制约患者自主知情同意的因素研究

目的 了解医患双方对家属代理同意的认识与态度、探究制约患者自主知情同意的因素.方法 随机选取96名临床医师、230名住院患者及其家属,采用自制问卷进行调查.结果 患者对家属代理同意的态度受其自身年龄、经济状况、医疗保障、生活自理能力和学历的影响;家属倾向于向年老、低收入、生活不能自理的患者隐瞒病情;除法律规定外,避免与家属产生纠纷是医生更注重与家属沟通的主要目的.结论 法律制度、家属对知情同意作用的认识及患者自身的年龄、经济状况、自理能力是影响患者自主知情同意的主要因素.

The Factors Restricting Patients to Implement Their Right of Informed Consent Independently

Objective：To evaluate the cognitive status of proxy informed consent among medical staffs,patients and their family members,and explore the factors restricting patients to implement their right independently.Methods：96 medical staffs,230 inpatients and their family members chose by the random sampling method were measured by custom made questionnaires.Results：The results showed that age,financial status,healthy insurance,education and self care ability had remarkable correlation with patients＇ attitude toward proxy informed consent; if a patient was aged,depending on family members for financial or nursing support,his relatives inclined to conceal the diagnosis from him; except for abiding by the law,avoiding dispute was another important reason for medical staffs to adopt the relatives opinion other than respect the patient’s choice.Conclusion：Legal system,family members attitude toward informed consent,patient＇s age,financial status and self care ability are the main factors determining whether the patient could implement their right of informed consent independently.