Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

Nurse and Patient's Experiences Regarding the Use of Electronic Informed Consent in Hospital: A Qualitative Study

의료기관에서 간호사와 환자의 전자동의서 사용 경험: 질적 연구

  • Kim, Sun Hee (Graduate School, Red Cross College of Nursing, Chung-Ang University) ;
  • Kang, Hee Sun (Red Cross College of Nursing, Chung-Ang University)
  • 김선희 (중앙대학교 적십자 간호대학, 일반대학원) ;
  • 강희선 (중앙대학교 적십자 간호대학)
  • Received : 2020.07.21
  • Accepted : 2020.12.04
  • Published : 2020.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study examined the experiences of users regarding their use of electronic informed consent in hospital. A qualitative descriptive study was conducted using focus groups and in-depth interviews with 30 Korean nurses and 27 patients. Data were collected from one university hospital. The responses were analyzed by qualitative content analysis. Most participants perceived the use of electronic informed consent as convenient and straightforward, as well as saving space and money. On the other hand, the participants stated that the system was unsatisfactory in part because of the occasional unexpected machinery error or malfunction. Some patients wished for function improvements related to the e-signature, making it more comparable to a handwritten signature, and the adjustability of the font size. The nurses wanted a wider implementation of electronic informed consent because it was not being used for all informed consent cases, resulting in confusion and an additional workload. For the use of an electronic informed consent system, it is important to minimize the inconvenience and to maximize the satisfaction of the users, including nurses and patients.

본 연구의 목적은 의료기관에서 간호사와 환자의 전자동의서 작성 경험을 파악하고자 하는 것이다. 본 연구는 포커스 그룹 인터뷰를 적용한 질적 내용 분석 연구이며, 연구 참여자는 간호사 30명과 환자 27명이었다. 포커스 그룹 인터뷰와 심층 면담을 통해 자료를 수집하였고 내용분석 하였다. 본 연구결과 전자동의서 사용 경험과 관련된 주요 주제는 '전자 동의서 사용에 대한 유용성', '전자동의서 태블릿 PC 사용과 관련된 불편함', '전자동의서 기능향상에 대한 바람'이었다. 참여자들은 전자동의서는 간편하고 편리하며, 자원과 공간이 절약되고, 향상된 전자시스템의 기능이 있어 만족하나, 예기치 못한 기계의 오작동이 생기거가 충전 펜과 고정형 모니터를 사용할 때 또는 사용법이 익숙하지 않은 경우에는 불편하다고 하였다. 참여자들은 추후 점차 사용이 확대되고, 친필과 유사한 필체, 화면 확대 조정 및 시청각 보조 기능이 지원되기를 원했다. 전자동의서 사용자들의 불편함을 최소화하고 만족도를 최대화하기 위한 노력이 필요하다.

Keywords

References

  1. Y. T. Park, D. Han, "Current status of electronic medical record systems in hospitals and clinics in Korea", Healthcare Informatics Research, Vol.23, No.3, pp.189-198, 2017. DOI: https://doi.org/10.4258/hir.2017.23.3.189
  2. M. Khalifa, "Perceived benefits of implementing and using hospital information systems and electronic medical records", Studies in Health Technology & Informatics, Vol.238, pp.165-168, 2017. DOI: https://doi.org/10.3233/978-1-61499-781-8-165
  3. S. Ajami, R. Arab-Chadegani, "Barriers to implement electronic health records (EHRs)", Materia Socio-medica, Vol.25, No.3, pp.213-215, 2013. DOI: https://doi.org/10.5455/msm.2013.25.213-215
  4. P. Ngugi, M. C. Were, A. Babic, "Facilitators and barriers of electronic medical records systems implementation in low resource settings: A holistic view", Studies in Health Technology & Informatics, Vol.251, pp.187-190, 2018. DOI: https://doi.org/10.3233/978-1-61499-880-8-187
  5. K. S. Choi, C. M. Koo, D. Y. Lee, "The case study of EMR system implementation: Chosun university hospital", Information Systems Review, Vol.15, No.2, pp.41-58, 2013. Available From: https://scienceon.kisti.re.kr/srch/selectPORSrchArticle.do?cn=JAKO201302847558177
  6. M. Zwaanswijk, R. A. Verheij, F. J. Wiesman, R. D.Friele, "Benefits and problems of electronic information exchange as perceived by health care professionals: an interview study", BMC Health Services Research, Vol.11, p.256, 2011. DOI: https://doi.org/10.1186/1472-6963-11-256
  7. J. Keasberry, I. A. Scott, C. Sullivan, A. Staib, R. Ashby, "Going digital: a narrative overview of the clinical and organizational impacts of eHealth technologies in hospital practice", Australian Health Review. Vol.41, No.6, pp.646-664, 2017. DOI: https://doi.org/10.1071/AH16233
  8. U. S. Yi, "A study on the satisfaction of nurses with electronic medical record in general hospitals", Health & Welfare, Vol.14, p.59-80, 2012. http://www.dbpia.co.kr/journal/articleDetail?nodeId=NODE02078968 https://doi.org/10.23948/kshw.2012.12.14.59
  9. E. Downes, A. Horigan, P. Teixeire, "The transformation of health care for patients: information and communication technology, digiceuticals, and digitally enabled care", Journal of American Association of Nurse Practitioners, Vol.31, No.3, pp.156-161, 2019. DOI: https://doi.org/10.1097/JXX.0000000000000109
  10. K. Chalil Madathil, R. Koikkara, J. Obeid, J. S. Greenstein, I. C., Sanderson, et al., "An investigation of the efficacy of electronic consenting interfaces of research permissions management system in a hospital setting", International Journal of Medical Informatics, Vol.82, No.9, pp.854-863, 2013. DOI: https://doi.org/10.1016/j.ijmedinf.2013.04.008
  11. J. S. Obeid, K. Gerken, K. C. Madathil, D. Rugg, C. E. Alstad, et al., "Development of an electronic research permissions management system to enhance informed consents and capture research authorizations data", American Medical Informatics Association (AMIA) Summits on Translational Science Proceedings, pp.189-193, 2013. Available From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3845791/pdf/AMIA_CRI_2013_189.pdf
  12. D. C. Haussen, L. Craft, S. Doppelheuer, G. M. Rodrigues, A. RAl-Bayati, K. Ravindran, et al., "Legal authorized representative experience with smartphone-based electronic informed consent in an acute stroke trial", Journal of Neurointervention Surgery, Vol.12, No.5, pp.483-485, 2019. DOI: https://doi.org/10.1136/neurintsurg-2019-015283
  13. M. Rowbotham, J. Astin, K. Greene, S. R. Cummings, "Interactive informed consent: randomized comparison with paper consents", PLoS One, Vol.8, No.3, pp.e58603, 2013. DOI: https://doi.org/10.1371/journal.pone.0058603
  14. D. C. Haussen, S. Doppelheuer, K. Schindler, J. A. Grossberg, M, Bouslama, et al., "Utilization of a smartphone platform for electronic informed consent in acute stroke trials", Stroke, Vol.48, No.11, pp.3156-3160, 2017. DOI: https://doi.org/10.1161/STROKEAHA.117.018380
  15. M. Young, "Electronic informed consent platform enhances education and engagement", IRB Advisor, Vol.19, No.6, 2019. Available from: https://www.reliasmedia.com/articles/144485-electronic-informed-consent-platform-enhances-educationand-engagement
  16. J Nehme, U El-Khani, A Chow, S Hakky, AR Ahmed, S Purkayastha, "The use of multimedia consent programs for surgical procedures: a systematic review", Surgical Innovation, Vol.20, pp.13-23, 2013. DOI: https://doi.org/10.1177/1553350612446352
  17. Y. C. Yu, T. W. Hou, T. C. Chiang, "Dual function seal: Visualized digital signature for electronic medical record systems", Journal of Medical Systems, Vol.36, No.5, pp.3115-3121, 2012. DOI: https://doi.org/10.1007/s10916-011-9795-x
  18. T. L. Chen, F. Y. Lin, "Electronic medical archives: A different approach to applying re-signing mechanisms to digital signatures", Journal of Medical Systems, Vol.35, No.4, pp.735-742, 2011. DOI: https://doi.org/10.1007/s10916-009-9414-2
  19. P. D. Cleary, "Evolving concepts of patient-centered care and the assessment of patient care experiences: Optimism and opposition", Journal of Health Politics, Policy and Law, Vol.41, No.4, pp. 675-696, 2016. DOI: https://doi.org/10.1215/03616878-3620881
  20. H. F. Hsieh, S. E. Shannon, "Three approaches to qualitative content analysis", Qualitative Health Research, Vol.15, No.9, pp.1277-1288, 2005. DOI: https://doi.org/10.1177/1049732305276687
  21. Y. S. Lincoln, E. G. Guba, Naturalistic inquiry, Beverly Hills: Sage Publications, p.416, 1985, pp.105-117
  22. T. Franckle, D. Haas, K. D. Mandl, "App store for EHRs and patients both", American Medical Informatics Association (AMIA) Joint Summits on Translational Science Proceedings, 2013:73, 2013. https://europepmc.org/article/med/24303239
  23. J. C. Bauer, E. John, C. L. Wood, D. Plass, D. Richardson, "Data entry automation improves cost, quality, performance, and job satisfaction in a hospital nursing unit", Journal of Nursing Administration, Vol.50, No.1, pp.34-39, 2020. DOI: https://doi.org/10.1097/NNA.0000000000000836
  24. G. M. Saleh, J. I. Patel, S. Sivaprasad, E. Tsesmetzoglou, N. Fietje, N. M. Saleh, "Digital voice signature: the future of consent?", Clinical & Experimental Ophthalmology, Vol.35, No.3, p.297, 2007. DOI: https://doi.org/10.1111/j.1442-9071.2007.01470.x
  25. C. Papoutsi, J. E. Reed, C. Marston, R. Lewis, A. Majeed, D. Bell, "Patient and public views about the security and privacy of Electronic Health Records (EHRs) in the UK: results from a mixed methods study", BMC Medical Informatics and Decision Making, Vol.15, p.86, 2015. DOI: https://doi.org/10.1186/s12911-015-0202-2
  26. A. Bethune, M. Davila-Foyo, M. Valli, L. da Costa, "e-Consent: approaching surgical consent with mobile technology", Canadian Journal of Surgery, Vol.61, No.5, pp.339-344, 2018. DOI: https://doi.org/10.1503/cjs.016017
  27. S. A. Kraft, M. Constantine, D. Magnus, K. M. Porter, S. S. Lee, et al., "A randomized study of multimedia informational aids for research on medical practices: Implications for informed consent", Clinical Trials, Vol.14, No.1, pp.94-102, 2017. DOI: https://doi.org/10.1177/1740774516669352
  28. E. H. Farrell, R. N. Whistance, K, Phillips, B. Morgan, K. Savage, et al., "Systematic review and meta-analysis of audio-visual information aids for informed consent for invasive healthcare procedures in clinical practice", Patient Education and Counseling, Vol.94, No.1, pp.20-32, 2014. DOI: https://doi.org/10.1016/j.pec.2013.08.019