上肢血管化复合性全体移植决策和知情同意过程中的伦理和心理社会因素:混合方法研究
Elisa J Gordon1, Jessica Gacki-Smith2, Brianna R Kuramitsu2
1Department of Surgery, and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN.
Transplantation direct
|July 26, 2023
概括
上肢 (UE) 血管化复合性全体移植 (VCA) 的决策涉及心理社会因素和感知到的替代方案. 对UE VCA的知情同意应该解决这些因素,并在截肢后提供早期同意.
科学领域:
- 医学研究 医学研究
- 手术方面的创新.
- 移植科学 移植科学
背景情况:
- 上肢血管化复合性全体移植 (UE VCA) 旨在改善生活质量,但很少进行.
- 仅有有限的数据支持基于证据的治疗和UE VCA的知情决策.
研究的目的:
- 质量检查影响UE VCA决策的因素.
- 了解截肢者和UE VCA候选人/接受者对知情同意的看法.
主要方法:
- 与50名参与者进行了深入采访,包括截肢者和UE VCA候选人/接受者.
- 专题分析用于分析决策和知情同意的定性数据.
主要成果:
- 三分之一的参与者非常愿意追求UE VCA.
- 关键的决策主题包括实用性,心理社会影响,利他主义和生活方式负担.
- 大多数参与者认为其他治疗方法有限,并承认接受UE VCA的潜在压力.
结论:
- 心理社会因素和对替代品的看法对UE VCA决策和知情同意产生重大影响.
- 研究结果表明,需要重新评估UE VCA临床评估过程中的假设.
- 建议对截肢患者提供有关UE VCA选项的早期信息.
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