Health Commun.  2020 Jun;15(1):61-66. 10.15715/kjhcom.2020.15.1.61.

A study on the discharge against medical advice in the emergency room from the communication perspective

Affiliations
  • 1Resident, Department of Emergency Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
  • 2Clinical Assistant Professor, Department of Emergency Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
  • 3Assistant Professor, Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea

Abstract

Background
: It is called a discharge against medical advice (DAMA) that a patient needs continuous medical care, but leaving the hospital contrary to a doctor’s medical advice. DAMA also occurs in the emergency room, and sometimes it can make the patient's symptoms and states worse or even lead to death.
Methods
:
Results
: There are various reasons for deciding to DAMA. Among those reasons, the poor communication skills of medical staff can cause the disease insight of patient to be lowered, create unsatisfactory medical services, and create distrust for the medical staff.
Conclusion
: Medical staff can lower the frequency of DAMA through following patient-oriented communication : listening to the patient's symptoms and information, talking to the patient in an easy-to-understand language, and conducting two-way communication with appropriate feedback.

Keyword

Discharge against medical advice; Communication; Emergency service; Patients
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