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医学实践中真正的知情同意是什么,对风险的认知与之有何关系?

What Is Truly Informed Consent in Medical Practice and What Has the Perception of Risk Got to Do with It?

作者信息

Calderwood Catherine Jane, Braut Geir Sverre, Wiig Siri

机构信息

Faculty of Science, University of Strathclyde, Glasgow G1 1XQ, UK.

Stavanger University Hospital, N-4068 Stavanger, Norway.

出版信息

Healthcare (Basel). 2024 Dec 24;13(1):8. doi: 10.3390/healthcare13010008.

DOI:10.3390/healthcare13010008
PMID:39791614
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11719812/
Abstract

Making decisions about risk, describing and appropriately explaining risk in medical practice is complex for patients and professionals. In this paper, we investigate how the concept of consent is practiced differently in the UK and Norway and discuss pros and cons of the chosen approaches from a patient safety culture perspective. We argue that consent is a fundamental part of the safety culture and influence on health system functioning and patient and staff safety. Examples from the UK and Norway are used and discussed in terms of how risk perception influences consent processes and practices.

摘要

在医疗实践中,患者和专业人员在做出风险决策、描述并适当地解释风险方面都面临着复杂的情况。在本文中,我们研究了英国和挪威在实践同意概念时的差异,并从患者安全文化的角度讨论了所选方法的优缺点。我们认为,同意是安全文化的基本组成部分,会影响卫生系统的运作以及患者和工作人员的安全。本文运用了英国和挪威的实例,并就风险认知如何影响同意过程和实践进行了讨论。

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本文引用的文献

1
Valid consent in the acute hospital setting: perspectives of patients and members of the public.急症医院环境中的有效同意:患者及公众的观点
Ir J Med Sci. 2024 Aug;193(4):1703-1714. doi: 10.1007/s11845-024-03658-w. Epub 2024 Apr 5.
2
Comparative study on informed consent regulation in health care among Italy, France, United Kingdom, Nordic Countries, Germany, and Spain.意大利、法国、英国、北欧国家、德国和西班牙的医疗保健知情同意法规比较研究。
J Forensic Leg Med. 2024 Apr;103:102674. doi: 10.1016/j.jflm.2024.102674. Epub 2024 Mar 14.
3
Examining the variation in consent in general surgery.检查普通外科手术中的同意书差异。
Ann R Coll Surg Engl. 2024 Feb;106(2):140-149. doi: 10.1308/rcsann.2023.0020. Epub 2023 May 23.
4
Consent and refusal of procedures during labour and birth: a survey among 11 418 women in the Netherlands.分娩过程中对医疗操作的同意与拒绝:荷兰 11418 名女性的调查。
BMJ Qual Saf. 2024 Jul 22;33(8):511-522. doi: 10.1136/bmjqs-2022-015538.
5
Naming the "baby" or the "beast"? The importance of concepts and labels in healthcare safety investigation.命名“婴儿”还是“野兽”?医疗保健安全调查中概念和标签的重要性。
Front Public Health. 2023 Feb 10;11:1087268. doi: 10.3389/fpubh.2023.1087268. eCollection 2023.
6
Comparing shared decision making using a paper and digital consent process. A multi-site, single centre study in a trauma and orthopaedic department.比较纸质和数字化知情同意过程中的共同决策。创伤骨科多中心单中心研究。
Surgeon. 2023 Aug;21(4):235-241. doi: 10.1016/j.surge.2022.05.004. Epub 2022 Jun 11.
7
Improving informed consent in cardiac surgery by enhancing preoperative education.通过加强术前教育来改善心脏外科手术中的知情同意。
Patient Educ Couns. 2018 Dec;101(12):2047-2053. doi: 10.1016/j.pec.2018.06.008. Epub 2018 Jun 18.
8
From the Patient Perspective, Consent Forms Fall Short of Providing Information to Guide Decision Making.从患者角度来看,同意书未能提供足够的信息来指导决策。
J Patient Saf. 2021 Apr 1;17(3):e149-e154. doi: 10.1097/PTS.0000000000000310.
9
Patient safety research: an overview of the global evidence.患者安全研究:全球证据概述
Qual Saf Health Care. 2010 Feb;19(1):42-7. doi: 10.1136/qshc.2008.029165.
10
Norway: valid (as opposed to informed) consent.挪威:有效(而非知情)同意。
Lancet. 2000 Oct 14;356(9238):1347-8. doi: 10.1016/S0140-6736(00)02828-2.