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医生从谁那里获得手术同意?

From whom do physicians obtain consent for surgery?

机构信息

Department of Gynecology, Golestan University of Medical Sciences, Gorgan, The Islamic Republic of Iran.

Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, The Islamic Republic of Iran.

出版信息

J Med Ethics. 2018 Jun;44(6):366-370. doi: 10.1136/medethics-2017-104556. Epub 2018 Mar 6.

Abstract

OBJECTIVE

To evaluate the knowledge and performance of surgical residents regarding the person from whom informed consent should be taken for surgery and from whom the consent is taken in practice.

MATERIALS AND METHODS

This study was done in 2013. The population of this study was all residents of urology, surgery, orthopaedic surgery and gynaecology of Tehran and Iran University of Medical Sciences. The study tool was a self-administered questionnaire, containing questions on their knowledge and performance regarding informed consent acquisition from patients with different conditions in terms of age, sex, marital status and their capacity to make treatment decisions.

RESULTS

A total of 213 residents participated in the study (response rate=51.9%). The mean score of the participants' knowledge was 72.95 out of 100. There was no significant correlation between the residents' knowledge and performance. Regarding a competent married male patient, 98.2% of the residents knew that the person's consent was enough, but only 63.6% obtained informed consent only from the patient. These percentages were 69% and 19.7% for a competent married female patient, respectively. For a competent single male patient, 90.9% of the residents were aware that the patient's consent was enough, while only 40% of the residents obtained informed consent only from the patient. These percentages were 65.3% and 16% for a competent single female patient, respectively.

CONCLUSION

Despite the residents' average knowledge of patient autonomy, this right is not observed for female patients, and their treatment is subject to consent acquisition from other family members.

摘要

目的

评估外科住院医师对手术知情同意书签署人的认知和实践情况。

材料与方法

本研究于 2013 年进行,研究对象为德黑兰和伊朗医科大学泌尿科、外科、矫形外科和妇科的所有住院医师。研究工具为一份自我管理问卷,其中包含有关住院医师在不同情况下(年龄、性别、婚姻状况和做出治疗决策的能力)从患者处获取知情同意书的知识和表现的问题。

结果

共有 213 名住院医师参与了研究(应答率为 51.9%)。参与者的知识平均得分为 100 分中的 72.95 分。住院医师的知识与表现之间没有显著相关性。对于有能力的已婚男性患者,98.2%的住院医师知道该人的同意就足够了,但只有 63.6%的人仅从患者处获得了知情同意。对于有能力的已婚女性患者,这些百分比分别为 69%和 19.7%。对于有能力的单身男性患者,90.9%的住院医师意识到患者的同意就足够了,但只有 40%的人仅从患者处获得了知情同意。对于有能力的单身女性患者,这些百分比分别为 65.3%和 16%。

结论

尽管住院医师对患者自主权的平均认知,但对于女性患者,这一权利并未得到尊重,其治疗仍需获得其他家庭成员的同意。

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