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一项关于瑞士一家儿科手术科室外科医生对知情同意过程感知质量的调查。

A survey on surgeons' perceived quality of the informed consent process in a Swiss paediatric surgery unit.

作者信息

Guinand Julie, Gapany Christophe, Simon Jeanne-Pascale, Wasserfallen Jean-Blaise, Joseph Jean-Marc

机构信息

Peadiatric surgery Department, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011 Lausanne, Switzerland.

Peadiatric Surgery Private Practice, 1003 Lausanne, Switzerland.

出版信息

Patient Saf Surg. 2015 Aug 28;9:30. doi: 10.1186/s13037-015-0076-3. eCollection 2015.

Abstract

AIM

To evaluate the levels of satisfaction and opinions on the usefulness of the informed consent form currently in use in our Paediatric Surgery Department.

DESIGN

Qualitative study carried out via interviews of senior paediatric surgeons, based on a questionnaire built up from reference criteria in the literature and public health law.

RESULTS

Physicians with between 2 and 35 years experience of paediatric surgery, with a participation rate of 92 %, agreed on the definition of an informed consent form, were satisfied with the form in use and did not wish to modify its structure. The study revealed that signing the form was viewed as mandatory, but meant different things to different participants, who diverged over whom that signature protected. Finally, all respondents were in agreement over what information was necessary for parents of children requiring surgery.

CONCLUSION

Paediatric surgeons seemed to be satisfied with the informed consent form in use. Most of them did not identify that the first aim of the informed consent form is to give the patient adequate information to allow him to base his consent, which is a legal obligation, the protection of physicians by the formalisation and proof of the informed consent being secondary. Few surgeons brought up the fact that the foremost stakeholder in paediatric surgery are the children themselves and that their opinions are not always sought. In the future, moving from informed consent process to shared decision-making, a more active bidirectional exchange may be strongly considered. Involving children in such vital decisions should become the norm while keeping in mind their level of maturity.

摘要

目的

评估我院小儿外科目前使用的知情同意书的满意度及有用性意见。

设计

基于文献参考标准和公共卫生法编制的问卷,通过对资深小儿外科医生进行访谈开展定性研究。

结果

有2至35年小儿外科手术经验的医生,参与率为92%,对知情同意书的定义达成一致,对现行表格满意,不希望修改其结构。研究表明,签署该表格被视为强制性的,但对不同参与者意味着不同的事情,他们在该签名保护谁的问题上存在分歧。最后,所有受访者就需要手术的儿童家长所需的信息达成了一致。

结论

小儿外科医生似乎对现行知情同意书感到满意。他们中的大多数人没有认识到知情同意书的首要目的是向患者提供足够的信息,使其能够做出同意,这是一项法定义务,通过形式化和证明知情同意来保护医生是次要的。很少有外科医生提到小儿外科手术中最重要的利益相关者是儿童本身,而且他们的意见并不总是被征求。未来,从知情同意过程转向共同决策时,可能会强烈考虑更积极的双向交流。在考虑儿童成熟程度的同时,让他们参与此类重要决策应成为常态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ac2/4552157/b0ad2a83326b/13037_2015_76_Fig1_HTML.jpg

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