Department of Surgery, Makerere University College of Health Sciences, Kampala, Uganda.
Department of Anatomy, Makerere University College of Health Sciences, Kampala, Uganda.
BMC Emerg Med. 2023 Aug 2;23(1):82. doi: 10.1186/s12873-023-00856-0.
Informed consent for emergency surgery is a process in which a patient or their next of kin must make quick decisions required for surgery in a life-threatening situation or surgery that may have life-altering outcomes. The objective of the study was to describe patients and their next of kin experiences and factors influencing the informed consent process in two urban university teaching hospitals in Uganda.
A cross-sectional survey involving patients who underwent emergency surgery and their next of kin was conducted in two tertiary care hospitals; one public and one private-not-for profit institution. A questionnaire was administered to collect sociodemographic information, type of Surgery that was done, how informed consent was obtained and experiences and expectations from the informed consent process. Univariate and multivariate analyses of the variables was done.
We collected data from 210 patients from a public hospital and 170 from a private-not-for profit hospital. Overall, most patients did not have the risks of the surgery communicated to them (79.7%), were not given alternative options (87.6%) and had no opportunity to ask questions (57.4%). Patients at the private institution had 3.35 times the odds of expecting the consent form to be explained to them than those at the public institution. Patients at the public hospital had 0.12 times the odds of preferring to have consent administered by a nurse than patients at the private institution OR 0.12 (0.05-0.29, p < 0.001). Patients in the public institution had 0.18 times the odds of preferring to have consent administered by a doctor than patients in the private institution OR 0.18 (0.08-0.45, p < 0.001).
Patients in both public and private institutions are not informed about the risks of surgery, alternative options and are not given the opportunity to ask questions. Interpretation of the findings of this study on patient preferences on who administered consent though statistically significant were inconclusive due to the responses not being mutually exclusive.
描述乌干达两家城市教学医院的患者及其家属的经历，并探讨影响知情同意过程的因素。
在两家三级保健医院（一家公立和一家私立非营利机构）中进行了一项涉及接受急诊手术的患者及其家属的横断面调查。使用问卷收集人口统计学信息、手术类型、如何获得知情同意以及对知情同意过程的经验和期望。对变量进行单变量和多变量分析。
我们从一家公立医院收集了 210 名患者的数据，从一家私立非营利性医院收集了 170 名患者的数据。总体而言，大多数患者未被告知手术风险（79.7%），未提供替代方案（87.6%），也没有机会提问（57.4%）。与公立医院相比，私立医院的患者有 3.35 倍的可能性期望向他们解释同意书。公立医院的患者有 0.12 倍的可能性比私立医院的患者更愿意让护士来管理同意书，OR 0.12（0.05-0.29，p<0.001）。公立医院的患者有 0.18 倍的可能性比私立医院的患者更愿意让医生来管理同意书，OR 0.18（0.08-0.45，p<0.001）。
公立和私立机构的患者都没有被告知手术风险、替代方案，也没有机会提问。尽管关于患者对谁管理同意书的偏好的研究结果在统计学上有意义，但由于答复并非互斥，因此解释这些结果并不明确。
