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埃塞俄比亚吉马市吉马医疗中心外科手术中的决策模式方法

Mode of decision making's approach in surgical procedures at Jimma Medical Center, Jimma, Ethiopia.

作者信息

Biyazin Tsegaw, Yetwale Aynalem, Fenta Belete

机构信息

Institute of Health, Faculty of Health Science, School of Midwifery, Jimma University, Ethiopia.

出版信息

J Eval Clin Pract. 2022 Apr;28(2):194-200. doi: 10.1111/jep.13607. Epub 2021 Aug 8.

Abstract

BACKGROUND

Perform sound decisions making while operating is crucial to the success of surgical procedures. The bewildering to choose the preferred mode of decision-making during a surgical procedure is regularly observed. This study was aimed to assess the mode of decision-making approach in surgical procedures among women who have undergone obstetrics and gynaecologic surgeries, Jimma, Ethiopia 2020.

METHODS

Facility-based cross-sectional study was conducted from April 1 to May 30, 2020, at Jimma Medical Center. A total of 372 surgical patients were selected using a systematic sampling method. The collected data were coded, entered into Epi data version 3.1, and analysed using SPSS version 25. Multinomial logistic regression was carried out to determine the association between the outcome variable and independent variables.

RESULTS

Three hundred seventy-two respondents were interviewed and give a 92% response rate. The majority of 220 (59.1%) respondents reported that they decided on the surgical procedures through themselves without external coercion, followed by a shared 94 (25.3%) and paternalism 58 (15.6%). The multinomial logistic regression analysis in model-1 shows that patient-healthcare provider's relationship and practice of informed consent predictors were statistically significant with shared decision making. Moreover in model-2 patient healthcare providers' relationship, marital status, and time spent on decision variables were statistically significant with the outcome variable.

CONCLUSION

In the study, the shared decision-making was inadequate and not in line with recent recommendation guidelines. The paternalism mode of decision-making was still practice. Build patient-health care providers' relationship is vital for promoting and advance the patients' autonomy on the decision-making approach. The healthcare providers should be motive for collaborative decision-making with the patient.

摘要

背景

手术过程中做出明智的决策对手术的成功至关重要。在手术过程中,选择首选决策模式常常令人困惑。本研究旨在评估2020年在埃塞俄比亚吉马接受妇产科手术的女性在手术过程中的决策模式。

方法

2020年4月1日至5月30日,在吉马医疗中心进行了一项基于机构的横断面研究。采用系统抽样方法共选取了372名手术患者。收集的数据进行编码,录入Epi data 3.1版本,并使用SPSS 25版本进行分析。进行多项逻辑回归以确定结果变量与自变量之间的关联。

结果

对372名受访者进行了访谈,回复率为92%。大多数220名(59.1%)受访者表示,他们在没有外部强迫的情况下自行决定手术程序,其次是共同决策94名(25.3%)和家长式决策58名(15.6%)。模型1中的多项逻辑回归分析表明,患者与医疗服务提供者的关系以及知情同意预测因素的实践与共同决策在统计学上具有显著意义。此外,在模型2中,患者与医疗服务提供者的关系、婚姻状况以及在决策变量上花费的时间与结果变量在统计学上具有显著意义。

结论

在该研究中,共同决策不足,不符合近期的推荐指南。家长式决策模式仍在实践中。建立患者与医疗服务提供者的关系对于促进和提高患者在决策方法上的自主权至关重要。医疗服务提供者应积极与患者进行共同决策。

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