Abstracts
Abstract
Background: Informed consent (IC) is an ethical and legal obligation protected by constitutional rights to bodily integrity, well-being, and privacy in South Africa. The National Health Act 2003 codified IC regulations, requiring that all healthcare professionals inform patients about diagnosis, risks, benefits, options, and refusal rights while factoring in patients’ language and literacy levels. Objectives: This study’s primary aim was to determine the extent of South African professional/staff nurses’ compliance with current IC regulations and ascertain socio-cultural impediments impacting proper IC practice. Methods: A cross-sectional survey using semi-structured questionnaires was used to evaluate knowledge and practice of IC among nurses in KwaZulu-Natal province. Data were analyzed using SPSS, v.21. Descriptive statistics, chi-squared tests, and content analysis were used to compare nursing domains. Results: Three hundred fifty-five (355) nurses, 92% females, with 1 to 41 years of professional experience, completed this study. Information disclosed by nurses to patients included diagnosis (77%), treatment benefits (71%), risks (69%), recommendations (65%), risks of refusal (80%), and right of refusal (67%). Nurses (80%) felt information disclosure was adequate, while 85% reported that patients understood disclosed information. Conclusions: Nurses practicing in local public hospitals had moderate knowledge of IC regulations. Practical implementation appeared deficient. Barriers to IC included language, workload, time constraints, lack of interpreters, and skewed gender norms in the nursing profession. Nurses require continuing professional education in healthcare law and ethics, a “corps of trained interpreters”, and gender transformation in the nursing profession to improve IC practice and overall quality of healthcare service delivery in South Africa.
Keywords:
- South Africa,
- empirical bioethics,
- informed consent,
- laws,
- nursing,
- gender dynamics,
- public hospitals,
- regulations,
- healthcare,
- developing countries
Résumé
Contexte : Le consentement éclairé (CE) est une obligation éthique et juridique protégée par les droits constitutionnels à l’intégrité corporelle, au bien-être et à la vie privée en Afrique du Sud. La loi nationale sur la santé de 2003 a codifié les règlements en matière de CE, exigeant que tous les professionnels de la santé informent les patients sur le diagnostic, les risques, les avantages, les options et les droits de refus, tout en tenant compte de la langue et du niveau d’alphabétisation des patients. Objectifs : L’objectif principal de cette étude était de déterminer le degré de conformité des infirmières professionnelles/du personnel infirmier sud-africain avec les réglementations actuelles en matière de CI et de vérifier les obstacles socioculturels ayant un impact sur la pratique correcte de la CE. Méthodes : Une enquête transversale utilisant des questionnaires semi-structurés a été utilisée pour évaluer les connaissances et la pratique de la CE parmi les infirmières de la province de KwaZulu-Natal. Les données ont été analysées à l’aide de SPSS, v.21. Des statistiques descriptives, des tests de chi carré et une analyse de contenu ont été utilisés pour comparer les cadres/domaines infirmiers. Résultats : Trois cent cinquante-cinq (355) infirmières, 92% de femmes, ayant de 1 à 41 ans d’expérience professionnelle, ont participé à cette étude. Les informations divulguées par les infirmières aux patients comprenaient le diagnostic (77 %), les avantages du traitement (71 %), les risques (69 %), les recommandations (65 %), les risques de refus (80 %) et le droit de refus (67 %). Les infirmières (80 %) ont estimé que la divulgation des informations était adéquate, tandis que 85 % ont déclaré que les patients comprenaient les informations divulguées. Conclusions : Les infirmières exerçant dans les hôpitaux publics locaux avaient une connaissance modérée des règlements sur la CE. La mise en oeuvre pratique semblait déficiente. Les obstacles à la CE sont la langue, la charge de travail, les contraintes de temps, le manque d’interprètes et les normes de genre biaisées dans la profession infirmière. Pour améliorer la pratique de la CE et la qualité globale des services de santé en Afrique du Sud, les infirmières ont besoin d’une formation professionnelle continue en matière de droit et d’éthique de la santé, d’un « corps d’interprètes formés » et d’une transformation de la profession infirmière en fonction du genre.
Mots-clés :
- Afrique du Sud,
- bioéthique empirique,
- consentement éclairé,
- lois,
- soins infirmiers,
- dynamique des genres,
- hôpitaux publics,
- réglementations,
- soins de santé,
- pays en développement
Appendices
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