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中国精神科医生对治疗同意程序态度的转变及其与中国《精神卫生法》的关联

Changing of Chinese psychiatrists' attitudes toward consent process to treatment and its association with the China's National Mental Health Law.

作者信息

Huang Jingjing, Shao Yang, Ma Huajian, Yang Weimin, Li Huafang

机构信息

1 Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Int J Psychiatry Med. 2019 Jan;54(1):11-21. doi: 10.1177/0091217418791436. Epub 2018 Aug 19.

DOI:10.1177/0091217418791436
PMID:30122100
Abstract

OBJECTIVE

Few studies have addressed informed consent in Chinese psychiatric practice. We wished to explore psychiatrists' attitudes toward informed consent in Shanghai after promulgation of the first national law for mental health care in China: the National Mental Health Law.

METHOD

A total of 398 psychiatrists were recruited from seven psychiatric hospitals in Shanghai. Their anthropometric data were collected. A confidential, self-report questionnaire addressing attitudes toward the informed consent process was completed by all participants.

RESULTS

Most respondents would like to inform patients/guardians of the diagnosis (95.2%), treatment plan (93.5%), treatment goals and potential adverse effects of prescribed medications (94.7%), and alternative treatment plans (71.9%). In addition, 58.4% of psychiatrists thought that the informed consent process for physical restraint was difficult to follow. According to logistic regression, psychiatrists not trained to use the National Mental Health Law were more likely to have a negative attitude toward the informed consent process compared with those trained (adjusted odds ratio = 0.21; 95% confidence interval: 0.07-0.59; p = 0.003).

CONCLUSIONS

Psychiatrists trained to use the National Mental Health Law had more positive attitudes toward the informed consent process. Lack of such training could affect the attitudes of psychiatrists toward the informed consent process in China.

摘要

目的

在中国,很少有研究探讨精神科临床实践中的知情同意问题。我们希望在中国第一部精神卫生保健国家法律《中华人民共和国精神卫生法》颁布后,探究上海精神科医生对知情同意的态度。

方法

从上海的七家精神病医院招募了398名精神科医生。收集他们的人体测量数据。所有参与者均完成了一份关于对知情同意过程态度的保密自填问卷。

结果

大多数受访者愿意告知患者/监护人诊断结果(95.2%)、治疗方案(93.5%)、治疗目标及处方药的潜在不良反应(94.7%)以及替代治疗方案(71.9%)。此外,58.4%的精神科医生认为身体约束的知情同意过程难以遵循。根据逻辑回归分析,未接受过《中华人民共和国精神卫生法》培训的精神科医生与接受过培训的医生相比,更有可能对知情同意过程持消极态度(调整比值比=0.21;95%置信区间:0.07 - 0.59;p = 0.003)。

结论

接受过《中华人民共和国精神卫生法》培训的精神科医生对知情同意过程持更积极的态度。缺乏此类培训可能会影响中国精神科医生对知情同意过程的态度。

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