Hamaguchi K
Department of Nursing, Higashi Sapporo Hospital, Japan.
Hokkaido Igaku Zasshi. 1998 Jan;73(1):21-5.
Informed consent is important for medical practice. Pilot study of comprehensive discharge planning at Higashi Sapporo Hospital suggested that there was a relationship between informed consent and patients' length of stay. Also in a study of home care systems for advanced cancer patients, it was one of the most important factors that they knew their true diagnoses, especially in young cancer patients. Informed consent, that is shared decision making, is an important communication process between patients and professional care givers. We consider the roles of nursing for informed consent are as follows: 1. Support of patients' decision making; 1) promotion of patients' understanding of their own situation, a. active listening, b. information disclosure, c. psychological support, 2) advocation, 3) assisting patients understanding of doctor's explanations, 2. Promotion of good relationships between patients and professional staff, 3. Coordination with patients and/or their families and/or professional care givers, 4. Ethical issues, and 5. Education for health promotion. However there are some problems remaining: for example, 1. Nurses after feel then have little role in informed consent, which is an issue for physicians. 2. Nurses must improve their professional skill and knowledge, 3. Nurses must perform more actively and independently.
知情同意对于医疗实践至关重要。在东札幌医院进行的综合出院计划试点研究表明，知情同意与患者住院时间之间存在关联。同样，在一项针对晚期癌症患者家庭护理系统的研究中，患者了解其真实诊断是最重要的因素之一，尤其是在年轻癌症患者中。知情同意，即共同决策，是患者与专业护理人员之间重要的沟通流程。我们认为护理在知情同意方面的作用如下：1. 支持患者决策；1）促进患者对自身状况的理解，a. 积极倾听，b. 信息披露，c. 心理支持，2）倡导，3）协助患者理解医生的解释，2. 促进患者与专业人员之间的良好关系，3. 与患者和/或其家属和/或专业护理人员进行协调，4. 伦理问题，以及5. 促进健康的教育。然而，仍然存在一些问题：例如，1. 护士事后觉得自己在知情同意方面作用不大，这是医生的问题。2. 护士必须提高其专业技能和知识，3. 护士必须更积极、独立地开展工作。
