Language, cultural brokerage and informed consent - will technological terms impede telemedicine use?
Language, cultural brokerage and informed consent - will technological terms impede telemedicine use?
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DOI：
10.7196/sajbl.291
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发表时间：
2014-05-01
影响因子：
0.9
通讯作者：
Mars, M.
中科院分区：
文献类型：
--
作者：
Jack, C.;Singh, Y.;Mars, M.
背景。远程医疗为经济和地理条件不佳的患者提供了治疗解决方案，并提高了护理水平。然而，在保障患者知情同意的权利方面出现了一个问题。确定语言、翻译和口译障碍对远程医疗中获得合法有效的知情同意的影响。选出41个与获得远程医疗会诊知情同意所需的计算机术语和概念相关的关键词，并将其翻译成南非夸祖鲁-纳塔尔省当地土著语言isiZulu。编制了一份带有词汇表的调查问卷，涉及三个领域，包括信息通信技术的使用、信息通信技术术语和道德术语。这是在夸祖鲁-纳塔尔省农村医院的四个门诊部对患者实施的。在54名受访者中，50人（92.6%）不知道或不理解“远程医疗”，49人（90.7%）不知道“视频会议”，49人（90.7%）不知道“电子病历”。只有不到三分之一的参与者理解“同意”和“自主”等词。只有19人（35.2%）理解“同意”一词，只有4人（7.4%）理解“同意”和“远程医疗”两词。结论。获得远程医疗咨询的知情同意是有问题的。需要研究这样做的其他方法。
Background. Telemedicine provides a solution to treatment of economically and geographically compromised patients and enhances the level of care. However, a problem has arisen in safeguarding patients' rights to informed consent.Objective. To determine the impact of language, translation and interpretation barriers on gaining legally valid informed consent in telemedicine.Methods. Forty-one key words relevant to computer terminology and concepts required to gain informed consent for a telemedicine encounter were selected and sent for translation into isiZulu, the local indigenous language of KwaZulu-Natal, South Africa. A questionnaire with the list of words was developed with three domains covering information communication technology (ICT) use, ICT terms and ethics terms. This was administered to patients at four outpatient departments in rural KwaZulu- Natal hospitals.Results. Of the 54 participants, 50 (92.6%) did not know or understand the term 'telemedicine', 49 (90.7%) the term 'video conference' and 49 (90.7%) the term 'electronic records'. Words such as 'consent' and 'autonomy'were understood by less than a third of the participants. Only 19 individuals (35.2%) understood the word 'consent', and only 4 (7.4%) understood both the words 'consent' and 'telemedicine'. Conclusions. Obtaining informed consent for a telemedicine consultation is problematic. Alternative ways of doing so need to be investigated.