Tedavi reddi çocuk acil servislerinde hekim ve hasta için önemli bir sağlık sorunudur. Hastalar acil tıbbi tedaviyi herhangi bir zamanda reddedebilir. Bu çalışmada çocuk acil servise başvuran ebeveynlerin çocuklarının tedavisini reddetme nedenlerinin belirlenmesi amaçlanmıştır. Sağlık Bilimleri Üniversitesi Dr Sami Ulus Kadın Doğum Çocuk Sağlığı ve Hastalıkları Eğitim Araştırma Hastanesi Çocuk Acil Kliniği’ne 2016 - 2018 yılları arasında başvuran ve ebeveynlerinin tedaviyi reddettiği hastaların verileri red formları ve elektronik kayıtları incelenerek geriye dönük incelendi.İki yıllık dönemde çocuk acil kliğine 207.494 hasta başvurusundan 118 (%0,05) hastanın ebeveyni tedaviyi reddetmiştir. Hastaların tanıları sıklık sırasıyla; alt solunum yolu enfeksiyonu 46 (%39), akut odağı olmayan ateş 14 (%11.9), beşer hasta ilaç zehirlenmesi ve akut gastroenterit idi. Hastaların 71’i (%60.2) tedaviye evde devam etmek için, 24’ü (%20.3) takip ve tedaviyi başka merkezde yaptırmak istediği için tedaviyi reddetmiştir. 16 (%13.5) hasta lomber ponksiyon girişimini kabul etmeyerek tedaviyi reddetti. Çocuk acil servise 2 yıllık sürede başvuran hastaların %0,05 tedaviyi reddetmiştir. En sık tedavi reddi nedenleri; ailelerin tedaviyi evde veya başka merkezlerde devam etmek istemesi ve girişimsel işlemler ile ilgili olası yan etkilerin ailelerde korkulara neden olup, hastada ağrı olasılığı nedeniyle tedaviyi reddetme karar vermesi olarak görülmektedir.
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13. Lee B, Ishimine P, Joseph M. Et al. Evaluation and Treatment of Minors Ann Emerg Med. 2017: 1-8.
14.-Dreisinger N, Zapolsky N.; Complexities of Consent: Ethics in the Pediatric Emergency Department, Pediatr Emerg Care. 2018; 34:288-290.
15.Altınel-Açoglu E, Oguz M.M, Sarı E, Yücel et al. Parental Attitudes and Knowledge About Lumbar Puncture in Children.Ped Emerg Care. 2018 Sep 21.
Year 2021,
Volume: 6 Issue: 2, 13 - 19, 01.08.2021
1. Magauran BG. Risk management for the emergency physician: competency and decision-making capacity, informed consent, and refusal of care against medical advice. Emerg Med Clin North Am. 2009;27: 605–614.
2. Sosyal Sigortalar ve Genel Sağlık Sigortası Kanunu (2016, madde 24-25), T. C. Resmi Gazete, 28994, 26 Şubat 2016.
3. Rochdale Borough Safeguarding Adults Board. Multi Agency Practice Guide: Refusal of Medical Treatment Guidelines. 2013. Available at: www. Rochdale.gov.uk.
4. Informed consent, parental permission, and assent in pediatric practice. Committee on Bioethics, AmericanAcademy of Pediatrics. Pediatrics 1995; 95: 314–317.
5. De Lourdes Levy M, Larcher V, Kurz R. Informed consent/assent in children. Statement of the Ethics Working Group of the Confederation of European Specialists in Paediatrics (CESP). Eur J Pediatr 2003;162: 629-633.
6. Spinetta JJ, Masera G, Eden T, Oppenheim D, Martins AG,van Dongen-Melman J, et al. Refusal, non-compliance, and abandonment of treatment in children and adolescents with cancer: A report of the SIOP Working Committee on Phychosocial Issues in Pediatric Oncology. Vol. 38, Medical and Pediatric Oncology. 2002. p. 114–7.
7. Tahura S, Hussain M. Treatment Refusal and Abandonment in Pediatric Patients with Acute Lymphoblastic Leukemia in Bangladesh. Int J Sci Res. 2017;6:643–5.
8. Sitaresmi MN, Mostert S, Schook RM, Sutaryo, Veerman AJP. Treatment refusal and abandonment in childhood acute lymphoblastic leukemia in Indonesia: An analysis of causes and consequences. Psychooncology. 2010;19:361–7.
9. Wang Y rong, Jin R ming, Xu J wei, Zhang Z quan. A report about treatment refusal and abandonment in children with acute lymphoblastic leukemia in China, 1997-2007. Leuk Res. 2011;35:1628–31.
10. Prasad VSV, Chawla N, Salukuti S.Profile of LAMA (Left against Medical Advice) Patients from a PediatricEmergency Room: A two year experience from a tertiary care children’s hospital. Crıtıcal Care Ped.2018;1: 19-22.
11. Keser N, Arguz P. Parents’ reasons for refusing treatment of their children. Turk J Pediatr Dis 2010; 4: 5-11.
12. Gündüz RC, Halil H, Gürsoy C, Çifci A, Özgün S, Kodaman T, et al. Refusal of medical treatment in the pediatric emergency service: Analysis of reasons and aspects. Turk J, Pediatr. 2014; 56:638–42.
13. Lee B, Ishimine P, Joseph M. Et al. Evaluation and Treatment of Minors Ann Emerg Med. 2017: 1-8.
14.-Dreisinger N, Zapolsky N.; Complexities of Consent: Ethics in the Pediatric Emergency Department, Pediatr Emerg Care. 2018; 34:288-290.
15.Altınel-Açoglu E, Oguz M.M, Sarı E, Yücel et al. Parental Attitudes and Knowledge About Lumbar Puncture in Children.Ped Emerg Care. 2018 Sep 21.
Tekeli, A., Akca Çağlar, A., Halil, H., Karacan, C. D., et al. (2021). ÇOCUK ACİL SERVİSE BAŞVURAN HASTALARDA TEDAVİ REDLERİNİN DEĞERLENDİRİLMESİ. Health Academy Kastamonu, 6(2), 13-19. https://doi.org/10.25279/sak.709487
Health Academy Kastamonu is included in the class of 1-b journals (journals scanned in international indexes other than SCI, SSCI, SCI-expanded, ESCI) according to UAK associate professorship criteria. HEALTH ACADEMY KASTAMONU Journal cover is registered by the Turkish Patent Institute.