Department of Pediatrics, Manipal College of Medical Sciences, Phulbari, Pokhara, Nepal.
Manipal College of Medical Sciences, Phulbari, Pokhara, Nepal.
JNMA J Nepal Med Assoc. 2021 Sep 11;59(241):897-901. doi: 10.31729/jnma.5757.
Leave against medical advice has a potentially deleterious effect on the health of a child. This is particularly alarming in case of pediatric patients as they are unable to understand the implications of it and rely on parents to make decisions regarding their health. This study was undertaken to find out the prevalence of leave against medical advice among pediatric patients admitted in a tertiary teaching hospital in Nepal.
A descriptive cross-sectional study was conducted in the Department of Pediatrics, Manipal Teaching Hospital between August 2019 and July 2020. Ethical clearance was obtained from the Institutional Review Committee (Ref: 256). Convenient sampling method was used. Data entry and analysis was done on Statistical Package for Social Sciences version 23. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.
Out of 1608 pediatric admissions taken in our study, the prevalence of leave against medical advice was found to be 67 (4.2%) at 95% Confidence Interval (3.22-5.18). Maximum 22 (33%) and minimum 6 (9%) patients respectively belonged to the age group from birth to 7 days and more than 10 years. Out of 67 cases, there were 36 (54%) males and 31 (46%) females.
The prevalence of leave against medical advice among admitted pediatric patients in our study was similar to that of other studies. It is a social health problem which can be prevented by increasing the awareness and facilitating the use of health insurance schemes. More effective communication is required between the treating physicians and the parents to prevent this detrimental practice.
未经医嘱擅自离院对儿童的健康可能产生有害影响。对于儿科患者来说，这种情况尤其令人担忧，因为他们无法理解其中的含义，只能依靠父母来决定自己的健康。本研究旨在了解尼泊尔一家三级教学医院儿科住院患者中未经医嘱擅自离院的发生率。
本研究是在 2019 年 8 月至 2020 年 7 月期间在曼尼帕尔教学医院儿科进行的一项描述性横断面研究。本研究获得了机构审查委员会的伦理批准（注册号：256）。采用便利抽样法。使用社会科学统计软件包（SPSS）版本 23 进行数据录入和分析。计算了 95%置信区间的点估计值以及二进制数据的频率和比例。
在我们的研究中，1608 例儿科住院患者中，未经医嘱擅自离院的发生率为 67 例（4.2%），95%置信区间为 3.22-5.18。最大的 22 例（33%）和最小的 6 例（9%）患者分别属于出生至 7 天和 10 岁以上的年龄组。在 67 例病例中，有 36 例（54%）为男性，31 例（46%）为女性。
我们的研究中，住院儿科患者中未经医嘱擅自离院的发生率与其他研究相似。这是一个社会健康问题，可以通过提高认识和促进医疗保险计划的使用来预防。需要在治疗医生和父母之间进行更有效的沟通，以防止这种有害的做法。
