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 That could have an important effect on patient dignity, the authors
suggest.
Dr. Todd C. Lee, who participated in the research, said he was
struck by how bizarre it was to see one of his patients leave the
ward briefly to attend to business wearing a suit, and then return
and don an undignified open-backed hospital gown again.
“Clearly he was capable of wearing normal clothes - it was our
system and its expectations (and perhaps his preconceived notion of
them) that led to him awkwardly strutting down the hall in that
fashion,” Lee told Reuters Health in an email.
“Since then, I have always believed that patients should be
encouraged to wear their own clothing if it is appropriate,” he
said. “It is interesting in that most times I have ever suggested it
to my patients, they usually take to the idea quite quickly.”
Lee is a doctor in the division of general internal medicine at
McGill University Health Center in Montreal, Quebec.
For the study, he and his colleagues noted whether or not patients
entering six clinical teaching units at five hospitals in Canada on
the same day were wearing any garments below the waist, other than
underwear or a diaper.
They also asked the attending doctors if each patient would be
allowed to wear garments like pants if they wanted to.
Of the 127 patients entering the units that day, doctors said that
57 would be eligible to wear pants, but only 14 of those were doing
so, Lee and his team reported in a research letter in JAMA Internal
Medicine.
Some patients weren’t eligible to wear regular clothes below the
waist because they had wounds or catheters. In other cases, patients
were too immobile, too incontinent, too confused, or too ill to wear
such attire, given the available nursing resources.
At one center, researchers also asked 17 patients who were eligible
to wear pants but were not doing so if they would like to, and 13
said yes.
“Our study, which was small, suggested that probably more than one
in two patients could have been wearing their own clothing, but were
not,” Lee said. “On some units that proportion will be higher, on
others lower.”
In certain circumstances, gowns do have practical advantages, making
physical examinations easier for doctors, and making laundering and
disinfecting easier for those caring for patients with frequent
urinary or fecal incontinence, he said.
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But as others have suggested, taking away a patient’s clothes and
forcing them to adopt the familiar hospital gown may cause
additional emotional trauma to some patients, he said.
“I think all patients should therefore have the option to wear their
own clothing if it is clinically reasonable to do so,” Lee said.
“Clothing worn needs to be hygienic, able to be laundered, and
shouldn't preclude the examination of patients or the performing of
medically necessary acts.”
Patients should be prepared to change into the hospital gown for
procedures or examinations, which require them, he said.
One way to address the problem would be for a Canadian or American
company to design updated ‘functional fashions’ for the hospital
that are easy to put on, easy to take off, easy to launder, and that
facilitated examinations and tests, but preserve more dignity for
the patient, he said. Until then, the base option may be for
patients to ask for their own clothes and see if it would be an
option.
“Much as I think patients should politely ask all health care
practitioners who see them in the hospital to wash their hands, I
think they should also ask, if they are interested in doing so, if
they can wear their own clothing,” Lee said. “To my mind, there is
no harm in asking politely.”
SOURCE: http://bit.ly/1emvR3n JAMA Internal Medicine, September 22,
2014.
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