Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia.
Monash University Endocrine Surgery Unit, Alfred Hospital, Melbourne, Victoria, Australia; Department of Surgery, Monash University, Melbourne, Victoria, Australia.
J Surg Res. 2021 Sep;265:114-121. doi: 10.1016/j.jss.2021.03.026. Epub 2021 Apr 23.
Informed consent for surgery is a medical and legal requirement, but completing these does not necessarily translate to high patient satisfaction. This patient-reported experience study aimed to examine the surgical consent process, comparing the patients' experience in elective and emergency settings.
Over a 6-mo period, postoperative patients at The Alfred Hospital Breast and Endocrine Surgical Unit were invited to participate in a survey on the surgical consent process - including perceived priorities, information provided and overall experience. Standard statistical techniques were used, with a significant P-value of < 0.05.
A total of 412 patients were invited, with 130 (32%) responses. More patients underwent elective surgery (N= 90, 69%) than emergency surgery (N = 40, 31%). Emergency patients were more likely to sign the consent form regardless of its contents (93% versus 39%, P < 0.001) and more likely to be influenced by external pressures (63% versus 1%, P < 0.001). Elective patients were more likely to want to discuss their surgery with a senior surgeon (74% versus 23%, P < 0.001) and more likely to seek advice from external sources (83% versus 10%, P < 0.001). Both groups highly valued the opportunity to ask questions (67% versus 63%, P = 0.65).
This study shows patients have a range of different priorities in preparation for surgery. Therefore, each consent process should be patient-specific, and focus on providing the patient with quality resources that inform decision-making.
手术前的知情同意是医疗和法律要求,但完成这些并不一定能转化为高患者满意度。这项基于患者报告的体验研究旨在检查手术同意书的签署过程,比较择期和急诊手术患者的体验。
在 6 个月的时间内,The Alfred Hospital 乳腺和内分泌外科病房的术后患者受邀参与了一项关于手术同意书签署过程的调查,包括患者对手术的预期、提供的信息和总体体验。采用标准统计技术,显著性 P 值<0.05。
共邀请了 412 名患者,其中 130 名(32%)患者做出了回应。择期手术患者(N=90,69%)多于急诊手术患者(N=40,31%)。急诊患者更有可能在不考虑同意书内容的情况下签署同意书(93%与 39%,P<0.001),更有可能受到外部压力的影响(63%与 1%,P<0.001)。择期手术患者更希望与资深外科医生讨论手术(74%与 23%,P<0.001),更可能向外部资源寻求建议(83%与 10%,P<0.001)。两组患者都非常重视提问的机会(67%与 63%,P=0.65)。
本研究表明,患者在手术准备方面有不同的优先级。因此,每个同意书的签署过程都应该是个体化的,重点是为患者提供有质量的信息资源,以帮助其做出决策。