Gaan we nog nabespreken?

Kleffens, Cora van; Bierbooms, C.E.M.; Toet, J.; Smit, Ronel

doi:10.1007/s12452-013-0060-1

Cited by 1 publication

(2 citation statements)

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“…10 Studies have shown that patients' and physicians' criteria in making decisions on treatment refusal are different, 11 with patients mostly considering personal reasons rather than medical ones, 12 while physicians evaluating patients' refusal are mainly based on medical criteria. 13 Experts believe that refusal of treatment should be assessed by taking into account the patients' values, beliefs, feelings, motivations, reasons and attitudes, 14 and after obtaining this information, a shared decision should be made. One of the fundamental principles of shared decision making is communication with patients and obtaining informed refusal/consent for medical procedures.…”

Section: Introductionmentioning

confidence: 99%

“…24 Therefore, there are few generalizable studies about current practices of obtaining informed refusal. Problems such as; not considering patients' capacity to refuse treatment, 25 nurses' decisions without consulting physicians about patients' treatment refusal, 26 not paying attention to the patients' right to refuse treatment and imposing pressure on patients to accept it, 27 alarming patients by stating the probability of death in order to encourage acceptance of the treatment, 28 and not providing patients with an opportunity to state their viewpoints, feelings and reasons for refusing the suggested treatments, 29 have been reported in previous studies on treatment refusal. In Iran, one study has reported improper procurement of surgical consents, 30 but no studies have reported the practice of informed refusal.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Perceived Quality of Informed Refusal Process: A Cross‐Sectional Study from Iranian Patients' Perspectives

Farzandipour¹,

Sheikhtaheri²,

Jabali³

2014

Developing World Bioethics

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Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure (9.6 ± 6.4 out of 22 points) was perceived to be moderate, however, comprehension (2.3 ± 1.4 out of 4 points), voluntariness (8.7 ± 1.5 out of 12 points) and provider-patient relationship (10.2 ± 5.2 out of 16 points) were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed.

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