Newton-Howes P A, Bedford N D, Dobbs B R, Frizelle F A
Department of Surgery, Christchurch Hospital.
N Z Med J. 1998 Sep 11;111(1073):340-2.
To determine which aspects of informed consent are important to patients and surgeons and to determine where there is disparity and similarity.
A questionnaire was developed from the Disability Commissioner's Regulations (1996) and was administered to 256 patients and 37 doctors at Christchurch Hospital.
According to patients the five most important aspects of informed consent were: (1) the major risks, (2) quality of life, (3) outcome, (4) consequences of not undergoing the procedure and (5) quantity of life. The five most important aspects to the doctors were (1) the general nature of the procedure, (2) major risks, (3) consequences of not undergoing the procedure, (4) alternative options and (5) consequences of the procedure in regard to management. The aspects of informed consent of greatest divergence (power of divergence, p < 0.05) between patient and doctor were (1) the importance of technical details of the procedure, (2) cost to the country, (3) qualifications of the doctor, (4) experimental and non-conventional treatment options and (5) whether the doctor would have the procedure if they were in the position of the patient.
This study has identified aspects of informed consent that patients and doctors consider important, as well as aspects where there are significant differences. Both patients and doctors consider the explanations of risks and complications important, especially if the complication is serious and risk is greater than 1 in 1000. Patients consider aspects of outcome (quantity and quality of life) important, while doctors are concerned about "process" including the general nature of the procedure and consequences of the procedure for the patient's management. This study gives direction to medical practitioners concerning what it is that patient's are wanting to know during informed consent about a procedure.
确定知情同意的哪些方面对患者和外科医生很重要，并确定存在差异和相似之处的地方。
根据《残疾问题专员条例》（1996年）编制了一份问卷，并对克赖斯特彻奇医院的256名患者和37名医生进行了调查。
根据患者的意见，知情同意的五个最重要方面是：（1）主要风险，（2）生活质量，（3）结果，（4）不进行该手术的后果，以及（5）生命数量。对医生来说最重要的五个方面是：（1）手术的一般性质，（2）主要风险，（3）不进行该手术的后果，（4）替代方案，以及（5）手术对治疗的后果。患者和医生之间在知情同意方面差异最大的方面（差异强度，p < 0.05）是：（1）手术技术细节的重要性，（2）国家成本，（3）医生的资质，（4）实验性和非常规治疗方案，以及（5）如果医生处于患者的位置是否会进行该手术。
本研究确定了患者和医生认为重要的知情同意方面，以及存在显著差异的方面。患者和医生都认为对风险和并发症的解释很重要，特别是如果并发症严重且风险大于千分之一。患者认为结果方面（生活质量和数量）很重要，而医生则关注“过程”，包括手术的一般性质和手术对患者治疗的后果。本研究为医生提供了指导，让他们了解患者在手术知情同意过程中想知道什么。
