精神分裂症患者及其家属对住院知情同意权的态度及影响因素

The Effect of Schizophrenia Patients and Their Families on Their Right of Knowing and Agreeing on the Facts of Hospitalization

目的探讨精神分裂症患者及其家属对患者住院知情同意权的态度及其影响因素。方法对符合CCMD-3的精神分裂症患者及其法定监护人各986例,进行患者知情同意和入院方式的相关调查。结果家属让患者对住院知情387例(39.2%),不让知情599例(60.8%);患者同意入院249例(25.3%),不同意入院737例(74.7%)。影响患者享有住院知情权的因素是:监护人态度和患者的性别、MOAS总分、自身攻击因子分、体力攻击因子分、有攻击行为、PANSS总分、P分、SI分、G分;影响患者自愿入院的因素是:监护人态度和患者MOAS总分、体力攻击因子分、SI分、P分、G分和攻击行为。结论目前精神分裂症患者对住院的知情同意率和自愿入院率仍很低;监护人和患者的特征都影响患者家属对患者知情同意权的态度;精神分裂症患者住院与否主要取决于监护人的态度;保证监护人的知情同意权是解决患者住院和减少医疗纠纷的关键。

Objective To probe into the effect of schizophrenia patients and their families on their right of knowing and agreeing on the facts of hospitalization. Methods 986 schizophrenia patients in line with CCMD-3 as well as the same number of their families were investigated as regards their right of knowing and agreeing on the facts of hospitalization and the way they were admitted into the hospital. Results 387 families allowed the patients the right to know and agree on the facts of hospitalization, taking up 39.2%, but 599 did not allow, taking up 60.8. 249 agreed on admission into the hospital, taking up 25.3% and 737 did not, taking up 74.7%. The factors affecting their right of knowing the facts included, attitudes of their families, sex of patient, MOAS total score, self attack, physical attack, offensive action, PANSS total score, P score, SI score, G score. The factors affecting volunteering hospitalization of the patients include the attitude of their families, MOAS total score, physical attack, SI score, P score, G score and offensive actions. Conclusion At present, the rate of knowing the facts and volunteering into hospitalization is very low among the schizophrenia. Their families and the patients both affect the attitude of their families on patients＇ right to know the factors for hospitalization. Whether they are permitted into hospital or not is determined by their families. The key to reduction of medical disputes exists in ensuring the patients＇ members with knowing the facts.