Yusuf Moruf Babatunde, Ogunlusi Johnson Dare, Popoola Sunday Ogunsuyi, Ogunlayi Sheriff Olawale, Babalola Waheed Olaide, Oluwadiya Kehinde Sunday
Department of Surgery, Ekiti State University, Ado Ekiti, Nigeria.
Department of Surgery, Ekiti State University Teaching Hospital, Ado Ekiti, Nigeria.
Niger Postgrad Med J. 2017 Jul-Sep;24(3):174-177. doi: 10.4103/npmj.npmj_88_17.
Self-discharge by patients without completing their treatment is a problematic issue in healthcare and is strongly associated with readmission and poor treatment outcome.
A descriptive study of the rate and reasons why patients with limb injuries took self-discharge against medical advice (DAMA) from our facility, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria, a tertiary health institution between May 2011 and April 2014.
One hundred and thirty-one (16.2%) patients took DAMA out of 810 patients seen with limb injuries. Age ranges from 3 to 95 years with a mean of 36.31 ± 19.34 years. Road traffic crash accounted for 110 (84%) of the injuries. One hundred and sixteen (88.5%) had fractures and 9 (6.9%) had soft tissue injuries. Fifty-eight (44.3%) of the patients were referred cases, 128 (97.7%) signed DAMA form while 3 (2.3%) absconded from the hospital. Reasons for DAMA were mainly; belief more in traditional bone setters (TBSs) (36.6%); pressure from relations (22.9%) and high cost of hospital care (19.8%). One hundred and one (77.1%) of the patients volunteered that they were going to TBS for continued care.
High percentage of patients DAMA from our facility and majority of them were in favour of unorthodox form of treatment.
患者未完成治疗即自行出院是医疗保健中的一个问题，并且与再次入院和不良治疗结果密切相关。
对2011年5月至2014年4月期间在尼日利亚阿多-埃基蒂的埃基蒂州立大学教学医院（一家三级医疗机构）因肢体受伤而违反医嘱自行出院（DAMA）的患者比例及原因进行描述性研究。
在810例肢体受伤患者中，有131例（16.2%）违反医嘱自行出院。年龄范围为3至95岁，平均年龄为36.31±19.34岁。道路交通事故导致110例（84%）受伤。116例（88.5%）有骨折，9例（6.9%）有软组织损伤。58例（44.3%）患者为转诊病例，128例（97.7%）签署了违反医嘱自行出院表格，3例（2.3%）从医院潜逃。违反医嘱自行出院的主要原因是：更相信传统接骨师（36.6%）；来自亲属的压力（22.9%）以及医院护理费用高昂（19.8%）。101例（77.1%）患者自愿表示他们将前往传统接骨师处继续治疗。
我院违反医嘱自行出院的患者比例较高，且大多数患者倾向于非正统的治疗方式。
