Current Status of Informed Consent Form for Acupotomy in Korean Medicine Hospitals and Development of a Standard Informed Consent Form Using Delphi Method

Jihun Kim, Bonhyuk Goo, Hyongjun Kim, Kyoungsuk Seo, Myungjin Oh, Myungseok Ryu, Sang-hoon Yoon, Kwang Ho Lee, Hyun-Jong Lee, Jungtae Leem, Hyungsun Jun, I. Jeong, Sung Woon Choi, T. Lee, Y. Kim, Yoona Oh, K. Kim, G. Yang, Eunseok Kim
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Abstract

Objectives: This study was conducted to develop a standard acupotomy consent form that takes into account the unique characteristics of Korean Medicine. The study was motivated by the increasing importance of patient autonomy and the growing number of legal disputes related to medical malpractice in the clinical field of Korean Medicine.Methods: The analysis phase of the study involved a survey of the current status of acupotomy consent forms in Korean Medicine hospitals nationwide. The items of each form were analyzed based on the contents of the Medical law and the standard contract for medical procedures of the Fair Trade Commission (FTC). In the development and evaluation phase, the items and contents of the acupotomy consent form were evaluated using a 5-point Likert scale and content validity was assessed through two rounds of Delphi surveys. In the improvement phase, the contents of the consent form were revised based on the results of a survey of inpatient and outpatient patients in the Department of Acupuncture and Moxibustion at Pusan National University Korean Medicine Hospital, and real-time online meeting. The final version of the standard acupotomy consent form was completed after undergoing proofreading and corrections by a linguistics expert.Results: Only 30% of Korean Medicine hospitals have implemented acupotomy consent forms. The items of the consent forms did not fully include the items presented in the Medical act and the standard contract for medical procedures of the FTC. To address this issue, two rounds of Delphi surveys and a real-time discussion were conducted with a panel of 12 experts on 27 preliminary items of consent forms. The items and contents that met the criteria for content validity ratio, convergence, and consensus were derived. Based on the derived items and content, a standard acupotomy consent form was developed.Conclusions: The standard consent form for acupotomy is anticipated to ensure patient autonomy and enhance transparency and liability in acupotomy. Furthermore, it is expected to serve as evidence in case of medical disputes related to acupotomy and contribute as a reference document for the development of standard consents forms for various procedures of Korean Medicine. However, the limitations of the study include that the survey of consent forms was limited to only training hospitals of Korean Medicine, and the standard consent form is only applicable to adults in Korea. Future studies are needed to address these limitations.
韩医医院针灸术知情同意书的现状及使用德尔菲法制定标准知情同意书
研究目的本研究旨在制定一份标准的穴位切开术同意书,其中应考虑到韩国医学的独特性。这项研究的动机是,在韩医学临床领域,患者自主权越来越重要,与医疗事故相关的法律纠纷也越来越多:研究的分析阶段包括对全国韩医医院穴位切开术同意书的现状进行调查。根据公平交易委员会(FTC)的医疗法和医疗程序标准合同的内容,对每份表格的项目进行分析。在开发和评估阶段,使用 5 分李克特量表对穴位切开术同意书的项目和内容进行了评估,并通过两轮德尔菲调查对内容有效性进行了评估。在改进阶段,根据对釜山大学韩医医院针灸科住院和门诊病人的调查结果以及实时在线会议,对同意书的内容进行了修订。经过语言学专家的校对和修改,最终完成了标准针灸同意书:结果:只有 30% 的韩医医院实施了穴位切开术同意书。同意书的项目没有完全包括《医疗法》和联邦贸易委员会《医疗程序标准合同》中提出的项目。为解决这一问题,由 12 位专家组成的小组对同意书的 27 个初步项目进行了两轮德尔菲调查和实时讨论。得出了符合内容效度比、趋同性和共识性标准的项目和内容。根据得出的项目和内容,制定了标准的穴位切开术同意书:穴位切开术标准同意书有望确保患者的自主权,并提高穴位切开术的透明度和责任。此外,它还有望在发生与穴位切开术有关的医疗纠纷时作为证据,并为韩国医学界制定各种手术的标准同意书提供参考文件。不过,这项研究也存在局限性,包括同意书调查仅限于韩医学培训医院,而且标准同意书仅适用于韩国成年人。今后的研究需要解决这些局限性。
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