背景:具有文化能力的医疗保健可改善患者满意度和临床结果。许多药物,敷料和植入物含有人类或动物来源的内容,可能与患者的宗教信仰相冲突,甚至可能有法医学意义。
方法:这项横断面研究(基于网络的匿名调查)旨在了解印度儿科医生和新生儿科医生遵循的知情同意过程,他们关于向患者家庭披露外源性表面活性剂动物来源的观点,以及他们基于父母偏好提供替代表面活性剂的意愿和能力。
结果:共有114名参与新生儿护理并在其实践中使用表面活性剂的新生儿科医师/儿科医生对调查做出了回应。尽管61家(53.5%)新生儿护理单位在其库存中储备了两种或两种以上品牌的表面活性剂,只有38个单位(33.3%)同时含有牛和猪制剂.大多数(104,91.2%)的医生在使用表面活性剂之前总是征得父母的同意;但只有少数(12,10.5%)的医生说他们总是告知父母其动物来源。没有一个受访者向父母提供牛或猪来源的表面活性剂之间的选择,大多数(73,64%)认为这对父母来说是无关紧要的。然而,许多受访者(27,23.7%)提到他们希望为父母提供选择,但由于他们不同时储存牛和猪制剂而无法这样做。
结论:尽管大多数父母可能同意在紧急情况下服用救命药,这并不意味着他们不想被告知。医疗保健专业人员不应该对父母的信仰体系持不屑一顾的态度。他们必须利用产前时期进行文化/精神历史和必要的同意。
BACKGROUND: Culturally competent healthcare improves patient satisfaction and clinical outcomes. Many drugs, dressings and implants have human or animal-derived content which may conflict with patients\' religious beliefs, and may even have medicolegal implications.
METHODS: This cross-sectional study (anonymous web-based survey) was done to understand the informed consent process followed by paediatricians and neonatologists in India, their views regarding disclosure pertaining to the animal origin of exogenous surfactants to patients\' families, and their willingness and ability to provide alternative surfactants based on parental preferences.
RESULTS: A total of 114 neonatologists/paediatricians involved in neonatal care and using surfactants in their practice responded to the survey. Although 61(53.5%) neonatal care units stocked two or more brands of surfactant in their inventory, only 38(33.3%) units had both bovine and porcine preparations. Most (104, 91.2%) of the doctors always take parental consent before administering surfactants; but only a few (12,10.5%) said they always inform parents about its animal origin. None of the respondents offer parents a choice between bovine or porcine-origin surfactants, most (73, 64%) presuming that it would be irrelevant for the parents. However, many respondents (27, 23.7%) mentioned that they want to offer the choice to parents but are unable to do so because they do not stock both bovine and porcine preparations.
CONCLUSIONS: Although most parents might agree to a life-saving medicine in emergency situations, this does not mean they do not want to be informed. Healthcare professionals should not have a dismissive attitude to parental belief systems. They must use the antenatal period to take the cultural/spiritual history and the necessary consent.