急性期精神分裂症患者知情权问题探讨

目的探讨急性期精神分裂症患者住院过程中的知情权问题。方法将630例精神分裂症患者按人院顺序分为A组316例和B组314例；A组只让家属享受知情同意权，B组先让家属享受知情同意权，如家属同意让患者享受知情权，再让患者享受知情权，如患者拒绝住院，在家属同意的情况下强制住院。根据家属的意愿，两组之间可相互调整，调整后的A组为研究组382例，B组为对照组248例。于患者入院24h内采用攻击行为量表、阳性症状和阴性症状量表、临床总体印象量表评定两组患者的临床特征，采用自拟问卷统计患者及家属的一般资料，并进行对比分析。结果60．63％家属不同意让患者享受知情权，不同意享受知情权患者的特征是：男性多，年龄低，病程长，受教育年限短，从事体力劳动者，性格外向，家族史阳性者，有攻击行为，阳性症状和阴性症状量表总分及P分和G分，临床总体印象量表严重程度总分，攻击行为量表总分及4个因子分高。结论急性期精神分裂症患者的知情权可以转移给患者的法定监护人；既不能忽视患者的知情权，也不能盲目地强调患者的知情权，最重要的是保证患者监护人对就诊和住院治疗的知情同意权。

Investigations of right to know in schizophrenics at acute stage

Objective To explore the right to know for acute schizophrenics being in hospital.Methods 630 schizophrenics were divided into group A(n=316) and B(n=314) according to admission order;in group A only families enjoyed informed consent right;in group B,families first enjoyed informed consent right,then patients if families agree;if patients refused to be in hospital,they were forced to under families' consent.According to families' wish,intergroup regulation could be made,post-regulation group A was research group(n=382) and B control group(n=248).Clinical features of both groups were assessed with the Modified overtaggression scale(MOAS),the Positive and Negative Syndrome Scale(PANSS) and the Clinical Global Impression(CGI) within 24 hours after admition,general data added up and analyzed contrastively with the Self-made Questionnaire(SQ).Results 60.63% of families didn't agree that patients enjoyed the right to know,their features were that most of male,low of age,long of course of disease,short of education,manual workers,extroversion,positive family history,aggressive behaviors,higher scores of total PANSS,P,G,total severity of the CGI,total MOAS and 4 factor.Conclusion Rights to know of acute schizophrenics may transfer to patients' legal guardian;patients' rights to know can neither be neglected nor be blindly emphasized,it is the most important to ensure for patients' guardian informed consent right of doctors' office visiting and hospitalization.