Gupta Mehek, Madhavan Sudharsan, Teo Felicia Siok Ying, Low Jee Keem, Shelat Vishal G
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Ministry of Health Holdings, Singapore.
Singapore Med J. 2024 Feb 1;65(2):91-98. doi: 10.11622/smedj.2021163. Epub 2021 Oct 31.
In a patient-centric health system, it is essential to know patients' views about informed consent. The objective of this study was to understand the perceptions of the local population regarding informed consent.
Spanning 6 weeks from January 2016 to March 2016, a cross-sectional survey of adults attending the General Surgery outpatient clinics at Tan Tock Seng Hospital was conducted. Sociodemographic data, lifestyle- and health-related information, perception and purpose of consent forms, and decision-making preferences were studied.
A total of 445 adults participated in the survey. Most participants were aged below 40 years ( n = 265, 60.1%), female ( n = 309, 70.1%) and degree holders ( n = 196, 44.4%). Also, 56.9% of participants wanted to know every possible risk, while 28.3% wanted to know the common and serious risks. On multivariate analysis, age (61-74 years: odds ratio [OR] 11.1, 95% confidence interval [CI] 2.2-56.1, P = 0.004; age >75 years: OR 22.2, 95% CI 1.8-279.1, P = 0.017) was a predictor of not wanting to know any risks. Age also predicted risk of disclosure for death (age 61-74 years: OR 13.4, 95% CI 4.2-42.6, P < 0.001; age >75 years: OR 32.0, 95% CI 4.5-228.0, P = 0.001). Most participants (48.1%) preferred making shared decisions with doctors, and an important predictor was employment status (OR 4.8, 95% CI 1.9-12.2, P = 0.001).
Sociodemographic factors and educational level influence decision-making, and therefore, the informed consent process should be tailored for each patient.
在以患者为中心的医疗体系中,了解患者对知情同意的看法至关重要。本研究的目的是了解当地居民对知情同意的认知。
2016年1月至2016年3月期间,对在陈笃生医院普通外科门诊就诊的成年人进行了为期6周的横断面调查。研究了社会人口统计学数据、与生活方式和健康相关的信息、对同意书的认知和目的以及决策偏好。
共有445名成年人参与了调查。大多数参与者年龄在40岁以下(n = 265,60.1%),女性(n = 309,70.1%),拥有学位(n = 196,44.4%)。此外,56.9%的参与者想了解每一种可能的风险,而28.3%的参与者想了解常见和严重的风险。多因素分析显示,年龄(61 - 74岁:比值比[OR] 11.1,95%置信区间[CI] 2.2 - 56.1,P = 0.004;年龄>75岁:OR 22.2,95% CI 1.8 - 279.1,P = 0.017)是不想了解任何风险的一个预测因素。年龄也是死亡信息披露风险的预测因素(61 - 74岁:OR 13.4,95% CI 4.2 - 42.6,P < 0.001;年龄>75岁:OR 32.0,95% CI 4.5 - 228.0,P = 0.001)。大多数参与者(48.1%)倾向于与医生共同做出决策,一个重要的预测因素是就业状况(OR 4.8,95% CI 1.9 - 12.2,P = 0.001)。
社会人口统计学因素和教育水平会影响决策,因此,知情同意过程应针对每个患者进行调整。