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越南河内地区对完整诊断性尸检和微创尸检的认知与态度:一项横断面调查

Knowledge and attitudes toward complete diagnostic autopsy and minimally invasive autopsy: A cross-sectional survey in Hanoi, Vietnam.

作者信息

Dieu Ngan Ta Thi, Phuong Nhung Doan, Le Thao My Nguyen, Chambers Mary, Nguyen Duy Manh, Nguyen Ha Thi Lien, Vu Huong Thi Thu, Pham Thach Ngoc, van Doorn Rogier, Van Nuil Jennifer Ilo

机构信息

National Hospital for Tropical Diseases, Ha Noi, Vietnam.

Department of Infectious Diseases-Hanoi Medical University, Ha Noi, Vietnam.

出版信息

PLOS Glob Public Health. 2023 Mar 17;3(3):e0001685. doi: 10.1371/journal.pgph.0001685. eCollection 2023.

Abstract

Knowing the cause of death (CoD) plays an important role in developing strategies and interventions to prevent early mortality. In Vietnam, the CoD of the majority of patients who acquired infectious diseases remains unknown. While there are challenges that hinder the use of complete diagnostic autopsy (CDA) in practice, minimally invasive autopsy (MIA) might be a promising alternative to establish CoD in Vietnam. The current study aims to explore knowledge of and attitudes toward CDA and MIA in the wider population in Vietnam. The study was cross-sectional, using structured questionnaires that were disseminated electronically via several websites and as paper-based forms in a national level hospital in Vietnam. Descriptive analyses were performed and where appropriate, comparisons between the healthcare workers and the general public were performed. We included 394 questionnaires in the analysis. The majority of participants were under age 40, living in major cities and currently practicing no religion. 76.6% of respondents were aware of CDA and among them, 98% acknowledged its importance in medicine. However, most participants thought that CDA should only be performed when the CoD was suspicious or unconfirmed because of its the invasive nature. For MIA, only 22% were aware of the method and there was no difference in knowledge of MIA between healthcare workers and the wider public. The questionnaire results showed that there are socio-cultural barriers that hinder the implementation of CDA in practice. While the awareness of MIA among participants was low, the minimally invasive nature of the method is promising for implementation in Vietnam. A qualitative study is needed to further explore the ethical, socio-cultural and/or religious barriers that might hinder the implementation of MIA in Vietnam.

摘要

了解死因在制定预防过早死亡的策略和干预措施中起着重要作用。在越南,大多数感染性疾病患者的死因尚不清楚。虽然在实践中存在阻碍使用完整诊断尸检(CDA)的挑战,但微创尸检(MIA)可能是在越南确定死因的一种有前景的替代方法。本研究旨在探讨越南更广泛人群对CDA和MIA的了解及态度。该研究为横断面研究,使用结构化问卷,通过多个网站以电子方式分发,并在越南一家国家级医院以纸质形式发放。进行了描述性分析,并在适当情况下对医护人员和普通公众进行了比较。我们纳入了394份问卷进行分析。大多数参与者年龄在40岁以下,居住在主要城市,目前无宗教信仰。76.6%的受访者知晓CDA,其中98%承认其在医学上的重要性。然而,大多数参与者认为,由于CDA具有侵入性,仅应在死因可疑或未得到证实时进行。对于MIA,只有22%的人知晓该方法,医护人员和更广泛公众对MIA的了解没有差异。问卷调查结果表明,在实践中存在阻碍CDA实施的社会文化障碍。虽然参与者对MIA的知晓率较低,但该方法的微创性质有望在越南得到应用。需要进行定性研究,以进一步探索可能阻碍MIA在越南实施的伦理、社会文化和/或宗教障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c875/10022770/eca0fae22f3a/pgph.0001685.g001.jpg

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