从医师和儿童家长角度探讨儿科病房知情同意书的获取

IF 0.5 Q4 PEDIATRICS Archives of Pediatric Infectious Diseases Pub Date : 2021-08-07 DOI:10.5812/pedinfect.111168
S. Rezvani, M. Fadavi, S. Bazmi
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引用次数: 0

摘要

背景:获得诊断和治疗程序的知情同意具有重要的道德和法律意义,由于其具体问题,在儿科领域更为重要。目的:在儿科领域获得知情同意是特定的,因为许多因素,包括患者的年龄和获得父母或法定监护人同意的必要性。本研究旨在从替代决策者(父母或监护人)和医生的角度评估获得知情同意的过程。通过在这两组人之间建立适当和正确的沟通技巧来关注他们的观点之间的差异,可以提高治疗的满意度和有效性。方法:在这项描述性研究中,通过188名家长和23名医生完成的问卷调查收集数据。最后,使用SPSS 16中的单样本t检验方法进行统计分析。结果:在96.3%的病例中,父母认为,如果患者、他们的亲属和医疗团队对治疗方式存在分歧,最终由医疗团队做出决定。其中三分之一的人没有收到足够的信息或根本没有收到任何信息。告知父母其他可能的治疗方法、手术并发症、考虑患者及其亲属的意见以做出最终决定、告知孩子他/她的疾病和治疗计划以及告知父母可能的结果都不在有利范围内。医生们认为,关于治疗的决定是根据父母和临床委员会的意见做出的,只有3.4%的病例以他们的意见为决策依据。结论:研究结果表明,父母和医生对知情同意的意见存在差距,因为医生认为他们是按照患者父母的意愿行事的,而父母认为他们的意见在孩子健康的最终决定中没有重要作用。因此,似乎有必要将医生和家长参与儿童诊断和治疗决策的文化制度化,并应更加重视在治疗人员与患者及其亲属之间建立正确的关系。
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Study of Obtaining Informed Consent in Pediatric Wards from the Viewpoint of Physicians and Children’s Parents
Background: Obtaining informed consent for diagnostic and therapeutic procedures is of great moral and legal importance, which is more important in the field of pediatrics due to its specific issues. Objectives: Obtaining informed consent in the pediatric field is specific because of many factors, including the age of the patients and the necessity of obtaining consent from parents or legal guardians. This study aimed to evaluate the process of obtaining informed consent from the viewpoint of substitute decision-makers (parents or guardians) and physicians. Attention to the differences between the views of these two groups by establishing appropriate and correct communication skills between them can lead to greater satisfaction and increased effectiveness of treatments. Methods: In this descriptive study, the data were collected through questionnaires completed by 188 parents and 23 physicians. Finally, the statistical analysis was conducted using the one-sample t test method in SPSS 16. Results: In 96.3% of the cases, parents believed that where the patient, their relatives, and the medical team disagreed about the kind of treatment, the final decision was made by the medical team. One-third of them did not receive enough information or received no information at all. Informing parents about other possible treatments, complications of the procedures, considering the patients and their relatives’ opinions for the final decision, informing the child about his/her disease and treatment plans, and informing the parents about the possible outcomes were not in the favorable range. Physicians believed that decision about the treatment was made based on the opinion of the parents and the clinical committee, and only in 3.4% of the cases, their opinion was the basis for decision-making. Conclusions: The results showed that there was a gap between the parents and physicians’ opinions about informed consent, as the physicians believed that they act as the patients’ parents wish and the parents believed that their opinion played no important role in the final decision regarding the health of their children. Thus, it seems necessary to institutionalize the culture of participatory decision-making by physicians and parents in decisions related to the diagnosis and treatment of children, and more emphasis should be placed on establishing the right relationship between treatment staff and patients and their relatives.
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来源期刊
CiteScore
1.80
自引率
14.30%
发文量
22
期刊介绍: Archives Of Pediatric Infectious Disease is a clinical journal which is informative to all practitioners like pediatric infectious disease specialists and internists. This authoritative clinical journal was founded by Professor Abdollah Karimi in 2012. The Journal context is devoted to the particular compilation of the latest worldwide and interdisciplinary approach and findings including original manuscripts, meta-analyses and reviews, health economic papers, debates and consensus statements of clinical relevance to pediatric disease field, especially infectious diseases. In addition, consensus evidential reports not only highlight the new observations, original research and results accompanied by innovative treatments and all the other relevant topics but also include highlighting disease mechanisms or important clinical observations and letters on articles published in the journal.
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