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目的 了解院前患者与救护人员判断及急救网络管理制度的冲突情况.方法 采用<院前急救中遇到伦理学问题调查表>,对全市80家急救网络医院从事院前急救工作的80名医生和248名护士进行问卷调查,调查患者与院前急救服务伦理冲突的情况.结果 328份问卷中,认为需要救护的患者中完全拒绝的患者占(8.046±6.990)%,部分拒绝的占(14.544±10.558)%;需要救护车转运的患者中拒绝的占(14.451±14.747)%;拒绝救护和转运的原因中付费问题占(23.52±~19.79)%.认为自己不需要占(22.22±20.84)%,自己想死占(5.77±4.47)%,难以判断占(19.44±18.65)%,其他原因占(30.08±25.78)%;(20.31±16.66)%的患者拒绝救护人员判断其处于某种状态;得到救护车服务的患者中(29.66±24.02)%的患者认为无出车必要;(22.11+19.52)%患者的要求与院前急救服务管理的规定有冲突.结论 院前患者与院前急救服务伦理存在一定程度上的冲突.

Objective To understand the ethics conflict situations between the pre-hospital patients and ambulance staff's determinations. Methods Taking a survey among the pre-hospital emergency physicians(80 people)and nurses(248 people)by Questionnaire of ethics conflicts during pre-hospital emergeney service,to investigate the ethics conflict situations between the pre-hospital patients and ambulance staff's determinations. Resulls (8.046±6.990)%of the patients who needed treatments refused to be treated completely,and(14.544±10.558)%of them refused partially.(14.451±14.747)% of the patients who needed ambulance transport refused to be delivered.In the patients who refused treatments and transportation.payment problem accounted for(23.52±19.79)%,(22.22±20.84)%of them did not believe they needed.(5.77±4.47)%of them wished to die,(19.44.4±18.65)%of them were hard to be idenfified.Other reasons accounted for(30.08±25.78)%.(20.31.4±16.66)% of the patients refused the ambulance crews' judge for some state.(29.66.4±24.02)%of the patients who got the pre-hospital emergency service were not necessary to call an ambulance.(22.1 l±19.52)%of the patients' demand conflicted with pre-hospital emergency services network management system.Conclusions There exists some conflicts between the pre-hospital patients and ambulance crews' determinations.