近视眼准分子激光原位角膜磨镶术知情告知的探索

On Myopic Patients' Right to be Informed of LASIK Problems

调查了解准分子激光原位角膜磨镶术患者的知情状况,探索医方告知和告知方法对患者术后康复满意度的影响。对接受近视眼准分子激光原位角膜磨镶(LASIK)手术的566例(1115眼)近视眼患者进行自设知情问卷调查,根据问卷中存在的问题开展知情告知。本组患者完全知情者12例,完全不知情者8例,其余均为部分知情。在问卷过程感觉到接受LASIK的患者对该手术存在强烈的了解欲望,希望通过医患沟通消除疑虑,这主要表现为三方面:第一,对LASIK矫正近视的原理存在较为严重的认识误区;第二,大多数患者对术前准备虽较为重视,但知情较少;第三,对术后可能发生的问题知之甚少。调查结果显示医方恰当告知能让患者基本了解手术原理,消除存在的误区和疑虑。知情同意原则是临床上处理医患关系的基本伦理准则,患者有知情权,医方有告知义务,做好诊疗过程各环节恰当的知情告知,是提高医患双方满意度和构建良好医患关系的重要手段。

Objective To determine the informed status of the patients undergoing laser in situ keratomileusis （LASIK） and explore how doctors＇ informing them affects their recovery after operation. Methods 572 myopic patients （1121 eyes） receiving LASIK were asked m report their results based on questionnaires. Results Among them, 12 patients were completely insiders, 8 fully outsiders, and the rest between them. In answering the questionnaires, they showed strong wishes to know about LASIK, hoping to wipe out their worries by commu- nicating with doctors, which was mainly presented as follows： 1） they seriously misunderstood the principle to correct myopia with LASIK; 2） they attached much importance to preparation for LASIK but knew little; 3） they even knew less about what would occur after operation. The results indicated that misunderstandings and worries could have been eliminated if the doctors had properly informed them of its principle and procedures. Conclusion Principle of informed consent is the fundamental code of ethics to deal with clinical doctor-patient relationship. It is the doctors＇ duty to guarantee patients＂ right to know what they should know. To do it well in the process of treatment is an important factor to improve patients＇ satisfaction with doctors and nurses, and build up good relationship between them.