What patients really got and what they wanted in surgical informed consent: a cross-sectional survey in China

2019 ◽  
Author(s):  
Jing Wu ◽  
Jiajia Yu ◽  
Xuchun Ye ◽  
Qing Wu ◽  
Chenling Luo
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Clinical Medicine ◽  
Focal Point ◽  
Final Analysis ◽  
Individual Autonomy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Potential Risks ◽  
Perceptions And Expectations

Abstract Background Informed consent (IC) is a fundamental element of modern clinical medicine based on the spirit of individual autonomy. Patients’ comprehension of the key elements of clinical IC is often poor. Aims and Objectives This study aimed to explore patients’ perceptions and expectations of IC process in invasive and surgical procedures. Design A cross-sectional descriptive study was carried out in Shanghai, China. Methods A self-administered structured questionnaire was developed to evaluate patients’ perceptions and expectations of the IC process. In total, 317 individuals were included in the final analysis. Results Majority (73.8%) of the process was undertaken one day prior to the procedure and nearly half (47.6%) lasted less than 15 minutes. Most (96.8%) patients were given verbal explanation information by healthcare professionals. The nature of illness, potential risks and complications (74.1%) and the necessity of the procedure (69.4%) were mostly memorized while alternative treatments rarely (13.6%). Patients expected their family members involved in the decision making and could be provided more time to read the IC document and prepare for the decision-making. What the patients got was significantly different from what they expected in the following aspects, such as who participated in IC, where and when it took place, how long it lasted and main contents that should be discussed in IC (P <0.05). Statistically significant relationship was found in expectations of IC patients and their income and payment type of medical expenses (P <0.05). Discussion This study explored patients’ expectation and perception of IC process regarding invasive procedures. Patients wanted to be more involved in IC process. To promote patient participation, more time should be given to the patients to comprehend and understand the IC document. In addition, information related with long-term issues should be discussed as a focal point. There is a need to re-consider IC process and to develop methods to promote the patients’ satisfaction in achieving autonomy.

Decision-Making Regarding Ventilator Support in Children with SMA Type 1—A Cross-Sectional Survey among Physicians

2019 ◽  
Vol 50 (06) ◽  
pp. 359-366
Author(s):  
Astrid Pechmann ◽  
Thorsten Langer ◽  
Janbernd Kirschner
Keyword(s):  
Decision Making ◽  
Mechanical Ventilation ◽  
Informed Consent ◽  
Muscular Atrophy ◽  
Neuromuscular Disorder ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Ventilator Support ◽  
Case Vignettes

AbstractSpinal muscular atrophy (SMA) is a neuromuscular disorder characterized by muscle atrophy and severe proximal muscle weakness. In the absence of curative treatment, it has been controversial whether critically ill infants with SMA type 1 should receive ventilator support. The aim of this study was to investigate the process of decision-making regarding ventilator support in children with SMA type 1 from the perspectives of physicians. A web-based survey with 17 questions and 2 case vignettes was conducted in 671 physicians in Germany and Switzerland from 12/2016 to 03/2017. The survey focused on factors influencing the decision about ventilator support and the content in informed consent discussions. Additionally, physicians were asked about their general attitude towards mechanical ventilation in children with SMA type 1 and their hypothetical clinical management in emergency settings using case vignettes. Hundred and sixty-five physicians participated in the survey (50.3% child neurologists, 18.8% specialists for ventilator support, 6.1% pediatric palliative care physicians, and 6.1% with more than one of these specializations). Of all physicians, 44.2% confirmed to have experience with SMA type 1 patients using ventilator support. In summary, our results show that physicians' attitudes and experiences about mechanical ventilation in children with SMA type 1 vary considerably and are likely to influence the outcome in informed consent discussions and the hypothetical management in emergency settings.

scholarly journals Perceptions of Singaporeans towards informed consent: a cross-sectional survey

2021 ◽  
Author(s):  
M Gupta ◽  
S Madhavan ◽  
FSY Teo ◽  
JK Low ◽  
VG Shelat
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Employment Status ◽  
Local Population ◽  
Sociodemographic Factors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Related Information ◽  
Health Related ◽  
Predicted Risk

Introduction: In a patient-centric health system, it is essential to know patients’ views about informed consent. The objective of this study was to understand the perceptions of the local population regarding informed consent. Methods: Spanning across six weeks from January 2016 to March 2016, a cross-sectional survey of adults attending General Surgery outpatient clinics at Tan Tock Seng Hospital was performed. Sociodemographic data, lifestyle and health-related information, perception and purpose of consent forms, and decision-making preferences were studied. Results: 445 adults participated in the survey. Most participants were below 40 years old (n = 265, 60.1%), female (n = 309, 70.1%) and degree holders (n = 196, 44.4%). 56.9% of participants wanted to know every possible risk, while 28.3% wanted to know common and serious risks. On multivariate analysis, age (age 61–74 years: odds ratio [OR] 11.1, 95% confidence interval [CI] 2.2–56.1, p = 0.004; age > 75 years: OR 22.2, 95% CI 1.8–279.1, p = 0.017) was a predictor of not wanting to know any risks. Age also predicted risk of disclosure for death (age 61–74 years: OR 13.4, 95% CI 4.2–42.6, p < 0.001; age > 75 years: OR 32.0, 95% CI 4.5–228.0, p = 0.001). Most participants (48.1%) preferred making shared decisions with doctors, and an important predictor was employment status (OR = 4.8, 95% CI 1.9–12.2, p = 0.001). Conclusion: Sociodemographic factors and educational level influence decision-making, and therefore, the informed consent process should be tailored for each patient.

Risk Minimization Measures in Off-Label Drug Use: A Survey of Community Pharmacists in Malaysia

2020 ◽  
Vol 15 (3) ◽  
pp. 181-189
Author(s):  
Omotayo Fatokun
Keyword(s):  
Informed Consent ◽  
Drug Use ◽  
Perceived Risk ◽  
Adverse Drug Events ◽  
Community Pharmacists ◽  
Risk Minimization ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Off Label ◽  
Written Informed Consent

Background: While off-label drug use is common and sometimes necessary, it also presents considerable risks. Therefore, measures intended to prevent or reduce the potential exposure to off-label risks have been recommended. However, little is known about community pharmacists’ beliefs regarding these measures in Malaysia. Objectives: This study examined community pharmacists’ beliefs towards risk minimization measures in off-label drug use in Malaysia and assessed the relationship between perceived risk of off-label drug use and beliefs towards risk minimization measures. Methods: A cross-sectional survey was conducted among 154 pharmacists practicing in randomly selected community pharmacies in Kuala Lumpur and the State of Selangor, Malaysia. Results: The majority agreed or strongly agreed that adverse drug events from the off-label drug should be reported to the regulatory authority (90.9%) and the off-label drug should only be used when the benefit outweighs potential risks (88.3%). Less than half (48.1%) agreed or strongly agreed that written informed consent should be obtained before dispensing off-label drugs and a majority (63.7%) agreed or strongly agreed that the informed consent process will be burdensome to healthcare professionals. Beliefs towards risk minimization measures were significantly associated with perceived risk of off-label drug use regarding efficacy (p = 0. 033), safety (p = 0.001), adverse drug rection (p = 0.001) and medication errors (p = 0.002). Conclusion: The community pharmacists have positive beliefs towards most of the risk minimization measures. However, beliefs towards written informed consent requirements are not encouraging. Enhancing risk perception may help influence positive beliefs towards risk minimization measures.

Knowledge, Attitudes and associated factors to Use District Health Information System (DHIS2 data) for decision making among health professionals in a Resource limited settings: Cross-sectional Survey (Preprint)

2020 ◽  
Author(s):  
Shuma Gosha Kanfe ◽  
Nebyu Demeke Mengiste ◽  
Mohammedjud Hassen Ahmed ◽  
Gebiso Roba Debele ◽  
Berhanu Fikadie Endehabtu
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Associated Factors ◽  
Good Knowledge ◽  
Cross Sectional Survey ◽  
District Health ◽  
Cross Sectional ◽  
Determinant Factors ◽  
Knowledge And Attitudes ◽  
Health Need

BACKGROUND Evidence based practice is a key to increase effectiveness and efficiency of quality health services. To achieve this, utilization of health facility data (DHIS2 data) is required which is determined by knowledge and attitudes of health professionals. Thus, this study aimed to assess knowledge and attitudes of health professionals to use DHIS2 data for decision making. OBJECTIVE This study aimed to assess the knowledge, attitudes and its associated factors among health professionals to use DHIS2 data for decision making at South west of Ethiopia 2020 METHODS Cross sectional quantitative study methods was conducted to assess Knowledge and Attitudes of health professionals to use DHIS2 data. A total of 264 participants were approached. SPSS version 22 software was used for data entry and analysis. Descriptive and analytical statistics including Bivariable and Multivariable analyses was done RESULTS Overall 130(49.2%) of the respondents had good knowledge to use DHIS2 data (95% CI: [43, 55.3]), whereas over 149 (56.4%) of the respondents had favorable attitudes towards the use of DHIS2 data for decision making purpose (95% CI: [53.2, 59.8]). Skills [AOR=2.20,95% CI:(1.16, 4.19)], Age [AOR= 1.92, 95% CI: (1.03, 3.59)] ,Resources[AOR=2.56, 95% CI:(1.35,4.86)], Staffing[AOR= 2.85, 95% CI : (1.49, 5.48)] and Experiences[AOR= 4.66, 95% CI: (1.94, 5.78)] were variables associated with knowledge to use DHIS2 data whereas Training [AOR= 5.59, 95% CI: (2.48, 5.42)], Feedback [AOR= 4.08, 95% CI: (1.87, 8.91)], Motivation [AOR=2.87, 95% CI: (1.36, 6.06)] and Health need [AOR=2.32, 95% CI: (1.10-4.92)] were variables associated with attitudes of health professionals to use DHIS2 data CONCLUSIONS In general, about half of the study participants had good knowledge of DHIS2 data utilization whereas more than half of respondents had favorable attitudes. Skills, resources, ages, staffing and experiences were the most determinant factors for the knowledge to use DHIS2 data whereas health need, motivation, feedback and training were determinant factors for attitudes to use DHIS2 data

scholarly journals Is polycystic ovary syndrome appropriately diagnosed by obstetricians and gynaecologists across China: a nationwide survey

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Deng Yan ◽  
Wang Yan-Fang ◽  
Zhu Shi-Yang ◽  
Ma Rui-Lin ◽  
Ding Xue-Song ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Diagnostic Criteria ◽  
Polycystic Ovary ◽  
Final Analysis ◽  
Nationwide Survey ◽  
Care Quality ◽  
Cross Sectional Survey ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Rotterdam Criteria

Abstract Background To describe the diagnostic criteria used and their application accuracy in the practice of polycystic ovary syndrome (PCOS) caring among obstetricians and gynaecologists across China. Methods This was an Online cross-sectional survey of Obstetricians and gynecologists involved in PCOS caring conducted via the largest continuing education platform of obstetrics and gynecology across China from September 2019 to November 2019. Results A total of 2,328 respondents were eligible for the final analysis. Of these, 94.5 % were general obstetricians and gynaecologists (Ge-ObGyn), and 5.5 % were reproductive endocrinologists (Re-ObGyn). Overall, the most frequently used criteria were the Androgen Excess and Polycystic Ovary Syndrome Society (AE-PCOS) criteria (48.2 %), followed by the Rotterdam criteria (35.7 %) and NIH criteria (12.1 %). Of the respondents, 31.3 % used their diagnostic criteria in their clinical practice. More respondents who chose the Rotterdam criteria could accurately apply the diagnostic criteria than those who chose the AE-PCOS criteria (41.2 % vs. 32.1 %, P < 0.001). Compared with Ge-ObGyn, Re-ObGyn were less likely to use the AE-PCOS criteria (adjusted odds ratio, 0.513; 95 % CI, 0.328–0.802; P < 0.05) and 1.492 times more likely to accurately use their criteria (95 % CI, 1.014–2.196; P < 0.05). Conclusions Less than one-third of obstetricians and gynaecologists across China could accurately use the diagnostic criteria they choose to diagnose PCOS. There is an urgent need to train obstetricians and gynaecologists on PCOS diagnosis in an effort to improve the medical care quality of patients with PCOS.

scholarly journals Public knowledge, preferences and experiences about medical substitute decision-making: a national cross-sectional survey

2021 ◽  
pp. bmjspcare-2020-002619
Author(s):  
Marcus Sellars ◽  
Julien Tran ◽  
Linda Nolte ◽  
Ben White ◽  
Craig Sinclair ◽  
...  
Keyword(s):  
Decision Making ◽  
Online Survey ◽  
Public Knowledge ◽  
Cross Sectional Survey ◽  
Medical Decisions ◽  
Cross Sectional ◽  
Minimal Support ◽  
Substitute Decision Maker ◽  
Final Sample ◽  
Advance Care

ObjectiveTo describe the Australian adult public’s knowledge and experiences regarding substitute decision-making for medical decisions and their preferences for obtaining information about the substitute decision-maker (SDM) role.MethodsThis is a national cross-sectional online survey of the Australian adult public. The survey examined participants’ advance care planning (ACP) awareness and experience, SDM experiences and preferences for obtaining more information about SDM, and participant knowledge about SDM.ResultsOf 1586 people who opened the survey, 1120 (70.6%) were included in the final sample. 13% (n=142) of participants indicated they had acted as an SDM. A median score of two correct responses out of five showed low to moderate knowledge about the SDM role among all participants, with only 33% reporting awareness of SDM laws existing in Australia. While most (59%) participants ranked a health professional as their preferred source of obtaining information about supporting SDMs, few participants who had been an SDM (n=64, 45%) reported obtaining any support in making medical decisions. The median SDM knowledge scores for people who had discussed ACP (3.0 vs 2.0, U=1 45 222, z=6.910, p<0.001), documented their ACP preferences (3.0 vs 2.0, U=71 984, z=4.087, p<0.001) or acted in the SDM role (3.0 vs 2.0, U=56 353, z=−3.694, p<0.001) were significantly higher compared with those who had not.ConclusionsThe Australian public may have low to moderate knowledge about the SDM role and access only minimal support when making challenging medical decisions.

scholarly journals Job satisfaction and its associated factors among optometrists in Ghana: a cross-sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kwadwo Owusu Akuffo ◽  
Eldad Agyei-Manu ◽  
David Ben Kumah ◽  
Anthony Danso-Appiah ◽  
Abubakar Sadik Mohammed ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Human Resources ◽  
Associated Factors ◽  
Critical Role ◽  
Final Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Eye Health ◽  
Overall Job Satisfaction

Abstract Background Job satisfaction describes an employee’s motivation and/or feeling of satisfaction towards his/her work. Globally, healthcare professionals’ turnover and retention play a critical role in the delivery of essential health services. In Ghana, however, little has been done to ascertain job satisfaction levels among human resources for eye-health. The objective of this study therefore was to assess job satisfaction and its associated factors among optometrists in Ghana. Methods A cross-sectional survey was conducted among 304 registered and licensed optometrists of the Ghana Optometric Association between September 2018 and June 2019. A validated, well-structured questionnaire was used to elicit information on socio-demographic characteristics of participants and measures on job satisfaction. Scores from a five-point Likert scale was employed to examine job satisfaction and its associated factors. Linear regression analyses were used to evaluate the association between overall job satisfaction and its associated factors using Rasch logit scores. Results A total of 214 optometrists gave valid responses to the questionnaires used for the final analysis. The mean (± SD) score of the overall perception of job satisfaction among optometrists was 3.36 (± 1.00), with 74.3% of them being satisfied with their jobs. After statistical adjustment, Good work-life balance (Unstandardized co-efficient (β) = 0.288, p = 0.001), Salary (β = 0.222, p < 0.0005), Supervision (β = 0.117, p = 0.044), and Continuing Education Opportunities (β = 0.138, p = 0.017) were all significantly associated with higher levels of overall job satisfaction. Conclusions Most optometrists were satisfied with their jobs. Effective strategic planning and management of human resources for eye-health in Ghana are essential in the development of quality eye-health systems and the provision of high-quality eyecare services.

scholarly journals US-based cross-sectional survey of clinicians’ knowledge and attitudes about shared decision-making across healthcare professions and specialties

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022730 ◽  
Author(s):  
Rachel C Forcino ◽  
Renata West Yen ◽  
Maya Aboumrad ◽  
Paul J Barr ◽  
Danielle Schubbe ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Shared Decision Making ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Knowledge And Attitudes ◽  
Positive Attitudes

ObjectiveIn this study, we aim to compare shared decision-making (SDM) knowledge and attitudes between US-based physician assistants (PAs), nurse practitioners (NPs) and physicians across surgical and family medicine specialties.SettingWe administered a cross-sectional, web-based survey between 20 September 2017 and 1 November 2017.Participants272 US-based NPs, PA and physicians completed the survey. 250 physicians were sent a generic email invitation to participate, of whom 100 completed the survey. 3300 NPs and PAs were invited, among whom 172 completed the survey. Individuals who met the following exclusion criteria were excluded from participation: (1) lack of English proficiency; (2) area of practice other than family medicine or surgery; (3) licensure other than physician, PA or NP; (4) practicing in a country other than the US.ResultsWe found few substantial differences in SDM knowledge and attitudes across clinician types, revealing positive attitudes across the sample paired with low to moderate knowledge. Family medicine professionals (PAs) were most knowledgeable on several items. Very few respondents (3%; 95% CI 1.5% to 6.2%) favoured a paternalistic approach to decision-making.ConclusionsRecent policy-level promotion of SDM may have influenced positive clinician attitudes towards SDM. Positive attitudes despite limited knowledge warrant SDM training across occupations and specialties, while encouraging all clinicians to promote SDM. Given positive attitudes and similar knowledge across clinician types, we recommend that SDM is not confined to the patient-physician dyad but instead advocated among other health professionals.

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