Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone
Yıl: 2022 Cilt: 25 Sayı: 2 Sayfa Aralığı: 177 - 183 Metin Dili: İngilizce DOI: 10.5505/kpd.2022.13245 İndeks Tarihi: 05-06-2022
Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone
Öz: Objective: The aim of this study is to demonstrate the
level of reconciliation between different medical branches, decision-making processes over the same facts,
both among themselves and with others. Method: An
online survey was created with three cases and six questions in the grey area related to the decision-making
capacity (DMC) situations. Surveys were sent to participants through their e-mails registered in hospital systems. A total of 165 physicians participated in the study.
The first scenario concerned an unstable patient with
gastrointestinal bleeding and major depression requesting discharge despite medical advice. The second scenario included the discharge request of a patient who
was on the border of pulmonary insufficiency with a
severe asthma attack. The final scenario was about a
homeless person with chest pain that occurred at the
time of alcohol withdrawal, demanding discharge, at a
point where a heart attack wasn’t excluded. Results:
54% of psychiatry specialists, 77% of psychiatry residents, 82% of emergency medicine specialists and 76%
of emergency medicine residents stated that DMC was
intact for scenario 1. For scenario 2, these rates were
determined as %88, %90, %76, %71 while for scenario 3
they were %44, %35, %44 and 47%, respectively.
Among the psychiatrists and residents, a statistically significant difference was found between the two groups
only in scenario 1. Discussion: : Consistent with the literature, it was observed that the interrater agreement
of DMC decisions between different medical branches
was low. Differences can be explained by different experience years, educational differences, evaluating basic
decision-making competencies with different degrees of
importance and differences in malpractice concerns.
Anahtar Kelime: Gri bölgedeki karar verme kapasitesi vakalarına ilişkin acil servis vepsikiyatri hekimlerinin görüşlerinin karşılaştırılması
Öz: Amaç: Bu çalışmanın amacı, farklı meslek gruplarından
değerlendiricilerin, aynı olgular üzerinden karar verme
süreçlerinin hem kendi aralarında hem de diğerleriyle
olan uzlaşma düzeyini ortaya koymaktır. Yöntem: Karar
verme kapasitesi (KVK) ile ilgili gri alanda üç vaka ve altı
soru ile çevrimiçi bir anket oluşturulmuştur. Anketler,
katılımcılara e-posta adresleri üzerinden gönderilmiştir.
Çalışmaya toplam 165 hekim katılmıştır. Senaryolardan
birincisi, anstabil gastrointestinal kanaması ve majör
depresyonu olan bir hastanın tıbbi önerilere karşın,
taburcu olma talebiyle ilgiliydi. İkinci senaryo, ciddi astım
atağı ile pulmoner yetmezlik sınırında olan hastanın
taburculuk talebini içermekteydi. Son senaryo ise evsiz
bir bireyin alkol yoksunluğu belirtilerinin olduğu anda
ortaya çıkan göğüs ağrısının kalp krizi dışlanmadan
taburculuk talebi hakkındaydı. Bulgular: Psikiyatri
uzmanlarının %54'ü, psikiyatri araştırma görevlilerinin
%77'si, acil tıp uzmanlarının %82'si ve acil tıp araştırma
görevlilerinin %76'sı senaryo 1 için KVK’nin korunduğunu
belirtmiştir. Senaryo 2 için bu oranlar %88, %90, %76,
%71 iken senaryo 3 için sırasıyla %44, %35, %44 ve %47
olarak bulunmuştur. Psikiyatristler ve araştırma görevlileri
arasında sadece senaryo 1'de iki grup arasında istatistiksel olarak anlamlı bir fark bulunmuştur. Sonuç:
Literatürle uyumlu olarak, önemli sayıda vakada farklı tıp
dalları arasında KVK kararlarının tutarlılığının düşük
olduğu gözlendi. Farklılıklar, farklı deneyim yılı, eğitim
farklılıkları, temel karar verme yetkinliklerinin farklı önem
dereceleriyle değerlendirilmesi ve malpraktis
kaygılarındaki farklılıklar ile açıklanabilir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Olcay SONKURT H, ALTINÖZ Ş, Altınöz A (2022). Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. , 177 - 183. 10.5505/kpd.2022.13245 |
| Chicago | Olcay SONKURT Harun,ALTINÖZ Şengül Tosun,Altınöz Ali Ercan Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. (2022): 177 - 183. 10.5505/kpd.2022.13245 |
| MLA | Olcay SONKURT Harun,ALTINÖZ Şengül Tosun,Altınöz Ali Ercan Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. , 2022, ss.177 - 183. 10.5505/kpd.2022.13245 |
| AMA | Olcay SONKURT H,ALTINÖZ Ş,Altınöz A Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. . 2022; 177 - 183. 10.5505/kpd.2022.13245 |
| Vancouver | Olcay SONKURT H,ALTINÖZ Ş,Altınöz A Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. . 2022; 177 - 183. 10.5505/kpd.2022.13245 |
| IEEE | Olcay SONKURT H,ALTINÖZ Ş,Altınöz A "Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone." , ss.177 - 183, 2022. 10.5505/kpd.2022.13245 |
| ISNAD | Olcay SONKURT, Harun vd. "Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone". (2022), 177-183. https://doi.org/10.5505/kpd.2022.13245 |
| APA | Olcay SONKURT H, ALTINÖZ Ş, Altınöz A (2022). Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. Klinik Psikiyatri Dergisi, 25(2), 177 - 183. 10.5505/kpd.2022.13245 |
| Chicago | Olcay SONKURT Harun,ALTINÖZ Şengül Tosun,Altınöz Ali Ercan Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. Klinik Psikiyatri Dergisi 25, no.2 (2022): 177 - 183. 10.5505/kpd.2022.13245 |
| MLA | Olcay SONKURT Harun,ALTINÖZ Şengül Tosun,Altınöz Ali Ercan Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. Klinik Psikiyatri Dergisi, vol.25, no.2, 2022, ss.177 - 183. 10.5505/kpd.2022.13245 |
| AMA | Olcay SONKURT H,ALTINÖZ Ş,Altınöz A Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. Klinik Psikiyatri Dergisi. 2022; 25(2): 177 - 183. 10.5505/kpd.2022.13245 |
| Vancouver | Olcay SONKURT H,ALTINÖZ Ş,Altınöz A Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone. Klinik Psikiyatri Dergisi. 2022; 25(2): 177 - 183. 10.5505/kpd.2022.13245 |
| IEEE | Olcay SONKURT H,ALTINÖZ Ş,Altınöz A "Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone." Klinik Psikiyatri Dergisi, 25, ss.177 - 183, 2022. 10.5505/kpd.2022.13245 |
| ISNAD | Olcay SONKURT, Harun vd. "Comparison of emergency department and psychiatry physicians’ views on decisionmaking capacity cases in the grey zone". Klinik Psikiyatri Dergisi 25/2 (2022), 177-183. https://doi.org/10.5505/kpd.2022.13245 |
