Experiences of patients and next of kin on informed consent process for emergency surgery in two Urban university teaching hospitals in Uganda: a comparative cross sectional study.
Experiences of patients and next of kin on informed consent process for emergency surgery in two Urban university teaching hospitals in Uganda: a comparative cross sectional study.
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DOI：
10.1186/s12873-023-00856-0
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发表时间：
2023-08-02
影响因子：
2.5
通讯作者：
中科院分区：
文献类型：
--
作者：
紧急手术的知情同意是一个过程，患者或其近亲必须在危及生命的情况下或可能改变生命的手术中做出所需的快速决定。该研究的目的是描述乌干达两所城市大学教学医院的患者及其近亲的经历以及影响知情同意过程的因素。方法：对两家三级医院接受急诊手术的患者及其近亲进行横断面调查；一个公立机构和一个私立非营利机构。进行问卷调查以收集社会人口统计信息、进行的手术类型、如何获得知情同意以及知情同意过程中的经验和期望。对变量进行了单变量和多变量分析。结果：我们收集了来自公立医院的 210 名患者和来自私立非营利医院的 170 名患者的数据。总体而言，大多数患者没有被告知手术风险（79.7%），没有获得其他选择（87.6%）并且没有机会提问（57.4%）。私立机构的患者期望向他们解释同意书的几率是公立机构患者的 3.35 倍。公立医院的患者更愿意由护士给予同意的几率是私立医院患者的 0.12 倍，即 0.12（0.05–0.29，p<0.001）。公立机构的患者更愿意获得医生同意的几率是私立机构患者的 0.18 倍，即 0.18（0.08–0.45，p<0.001）。结论：公立和私立机构的患者都没有被告知手术风险、替代选择，也没有机会提问。这项研究的结果解释了患者对谁给予同意的偏好，尽管具有统计学意义，但由于反应并不相互排斥，因此尚无定论。在线版本包含可在 10.1186/s12873-023-00856-0 获取的补充材料。
Informed consent for emergency surgery is a process in which a patient or their next of kin must make quick decisions required for surgery in a life-threatening situation or surgery that may have life-altering outcomes. The objective of the study was to describe patients and their next of kin experiences and factors influencing the informed consent process in two urban university teaching hospitals in Uganda. Methods: A cross-sectional survey involving patients who underwent emergency surgery and their next of kin was conducted in two tertiary care hospitals; one public and one private-not-for profit institution. A questionnaire was administered to collect sociodemographic information, type of Surgery that was done, how informed consent was obtained and experiences and expectations from the informed consent process. Univariate and multivariate analyses of the variables was done. Results: We collected data from 210 patients from a public hospital and 170 from a private-not-for profit hospital. Overall, most patients did not have the risks of the surgery communicated to them (79.7%), were not given alternative options (87.6%) and had no opportunity to ask questions (57.4%). Patients at the private institution had 3.35 times the odds of expecting the consent form to be explained to them than those at the public institution. Patients at the public hospital had 0.12 times the odds of preferring to have consent administered by a nurse than patients at the private institution OR 0.12 (0.05–0.29, p < 0.001). Patients in the public institution had 0.18 times the odds of preferring to have consent administered by a doctor than patients in the private institution OR 0.18 (0.08–0.45, p < 0.001). Conclusion: Patients in both public and private institutions are not informed about the risks of surgery, alternative options and are not given the opportunity to ask questions. Interpretation of the findings of this study on patient preferences on who administered consent though statistically significant were inconclusive due to the responses not being mutually exclusive. The online version contains supplementary material available at 10.1186/s12873-023-00856-0.
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影响因子：
3.1
作者：
Jones, James W.;McCullough, Lawrence B.;Richman, Bruce W.
通讯作者：
Richman, Bruce W.
影响因子：
2
作者：
Muskens, Ivo S.;Gupta, Saksham;Broekman, Marike L. D.
通讯作者：
Broekman, Marike L. D.
影响因子：
4.2
作者：
Susilo, Astrid P.;Van Dalen, Jan;Ekawati, Nora
通讯作者：
Ekawati, Nora
影响因子：
2.2
作者：
LUNA, F
通讯作者：
LUNA, F
影响因子：
2.7
作者：
Chima, Sylvester C.
通讯作者：
Chima, Sylvester C.