Análisis de la percepción del Consentimiento Informado de la cirugía y de la anestesia por pacientes de cirugía otorrinolaringológica

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2021
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08-06-2021
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INTRODUCTION: The doctor-patient relationship is a key element in healthcare and must be individualized and personalized. The patient’s right to information about his disease and the proposed treatment is an expression of his right of Autonomy. To obtain Informed Consent before any healthcare procedure is mandatory by law and guarantees its compliance. The information provided by the doctor must include the risks, benefits and alternatives of the proposed treatment and must be adapted to the needs and capacities of the patient to allow him to make an autonomous decision. Reviewing the legality and jurisprudence on this issue is crucial for the doctor to know the problems that may arise from the non-compliance of it; the omission or defective compliance of this issue brings liability; in fact, there are more court cases to doctors due to its absence than due to bad practice. Multiple factors such as the physician’s communication skills, the legibility of the provided documents, the patient’s anxiety and health literacy, or their sociodemographic and clinical background can influence true communication and understanding. When the patient feels involved and autonomous in decision-making, and his personal circumstances are heard, greater adherence to the proposed treatment is achieved. The health institutions aim is to offer citizens a high level of quality of care. The positive experiences of patients with health services and their satisfaction with them are important indicators of the quality of healthcare. Satisfaction depends largely on the expectations generated on the patients. The objective of this work is to delve into the Informed Consent process and study the degree of satisfaction with the information that we offer our patients before surgery and anaesthesia, as well as the factors that may influence it. MATERIAL AND METHODS: A theoretical and legal review of the Informed Consent process was carried out. The degree of satisfaction with the information received from subsidiary patients scheduled for anaesthesia and otorhinolaryngology surgery during the year 2020 was evaluated at the University General Hospital of Valencia. For this goal, a measurement instrument was designed, the satisfaction survey, based on the medical literature, marketing techniques and the experience of professionals in both specialties. The completion of the survey was self-administered, using the usual clinical circuits. The degree of legibility of the texts and the influence on the satisfaction of the different clinical and sociodemographic variables of the patients were also evaluated. María Otero Pérez 14 RESULTS: The treatment received by the medical specialist, the time devoted to the visit and the installation in which it takes places, are the factors most valued by patients before the ongoing surgical-anaesthetic procedure. The adequacy of the information to the reality, provided in the preoperative period, of what was subsequently experienced dealing with surgery and anaesthesia is what most influences the final general satisfaction of the patient. Previous surgical experience predisposes to greater satisfaction in subsequent surgical procedures. According to the INFLESZ index, the informative texts that we provide to our patients for anaesthesia and otorhinolaryngology surgery are somewhat difficult. CONCLUSIONS: There are national and regional regulations that rule the requirements, content and exceptions of Informed Consent. The less necessary an intervention is, the greater the amount of information that must be provided to the patient. Satisfaction with the information depends to a large extent on whether the “a priori” information needs are covered and this is variable as its depends on contextual and personal factors. There is a high degree of satisfaction with the information received before an anaesthesia and otorhinolaryngology surgery at the University General Hospital of Valencia. The existence of factors such as age, previous experience, waiting time for the visits with the doctors and the surgery or the severity of the surgery, have a significant influence in the satisfaction. This work is reference for psychometric in bioethics, in the field of patient Autonomy and Informed Consent regarding the information that patients receive before surgery and anaesthesia.
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