Consent for Examinations Under Anesthesia With Learners at the Time of Abortion: Physician Perspectives

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Kaitlin Ellis MD , Kristin Pascoe MD , Courtney Amegashie BA , Adrianne Dade MD , Victoria deMartelly MPH , Julie Chor MD, MPH
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引用次数: 1

Abstract

Introduction

Although obtaining specific consent for examinations under anesthesia with learners is recommended by major professional organizations and mandated by many state laws and institutions, it is not practiced universally. We sought to investigate physicians’ experiences using a formalized process to obtain consent from patients presenting for surgical abortions under anesthesia for pelvic examinations with learners.

Methods

Semistructured qualitative interviews were conducted with residents, fellows, and faculty who work or have rotated in a single family planning clinic after the clinic introduced this consent process. Participants were asked about their experiences obtaining informed consent from patients for examinations under anesthesia with learners. Interviews were audiorecorded, transcribed, and analyzed using modified grounded theory. All study procedures were institutional review board approved.

Results

Twenty interviews were performed, achieving thematic saturation, with 14 residents, 4 fellows, and 2 faculty members. Participants described initial discomfort with the consent process and their wording choices, which improved with increased familiarity and almost universal patient acceptance. Some participants felt that an informal training or practice before obtaining informed consent may have been helpful. Participants stressed the importance of this consent process to foster patient autonomy and choice. Participants reported that the fact that patients were presenting for abortion care did not influence their overall process or comfort level obtaining consent for pelvic examinations under anesthesia with learners; however, some noted that they gave patients more time to process the consent or used more intentional language during these encounters.

Conclusions

Physicians desire and accept the integration of a formal consent process for examinations under anesthesia with learners at the time of abortion.

同意在麻醉下与学习者在堕胎时进行检查:医生的观点
引言尽管主要专业组织建议并由许多州法律和机构强制要求学生在麻醉下进行考试时获得特定同意,但这并不是普遍的做法。我们试图调查医生使用正式程序获得患者同意的经验,这些患者在麻醉下进行手术流产,并与学习者一起进行骨盆检查。方法采用半结构化的定性访谈方法,对在一家计划生育诊所工作或轮换的住院医师、研究员和教员进行访谈。参与者被问及他们与学习者在麻醉下进行检查时获得患者知情同意的经历。访谈被录音,转录,并使用修正的基础理论进行分析。所有研究程序均由机构审查委员会批准。结果共进行了20次访谈,达到了主题饱和,共有14名住院医师、4名研究员和2名教员。参与者描述了最初对同意过程和措辞选择的不适,随着熟悉程度的提高和患者几乎普遍接受,这种不适有所改善。一些与会者认为,在获得知情同意之前进行非正式培训或实践可能会有所帮助。与会者强调了这一同意程序对培养患者自主性和选择的重要性。参与者报告说,患者接受堕胎护理的事实并没有影响他们在麻醉下与学习者一起获得骨盆检查同意的整体过程或舒适度;然而,一些人指出,他们给了患者更多的时间来处理同意书,或者在这些遭遇中使用了更多有意的语言。结论物理学家希望并接受在堕胎时与学习者一起在麻醉下进行检查的正式同意程序。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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