Alharbi Ebtehal S, Alwabel Assia S, Algaith Nada K, Alqarzaee Razan S, Alharbi Rawan H, Alkuraydis Samah F, Alrashidi Ibrahim A
Pediatric, College of Medicine, Qassim University, Qassim, SAU.
Cureus. 2025 Mar 21;17(3):e80936. doi: 10.7759/cureus.80936. eCollection 2025 Mar.
Refusal of procedures and treatment for ill children aged up to 14 years old remains a significant issue in the pediatric service. When families refuse medical treatment for their ill children for various reasons, such as financial or transportation difficulties, and concerns about severe side effects, healthcare professionals may attempt to provide information and negotiate with the family about treatment and procedure refusal and its potential consequences, as well as request consent for treatment refusal. In Saudi Arabia, there is a need for more data on treatment refusal. Objective: We aim to determine the frequency of refusal of medical procedures and treatment in pediatric patients at a children's hospital in Qassim, Saudi Arabia.
A retrospective review of 1,296 medical records were included. All patients were less than 14 years old. Data were extracted from the hospital's database system. Data analysis was carried out using Statistical Product and Service Solutions (SPSS, version 24; IBM SPSS Statistics for Windows, Armonk, NY). Results: In a total of 1,296 children attending a children's hospital in Qassim, Saudi Arabia, we found that the distribution of their age was as follows: 20.8% were one year or less, 30% were two to three years, 23.4% four to six years, and 25.8% were more than six years. The most common reasons for coming to the hospital are that 41% of children came with respiratory symptoms, 18.4% with trauma, and 15% with gastrointestinal symptoms. Respiratory infection/disease was the most commonly reported diagnosis among participants (43.5%), followed by trauma (18.6%) and gastroenteritis (15.3%). Furthermore, we found that (55.6%) refused intervention, while (39.7%) refused observation, 0.7% refused hospitalization, and 0.2% refused examination. A nasal swab was the most commonly refused procedure (28.9%), followed by blood investigations (9.9%) and IV fluids (5.7%).
Refusal of essential medical interventions based on evidence-based practice is still a critical issue in pediatric patients. Identifying the most frequent refused intervention and the reasons beyond intervention refusal is crucial to minimizing the refusal rates.
14岁及以下患病儿童拒绝接受治疗和程序仍是儿科医疗服务中的一个重大问题。当家庭因各种原因，如经济或交通困难以及对严重副作用的担忧，而拒绝为患病儿童提供医疗时，医护人员可能会试图提供信息，并就治疗和程序拒绝及其潜在后果与家庭进行协商，同时请求同意拒绝治疗。在沙特阿拉伯，需要更多关于治疗拒绝的数据。目的：我们旨在确定沙特阿拉伯卡西姆一家儿童医院儿科患者拒绝医疗程序和治疗的频率。
对1296份病历进行回顾性研究。所有患者年龄均小于14岁。数据从医院数据库系统中提取。使用统计产品与服务解决方案（SPSS，版本24；IBM SPSS Statistics for Windows，纽约州阿蒙克）进行数据分析。结果：在沙特阿拉伯卡西姆一家儿童医院就诊的1296名儿童中，我们发现他们的年龄分布如下：1岁及以下占20.8%，2至3岁占30%，4至6岁占23.4%，6岁以上占25.8%。来医院最常见的原因是41%的儿童有呼吸道症状，18.4%有外伤，15%有胃肠道症状。呼吸道感染/疾病是参与者中最常报告的诊断（43.5%），其次是外伤（18.6%）和肠胃炎（15.3%）。此外，我们发现（55.6%）拒绝干预，（39.7%）拒绝观察，0.7%拒绝住院，0.2%拒绝检查。鼻拭子是最常被拒绝的程序（28.9%），其次是血液检查（9.9%）和静脉输液（5.7%）。
基于循证实践拒绝基本医疗干预仍是儿科患者中的一个关键问题。确定最常被拒绝的干预措施以及拒绝干预背后的原因对于降低拒绝率至关重要。
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