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1.
Isabel L. Silva José Pais-Ribeiro Helena Cardoso 《Applied research in quality of life》2008,3(2):127-136
The purpose of this study was to determine the differences in general health status and quality of life between patients who
present “non-normative eating behaviours” (namely, binge eating disorder, night eating syndrome, sweet /fat food cravings
and continuous nibbling) and patients without these eating behaviour characteristics. A cohort of 168 women with obesity,
all candidates to bariatric surgery, aged between 15 and 65 (M = 39.04; SD = 10.86), with a body mass index ranging between
30.37 and 80.65 (M = 48.79; SD = 8.37), was studied. Participants answered to a clinical interview, to SF-36 and to ORWELL-97,
after their informed consent. Results suggest that women with obesity reporting binge eating disorder, night eating syndrome
and continuous nibbling show poorer general health status and worst quality of life than those who do not present these “non-normative
eating behaviours”. Moreover, the general health status and the quality of life of patients with sweet/fat food cravings do
not differ from those who do not report this eating behaviour. Nevertheless, patients reporting the eating behaviours studied
do not differ from the others regarding their body mass index. 相似文献
2.
The extensive research on date rape attitudes and experiences has left sexual consent itself largely unexamined. The objective
of this study was to develop a measure to assess women’s and men’s attitudes and behaviors regarding sexual consent. Using
both focus groups (N = 18) and a mail survey (N = 514) of undergraduate students at a Canadian university, two scales of sexual consent were developed: (1) a Sexual Consent
Attitudes Scale, and (2) a Sexual Consent Behaviors Scale. Preliminary psychometric evidence suggested good reliability and
validity. As hypothesized, women, more than men, preferred a more cautious approach to sexual consent by stressing the need
to obtain consent more explicitly. Multiple regression analyses supported a reciprocal relationship between sexual consent
attitudes and sexual consent behaviors. 相似文献
3.
The study assessed perceptions of breast cancer genetic counseling. Focus groups were conducted with twenty women (ages < = 50 years)
in a Midwestern, urban health system identified as at above average risk of developing hereditary breast cancer and referred
for breast cancer genetic counseling following mammography. All participants associated the words “breast cancer” with fear.
African American women who received breast cancer genetic counseling may have channeled their fear into increased vigilance
related to breast health. African American women who did not receive breast cancer genetic counseling were most knowledgeable
about it. In contrast, Caucasian women who did not receive it reported uncertainty about the role of genetic counseling and
testing in assessing breast cancer risk, mistrust in medical professionals, and lack of trust in the accuracy of genetic tests.
The results could be used to help develop interventions to improve informed decision-making regarding breast cancer genetic
counseling. 相似文献
4.
知情同意书在医患沟通中起着间接传递信息的重要作用。以159名大学生为被试,通过操纵不同的知情同意方式,考察了纸质或视频补充信息对患者知情同意满意度、理解程度以及患者信息需求的满足程度影响。结果发现,接受纸质补充知情同意或视频补充知情同意的被试对知情同意过程的满意度、对手术信息的理解程度与知情同意信息需求的满足程度显著高于接受普通知情同意的被试。同时,纸质补充知情同意使得“治疗信息需求的满足程度”最高。这表明,纸质补充知情同意更能满足患者对治疗信息的需求。 相似文献
5.
Using an experimental design, male (n = 41) and female (n = 46) undergraduate students in the southeastern USA evaluated an identical written lecture by a male and female professor
on pay disparities between men and women in the workforce suggesting sex discrimination. Regardless of the students’ sex,
the male professor and his lecture was rated more positively and less sexist than the female professor. Moderated multiple
regression analysis indicated that more traditional and gender stereotypical attitudes toward women in male students were
related to greater sexism ratings of the female professor compared to the male professor whereas; no differences on ratings
of sexism between the male and female professor were found for male students with more liberal attitudes. 相似文献
6.
Halila R 《Science and engineering ethics》2007,13(3):305-313
Different ethical principles conflict in research conducted in emergency research. Clinical care and its development should
be based on research. Patients in critical clinical condition are in the greatest need of better medicines. The critical condition
of the patient and the absence of a patient representative at the critical time period make it difficult and sometimes impossible
to request an informed consent before the beginning of the trial. In an emergency, care decisions must be made in a short
period of time, and the more time is wasted, the more the risk of death or severe tissue damage and incapacity increases.
Consent requests take time, and so the time period before treatment might put the patient’s life in jeopardy. Not requesting
consent before a trial is also contradictory. A person should not be forced to participate in a trial against his or her will.
Due to the dark history of medical research previously, international declarations and conventions have set up ethical principles
for medical research. They emphasize the autonomy of the research participant—or his or her legal representative—to give a
free and informed consent prior to the initiation of research. In the case of a critical emergency, the unconscious state
of the patient, the emotional stress of family members or the lack of time to start life-sustaining measures may often restrict
the possibilities of communicating with the patient or his/her representative. Therefore, written informed consent is difficult
to achieve, and its voluntariness in emergency situations is, at best, open to question. The mortality of patients is high
without clinical interventions in emergency research. Random selection of patients is difficult and requires extra work from
personnel in the emergency rooms. Recruitment, information and asking for consent may also take time, postpone the initiation
of treatment and increase the risk of death and irreversible tissue and organ damage, and therefore be risky for the patient.
It is therefore essential that the health care professionals recruiting suitable research participants are well motivated
and well trained. Medical research in an emergency setting should always be regarded as an exceptional situation requiring
special provisions. Only such research should be done as cannot be done in other conditions. An independent body must approve
the research protocol and the ways in which the consent of the participant or proxy are to be sought. In addition, the trial
must be expected to result in direct and significant benefit for the research participants. If research without prior consent
is not approved, the development of emergency care is threatened. On the other hand, if prior consent is not required, a person
could be recruited into a clinical trial against his or her will. Doing good and avoiding harm, and respecting the autonomy
of the patient are in conflict in the context of emergency medical research. To develop better medicines for patients experiencing
acute medical emergencies, research into such conditions should be allowed. Research participants should have the possibility
to participate or refuse to participate in research that may benefit them and other patients. The risk of irreversible damage
occurring as the consequence of time delays for seeking consent is unacceptable. A prior wish about participation in clinical
trials should be respected, if known. The conditions under which medical research in emergencies can be considered acceptable
can be determined and agreed upon nationally and internationally.
An earlier version of this paper was presented at The 7th International Conference on Bioethics on “The Ethics of Research
in Emergency Medicine”, held on June 2, 2006, Warsaw, Poland. 相似文献
7.
The concept of informed consent was one of the most fruitful ideas that deeply changed the relationships between physicians
and their patients from paternalism to respect for the personal autonomy of subjects needing professional medical care. The
great progress in medicine, also involving the pharmaceutical industry, has created an increasing need to perform different
clinical and experimental trials. The evolution of clinical research in the last decades has influenced strongly the design
of these studies. One of the most important changes in this field has been the use of placebo groups in double-blind controlled
studies. The controversies have involved not only the use of placebo when standard or proven treatment was available, but
also some specific problems concerning the procedure of obtaining informed consent in such trials. This paper briefly presents
the evolution of informed consent in Poland as well as different ethical and legal problems concerning informed consent and
the use of placebo controls in clinical trials.
An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research
Today,” held in Warsaw, Poland on 12–13 April, 2003. 相似文献
8.
Powell KP Christianson CA Cogswell WA Dave G Verma A Eubanks S Henrich VC 《Journal of genetic counseling》2012,21(3):469-478
To assess the educational needs of North Carolina primary care physicians (PCPs) about direct-to-consumer (DTC) genetic testing,
surveys were mailed to 2,402 family and internal medicine providers in North Carolina. Out of 382 respondents, 323 (85%) felt
unprepared to answer patient questions and 282 (74%) reported wanting to learn about DTC genetic testing. A total of 148 (39%)
were aware of DTC genetic testing. Among these, 63 (43%) thought DTC genetic testing was clinically useful. PCPs who felt
either unprepared to answer patient questions (OR = 0.354, p = 0.01) or that DTC genetic testing was clinically useful (OR = 5.783, p = 0.00) were more likely to want to learn about DTC genetic testing. PCPs are interested in learning about DTC genetic testing,
but are mostly unaware of DTC testing and feel unprepared to help patients with DTC testing results. Familiar and trusted
channels that provide the information and tools PCPs need to help answer patient’s questions and manage their care should
be used when creating educational programs. 相似文献
9.
Girish N. Viswanathan Gnanamoorthy Mayurathan Tony Hildreth Stephen G. Worthley Azfar G. Zaman 《Applied research in quality of life》2011,6(3):311-324
Percutaneous coronary revascularisation [PCR] improves angina and health related quality of life [HRQOL] compared to standard
medical therapy. It is unknown whether PCR has the same benefits for patients with a history of CABG. Over a period of 5 years,
we assessed HRQOL of patients undergoing PCR using Part 1 of the Nottingham Health Profile [NHP] at baseline 3, 12 and 24 months.
We compared HRQOL after PCR in 255 patients with CABG to 2680 without. There were more males [81.1% v 69.6% p = 0.002] and older patients [mean age 60.1 years v. 58.0 p = 0.03] in CABG group. Perceived HRQOL improved at 24 months for pain, energy and emotional reaction but the improvement
was less in the CABG group. However, mean NHP scores at 24 months for those with CABG had returned to baseline levels for
sleep [34.9] and for physical function was worse than at baseline [22.0 vs 30.7]. This relationship persisted after adjustment
for male sex, history of previous MI and coronary stent usage. Patients with previous CABG had less improvement in HRQOL after
PCR. Further work is needed to assess the benefits and cost effectiveness of PCR in these patients. 相似文献
10.
L. Brent Hafen Rebecca S. Hulinsky Sara Ellis Simonsen Stephanie Wilder Nancy C. Rose 《Journal of genetic counseling》2009,18(4):395-400
In order to evaluate the utility of genetic counseling at the time of first trimester screening in patients with no previously
identified genetic concerns, we reviewed family history data for 700 women seen for genetic counseling in Utah during 2005-2006.
The mean maternal age was 35 years (Range: 16–47 years). The majority of patients seen were non-Jewish Caucasians (90.8%,
634/700). A three-generation pedigree was obtained from each woman by one of two certified genetic counselors and subsequently
classified as “negative” (no birth defects/genetic disorders); “positive” (birth defect or genetic condition with a minimal/low
risk of recurrence; additional evaluation/genetic testing during pregnancy not indicated); or “significant” (birth defect
or genetic condition with an increased risk of recurrence; additional evaluation/genetic testing during the pregnancy indicated).
About 72% (501/700) of the histories were negative, 19% (134/700) were positive, and about 9% (65/700) were significant. Among
patients with significant family histories, 66% (n = 43) were women less than 35 years of age. We conclude that assessing a patient’s family history at the time of first trimester
serum screening is a valuable resource for pregnancy management. 相似文献
11.
O'Shea R Murphy AM Treacy E Lynch SA Thirlaway K Lambert D 《Journal of genetic counseling》2011,20(2):192-203
Many children with chronic genetic diseases are followed by specialty clinics that provide genetic information as part of
the care. Health services restrictions in the Republic of Ireland (ROI) can make the wait for an appointment with a genetic
counsellor long. We examined whether genetic information was being adequately understood when presented by medical, but non-genetics
staff to long term patients, using our national metabolic service as an example. The aim was to inform health professionals
about the need or role of a genetic counsellor in a specialist setting. A questionnaire was used to assess knowledge among
parents and patients affected by galactosaemia and Maple Syrup Urine Disease (MSUD). Twenty seven families with galactosemia
and 10 with MSUD were interviewed in clinic. Comparative analysis showed significant differences in knowledge between parents
of children with galactosemia and adult patients (p = 0.001) and between ethnicities (p > 0.05). While parents are well informed, the majority expressed a wish for more information about the condition and its
transmission. Adult patients with galactosemia and parents from certain ethnic backgrounds could especially benefit from genetic
counselling. This study highlights the need for a genetic counsellor in specialist clinics. 相似文献
12.
Michael M. Knepp 《Ethics & behavior》2018,28(7):560-577
Previous research shows that students often do not read informed consent forms to understand their rights (Pederson, Neighbors, Tidwell, & Lostutter, 2011). Four hundred fifty-eight students participated in an advertised temperament study that actually measured whether they noticed a manipulation within the consent form. Answering five questions about the form raised the percentage of students noticing the manipulation in multiple settings; however, overall rates were low. Fewer than 10% of ethnic minority students noticed the manipulation. If the goal of consent forms in higher education remains an informed decision, these results indicate the need for increased interaction within the consent process. 相似文献
13.
美国与知情同意有关的一些问题 总被引:10,自引:1,他引:9
知情同意是医疗保健和医学研究的一个基本的伦理学要求。这两种情况中,当医学研究的知情同意标准比医疗保健要求更加严格时,知情同意包含了3种要素:(1)告知病人或受试者该研究的性质。包括益处,危险和其他有关内容;(2)确保病人受试者理解所提供的信息;(3)得到病人或受试者自愿的同意,没有能力参与知情同意的病人包括患痴呆和危重病等无决断 能力的病人,这些病人属弱势病人。如要获许对他们的疾病进行研究,我们必须制定保护弱势受试者有效的伦理政策,提出了关于对痴呆病人、危重病人,脑死亡病人研究的伦理学政策。 相似文献
14.
Nicholas Ladany Marilyn Stern Arpana G. Inman 《Journal of applied social psychology》1998,28(12):1031-1050
The purpose of this study is to examine the independent and joint influences of a patient's mode of acquisition of illness (blood transfusion vs. multiple sexual partners), attributions of responsibility (self-blame vs. chance blame), and sexual orientation (homosexual vs. heterosexual) on female and male medical students' attitudes toward and willingness to treat a patient who is HIV infected. One hundred nineteen 1st through internship-year medical students were randomly assigned to read and respond to case vignettes. Greater consistency between attribution of blame and mode of acquisition was related to more positive perceptions. Furthermore, the patient's sexual orientation influenced the providers' willingness to offer treatment, particularly for male medical students. Implications concerning health practices and medical education are considered. 相似文献
15.
This study assessed how the patient’s right to receive information and the right to self-determination were followed during
diagnostic testing, according to the perceptions of patients and parents of tested children (group 1, n = 106) and healthcare personnel (group 2, n = 162). Data were collected in three Finnish university hospitals using a questionnaire. Results revealed one between group
difference: patients/parents agreed more strongly than did personnel that self-determination was followed before testing.
Within groups included: patients/parents had stronger agreement that self-determination was followed before testing than after
testing; personnel had stronger agreement about information received after testing than before testing, and they had weaker
agreement about how well self-determination was followed before testing than after testing. Received information was experienced
as similar both before and after testing and by patients/parents and by personnel. Providing adequate time to consider whether
or not to be tested and giving more support to patients after testing would promote the rights of patients. Furthermore, assessment
of personnel characteristics is needed to determine, for example, the kinds of value conflicts that exist between personnel’s
own values and patients’ values. 相似文献
16.
Allyn McConkie-Rosell Elizabeth Melvin Heise Gail A. Spiridigliozzi 《Journal of genetic counseling》2009,18(4):313-325
Little is known about how and what genetic risk information parents communicate to their children and even less is known about
what children hear and remember. To address this void, we explored how genetic risk information was learned, what information
was given and who primarily provided information to adolescent girls and young adult women in families with fragile X syndrome.
We explored three levels of risk knowledge: learning that fragile X syndrome was an inherited disorder, that they could be
a carrier, and for those who had been tested, actual carrier status. These data were collected as part of a study that also
explored adolescent self concept and age preferences about when to inform about genetic risk. Those findings have been presented
separately. The purpose of this paper is to present the communication data. Using a multi-group cross-sectional design this
study focused on girls ages 14–25 years from families previously diagnosed with fragile X syndrome, 1) who knew they were
carriers (n = 20), 2) noncarriers (n = 18), or 3) at-risk to be carriers (n = 15). For all three stages of information the majority of the study participants were informed by a family member. We identified
three different communication styles: open, sought information, and indirect. The content of the remembered conversations
varied based on the stage of genetic risk information being disclosed as well as the girls’ knowledge of her own carrier status.
Girls who had been tested and knew their actual carrier status were more likely to report an open communication pattern than
girls who knew only that they were at-risk. 相似文献
17.
Little is known about factors predicting the likelihood of choosing genetic testing in college aged women versus older women,
including knowledge of quality of life (QOL) associated with a disorder. Using vignettes with female college students (Experiment
1: n = 257, mean age = 19.70 yrs) and female faculty/staff/alumni (Experiment 2: n
nulliparous = 83, mean age = 30.20 yrs; n
mothers = 53, mean age = 33.77 yrs), we examined the contribution of multiple factors to predicting genetic testing likelihood for
cystic fibrosis. We investigated malleable situational factors (style of genetic risk presentation and providing QOL information
including physical and social aspects) and stable dispositional factors (abortion views). Parity (i.e., prior births) was
more influential in women’s genetic testing likelihood than was age. Greater acceptability of abortion for oneself and self-assessed
knowledge following QOL information were predictors of higher testing likelihood for college students. Greater acceptability
of abortion for another person was a predictor for nulliparous women. Abortion views moderated the effect of predictors for
nulliparous women and mothers. Findings encourage genetic counselors to utilize QOL information to promote informed decision
making through genetic testing. 相似文献
18.
Marzieh Nojomi Bahar Mahjubi Zahra Mostafavian Bita Bijari 《Applied research in quality of life》2010,5(3):233-240
Pelvic floor dysfunction is a general public health problem with great impact on quality of life. Inability to control the
passage of stool can produce embarrassment and may limit daily activities. One of the most important indicators of effectiveness
of therapy in patients with fecal incontinence (FI) can be patient’s quality of life. Therefore, a well-constructed questionnaires
studying quality of life is necessary. The objective of this study was to assess the Iranian version of Fecal Incontinence
Quality of Life Scale in a hospital-based study on patients with FI. Two hundred women were recruited in the study. One group
included patients with FI (n = 100) and the control group (n = 100) included patients with any gastrointestinal (GI) problems except FI. The Persian version of fecal incontinence quality
of life scale completed by two groups. The FI patients completed the SF-36 questionnaire too. Reliability and validity of
questionnaire were evaluated by Cronbach’s alpha, test/retest using correlation analysis, Intraclass correlation coefficient,
paired t-test, and analysis of variance. There was not any significant differences between two groups for age, marital status, education,
and occupation. The mean age of FI patients and controls were 42.6 (±13.3) and 44.5 (±15.0) respectively. Cronbach’s-α for
all domains ranged between 0.72 and 0.92. All scales showed significant correlation between the test and retest administration
of questionnaire. The FI patients had lower scores than the controls for all domains adjusted for gender. All correlations
between six selected domains of Sf-36 scales and FIQL scales were significant at P ≤ 0.05 levels. The Persian version of FIQL had a good validity and reliability and can be used for accurate measure of quality
of life in FI patients. 相似文献
19.
Little research has examined the association between life satisfaction, self-rated health (SRH), and physical activity concurrently
for middle school students. A convenience sample of 245 students in grades 7 and 8 was surveyed about physical activity, life
satisfaction, and SRH using the U.S. Centers for Disease Control and Prevention (CDC) 2005 Middle School Youth Risk Behavior Survey. ANOVA analyses revealed significantly reduced life satisfaction for females who
reported not engaging in vigorous physical activity during the past 7 days [p < .01, effect size (ES) = .75]. Significantly reduced life satisfaction was detected for both males (p < .001, ES = .66) and females (p < .0001, ES = .80) who reported not playing on sports teams. Additionally, logistic regression analyses showed the odds of
reporting fair/poor SRH increased 5.4 times for males (CI = 1.30–22.39, p < .05) and 30.9 times for females (CI = 3.74–255.43, p < .001) who reported not playing on sports teams. Preliminary findings suggest physical activity and sports participation
is associated with improved life satisfaction and SRH for middle school students. In addition, although some gender differences
were observed, consistent findings for sports participation suggest sports participation may carry multiple social, mental,
and physical benefits for youth. 相似文献
20.
探讨知情同意对危重病患者的心理影响。根据知情同意实施现状,将患者分为患者知情组、家属知情组,采用问卷调查和访谈相结合的方法对两组知情同意前、后的心理状况进行评估和比较。采取自愿方式及适宜的告知方法由患者本人知情同意,患者的心理状况与选择家属知情同意的患者无明显区别。 相似文献