Maryam Abbasi Nejad, Ali Jafariyan, Fariba Asghari, Alireza Parsapoor, Mohammadreza Zafarghandi,
Volume 4, Issue 5 (10-2011)
Abstract
One of the manifestations of patient autonomy in practice is gaining informed consent prior to any invasive procedure. In Iran, the process of obtaining informed consent to surgical procedures is currently limited to the patient signing a consent form that often does not offer specific information on the procedure, and patients are not given adequate time to read the form. In order to improve the present circumstances, authors of this study created information sheets specific to each class of surgical procedure, and performed an evaluation of the effectiveness of these sheets in increasing patient awareness and satisfaction. Handouts containing specialized information on various surgical procedures were distributed among 110 patients hospitalized to undergo elective surgeries in surgical wards 1, 3, 4 and 5 of Imam Khomeini Hospital Complex and surgical ward 3 of Sina Hospital the patients received the handouts prior to procedures, and were free to use the information as they wished. These patients were then interviewed through an oral questionnaire after the procedure and at the closest time possible to their discharge. At a different time, 110 other patients in similar conditions and locality were interviewed after surgical operations and as close to being discharged as possible, but without receiving information sheets. The above-mentioned questionnaire contained essay type questions regarding patients’ information about their medical conditions and the required surgical procedures, and patients were also asked about their level of satisfaction with the information they had received.
The mean score for patients’ overall knowledge in the intervention group was 48.8%, and the same score was 44.6% in the control group. Distribution of specific information on the surgical procedures among the patients in the intervention group did not have a significant effect on their overall knowledge (p = 0.140), and only raised their awareness of the side effects associated with the procedures (p 0.001). Similarly, patient satisfaction levels were 60.2% in the intervention group and 56.4% in the control group, and distribution of information sheets did not affect the overall satisfaction level of patients significantly (p = 0.166), and it only increased their satisfaction with the information they had received regarding their convalescence period after surgery (p = 0.033). Since distribution of specialized information sheets like the ones used in this study generally appears to be inadequate in increasing patient awareness and satisfaction, it is recommended that in the process of obtaining informed consent, physicians dedicate enough time to educate patients on their conditions and their different aspects rather than simply present them with a consent form.
Seyed Saied Seyed Mortaz, Parvin Delavar, Nafiseh Zafarghandi, Mohammad Reza Yektaei, Qolamreza Moarefi, Ali Davati, Shiva Rafati, Siamak Afshin Majd, Ahia Garshasbi,
Volume 11, Issue 0 (3-2018)
Abstract
A 62-year-old man referred to the emergency department 48 hours ago with chief complaint of repeated bloody vomiting. The patient is admitted and the necessary measures are taken. Within 24 hours, he received 6 units of blood. The patient has undergone endoscopy, but endoscopic endorsement has failed to stop the bleeding. The surgeon consulted and visited the patient. He considered urgent emergency laparotomy. The patient is alert and refuses surgery. The hemodynamic status of the patient is not stable and gastrointestinal bleeding continues. These questions are posed to medical staff and hospital managers: "What is our duty”? "Should we respect the choice of the patient and witness the progress of the disease and deterioration of the patient's condition"? "Can he be discharged from the hospital on the basis of the patient's refusal to take medical treatment"? "Can we take appropriate diagnostic and therapeutic measures with the use of legal capacity and support despite patient’s opposition? "How can one regard autonomy, beneficence, and nonmaleficence at the same time, in this situation "? In this study, which is one of the problems of medical ethics, the ethical, legal, and health aspects of the presented patient are discussed.
Marjan Ghandi, Reza Dehnavieh, Reza Goudarzi, Mostafa Almasi Doughaee , Malahat Akbarfahimi,
Volume 13, Issue 0 (3-2020)
Abstract
Dementia is a major health problem due to the high costs of treatment, high prevalence in the elderly, severe consequences, and the imposition of physical and psychological stresses on families of the patients. Occupational therapy is one of the most important approaches among many technologies employed for helping the patient and reducing the burden of healthcare for patients. This applied study aimed to investigate the ethical and legal aspects of occupational therapy technology in the elderly with dementia using qualitative methods. The study population consisted of 12 specialists and practitioners in the field of dementia and elderly services in the country. Data collection was carried out by interviewing the expert subjects. The results of this study showed that beneficence/non- maleficence, autonomy/informed consent, maintaining dignity/respect for persons, concern for equality and justice in accessing services, legal support for technology use, need for the principle of discretion, and patient confidentiality, and proper technology utilization are seven major ethical and legal challenges in occupational therapy technology in the country. According to the results, lack of insurance coverage for occupational therapy technology and the lack of access to this service for the elderly are major barriers to its application and the Ministry of Health must provide the initiatives for its implementation across the country and place it in the elderly service package.
