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在患有大动脉动脉瘤的患者中,共享决策和具体知情同意
Marcela Juliano Silva Cunha1, Marcelo Passos Teivelis1, Cynthia de Almeida Mendes1
1Hospital Municipal da Vila Santa Catarina Dr. Gilson de Cássia Marques de Carvalho; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Einstein (Sao Paulo, Brazil)
|August 16, 2023
概括
大约26%的无症状的大动脉动脉瘤患者在经过详细的知情同意程序后拒绝选择性手术. 动脉瘤尺寸较小是影响这一决定的主要因素,尽管它超过了推的外科手术门.
科学领域:
- 血管外科 血管外科
- 患者的决策能力
- 健康结果的健康结果.
背景情况:
- 选择性手术修复适用于无症状的大动脉动脉瘤,以防止破裂.
- 患者的理解和同意对于治疗坚持至关重要.
- 共享决策旨在使患者的偏好与临床建议保持一致.
研究的目的:
- 为了确定无症状患者选择性大动脉动脉瘤手术的拒绝率.
- 在经过全面的知情同意程序后,分析影响患者决策的因素.
主要方法:
- 对49名接受选择性大动脉动脉瘤手术的患者进行了回顾性分析.
- 患者根据接受或拒绝手术被分为几组.
- 知情同意需要一份详细的表格和一个家庭会议.
主要成果:
- 49名患者中有13名 (26.5%) 拒绝接受手术.
- 拒绝手术的患者的动脉瘤在统计学上较小 (9%对26%).
- 动脉瘤的大小是影响拒绝的唯一重要因素.
结论:
- 很大一部分患者拒绝选择性大动脉动脉瘤修复,即使有指示.
- 更小的动脉瘤大小,虽然超过指示值,但与更高的拒绝率有关.
- 共享决策强调了患者的自主权,但揭示了接受预防性手术的复杂性.
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