Cerrahi kliniklerdeki sağlık çalışanlarının aydınlatılmış onam hakkındaki görüşleriyle uygulamaları örtüşüyor mu?

Aim. To evaluate the views and practices of physicians, nurses and midwives working in surgical clinics regarding the informed consent. Methods. The sample of this descriptive study comprises 143 health professionals working in surgical units of three hospitals in the province of Sivas. Data were collected using the questionnaire prepared by the researchers. The possible total score to be obtained from the questionnaire ranges from 45 to 225. Low scores indicate that their knowledge about the informed consent is correct and sufficient and high scores indicate that their knowledge is negative and insufficient. The data were evaluated with the Student's t test, Kruscall Wallis and Correlation Analysis. Results. The mean age of the participants was 32.4 ± 6.0. Of them, 63.6% were female. Their total length of service was determined as 10.0 ± 6.5. 47.6% partly agreed that informed consent was applied correctly, 56.6% considered informed consent as the evidence of proving, 57.4% stated that informed consent could not be obtained satisfactorily due to negative work conditions and the small number of the staff, 77.6% stated that informed consent was obtained upon the hospital management’s demand and due to legal obligation and 62.2% stated that it was the responsibility of the whole team to obtain informed consent. The lowest and the highest mean scores the participants obtained from the each item of the questionnaire were 1.60 ± 0.66 and 3.00 ± 1.30 respectively. Their total mean score was 92.99 ± 21.75. While the mean score given by health professionals to the sixth proposition stating that “information in the informed consent must be clear and understandable” was the lowest, the highest mean score was given to the twelfth proposition stating that “the informed consent given by the patient when he/she is admitted to the clinic is not valid for all the procedures”. No significant differences were determined between the total mean scores of the physicians, nurses and midwives (p> 0.05). Conclusion. Although the health professionals’ views regarding informed consent was positive, they did not applied it as required. They were concerned about the legal aspects of informed consent rather than ethical dimension. In this context, it is necessary to develop effective institutional strategies during the education process regarding the implementation of informed consent

Özet

Amaç. Sağlık profesyonellerinin aydınlatılmış onama ilişkin görüş ve uygulamalarını değerlendirmek. Yöntem. Tanımlayıcı tipteki araştırmanın örneklemini, Sivas il merkezinde bulunan üç hastanenin cerrahi ünitelerinde çalışan toplam 143 sağlık profesyoneli oluşturdu. Veriler aydınlatılmış onama ilişkin araştırmacılar tarafından oluşturulan form ile toplandı. Bu formdan alınabilecek toplam puan 45-225 arasında olup, alınan puanın düşük olması aydınlatılmış onam bilgilerinin doğru ve istendik olduğunu, puanın yüksek olması ise bilgilerinin olumsuz ve istendik olmadığını göstermektedir. Veriler Student t Testi, Kruskall Wallis Testi ve Korelasyon Analizi ile değerlendirildi. Bulgular. Araştırmaya katılan bireylerin yaş ortalaması 32,4 ± 6,0 olup, %63,6’sı kadındı. Çalışanların ortalama hizmet süresinin 10,0 ± 6,5 yıl olduğu belirlendi. Sağlık profesyonellerin %47,6’sının onamın doğru uygulandığına kısmen katıldığı, %56,6’sının onamı ispat güvencesi olarak değerlendirdiği, %57,4’ünün olumsuz iş koşulları ve personel sayısının azlığı nedeniyle çalışılan kurumda onamın istendik düzeyde alınamadığı, %77,6’sının hastane yönetimi ve yasal zorunluluk nedeniyle alındığı, onam alma sorumluluğu %62,2 oranında tüm ekibe ait olduğu saptandı. Katılımcıların anket formunun her bir maddesinden aldığı en düşük puan ortalaması 1,60 ± 0,66; en yüksek puan ortalaması ise 3,00 ± 1,30 olup anketten aldıkları toplam puan ortalaması 92,99 ± 21,75’ti. Katılımcıların verdikleri aydınlatılmış onamdaki bilginin açık anlaşılır olması gerektiğine yönelik altıncı maddenin puan ortalaması en düşük düzeydeyken hastanın kliniğe ilk geldiğinde verdiği onamın tüm işlemler için geçerli olamayacağına ilişkin 12. önermenin puan ortalaması en yüksek düzeydeydi. Hekim, hemşire ve ebenin aldığı toplam puan ortalamaları arasında anlamlı fark bulunamadı (p>0,05). Sonuç. Sağlık çalışanlarının aydınlatılmış onamla ilgili görüşleri olumlu yönde olmasına karşın uygulamaları istendik düzeyde değildir. Çoğunlukla onamın etik boyutundan çok yasal yönüyle ilgilenmektedirler. Bu bağlamda kurumsal ve eğitim süreci içerisinde aydınlatılmış onamın uygulanmasına ilişkin etkin stratejilerin geliştirilmesine gereksinim vardır.

Anahtar sözcükler: Aydınlatılmış onam, sağlık çalışanı, cerrahi klinik

 

Abstract

Aim. To evaluate the views and practices of physicians, nurses and midwives working in surgical clinics regarding the informed consent. Methods. The sample of this descriptive study comprises 143 health professionals working in surgical units of three hospitals in the province of Sivas. Data were collected using the questionnaire prepared by the researchers. The possible total score to be obtained from the questionnaire ranges from 45 to 225. Low scores indicate that their knowledge about the informed consent is correct and sufficient and high scores indicate that their knowledge is negative and insufficient. The data were evaluated with the Student's t test, Kruscall Wallis and Correlation Analysis. Results. The mean age of the participants was 32.4 ± 6.0. Of them, 63.6% were female. Their total length of service was determined as 10.0 ± 6.5. 47.6% partly agreed that informed consent was applied correctly, 56.6% considered informed consent as the evidence of proving, 57.4% stated that informed consent could not be obtained satisfactorily due to negative work conditions and the small number of the staff, 77.6% stated that informed consent was obtained upon the hospital management’s demand and due to legal obligation and 62.2% stated that it was the responsibility of the whole team to obtain informed consent. The lowest and the highest mean scores the participants obtained from the each item of the questionnaire were 1.60 ± 0.66 and 3.00 ± 1.30 respectively. Their total mean score was 92.99 ± 21.75. While the mean score given by health professionals to the sixth proposition stating that “information in the informed consent must be clear and understandable” was the lowest, the highest mean score was given to the twelfth proposition stating that “the informed consent given by the patient when he/she is admitted to the clinic is not valid for all the procedures”. No significant differences were determined between the total mean scores of the physicians, nurses and midwives (p> 0.05). Conclusion. Although the health professionals’ views regarding informed consent was positive, they did not applied it as required. They were concerned about the legal aspects of informed consent rather than ethical dimension. In this context, it is necessary to develop effective institutional strategies during the education process regarding the implementation of informed consent.

Keywords: Informed consent, health workers, surgical clinics

Anahtar sözcükler: Aydınlatılmış onam, sağlık çalışanı, cerrahi klinik