Characteristics of acute intoxications with regard to capacity for effective doctor-patient communication and competent informed decisions

Abstract

Introduction: Altered mental status caused by certain acute poisonings creates barriers for effective doctor-patient communication and compromises the process of informed consent (IC) for treatment. A categorization of toxicological patients with regard to communication capacity would be helpful for practical purposes. Aim : This article has the following aims: characterization of toxicology patients with mental status altered by poisoning according to the etiology of intoxication; discussion of the impact of cerebral toxic syndrome on the capacity for effective communication between the doctor and the patient and for IC. Materials and Methods : A retrospective study of the medical documentation of 2088 patients with acute intoxications, treated in the Clinic of Intensive Treatment of Acute Intoxications and Toxicoallergies at Naval Hospital, Varna during the 2010–2013 period: case files, IC forms, was conducted. The R program package, version 3.4.2 (2017-09-28), was used for statistics. Results : Toxic cerebral syndrome was found in 966 cases of acute intoxication, 46% of all patients, with especially high percentages in the medicament, alcohol, and narcotics intoxication groups. Regaining lucid mental state was observed within 1 hour in 21.9% of patients, and for the rest, it took from 2 hours to 7 days. Only 1211 patients, or 58%, signed the admission IC form themselves. Conclusion : Characterization of acute intoxications with regard to capacity for effective doctor-patient communication is necessary because of the great percentage of patients with cerebrotoxic syndrome. Good knowledge of the specificity of toxicology patients and good communication skills of physicians can help the proper process of informed decisions of the patient.