输血患者掌握输血知情同意告知相关知识的现状及其影响因素调查

Consent for blood transfusion:How is it understood by transfusion candidates

目的了解输血患者对输血知情同意告知相关知识的掌握现状及影响因素,为提高输血告知效果措施的制定和实施提供科学依据。方法采用现况调查法,对在某三甲医院2019年4月~2019年6月接受过1次输注红细胞的198名患者作问卷调查,调查项目18项,主要有输血患者基本信息、医生告知输血相关知识情景的回忆情况,告知内容的掌握情况。采用SPSS23.0统计学软件对数据统计学处理。结果问卷回收率100%(198/198),回收问卷有效率100%(198/198);纳入分析198名输血患者对医护告知的输血知情同意书相关知识掌握情况的分为2~9(5.293±1.549)分,其中内科与外科输血患者的得分为6.07±1.77vs 6.07±1.77(P<0.05)。单因素比较分析:患者治病的临床科室、年龄、学历以及输血前是否有人讲解、讲解时间、讲解者身份是影响输血患者对《输血知情同意书》内容掌握情况的变量(P<0.05);线性回归分析:患者治病的临床科室、输血前是否讲解以及讲解时间是对输血知识掌握情况的独立影响因素(P<0.05);患者掌握较差的输血知识排列前3项的条目分别为输血方式中的自体输血、输血替代治疗方案以及输血后1年不能献血。结论临床输血患者对输血知识知情同意内容的掌握仍有很大的提升空间,不同临床用血科室的输血患者对《输血知情同意书》内容的掌握情况存在差异;提升医生的输血专业知识储备和沟通技巧,为患者提供针对性的、多形式的告知方法是关键。

Objective To assess the sufficient information got by the informed transfusion recipients from the consents for blood transfusion and to explore the influencing factors, so as to provide scientific evidences for patients to comprehend the consent better.Methods A cohort study using questionnaire was conducted among 198 patients who received red blood cell transfusion from April 2019 to June 2019 in a tertiary hospital. 18 options were investigated, including basic information of patients, recall of the informed consent process performed by physicians and how well they comprehend the information. SPSS 23.0 statistical software was used for data statistical processing. Results All 198 questionnaires were returned and valid(100%, 198/198). The score of 198 informed transfusion recipients was 2~9(5.293±1.549), and the score of Internal Medicine and Surgical transfusion patients was 6.07±1.77 vs 6.07±1.77(P<0.05). Univariate comparative analysis showed that the clinical department, age, education background, instructions, including its time and identity of instructors, before transfusion were the variables that affected the comprehension of informed patients(P<0.05). Linear regression analysis indicated that the clinical department, pre-transfusion instruction and its time were independent influencing factors on the comprehension(P<0.05). The top 3 poorly-understood items included auto-transfusion, alternative transfusion therapy and 1-year donation deferral after blood transfusion.Conclusion More efforts are needed to help transfusion candidates to comprehend consent for blood transfusion better since their knowledge varied with clinical departments. Physicians′ transfusion knowledge and communication skills also need to be enhanced to provide targeted and multi-form informing methods.