Ethical considerations about informed consent in physiotherapy in Romania

Med Pharm Rep. 2019 Oct;92(4):362-367. doi: 10.15386/mpr-1223. Epub 2019 Oct 25.

Abstract

Background and aim: Physiotherapy has a distinct feature in terms of patient relationship, regarding the level of communication, especially how physical therapy sessions take place throughout the rehabilitation process. One of the particularities encountered in Romanian physiotherapy practice is related to obtaining informed consent (IC), considering that the initial contact of the patient is with a rehabilitation doctor when general consent is obtained. The aim of this study was to investigate Romanian physiotherapists aspects related to the frequency and use of IC at physiotherapy onset.

Method: A cross-sectional study was conducted among Romanian physiotherapists using a survey with 2 open and 37 closed items, including nine demographics items, developed after a systematic literature review. The closed items were Likert type scales, measuring frequency or agreement on scale from 1 to 5. The questionnaire was distributed online from November 2017 until May 2018 and data was gathered from 148 physiotherapists. The statistical analysis targeted descriptive analysis and multiple regression.

Results: The results suggested that only 40.82 % of physiotherapists are always seeking to obtain IC at physiotherapy onset, while 16.3 % never apply this legal demand in their professional activity, confidence intervals were set to 95% with 3.34 lower bound and 3.82 upper bound. Through multiple regression, we have identified factors which correlates with an increased frequency of IC obtaining at physiotherapy onset. Professional skills, ethical knowledge and ethical reasoning are factors with a positive influence towards obtaining IC with an increased frequency.

Conclusions: Ethical knowledge, moral reasoning and consideration for patient are elements which have a positive influence regarding the awareness of IC. The process of demanding and obtaining IC within Romanian physiotherapists must be improved despite the particularities of medical practice. Further research is needed to identify the methods by which Romanian physiotherapists awareness toward IC can be increased.

Keywords: ethics; informed consent; knowledge; physiotherapy.