Consentimento Informado - Visão e Perspetivas de Adolescentes, Pais e Profissionais: Estudo Multicêntrico em Seis Hospitais

Abstract

Introduction: According to the Convention on the Rights of Children and the national standards of the Portuguese Directorate-General for Health, adolescents have the right to make decisions about their own health. The aim of this study was to identify the dynamics of the implementation of assent and informed consent in hospital settings.Material and Methods: Cross-sectional and multicentre study based on surveys, which included adolescents from 14 to 18 years and their parents. Heads of departments of Pediatrics and attending physicians were also interviewed.Results: 194 responses from adolescents and parents were collected, and 46 interviews were conducted with physicians and heads of department. Adolescents and parents consider participation in decision making important, but parents value their own participation significantly higher (91.7% vs 47.8%, p < 0.001 in the 14 - 15 year group, 91.8% vs 53, (89.6% vs 69.6%, p = 0.016 in the 14 - 15 year group, 91.8% vs 69.4%, p = 0.005 in the 16 - 17 years group). Information leaflets are difficult to understand by teenagers. The eight heads of department felt that doctors have awareness towards communication with teenagers but have little time available. Of the 38 attending physicians, 36 said they had learned from their older colleagues and confirmed gaps in postgraduate training.Discussion: This pioneering study in Portugal enabled the identification of areas that can be optimized, through health education programs for parents and adolescents, written information that is adequate to the different age groups, training in undergraduate education for medical students and also education in health institutions for professionals.Conclusion: Adolescents and parents, are unaware of legal and ethical standards for consent and assent. The implementation of the adolescents’ right to informed assent / informed consent was not observed. Our proposal is to implement local programs for adolescents and parents.

Health literacy and medication health literacy in adolescents: Highlights from HBSC/WHO

“…In Portugal, under the age of 16, despite the need for consent from adolescents for medication use and related decisions (Direção Geral Saúde, 2013), it can be seen that this is not a common practice (Machado et al, 2019), and this is a factor that could explain the low level of HL. Medication-related brochures/flyers are often written in a language that young people do not easily understand (e.g.…”

“…Medication-related brochures/flyers are often written in a language that young people do not easily understand (e.g. due to clinical terminology) (Machado et al, 2019). Adequate information is needed from the Portuguese National Medicines Agency (INFARMED) with the elaboration of brochures/flyers prepared for young people with the appropriate approach for their age, mainly for those with chronic diseases (Machado et al, 2019).…”

“…due to clinical terminology) (Machado et al, 2019). Adequate information is needed from the Portuguese National Medicines Agency (INFARMED) with the elaboration of brochures/flyers prepared for young people with the appropriate approach for their age, mainly for those with chronic diseases (Machado et al, 2019). Because, for adolescents and young adults with a chronic illness, there were mixed findings between HL and medication adherence (Sansom-Daly et al, 2016).…”

A prática médica e o uso do termo de consentimento informado: uma revisão de escopo

“…Esta pesquisa foi realizada em um hospital pediátrico terciário com o objetivo de caracterizar o conteúdo das discussões de consentimento informado préanestesia e avaliar seu impacto na memória e compreensão dos pais. Em total, fez-se a análise descritiva de 97 discussões com anestesiologistas pediátricos e pais de crianças submetidas a cirurgias eletivas Machado et al (2019),. em estudo transversal e multicêntrico efetuado em seis hospitais de Portugal com adolescentes de 14 a 17 anos, pais e profissionais, no que diz respeito ao TCI em adolescentes, expõe que o Artigo 38º do Código Penal português e a privacidade entre os prestadores de cuidados de saúde, além de avaliar as percepções dos pacientes sobre práticas éticas.…”

“…publicaram um boletim na revista BMC Medical Ethics a respeito da aplicação de método de pesquisa para definir informações fundamentais sobre o consentimento informado. Os autores afirmam que o conhecimento previamente acordado sobre determinado procedimento, reduziria a variação na obtenção do TCI e seriam um ponto de partida no desenvolvimento de intervenções visando sua melhoria Machado et al (2019). realizaram um estudo multicêntrico com o objetivo de identificar as dinâmicas de implementação do assentimento e do consentimento informado, em ambiente hospitalar.…”