Singer D A, Donnelly M B, Messerschmidt G L
Mott Children's Hospital, University of Michigan Medical Center, Ann Arbor 48109.
Bone Marrow Transplant. 1990 Dec;6(6):431-7.
Two hundred Michigan hematologists-oncologists were sent a 34-item questionnaire designed to assess what patients should know at the time of giving consent to bone marrow transplant (BMT). Sixty-three (32%) responded to a single mailing and rated items on a 8-point scale, varying from 0 = no need to know to 7 = appreciation of consequences essential. The mean rating across items was 5.2, indicating that all items were important. Statistically, the items separated into three groups: (1) above average importance - 13 items; (2) average importance - 9 items; (3) below average importance - 12 items. Items of above average importance included the rationale for BMT and the collective risks and benefits of the process, including the patient's well-being post-transplant. Informed consent documents did not include 5/13 items of above average importance, yet 12/21 items of average and below average importance were included. Fourteen demographic variables were correlated with each item and none were significant, indicating that the ratings represent a broad consensus in the referring physician community as to what a patient should understand before consenting to BMT. The vast majority of referring physicians agreed that patients usually have an adequate understanding of BMT at the time of giving informed consent and that a fully informed patient is more likely to adhere to the treatment regimen.
向200名密歇根州的血液学肿瘤学家发送了一份包含34个条目的问卷，旨在评估患者在同意进行骨髓移植（BMT）时应该了解哪些内容。63人（32%）回复了一次邮寄的问卷，并在从0（无需了解）到7（必须了解后果）的8分制量表上对各个条目进行评分。所有条目的平均评分为5.2，表明所有条目都很重要。从统计学角度来看，这些条目分为三组：（1）重要性高于平均水平——13个条目；（2）重要性处于平均水平——9个条目；（3）重要性低于平均水平——12个条目。重要性高于平均水平的条目包括BMT的基本原理以及该过程的总体风险和益处，包括移植后患者的健康状况。知情同意文件未包含13个重要性高于平均水平条目中的5个，但包含了21个重要性处于平均水平和低于平均水平条目中的12个。14个人口统计学变量与每个条目相关，但均无显著相关性，这表明这些评分代表了转诊医生群体对于患者在同意进行BMT之前应该理解哪些内容的广泛共识。绝大多数转诊医生一致认为，患者在签署知情同意书时通常对BMT有足够的了解，并且充分知情的患者更有可能坚持治疗方案。
