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Treatment refusal: analysis of 15 cases
1Department of Psychiatry, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, R.O.C.
Chang Gung Medical Journal
|July 21, 2000
Summary
Understanding patient treatment refusal is key to improving healthcare. Effective communication and informed consent, alongside crisis intervention, can enhance the doctor-patient relationship and encourage treatment acceptance.
Area of Science:
- Medical Sociology
- Clinical Psychology
- Healthcare Management
Background:
- Investigates patient treatment refusal at two major hospitals.
- Aims to identify reasons for refusal and suggest improvements in doctor-patient communication.
Purpose of the Study:
- To analyze the underlying causes of treatment refusal in a clinical setting.
- To explore strategies for enhancing the doctor-patient relationship to improve treatment adherence.
Main Methods:
- Retrospective analysis of 1631 consultation sheets indicating 'refused treatment' over two years.
- Weekly case discussions involving psychiatrists and consulting medical staff.
- Follow-up assessments and application of informed consent and crisis intervention protocols.
Main Results:
- Fifteen cases met the criteria for treatment refusal (10 male, 5 female).
- Key reasons identified: poor communication, insufficient information, lack of competency, denial, shock, past trauma recall, and patient autonomy.
- Common psychiatric diagnoses included major depressive disorder (8 cases) and delirium (2 cases).
- Following intervention, 12 out of 15 patients accepted medical treatment.
Conclusions:
- Adequate informed consent and crisis intervention are crucial for establishing trust.
- Respecting patient autonomy in treatment decisions is vital.
- Improving communication and intervention strategies can significantly increase treatment acceptance.
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