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尼日利亚外科医生对知情同意的看法和实践。

Surgeons' opinions and practice of informed consent in Nigeria.

机构信息

Department of Surgery, College of Medicine, University of Ibadan and University College Hospital, PMB 5116, Ibadan, Nigeria.

出版信息

J Med Ethics. 2010 Dec;36(12):741-5. doi: 10.1136/jme.2010.037440. Epub 2010 Oct 12.

Abstract

BACKGROUND

Informed consent is perhaps more relevant to surgical specialties than to other clinical disciplines. Fundamental to this concept is the provision of relevant information for the patient to make an informed choice about a surgical intervention. The opinions of surgeons in Nigeria about informed consent in their practice were surveyed.

METHODS

A cross-sectional survey of surgeons in Nigeria was undertaken in 2004/5 using self-administered semistructured questionnaires.

RESULTS

There were 102 respondents, 85.3% of whom were men and 58.8% were aged 31-40 years. 43.1% were consultants and 54.0% were surgical trainees. 27.4% were in surgical subspecialties, 26.5% in general surgery and 21.6% were obstetricians and gynaecologists. 54.9% agreed that sufficient information is not provided to patients while obtaining their consent for surgical procedures. They listed medicolegal reasons (70.6%), informing patients about benefits, risks and alternatives (64.7%) and hospital policy (50.0%) as some reasons for obtaining consent for surgical procedures. When patients decline to give consent for surgery, 84.3% of them thought that poor communication between surgeons and patients may be contributory. They identified taking a course in bioethics during surgical training and compulsory communication skills course as some ways to improve communication between surgeons and patients.

CONCLUSION

Most Nigerian surgeons seemed to have a good knowledge of the informed consent requirements and process but fall short in practice. There is a need to improve the surgeon-patient relationship in line with modern exigencies to provide interactive environments for fruitful patient communication and involvement.

摘要

背景

知情同意对于外科专业可能比其他临床学科更为重要。这一概念的基础是为患者提供相关信息,以便他们对手术干预做出明智的选择。本研究调查了尼日利亚外科医生对其临床实践中知情同意的看法。

方法

2004/5 年,采用自我管理的半结构式问卷对尼日利亚的外科医生进行了横断面调查。

结果

共有 102 名受访者,其中 85.3%为男性,58.8%年龄在 31-40 岁之间。43.1%为顾问,54.0%为外科住院医师。27.4%从事外科亚专科,26.5%从事普通外科,21.6%为妇产科医生。54.9%的人认为在获得患者对手术的同意时,没有向他们提供足够的信息。他们列出了医疗法律原因(70.6%)、告知患者手术的益处、风险和替代方案(64.7%)以及医院政策(50.0%),作为获得手术同意的一些原因。当患者拒绝同意手术时,84.3%的人认为外科医生和患者之间沟通不畅可能是一个促成因素。他们认为在外科培训期间参加生物伦理学课程和必修沟通技巧课程是改善外科医生和患者之间沟通的一些方法。

结论

大多数尼日利亚外科医生似乎对知情同意的要求和程序有很好的了解,但在实践中却做得不够。需要根据现代需要改善医患关系,为富有成效的医患沟通和参与提供互动环境。

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