Identifier: TDX:488
Authors: Guix Oliver, Joan
Abstract:
The fact that in the relation doctor-patient, the doctor has all the information, tolerates the existence of a information asymmetry. An agency relation settles down that, actually, implies a relation of being able of the doctor towards the patient. This has tolerated the appearance of a movement in please the Rights of the Patients that, in the Spanish State was gathered by the General Law of Health of 1986. Our objective is to know the attitudes and perceptions the professionals and the users of the hospitals of the Sector of Reus (Catalonia), during the first semester of 1999, respect to the rights and duties of the patient. We analyzed, by means of focal groups of doctors, nurses, and patients, their attitudes and perceptions on the rights of the patients. From the results, we elaborated three structured surveys Likert directed to doctors, nurses and patients, that are validated and applied, by route telephone to expacientes (n=403), and by selfresponse to doctors (n=55) and nurses (n=93). We used the analysis of frequency allocation, standard error, and the test of χ2. To simplify the obtained data we have used the Analysis of Categorical Main Components. Our patients want to be informed (96,5%). They affirm that the doctor is the person more adapted to make decisions (81,2%) and see the consent informed like an exculpatory procedure (67,2%). They would want to preserve the confidentiality of its documentation towards the hospitable personnel who does not take part in its process (61,1%). They have felt correctly informed on what they were going to them to do and they say that they have understood this information (91,2%). The confidence in the doctor is considered important (72,9%), but not as much as to replace the information (71,4%). 5,6% thought that it did not have to provide information to the family unless the patient authorized it. The patients mainly think that she has guarded itself by his privacy, who have not been discriminated (2.8% think that if). 5,5% at some moment of their stay have felt like victims, in ridiculous situation or have passed shame. 37,9% of our patients do not want to participate in the decisions that affect (58.6% yes to them) and 28% think that they cannot refuse to the decisions that its medical respect takes from its health. As far as infirmary, their attitudes are of acceptance of the autonomy of the patients. The patient is a ambivalència with respect to himself is the unique one whom she has to make the decisions (favorable 44.1%, unfavorable 42.0%). 96,7% think that the patients want to participate in the referred decisions to their own health. The nurses think that the rights of the patients will affect the relation positively toilet-patients (61,3%). 83,6% affirm that they know the rights the patients. The doctors, affirm (51,5%) that the recognition of the rights of the patient podran to change to the relation medical-patient positively. 48,1% affirm to know the rights the patients. 20% think that the patient is the unique one whom she has to decide what wants that it is made him to cure his disease. 7,5% do not think that the patients want to take part in the decisions that affect their disease, and a 79.5% think yes that. The men, the patients of more age and smaller level of studies are less favorable to the autonomists positions, and the women think that less they have been informed. The fact of the different visions between the three types from actors, presenting/displaying significant differences among them is interesting, in spite of being same reality. By means of the CATPCA, the rights to the information and the autonomy of the patient they are the two dimensions that explain more of a 30% of the variance, with predominance of the value of the information on the one of autonomy. The main conclusions of present/display work are, then: I. The rights of the patients sufficiently are not known II. The right to the information is valued like more important that the right to the exercise of the autonomy, essentially on the part of the patients. III. We stated a predominance of respectful visions towards the autonomy of the patients. Even so an important refractory minority of patients to its implication in the decision making exists that affects it. IV. The women, youngest and those with more high levels of more favorable education són to the respect to the autonomy of the patient. V. Expacientes, doctors and nurses have attitudes and perceptions different front from similar situations. We observed positions less favorable to autonomist points of vue on the part of the patients, in comparison to the more favorable on the part of doctors and radically in favor visions on the part of the nurses. VI. The sense of the informed consent is not understood by a great majority of the patients, and by a great minority of the professionals. VII. A minority of patients considers victim, and a minority part, of the professionals presents/displays discriminatory attitudes. VIII. Between an important part of the infirmary group a feeling of position of defense counsel of the patient exists.
Repositori URV