Younger C W E, Douglas C, Warren-Forward H
The University of Newcastle, University Drive, Callaghan, NSW 2308 Australia.
Radiography (Lond). 2018 Aug;24(3):204-210. doi: 10.1016/j.radi.2018.01.005. Epub 2018 Feb 12.
For radiographers, gaining informed consent with our patients represents a challenging undertaking. Reconciling the need to gain meaningful consent with time pressures represents one challenge, as does differing expectations of how risk communication should be undertaken. Different methods and thresholds of risk disclosure are considered, with the aim of finding a realistic best practice.
A cross-sectional study of radiographers and members of the public was undertaken. Participants were asked their preferences for how they would like to receive ionising radiation risk information. This included the health care professional(s) most suited to provide the information, the media through which the information was delivered, and the technique for delivering the information. In addition, participants were asked to consider hypothetical scenarios in which they were a patient receiving an ionising radiation examination, and to give the threshold of ionising radiation cancer risk which they would consider material. These scenarios considered variations in the cancer-onset time, and the accuracy of the test.
One hundred and twenty-one (121) radiographer participants and one hundred and seventy two (172) members of the public met the inclusion criteria and completed the survey. There was strong agreement in the most appropriate media, and person, to disclose risk, as well as what represents a significant risk. There was considerable agreement in risk delivery technique. However, some of the agreed-upon strategies may be challenging to achieve in clinical practice.
Radiographers and patients fundamentally agree upon risk communication strategies, but implementing some strategies may prove clinically challenging.
对于放射技师而言,获得患者的知情同意是一项具有挑战性的任务。在时间压力下协调获得有意义的同意的需求是一项挑战,就像对风险沟通应如何进行存在不同期望一样。人们考虑了不同的风险披露方法和阈值,目的是找到切实可行的最佳实践。
对放射技师和公众进行了一项横断面研究。参与者被问及他们希望如何接收电离辐射风险信息的偏好。这包括最适合提供信息的医疗保健专业人员、传递信息的媒介以及传递信息的方式。此外,参与者被要求考虑假设情景,即他们是接受电离辐射检查的患者,并给出他们认为重要的电离辐射致癌风险阈值。这些情景考虑了癌症发病时间的变化以及检查的准确性。
121名放射技师参与者和172名公众符合纳入标准并完成了调查。在最合适的披露风险的媒介和人员以及什么构成重大风险方面存在强烈共识。在风险传递方式上也有相当多的共识。然而,一些达成共识的策略在临床实践中可能难以实现。
放射技师和患者在风险沟通策略上基本达成一致,但实施一些策略在临床上可能具有挑战性。