Teshome Million, Wolde Zenebe, Gedefaw Abel, Tariku Mequanent, Asefa Anteneh
Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, P.O.Box 1560, Hawassa, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.Box 70, Hawassa, Ethiopia.
BMC Med Ethics. 2018 May 24;19(1):38. doi: 10.1186/s12910-018-0293-2.
Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients' understanding of the intended procedure, increase client satisfaction, maintain trust between clients and health providers, and ultimately minimize litigation issues related to surgical procedures. The purpose of the current study is to assess the comprehensiveness of the SIC process for women undergoing obstetric and gynecologic surgeries.
A hospital-based cross-sectional study was undertaken at Hawassa University Comprehensive Specialized Hospital (HUCSH) in November and December, 2016. A total of 230 women who underwent obstetric and/or gynecologic surgeries were interviewed immediately after their hospital discharge to assess their experience of the SIC process. Thirteen components of SIC were used based on international recommendations, including the Royal College of Surgeon's standards of informed consent practices for surgical procedures. Descriptive summaries are presented in tables and figures.
Forty percent of respondents were aged between 25 and 29 years. Nearly a quarter (22.6%) had no formal education. More than half (54.3%) of respondents had undergone an emergency surgical procedure. Only 18.4% of respondents reported that the surgeon performing the operation had offered SIC, while 36.6% of respondents could not recall who had offered SIC. All except one respondent provided written consent to undergo a surgical procedure. However, 8.3% of respondents received SIC service while already on the operation table for their procedure. Only 73.9% of respondents were informed about the availability (or lack thereof) of alternative treatment options. Additionally, a majority of respondents were not informed about the type of anesthesia to be used (88.3%) and related complications (87.4%). Only 54.2% of respondents reported that they had been offered at least six of the 13 SIC components used by the investigators.
There is gap in the provision of comprehensive and standardized pre-operative counseling for obstetric and gynecologic surgeries in the study hospital. This has a detrimental effect on the overall quality of care clients receive, specifically in terms of client expectations and information needs.
手术知情同意书（SIC）长期以来一直被视为现代医学的重要组成部分。SIC的最终目标是提高患者对预定手术的理解，提高患者满意度，维持患者与医疗服务提供者之间的信任，并最终最大限度地减少与手术程序相关的诉讼问题。本研究的目的是评估产科和妇科手术女性患者的SIC流程的全面性。
2016年11月和12月，在哈瓦萨大学综合专科医院（HUCSH）进行了一项基于医院的横断面研究。共有230名接受产科和/或妇科手术的女性在出院后立即接受访谈，以评估她们在SIC流程中的体验。根据国际建议，采用了SIC的13个组成部分，包括皇家外科医学院手术程序知情同意实践标准。描述性总结以表格和图表形式呈现。
40%的受访者年龄在25至29岁之间。近四分之一（22.6%）没有接受过正规教育。超过一半（54.3%）的受访者接受过急诊手术。只有18.4%的受访者报告说，实施手术的外科医生提供了SIC，而36.6%的受访者记不起是谁提供了SIC。除一名受访者外，所有受访者都提供了接受手术的书面同意书。然而，8.3%的受访者在手术台上接受手术时才获得SIC服务。只有73.9%的受访者被告知是否有替代治疗方案。此外，大多数受访者未被告知将使用的麻醉类型（88.3%）和相关并发症（87.4%）。只有54.2%的受访者报告说，他们被告知了研究人员使用的13个SIC组成部分中的至少6个。
研究医院在为产科和妇科手术提供全面和标准化的术前咨询方面存在差距。这对患者接受的整体护理质量有不利影响，特别是在患者期望和信息需求方面。
