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Consent in hospital - theory and practice
SÝKOROVÁ, Marta
The diploma thesis is divided into a theoretical and a practical part. The first part describes the current state of the issue of informed consent in a general context and related topics. To obtain the data, I used the qualitative research, the method of questioning, and the data collection technique of a semi-structures interview. The research sample group consisted of 11 patients and two doctors. The objective of the thesis was to identify and describe the differences between the theory and the practice of informed consent in the hospital, and to find out whether there has been any shift in the mistakes and errors associated with informed consent as stated by Haškovcová (2007). The research results have shown that the interviewed patients are not familiar with the concept of informed consent. The knowledge of the informed consent concept was more accurate by doctors as presumed. On the issue of viewed benefits of informed consent, it is clear from respondents? answers that informed consent is viewed primarily as doctors? legal protection against any complaints or lawsuits made by the patients in the performance of their profession by making the patient familiar with any complications that may occur during the performance. This benefit is perceived by both patients and doctors. Doctors see its benefit also as the protection of patients. Another benefit viewed by doctors is the written informed consent form. Six of the interviewed patients stated that informed consent was submitted to them to sign by the nurse/male nurse without proper instructions. Furthermore, doctors? answers show that the timing of instructions depends on the nature of the surgery, whether it is planned or acute. However, some patients said that they were not even instructed with the sufficient time after giving informed consent even when related to a planned procedure. The most stated form was the combination of written and oral instructions, so the patient was first instructed orally and then he was also handed a detailed description of the particular procedure in the written form. There was no uniformity about the question of the amount of submitted information among the interviewed patients as well as doctors ? some of them prefer just basic information, some of them want to know all the information. One of the interviewed doctors favored just the adequate informed consent and saw the detailed informed consent as problematic, another doctor preferred introduction of all the details, although in the written form, mainly because of legal protection. In terms of quality of the provided information, it is clear from the statements of the patients that two most important facts for them are that the performance is in their benefit and the duration of hospitalization. All patients have agreed on the fact that it is very good that they are informed about the procedure which will be performed on them. However, they were not united regarding the issue of participation in the decision ? two patients stated that not even the properly informed patient should participate in the decision about their treatment. Only one doctor expressed his stance to the patient?s participation in the decision stating that he tries to persuade his patients that his proposed solution is the optimal. The standard for the patients is to ask questions when they are concerned about something or interested in it. However, the statements showed that they do not always get the answer they are satisfied with. When the patients stated that they do not ask their doctors about anything, their reasons were enough information, lack of staff and a feeling of unwillingness on the part of doctors. If the patients did not receive enough information from the medical staff, they looked for it in other sources of information. This thesis points to the broader psychosocial context of informed consent, so its results may help during the training of staff in the assisting professions.
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Media images related health professionals and patients
SÝKOROVÁ, Marta
Media image of a health worker ? a patient relationship The presented bachelor thesis describes the media image of a relationship between a health worker and a patient in the mirror of television series both from the view of present days and with looking back thirty years and their mutual comparison. A theoretical part concerns issues of medical ethics (basic concepts, a transformation of the relationship between a health worker and a patient, basic principles, Patients´ rights, Informed consent), then a communication in the health care and mass communication (especially the interaction relationship between mass media and reality). In the practical part there was used a method of a qualitative research, an observation of selected parts of the television series Hospital at the outskirts of the city (Nemocnice na kraji města) and Surgery in the Rose Garden 2 (Ordinace v růžové zahradě 2). Results of the observation were divided into six parts describing not only a general perspective of the relationship between the health worker and the patient (in terms of paternalism x partnership), but also partial facts which are important for this relationship (information for patients, a common health workers and patients´ communication, a communication of the health workers with close relatives of the patients, permitting of visits, a compliance with the mandatory medical confidentiality by the health workers and an image of a medicine doctor). According to the results the most noticeable shift in the relationship between the health worker and the patient can be observed in their everyday communication, the least noticeable in a compliance with the professional confidentiality. In practice, it would be possible to use the knowledge gained by the research for a publication in a professional literature and for a preparation of an educational material for workers in helping professions.
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