老年患者医疗知情同意现状和影响因素研究  

Study on the Status and Influencing Factors of Informed Consent on Medical Treatment among Elderly Patients

作　　者：王镭 刘婵娟[1] Nang Lei(Wenzhou Medical University,Wenzhou,P.R.China)

机构地区：[1]温州医科大学医学人文研究院(浙江省哲学社会科学重点研究基地),浙江温州325035

出　　处：《中国卫生事业管理》2024年第4期415-420,共6页Chinese Health Service Management

基　　金：国家社科基金重点项目“医学伦理委员会及其伦理审查能力建设研究”(19AZX014)。

摘　　要：目的:调查老年患者医疗知情同意现状,量化老年患者的知情意愿、知情程度,并确定影响老年患者知情同意的因素,提出相应对策。方法:对当日签署过知情同意书的患者开展问卷调查,问卷包含知情意愿量表、知情程度量表。进行访谈,调查知情同意影响因素,并对访谈材料进行质性分析。结果:老年患者的平均知情意愿水平为1.64±1.036(取值区间为0-3),老年患者的平均知情程度为5.28±2.112(取值区间为0-10)。确定的影响因素包括知情同意书的文本长度、可读性和内容完整性,缺乏口头介绍,隐形的年龄歧视,老年患者的生理、心理、社会因素和对知情同意的认知错误,医方决策和家属决策。结论:老年患者的知情意愿较低,知情程度较低。因此需要通过优化知情同意流程、在医患端建立以患者为中心的合作与互助、分享决策的民主模式、在患者家属端促进患者家属共享决策模式等方法改善老年患者的知情同意。Objective To investigate the status of informed consent on medical treatment among elderly patients,determine its influencing factors,and put forward countermeasures.Methods Patients who signed informed consent forms on the same day were selected for survey by questionnaire of PID scale and PICL scale,and interviewed on the influencing factors of informed consent.Qualitative analysis was conducted on the interview materials.Results The PID level of elderly patients was 1.64±1.036(the value range is 0-3),and their PICL was 5.28±2.112(the value range is 0-10).The influencing factors mainly included the length,readability,and content missing of the informed consent text,lack of oral introduction,hidden age discrimination,elderly patients'physiological,psychological and social factors,and misconceptions about informed consent,doctor-led consent,and family-led consent.Conclusion Elderly patients had lower PID and PICL.Therefore,it is necessary to improve the informed consent of elderly patients by optimizing the informed consent process procedures,establishing a patient-centered cooperation and mutual assistance model between doctors and patients,promoting a democratic mode of decision-making,and encouraging family members to share decision-making with patients.

关 键 词：知情同意 老年患者 知情意愿 知情程度 

分 类 号：R197[医药卫生—卫生事业管理]