Ihab B Abdalrahman

Autonomy and confidentiality: patients' perspectives.

Background Little is known about patients’ opinions about their rights in autonomy and confidentiality concerning their illness and this study was conducted to assess it. Methods This multi-centred, cross-sectional study was conducted in outpatient clinics in Khartoum, Sudan. It was delivered to 295 respondents. Data were managed using Microsoft Excel 2010 and SPSS. Results Eighty-five percent of the patients wanted to know about their conditions, of whom 17% wanted to choose their treatment and 29% believed they had the right to refuse treatment. Most of the respondents would not wish to hide information from their doctors. There was a wide variation at the rate of patients hiding information from their relatives, depending on their diagnosis (HIV 90%, malignancy 16.7% and tuberculosis 0%.) Conclusion Respondents want to choose their treating doctor, know about their diseases, be consulted before a procedure. They would like to leave technical issues to their treating doctors without jeopardising their own rights.

Breaking bad news from the doctors’ perspective in a paternalistic society: the case of Sudan

Breaking bad news is a global challenge for all types of health providers. Our study assessed the attitude and practice from the doctors’ perspective in a patriarchal society. A descriptive cross-sectional hospital-based study was conducted, involving doctors from both medical and surgical departments. Almost half of the respondents believed that Sudanese patients do not like to know their diagnosis, and a slightly higher proportion had no previous training on how to break bad news. Some 20% indicated that they would conceal the diagnosis from a patient if his or her relatives so requested. Less than one-quarter of respondents followed a standard protocol. Although most of the doctors subscribed to the notion that patients have the right to know everything about their illnesses, not all of them held this attitude towards their local patient population.

Self-reported, House-Officer's Competency and Knowledge

This study was conducted to assess the competency of fresh medical graduates in dealing with common emergency conditions. Graduates who received structured training in Emergency Medicine (EM) as part of their medical school curriculum (stratified group) were compared to those who did not (pooled group). Curricula of medical schools were reviewed. Structured questionnaire was used to collect data which included self-reported competencies and demographics among the medical graduates. The study population were 162 freshly graduated doctors, among them 35 received structured training in EM. Lack of competency in clinical skills ranged from 2.9% - 40% and 11.4% - 53% among stratified and pooled groups respectively. We found a statistically significant difference in skills related to assessment of acutely ill patient, use of ABCDE approach, valve mask ventilation, dysphagia screening, management of diabetic emergencies, and management of convulsions. A relatively higher level of competency was reported in those who received structured training in emergency medicine. Incorporation of emergency medicine in the curricula might improve the competency of junior doctors.