میزان آگاهانه بودن امتناع از درمان در بیمارستان‌های آموزشی شهر کاشان

Abstract

Introduction: Based on individual independence rights, patients can refrain from being treated or can voluntarily discontinue their treatment after receiving full information. This study aimed to review the reasons of treatment refusal and the status of informed refusals for patients. Methods: This was a cross-sectional descriptive study. The study population included 135 patients who refused to be treated in university hospitals of Kashan (except for the Psychiatric ward) during summer 2010. Data were collected through a 35-item questionnaire by means of interviewing. The data were analyzed using SPSS software. Results: The most important common reasons for treatment refusals were patients’ inappropriate feelings for hospitalization continuation (83%), low quality of hospital services (49%) and receiving advices from their friends and families (35.5%). Providing information before signing the consent form (64.2%), understandability of the consent form (69.2%) and interaction between the patient and the physician (72%) were items with adequate or somewhat adequate status mentioned by the patients. Conclusion: Improving status of hospitalization, mental condition, and patient tendency to be hospitalized and also promoting health quality can result in decreasing personal satisfaction for discharges against medical advices. To improve the status of informed refusals, more information about alternatives, their benefits and complications, and content of consent forms should be provided to patients. Physicians should understand patients’ reasons to refuse treatment and try to eliminate obstacles and persuade them to continue their treatments. Keywords: Patient Discharge; Consent Form; Informed Consent; Patient Rights