| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 7.66 MB | Adobe PDF |
Advisor(s)
Abstract(s)
O Consentimento informado fundamenta-se na informação adequada fornecida pelo médico ao doente e consentimento esclarecido por parte deste. Exprime respeito pelo princípio da autonomia do sujeito, atitudes, procedimentos, avaliação das expectativas, riscos, alternativas e benefícios associados. Ao médico apela-se ao acolhimento, responsabilidade e informação ao doente, esclarecendo-o, podendo este recusar a informação.
Transcrito da Convenção de Oviedo, para a jurisdição portuguesa - Dezembro 2001, estabelece como itens: Competência, Informação, Compreensão, Voluntariedade e Consentimento.
O formulário, para cirurgia oftalmológicas é prática comum. O ato de assinar e ler, não elimina o ónus de informar adequadamente.
Avaliaram-se duas amostras de documentos de consentimento informado, (49 portugueses/ 23 espanhóis), num estudo de observação analítico transversal, características: de base, gerais e legais. Após análise descritiva, aplicaram-se testes de hipóteses de qui-quadrado ou, testes de Fisher.
Analisaram-se 13 características globais: Informação sobre a doença; Clareza da informação; Detalhes técnicos; Riscos; Cuidados pré e pós operatórios; Compreensão da informação; Direito a ser e não ser informado; registo vídeo -foto - assistência formativa; Revogar sem consequências; Substituto legal; Benefícios; Alternativas.
Em 2012, redigimos um formulário informativo, para cirurgia de catarata posteriormente aprovado pelo Colégio e DGS.
Realizamos dois inquéritos a 111 doentes destinados a cirurgia de catarata, antes e após leitura do Formulário redigido (testes de hipóteses não-paramétricos (Wilcoxon, Mann-Withney e Kruskal-Wallis).
Conclusão 1. 91% Informam sobre o que é a doença, não mencionada em apenas 8% dos consentimentos nacionais; 2. O consentimento informado português é de natureza aberta (53%) servindo para todas as situações, sem especificações próprias;
3. Em 31% é em branco, parecendo ser essencialmente legalista;
4. Apenas 16% é descritivo, sobre benefícios, riscos, alternativas e consequências;
5. Em (59%) não existe informação clara, direito a ser ou não informado (90%), autorização para assistência formativa (88%), registo vídeo/foto (80%), revogação de consentimento sem consequências (80%), cuidados pré e pós operatórios (71%) ou benefícios (61%);
6. Inclui referência a substituto legal (67%), mencionando de forma geral descrição de riscos (57%);
7. Pelo contrário o formulário espanhol contém sempre informação: detalhada em (87%) e de natureza aberta (13%);
8. Após leitura do formulário nacional, a informação, amplia-se em 79%;
9. A cirurgia é considerada fácil, pelos doentes, mas gostam de estar informados e participar nas decisões relativas ao tratamento;
10. Os doentes têm confiança elevada nos médicos, sendo o documento visto como seu reforço;
11. O formulário promove o equilíbrio, entre doentes de idade e grau académico diferentes.
Informed consent is based on adequate information given by the doctor to the patient and well informed consent given by the patient. It expresses respect for the principle of autonomy, attitudes, procedures, estimated expectations, risks, alternatives and associated benefits. It is the doctor’s request to welcome the patient, to be responsible and inform the patient. The patient can refuse the information. Transcribed from Oviedo Convention to the Portuguese jurisdiction – December 2001 – establishes the items: competence, information, comprehension, determination by choice and consent. The formulary of ophthalmological surgery is a common practice. The act of reading and signing doesn’t eliminate the obligation of informing. Two samples of informed consent were evaluated (49 Portuguese - 23 Spanish) in an analytic-transversal observation study. After a descriptive analysis, Fisher tests were used. Thirteen global characteristics were analyzed: Information about the disease, clearness of the information, technical details, risks, medical care before and after surgery, understanding the information, the right to be or not to be informed. Video-photo register. Be able to annul the consent without consequences. Legal substitute, benefits, alternatives. In 2012 an informative formulary was written, for surgery of the cataract, it was approved by the Medical Council, and the National Health Board. Two surveys were realized to 111 patients that were going to have cataract surgery, before and after the reading of the written formulary (non-parametrical hypothesis tests (Wilcoxon, Mann-Withney, Kruskal-Wallis) Conclusion: 1. 91% of the national consents inform about the disease, 8% doesn’t mention the disease; 2. The common type of consents has an open nature(53%), without specifications; 3. 31% of the consents is without information- essentially a legalist type; 4. Only 16% are descriptive concerning benefits, risks, alternatives and consequences; 5. 59% doesn’t have clear information, right to be or not to be informed (90%), authorization for informative assistance (88%) Video-photo register (80%); 6. (67%) refer legal substitute; risks are mentioned in a general way (57%); 7. On contrary the Spanish formulary has always information of a descriptive type in (87%), and of opened nature in (13%); 8. After the reading of the written formulary the information increases (79%); 9. This surgery is considered easy, but patients like to be informed and participate in the decisions related to the treatment; 10. Patients strongly trust doctors. This document is as a reinforcement of this trust; 11. This formulary promotes the balance between patients of different age groups, and academic levels.
Informed consent is based on adequate information given by the doctor to the patient and well informed consent given by the patient. It expresses respect for the principle of autonomy, attitudes, procedures, estimated expectations, risks, alternatives and associated benefits. It is the doctor’s request to welcome the patient, to be responsible and inform the patient. The patient can refuse the information. Transcribed from Oviedo Convention to the Portuguese jurisdiction – December 2001 – establishes the items: competence, information, comprehension, determination by choice and consent. The formulary of ophthalmological surgery is a common practice. The act of reading and signing doesn’t eliminate the obligation of informing. Two samples of informed consent were evaluated (49 Portuguese - 23 Spanish) in an analytic-transversal observation study. After a descriptive analysis, Fisher tests were used. Thirteen global characteristics were analyzed: Information about the disease, clearness of the information, technical details, risks, medical care before and after surgery, understanding the information, the right to be or not to be informed. Video-photo register. Be able to annul the consent without consequences. Legal substitute, benefits, alternatives. In 2012 an informative formulary was written, for surgery of the cataract, it was approved by the Medical Council, and the National Health Board. Two surveys were realized to 111 patients that were going to have cataract surgery, before and after the reading of the written formulary (non-parametrical hypothesis tests (Wilcoxon, Mann-Withney, Kruskal-Wallis) Conclusion: 1. 91% of the national consents inform about the disease, 8% doesn’t mention the disease; 2. The common type of consents has an open nature(53%), without specifications; 3. 31% of the consents is without information- essentially a legalist type; 4. Only 16% are descriptive concerning benefits, risks, alternatives and consequences; 5. 59% doesn’t have clear information, right to be or not to be informed (90%), authorization for informative assistance (88%) Video-photo register (80%); 6. (67%) refer legal substitute; risks are mentioned in a general way (57%); 7. On contrary the Spanish formulary has always information of a descriptive type in (87%), and of opened nature in (13%); 8. After the reading of the written formulary the information increases (79%); 9. This surgery is considered easy, but patients like to be informed and participate in the decisions related to the treatment; 10. Patients strongly trust doctors. This document is as a reinforcement of this trust; 11. This formulary promotes the balance between patients of different age groups, and academic levels.