OBJECTIVES:To assess perceptions of the informed consent process in patients undergoing urgent abdominal surgery. DESIGN:A prospective observational study was carried out using structured questionnaire-based interviews. Patients who had undergone urgent abdominal surgery were interviewed in the postoperative period to ascertain their perceptions of the informed consent process. Replies were compared to responses obtained from a control group undergoing elective surgery, to identify factors common to the surgical process and those specific to urgent surgery. Patients' perceptions of received information were also compared to the information perceived to have been provided by the consent obtainers. SETTING:Gastrointestinal surgical service of a university teaching hospital. PATIENTS:Seventy-four consecutive patients undergoing urgent abdominal surgery and 80 control patients undergoing elective surgery. MAIN MEASUREMENTS:Principal outcome measures were patients perceptions of factors interfering with the ability to give informed consent, assessment of the quality of informed consent and the degree of discussion of the expected outcomes. RESULTS:Forty-nine of the seventy-four (66%) patients undergoing urgent surgery perceived that pain did not affect their ability to give informed consent. Twenty-seven reported an adverse effect of analgesia on the ability to give informed consent. Only 22% of patients undergoing urgent surgery perceived that there had been any discussion of potential side effects and complications of surgery. CONCLUSION:The majority of patients in this series with acute intra-abdominal surgical conditions perceive that they retain the ability to give informed consent for surgery. There is a need for improved discussion of therapeutic options and likely outcomes.

译文

目的:评估接受紧急腹部手术的患者对知情同意过程的看法。
设计:使用基于问卷调查的结构化访谈进行了一项前瞻性观察研究。接受紧急腹部手术的患者在术后接受采访,以确定他们对知情同意过程的看法。将答复与从进行择期手术的对照组得到的答复进行比较,以确定手术过程中常见的因素和急诊手术特有的因素。还将患者对收到信息的看法与知情同意书提供者所提供的信息进行比较。
单位:某大学教学医院的胃肠外科。
患者:连续接受紧急腹部手术的患者44例,接受择期手术的对照患者80例。
主要测量指标:主要结局指标是患者对影响给予知情同意能力的因素的看法,对知情同意质量的评估以及对预期结果的讨论程度。
结果:在接受紧急手术的七十四名患者中,有四十九名(66%)认为疼痛并没有影响他们给予知情同意的能力。 27例报告了镇痛对知情同意能力的不利影响。接受紧急手术的患者中只有22%认为有关于手术潜在副作用和并发症的讨论。
结论:该系列中大多数患有急性腹腔内手术条件的患者都认为他们保留了知情同意手术的能力。需要对治疗选择和可能的结果进行更好的讨论。

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