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Abstract
Introduction. l’objectif de notre étude était d’apprécier les attentes de la communauté sur le consentement médical. Matériel et méthodes. il s’agissait d’une étude prospective à visée descriptive réalisée auprès de 1068 personnes dans les différents districts de la ville de Bouaké. Nous avons effectué une procédure d'échantillonnage avec une triple stratification basée sur une méthode probabiliste. Cette méthode a été utilisée également pour la sélection des ménages au sein des différents districts de santé, puis le nombre de ménages en fonction des quartiers composant chaque district en se rapportant au nombre d’habitat dans chaque district. Résultats : il existait une égalité homme-femme dans notre étude. La majorité des personnes enquêtés appartenait à la tranche d’âge des moins de 45 ans (n= 738 ; 69,1 %) avec un âge moyen de 39,5+/-11,5 ans, vivant en couple (n= 815 ; 76,3 %) et ayant bénéficié d’un enseignement conventionnel (n= 705 ; 70,2 %) et dominé par le niveau secondaire (n= 470 ; 44 %). Nos enquêtés estimaient que le médecin devait avoir leur accord avant de poser un acte à visée diagnostic (62,8 %), thérapeutique (63 %) et préventif (55,7 %). De même, ils étaient pour que le médecin refuse leurs décisions si cela pouvait entrainer une aggravation de leur état de santé (84,7 %) et si cela pouvait entrainer leur décès (89,4 %). Pour 57,2 % de nos enquêtés, le médecin ne pouvait refuser une demande venant d’eux. Ils étaient également pour des sanctions à l’encontre du médecin si celui-ci n’avait pas pris leur consentement avant tout acte médical qui auraient entrainé des conséquences graves (76,2 %) ou mineures (63,7 %) sur leur santé. Nos enquêtés souhaitaient que le médecin les informe, leur explique et les aide à prendre la décision médicale (n= 794 ; 74,3 %). Les enquêtés estimaient que les membres de la famille étaient le groupe le mieux indiqué pour représenter leurs intérêts (845 ; 79,1%).Conclusion : le consentement médical devient une composante importante à prendre en compte dans la prise en charge médico-chirurgicale des patients.
ABSTRACT
Introduction: The aim of our study was to assess community expectations regarding medical consent. Material and methods: This was a prospective descriptive study involving 1,068 people in different districts of the city of Bouake. We used a sampling procedure with triple stratification based on a probabilistic method. A similar method was used to select households within the various districts, then the number of households according to the neighborhoods making up each district, with reference to the number of dwellings in each district. Results: In our study, there was equality between men and women. The majority of respondents were in the under-45 age bracket (n= 738; 69.1%), with an average age of 39.5+/-11.5 years, living as a couple (n= 815; 76.3%) and having received conventional education (n= 705; 70.2%) and secondary education (n= 470; 44%). Our respondents felt that the doctor should have their agreement before carrying out a diagnostic (62.8%), therapeutic (63%) or preventive (55.7%) procedure. Similarly, they were in favor of the doctor refusing their decisions if this could lead to a worsening of their state of health (84.7%), or even if it could lead to their death (89.4%). For 57.2 % of our respondents, the doctor could not refuse a request from them. They were also in favor of sanctions against the doctor if he failed to obtain their consent prior to any medical act that might have serious consequences for their health (76.2%). Our respondents wanted the doctor to inform, explain and help them make medical decisions (n= 794; 74.3%). Respondents felt that family members were the most appropriate group to represent their interests (845; 79.1%).Conclusion: Medical consent is becoming an important component to be taken into account in the medical-surgical management of patients.
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References
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- https://www.gouv.ci/doc/accords/1512502410CODE-PENAL.pdf Consulté le 19/05/2024
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- Loi n°2019-570 du 26 juin relative au mariage consulté le 21/10/2023 disponible sur http://www.ivoire-juriste.com/
- Cédric Bornes. La relation médecin-patient-aidant dans la maladie d’Alzheimer. Thèse Med. Université Paris Descartes, 2010.
- Pallocci M, Treglia M, Passalacqua P, Tittarelli R, Zanovello C, De Luca L, et al. Informed Consent: Legal Obligation or Cornerstone of the Care Relationship? International Journal of Environmental Research and Public Health [Internet]. 2023 Jan 24;20(3):2118. Available from: http://dx.doi.org/10.3390/ijerph20032118
- Jaunait A. Comment peut-on être paternaliste ? Confiance et consentement dans la relation médecin-patient. Raisons politiques [Internet]. 2003 ;11(3) : 59. Available from: http://dx.doi.org/10.3917/rai.011.0059
- Seror V, Cortaredona S, Bouhnik A, Meresse M, Cluze C, Viens P, et al. Young breast cancer patients’ involvement in treatment decisions: the major role played by decision‐making about surgery. Psycho-Oncology [Internet]. 2013 Jun 7;22(11):2546–56. Available from: http://dx.doi.org/10.1002/pon.3316
- Santema TBK, Stoffer EA, Kunneman M, Koelemay MJW, Ubbink DT. What are the decision-making preferences of patients in vascular surgery? A mixed-methods study. BMJ Open [Internet]. 2017 Feb;7(2):e013272. Available from: http://dx.doi.org/10.1136/bmjopen-2016-013272
- Bottrell MM. Hospital Informed Consent for Procedure Forms. Archives of Surgery [Internet]. 2000 Jan 1;135(1):26. Available from: http://dx.doi.org/10.1001/archsurg.135.1.26
- Dogan HH, I ik E, Vural E, Vehid H, Brezis M. Quality and extent of informed consent for invasive procedures: a pilot study at the institutional level in Turkey. International Journal for Quality in Health Care [Internet]. 2014 Dec 10;27(1):46–51. Available from: http://dx.doi.org/10.1093/intqhc/mzu093
References
Burkle CM, Pasternak JJ, Armstrong MH, Keegan MT. Patient perspectives on informed consent for anaesthesia and surgery: American attitudes. Acta Anaesthesiologica Scandinavica [Internet]. 2012 Dec 11 ;57(3):342–9. Available from: http://dx.doi.org/10.1111/aas.12037
Heywood R, Macaskill A, Williams K. Informed consent in hospital practice: health professionals’ perspectives and legal reflections. Medical Law Review [Internet]. 2010 Mar 1;18(2):152–84. Available from: http://dx.doi.org/10.1093/medlaw/fwq008
Glaser J, Nouri S, Fernandez A, Sudore RL, Schillinger D, Klein-Fedyshin M, et al. Interventions to Improve Patient Comprehension in Informed Consent for Medical and Surgical Procedures: An Updated Systematic Review. Medical Decision Making [Internet]. 2020 Jan 16;40(2):119–43. Available from: http://dx.doi.org/10.1177/0272989x19896348
Kent GG. The role of psychology in the teaching of medical ethics: the example of informed consent. Medical Education [Internet]. 1994 Mar;28(2):126–31. Available from: http://dx.doi.org/10.1111/j.1365-2923.1994.tb02531.x
https://www.gouv.ci/doc/accords/1512502410CODE-PENAL.pdf Consulté le 19/05/2024
Gupta M, Madhavan S, Teo FSY, Low JK, Shelat VG. Perceptions of Singaporeans towards informed consent: a cross-sectional survey. Singapore Medical Journal [Internet]. 2021 Oct 31; 65(2):91–8. Available from: http://dx.doi.org/10.11622/smedj.2021163
Nnabugwu II, Ugwumba FO, Udeh EI, Anyimba SK, Ozoemena OF. Informed consent for clinical treatment in low-income setting: evaluating the relationship between satisfying consent and extent of recall of consent information. BMC Medical Ethics [Internet]. 2017 Dec;18(1). Available from: http://dx.doi.org/10.1186/s12910-017-0227-4
Guengant JP, May JF. L’Afrique subsaharienne dans la démographie mondiale. Études [Internet]. 2011 Oct 1;Tome 415(10):305–16. Available from: http://dx.doi.org/10.3917/etu.4154.0305
Brezis M, Israel S, Weinstein-Birenshtock A, Pogoda P, Sharon A, Tauber R. Quality of informed consent for invasive procedures. International Journal for Quality in Health Care [Internet]. 2007 Nov 30;20(5):352–7. Available from: http://dx.doi.org/10.1093/intqhc/mzn025
Caínzos MA, Gonzalez-Vinagre S. The Surgical Informed Consent Process: Myth or Reality? Surgical Ethics [Internet]. 2019;203–16. Available from: http://dx.doi.org/10.1007/978-3-030-05964-4_19
Porcher R. Le consentement en droit médical. Médecine et Droit [Internet]. 2019 Feb ;2019(154) :8–19. Available from: http://dx.doi.org/10.1016/j.meddro.2018.08.002
Alazmi S. Patients’ Perception of Informed Consent for Surgical Operations in Kuwait. Journal of High Institute of Public Health [Internet]. 2018 Oct 1;48(2):92–6. Available from: http://dx.doi.org/10.21608/jhiph.2018.19915
https://loidici.biz/2019/08/18/le-code-de-deontologie-medicale/lois-article-par-article/autres-professions/15890/naty/ Consulté le 19/05/2024
Sargos P. Obligation de moyens et obligation de résultat du médecin. Médecine & Droit [Internet]. 1997 May ;1997(24):2–5. Available from: http://dx.doi.org/10.1016/s1246-7391(97)86004-6
Loi n°2019-570 du 26 juin relative au mariage consulté le 21/10/2023 disponible sur http://www.ivoire-juriste.com/
Cédric Bornes. La relation médecin-patient-aidant dans la maladie d’Alzheimer. Thèse Med. Université Paris Descartes, 2010.
Pallocci M, Treglia M, Passalacqua P, Tittarelli R, Zanovello C, De Luca L, et al. Informed Consent: Legal Obligation or Cornerstone of the Care Relationship? International Journal of Environmental Research and Public Health [Internet]. 2023 Jan 24;20(3):2118. Available from: http://dx.doi.org/10.3390/ijerph20032118
Jaunait A. Comment peut-on être paternaliste ? Confiance et consentement dans la relation médecin-patient. Raisons politiques [Internet]. 2003 ;11(3) : 59. Available from: http://dx.doi.org/10.3917/rai.011.0059
Seror V, Cortaredona S, Bouhnik A, Meresse M, Cluze C, Viens P, et al. Young breast cancer patients’ involvement in treatment decisions: the major role played by decision‐making about surgery. Psycho-Oncology [Internet]. 2013 Jun 7;22(11):2546–56. Available from: http://dx.doi.org/10.1002/pon.3316
Santema TBK, Stoffer EA, Kunneman M, Koelemay MJW, Ubbink DT. What are the decision-making preferences of patients in vascular surgery? A mixed-methods study. BMJ Open [Internet]. 2017 Feb;7(2):e013272. Available from: http://dx.doi.org/10.1136/bmjopen-2016-013272
Bottrell MM. Hospital Informed Consent for Procedure Forms. Archives of Surgery [Internet]. 2000 Jan 1;135(1):26. Available from: http://dx.doi.org/10.1001/archsurg.135.1.26
Dogan HH, I ik E, Vural E, Vehid H, Brezis M. Quality and extent of informed consent for invasive procedures: a pilot study at the institutional level in Turkey. International Journal for Quality in Health Care [Internet]. 2014 Dec 10;27(1):46–51. Available from: http://dx.doi.org/10.1093/intqhc/mzu093