tape of their consultation interview. On admission to the hospital, patients were interviewed with the Knowledge Questionnaire, the Multidimensional Health Locus of Control, and the Hospital Anxiety and Depression Scale.

MAIN OUTCOME MEASURES

The effect of audiotaping in improving the informed consent process for cardiac surgery.

RESULTS

The mean knowledge score of patients in the consultation group was much higher than that of the control individuals (P < .001). Patients in the consultation group reported a significantly greater sense of control with regard to their own health (P < .001) and being less anxious and depressed overall.

CONCLUSION

Providing an audiotaped recording of the consultation before cardiac surgery appears to improve patients' knowledge and perceptions of control of their health status and to reduce anxiety and depression.

TRIAL REGISTRATION

isrctn.org Identifier: ISRCTN20081026.

摘要

目的

评估门诊咨询录音对心脏手术知情同意的影响。

设计

随机对照试验。

地点

苏格兰的三级医疗保健中心。

参与者

2005年2月10日至2006年3月15日期间由1名外科医生首次进行冠状动脉手术的84例患者,其术前咨询进行了录音。

干预措施

随机分为3个试验组。对照组(n = 29)未接受录音带。通用组(n = 25)接受一盘关于冠状动脉手术的录音带,我们编写的脚本包含了涵盖英国医学总会所描述领域的信息。咨询组(n = 30)接受其咨询访谈的录音带。入院时,对患者进行知识问卷、多维健康控制点和医院焦虑抑郁量表的访谈。

主要观察指标

录音对改善心脏手术知情同意过程的效果。

结果

咨询组患者的平均知识得分远高于对照组(P <.001)。咨询组患者报告对自身健康的控制感明显更强(P <.001),总体焦虑和抑郁程度更低。

结论

在心脏手术前提供咨询录音似乎能提高患者对健康状况的认知和控制感,并减轻焦虑和抑郁。

试验注册

isrctn.org标识符:ISRCTN20081026。

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