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影响外科手术患者知情同意过程质量和范围的因素:一项横断面研究。

Factors Influencing the Quality and Extent of the Informed Consent Process in Patients Undergoing Surgical Procedures: A Cross-Sectional Study.

作者信息

Al-Jardani Ruqaiya, Al-Hadrami Wafa, Al-Balushi Majda H, Al-Adawi Mudhar, Al-Nasseri Samir

机构信息

Nursing, The Royal Hospital, Muscat, OMN.

Adult Critical Care Nursing Program, Higher Institute of Health Specialties, Muscat, OMN.

出版信息

Cureus. 2024 Aug 29;16(8):e68149. doi: 10.7759/cureus.68149. eCollection 2024 Aug.

Abstract

Background Informed consent is an essential component of medical practice, particularly in surgical procedures, as it guarantees that patients are thoroughly informed of the risks, benefits, and alternatives prior to receiving treatment. Nevertheless, research has demonstrated that patients frequently fail to recall critical information that was conveyed during the informed consent process, which emphasizes the potential for communication and comprehension deficiencies. Objective The objective of this study was to evaluate the quality of informed consent and the decision-making preferences of patients who are undergoing surgical procedures. Methodology A cross-sectional survey was conducted among 239 hospitalized patients who were scheduled for elective surgeries at a tertiary hospital in Muscat. The survey assessed patients' satisfaction with the process, preferences for decision-making, and comprehension of informed consent. Non-parametric correlation analysis was implemented to analyze the data. Results The consent form was signed by the majority of patients themselves (96.7%), with a median age range of 36-45 years and a relatively balanced gender distribution. For the remaining cases, where patients were unable to sign, the consent forms were signed by surrogates. The majority of patients were Omani nationals (96.7%), with a mixture of school and postgraduate education. The study did not identify any substantial disparities in the provision of informed consent between patients who received consent details in the outpatient clinic and those who received them in the ward. Although a small number of patients, particularly those with higher education, found the explanations unclear, the quality of the explanations was generally rated as explicit and sufficient. The ability to ask further questions, the degree of explanation, the explanation of alternative options, involvement in decision-making, the time to consider before making a decision, and the ability to repeat the explanation given were all positively correlated with satisfaction with the informed consent process. Conclusion The study emphasizes the significance of patient engagement and effective communication in the informed consent process. In order to improve patient satisfaction and comprehension, healthcare providers should prioritize interactive and comprehensive communication. It is imperative that policymakers establish policies that guarantee patients are afforded sufficient time and opportunity to comprehend the risks, advantages, and alternatives of surgical procedures.

摘要

背景

知情同意是医疗实践的重要组成部分,尤其是在外科手术中,因为它能确保患者在接受治疗前充分了解风险、益处和替代方案。然而,研究表明,患者常常无法回忆起在知情同意过程中传达的关键信息,这凸显了沟通和理解方面存在不足的可能性。

目的

本研究的目的是评估接受外科手术患者的知情同意质量和决策偏好。

方法

在马斯喀特一家三级医院对239名计划接受择期手术的住院患者进行了横断面调查。该调查评估了患者对该过程的满意度、决策偏好以及对知情同意的理解。采用非参数相关分析来分析数据。

结果

大多数患者(96.7%)亲自签署了同意书,年龄中位数在36 - 45岁之间,性别分布相对均衡。其余患者无法签署时,同意书由代理人签署。大多数患者是阿曼国民(96.7%),教育程度涵盖中学和研究生。该研究未发现门诊接受同意细节的患者与病房接受同意细节的患者在提供知情同意方面存在任何重大差异。尽管少数患者,特别是受过高等教育的患者,认为解释不清楚,但解释的质量总体上被评为明确且充分。提问的能力、解释的程度、替代方案的解释、参与决策、做出决定前考虑的时间以及重复所给解释的能力均与对知情同意过程的满意度呈正相关。

结论

该研究强调了患者参与和有效沟通在知情同意过程中的重要性。为了提高患者满意度和理解度,医疗服务提供者应优先进行互动式和全面的沟通。政策制定者必须制定政策,确保患者有足够的时间和机会了解外科手术的风险、益处和替代方案。

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