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通过多媒体工具加强小儿脊柱手术中的知情同意:一项全面综述。

Enhancing informed consent through multimedia tools in pediatric spinal surgery: a comprehensive review.

作者信息

Rosa Filezio Marina, Sharma Nishan, Thull-Freedman Jennifer, Ferri-de-Barros Fabio, Santana Maria J

机构信息

Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.

Department of Surgery, University of Calgary, Calgary, AB, Canada.

出版信息

Front Pediatr. 2024 Jul 19;12:1357462. doi: 10.3389/fped.2024.1357462. eCollection 2024.

Abstract

Pediatric spine surgery is a high complexity procedure that can carry risks ranging from pain to neurological damage, and even death. This comprehensive mini review explores current best practice obtaining valid and meaningful informed consent (IC) prior to pediatric spinal surgery, including modalities that support effective comprehension and understanding. An evaluation of the literature was performed to explore understanding of surgical IC by patients or their guardians and the role of multimedia tools as a possible facilitator. The evidence discussed throughout this review, based on legal and ethical perspectives, reveals challenges faced by patients and guardians in achieving comprehension and understanding, especially when facing stressful medical situations. In this context, the introduction of multimedia tools emerges as a patient-centered strategy to help improve comprehension and decrease pre-operative uncertainty. This review highlights the need for a tailored approach in obtaining IC for pediatric patients and suggests a potential role of shared decision-making (SDM) in the surgical discussion process.

摘要

小儿脊柱手术是一种高复杂性的手术,可能带来从疼痛到神经损伤甚至死亡等一系列风险。这篇全面的小型综述探讨了小儿脊柱手术前获得有效且有意义的知情同意(IC)的当前最佳实践,包括支持有效理解的方式。对文献进行了评估,以探究患者或其监护人对手术知情同意的理解以及多媒体工具作为一种可能的促进手段所起的作用。基于法律和伦理视角,本综述所讨论的证据揭示了患者和监护人在实现理解方面所面临的挑战,尤其是在面对压力重重的医疗状况时。在此背景下,引入多媒体工具成为一种以患者为中心的策略,有助于提高理解并减少术前的不确定性。本综述强调了为小儿患者获取知情同意时采用量身定制方法的必要性,并提出了共同决策(SDM)在手术讨论过程中的潜在作用。

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Barriers to consent in spine surgery.脊柱手术中的同意障碍。
Spine J. 2022 Jul;22(7):1073-1078. doi: 10.1016/j.spinee.2022.03.003. Epub 2022 Mar 7.
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Is "Informed Consent" Truly Informed?“知情同意”真的做到知情了吗?
Pediatr Crit Care Med. 2020 Jun;21(6):589-590. doi: 10.1097/PCC.0000000000002242.
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Informed consent in spinal surgery.脊髓手术中的知情同意。
Bone Joint J. 2019 Apr;101-B(4):355-360. doi: 10.1302/0301-620X.101B4.BJJ-2018-1045.R2.
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Medical decision-making in paediatrics: Infancy to adolescence.儿科医学决策:从婴儿期到青春期
Paediatr Child Health. 2018 May;23(2):138-146. doi: 10.1093/pch/pxx127. Epub 2018 Apr 12.
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Promoting patient comprehension of relevant health information.提高患者对相关健康信息的理解。
Isr J Health Policy Res. 2018 Sep 18;7(1):56. doi: 10.1186/s13584-018-0250-z.

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