对性别发育差异的个体进行手术决策:利益相关者的观点
Erica M Weidler1,2, Melissa Gardner3, Kristina I Suorsa-Johnson4
1Division of Pediatric Surgery, Phoenix Children's, Phoenix, Arizona.
Frontiers in urology
|November 3, 2023
概括
性发育差异 (DSD) 的青少年和成年人希望参与手术决定. 考虑到发育适宜性的共同决策是DSD护理中成功手术结果的关键.
科学领域:
- 医学伦理 医学伦理
- 儿科手术 儿科手术
- 内分泌学 在内分泌学.
背景情况:
- 倡导团体呼吁暂停选择性手术,直到患者能够充分参与决策.
- 性发育差异 (DSD) 提出了复杂的手术决策,并引发了持续的争议.
- 评估利益相关者的观点对于改善DSD的护理至关重要.
研究的目的:
- 从青少年,成年人,父母和医疗保健提供者的角度评估影响DSD护理复杂外科决定的因素.
- 了解利益相关者对与DSD手术相关的成功医疗保健结果的考虑.
- 在DSD中确定手术决策的关键元素和最佳方法.
主要方法:
- 与110名参与DSD护理的利益相关者进行了半结构化访谈.
- 采访被录音,转录,并使用定性数据软件进行分析.
- 研究了与决策过程和手术结果相关的特定代码.
主要成果:
- 确定的主题包括决策的性质,参与者的参与,讨论的时间,障碍,决策要素和最佳方法.
- 许多利益相关者一致认为,患有DSD的儿童和青少年应在适当的发育条件下参与决策.
- 患有DSD的青少年和成年人表达了在手术选择中对自主性的强烈愿望.
结论:
- 患有DSD的个体希望获得自主权,并参与手术决策.
- 父母对孩子或父母是否应该做出选择性手术决定有不同的看法.
- 医疗保健提供者强调了强有力的决策过程和对所有利益相关者的全面教育的重要性.
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