Evaluation of consent forms for clinical practice in Spanish Public Hospitals.

OBJECTIVE: To evaluate the access, development, and quality of consents forms for clinical practice within the Spanish Public Hospitals. METHOD: A cross-sectional study was conducted in a two-stage process (January 2018-September 2021). In stage 1, A nationwide survey was undertaken across all public general hospitals (n=223) in the Spanish Healthcare System. In stage 2, Data was taken from the regional health services websites and Spanish regulations. Health Regional Departments were contacted to verify the accuracy of the findings. Data was analyzed using a descriptive and inferential statistics (frequencies, percentages, Chi-square & Fisher's exact tests). RESULTS: The response rate was 123 (55.16%) of Spanish Public Hospitals. The results revealed a range of hospital departments involved in the development of consent documents and the absence of a standardized approach to consent forms nationally. Consent audits are undertaken in 43.09% hospitals and translation of written consents into other languages is limited to a minority of hospitals (35.77%). The validation process of consent documentation is not in evidence in 13% of Spanish Hospitals. Regional Informed Consent Committees are not place in the majority (70.7%) of hospitals. Citizens can freely access to consent documents through the regional websites of Andalusia and Valencia only. CONCLUSION: Variability is found on access, development and quality of written consent across the Spanish Public Hospitals. This points to the need for a national informed consent strategy to establish policy, standards and an effective quality control system. National audits at regular intervals are necessary to improve the consistency and compliance of consent practice.

[Global analysis of the readability of the informed consent forms used in public hospitals of Spain]. / Análisis global de la legibilidad de los documentos de consentimiento informado utilizados en los hospitales públicos de España.

PURPOSE: To analyse the readability of informed consent forms (ICF) used in Public Hospitals throughout Spain, with the aim of checking their function of providing comprehensive information to people who are making any health decision no matter where they are in Spain. MATERIAL AND METHODS: A descriptive study was performed on a total of 11,339 ICF received from all over Spanish territory, of which 1617 ICF were collected from 4 web pages of Health Portal and the rest (9722) were received through email and/or telephone contact from March 2012 to February 2013. The readability level was studied using the Inflesz tool. A total of 372 ICF were selected and analysed using simple random sampling. The Inflesz scale and the Flesch-Szigriszt index were used to analyse the readability. RESULTS: The readability results showed that 62.4% of the ICF were rated as a "little difficult", the 23.4% as "normal", and the 13.4% were rated as "very difficult". The highest readability means using the Flesch index were scored in Andalusia with a mean of 56.99 (95% CI; 55.42-58.57) and Valencia with a mean of 51.93 (95% CI; 48.4-55.52). The lowest readability means were in Galicia with a mean of 40.77 (95% CI; 9.83-71.71) and Melilla, mean=41.82 (95% CI; 35.5-48.14). CONCLUSIONS: The readability level of Spanish informed consent forms must be improved because their scores using readability tools could not be classified in normal scales. Furthermore, there was very wide variability among Spanish ICF, which showed a lack of equity in information access among Spanish citizens.

[Professional unemployment in Andalucia. Expectations and difficulties in the nursing profession]. / Desempeño profesional en Andalucía. Expectativas y dificultades en enfermería.

The primary objective of this article is to know the professional, academic and formative expectations in Nursing and those problems which hinder the performance of this profession among the Andalucian public health centers. The authors carried out an extensive descriptive study during the years 1994-1996 based on a sampling of 1020 nursing professionals pertaining to the Andalucian Health Service. These samples were obtained by means of a random stratification by provinces and care level, with an affixation proportional to the size of the stratum, having a 95% confidence rate and a 3.5% error rate. The data were acquired by means of a self-administered questionnaire sent in by mail. Among the most significant results, the authors highlight that fact that the professional, academic and performance expectations among Andalucian Nursing professionals center on research and investigation (71.5%), postgraduate courses (75%), possible Licentiate in Nursing (82.4%) and some nursing specialty (78.7%). Among the difficulties identified for professional performance, the items which stands out were those derived from the absence of a legal definition for Nursing functions (90.8%).