医生对手术知情同意（SIC）的知识和态度的审计。
An audit of the knowledge and attitudes of doctors towards Surgical Informed Consent (SIC).
机构信息
Department of Obstetrics and Gynecology, Mother and Child Health Centre, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
Department of Plastic Surgery and Burns, Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan.
出版信息
Int J Health Policy Manag. 2014 Oct 27;3(6):315-21. doi: 10.15171/ijhpm.2014.109. eCollection 2014 Nov.
BACKGROUND
The Surgical Informed Consent (SIC) is a comprehensive process that establishes an information-based agreement between the patient and his doctor to undertake a clearly outlined medical or surgical intervention. It is neither a casual formality nor a casually signed piece of paper. The present study was designed to audit the current knowledge and attitudes of doctors towards SIC at a tertiary care teaching hospital in Pakistan.
METHODS
This cross-sectional qualitative investigation was conducted under the auspices of the Department of Medical Education (DME), Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad over three months period. A 19-item questionnaire was employed for data collection. The participants were selected at random from the list of the surgeons maintained in the hospital and approached face-to-face with the help of a team of junior doctors detailed for questionnaire distribution among them. The target was to cover over 50% of these doctors by convenience sampling.
RESULTS
Out of 231 respondents, there were 32 seniors while 199 junior doctors, constituting a ratio of 1:6.22. The respondents variably responded to the questions regarding various attributes of the process of SIC. Overall, the junior doctors performed poorer compared to the seniors.
CONCLUSION
The knowledge and attitudes of our doctors particularly the junior ones, towards the SIC are less than ideal. This results in their failure to avail this golden opportunity of doctor-patient communication to guide their patients through a solidly informative and legally valid SIC. They are often unaware of the essential preconditions of the SIC; provide incomplete information to their patients; and quite often do not ensure direct involvement of their patients in the process. Additionally they lack an understanding of using interactive computer-based programs as well as the concept of nocebo effect of informed consent.
背景
外科手术知情同意书（SIC）是一个综合过程，它在患者和他的医生之间建立了基于信息的协议，以进行明确规定的医疗或手术干预。它既不是一种随意的形式，也不是一份随意签署的文件。本研究旨在审计巴基斯坦一家三级护理教学医院的医生目前对 SIC 的知识和态度。
方法
本横断面定性研究是在巴基斯坦医学科学院（PIMS）医学教育系（DME）的主持下进行的，为期三个月。采用 19 项问卷调查数据收集。参与者是从医院维护的外科医生名单中随机选择的，并在一组初级医生的帮助下面对面接触，他们负责在这些医生中分发问卷。目标是通过方便抽样覆盖这些医生的 50%以上。
结果
在 231 名受访者中，有 32 名高级医生，199 名初级医生，比例为 1:6.22。受访者对涉及 SIC 过程的各种属性的问题的回答各不相同。总的来说，初级医生的表现不如高级医生。
结论
我们的医生，特别是初级医生，对 SIC 的知识和态度并不理想。这导致他们无法利用医生与患者沟通的这一黄金机会，通过一个坚实的信息和合法有效的 SIC 来指导他们的患者。他们往往不知道 SIC 的基本前提条件；向患者提供不完整的信息；而且往往不能确保患者直接参与该过程。此外，他们缺乏对使用互动式计算机程序以及知情同意的否定义务的理解。
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