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Shreyas K, Jadhav A, Goel AD, Pathak M, Rathod K, Nayak S, Saxena R, Sinha A. Effect of Multimedia Teaching Tools in Parental Anxiety and Comprehension of Informed Consent Procedure in Pediatric Surgical Procedures: A Single Centre Randomized Control Trial. J Pediatr Surg 2023; 58:2000-2005. [PMID: 37217363 DOI: 10.1016/j.jpedsurg.2023.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Informed consent is an essential component of medical ethics. In children, the parent or legally authorized guardian must consent to any medical or surgical intervention. A number of adjuncts have been developed to supplement the consent process including multimedia tools. Unfortunately, there is little information regarding the use of Multimedia teaching tools (MMT) in pediatric settings in developing countries with diversities in language, socioeconomic and educational status. OBJECTIVES The objectives of the study were to compare the parental comprehension of the surgery through the informed consent obtained either by conventional method or by multimedia tool and the effect of MMT in alleviating parental anxiety against the conventional method and to assess their overall satisfaction. METHODS A randomized control trial was conducted between 2018 and 2020, including MMT and conventional groups. A novel Multimedia tool with a Microsoft PowerPoint presentation was created. A 5-Question knowledge-based test, State-Trait Anxiety Inventory (STAI) tool, and a Likert-based questionnaire were used to assess the comprehension, anxiety, and satisfaction of parents. RESULTS Among 122 randomized cohorts, the mean value of percentage fall in anxiety STAI score in the MMT group was 44.64 ± 10.14 whereas in the Conventional group it was 26.6 ± 11.91 (p < 0.05). MMT cohort scored higher in the knowledge-based test (p < 0.05) and recorded higher parental satisfaction. CONCLUSION The Multimedia tool aided consent procedure is effective in reducing parental anxiety and improving their comprehension and overall satisfaction. Thus, they can be used as an effective supplement in preoperative surgical education and consent procedure. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- K Shreyas
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Basni Phase 2 Industrial Area, Jodhpur, Rajasthan, 342001, India
| | - Avinash Jadhav
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Basni Phase 2 Industrial Area, Jodhpur, Rajasthan, 342001, India.
| | - Akhil D Goel
- Department of Community and Family Medicine, AIIMS, Jodhpur, India
| | - Manish Pathak
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Basni Phase 2 Industrial Area, Jodhpur, Rajasthan, 342001, India
| | - Kirtikumar Rathod
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Basni Phase 2 Industrial Area, Jodhpur, Rajasthan, 342001, India
| | - Shubhalaxmi Nayak
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Basni Phase 2 Industrial Area, Jodhpur, Rajasthan, 342001, India
| | - Rahul Saxena
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Basni Phase 2 Industrial Area, Jodhpur, Rajasthan, 342001, India
| | - Arvind Sinha
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Basni Phase 2 Industrial Area, Jodhpur, Rajasthan, 342001, India
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Fuji H, Fujibuchi T, Tanaka H, Ogawa Y, Noda C, Hayakawa M, Nakamura K, Tanaka K. Changes in satisfaction and anxiety about radiotherapy for pediatric cancer by two-step audio-visual instruction. Tech Innov Patient Support Radiat Oncol 2023; 27:100214. [PMID: 37521254 PMCID: PMC10371834 DOI: 10.1016/j.tipsro.2023.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 08/01/2023] Open
Abstract
Objectives Although radiotherapy is an essential component of pediatric cancer treatment, inadequate radiotherapy information for childhood cancer and unusual treatment situations can negatively affect parental perceptions and emotions. This study aims to investigate the effect of two-step audio-visual instruction system effects introduced by our institution on parent satisfaction and anxiety when initiating radiotherapy. Methods The two-step audio-visual instruction system comprised instructive animation using patient avatars and a live video system. The live video system has a 55-inch-wide monitor, and a no-latency sound module. Parents in the radiotherapy division can view the patient in the treatment room through the live video system. This prospective study compared satisfaction and anxiety about radiotherapy introduction before and after two-step audio-visual instruction. We enrolled 20 parents whose child underwent radiotherapy, and they completed a set of questionnaires-Client Satisfaction Questionnaire, State-Trait Anxiety Inventory, and original questionnaires about radiotherapy. Results Satisfaction scores improved significantly after two-step audio visual instruction (25.5 ± 3.4) compared with those before the instruction (27.7 ± 3.1) (p = <0.01). Anxiety scores also decreased significantly after the instruction (50 ± 9) compared with those before the instruction (54 ± 11) (p = 0.004). However, anxiety-related personality trait scores did not change drastically before and after viewing (48 ± 8.5 vs. 49 ± 7.5) (p = 0.419). Conclusion This single-arm prospective study indicates that two-step audio-visual instruction for radiotherapy is effective in improving parents' anxiety about radiotherapy introductions. However, large-scale and comparative studies are warranted to generalize the benefit of two-step audio visual instruction.
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Affiliation(s)
- Hiroshi Fuji
- Division Of Radiation Oncology, National Center For Child Health And Development, Tokyo, Japan
| | - Tomoyasu Fujibuchi
- Division Of Radiation Oncology, National Center For Child Health And Development, Tokyo, Japan
| | - Hideyuki Tanaka
- Division Of Radiation Oncology, National Center For Child Health And Development, Tokyo, Japan
| | - Yuu Ogawa
- Division Of Psychosocial Medicine, National Center For Child Health And Development, Tokyo, Japan
| | - Chihiro Noda
- Division Of Psychosocial Medicine, National Center For Child Health And Development, Tokyo, Japan
| | - Maoko Hayakawa
- Division Of Psychosocial Medicine, National Center For Child Health And Development, Tokyo, Japan
| | - Kazuaki Nakamura
- Department of Pharmacology, National Center for Child Health and Development, Tokyo, Japan
| | - Kyoko Tanaka
- Division Of Psychosocial Medicine, National Center For Child Health And Development, Tokyo, Japan
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Atsaidis Z, Robitaille S, Guadagno E, Wiseman J, Emil S, Poenaru D. "Your child needs surgery": A survey-based evaluation of simulated expert consent conversations by key stakeholders. J Pediatr Surg 2023; 58:902-907. [PMID: 36828674 DOI: 10.1016/j.jpedsurg.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND Consent conversations in pediatric surgery are essential components of pre-operative care which, when inadequate, can lead to significant adverse consequences for the child, parents, surgeon, and others in the healthcare system. The aim of this study is to explore expert consenting practice from the key stakeholders' perspective. METHODS Four senior attending pediatric surgeons obtained consent from a standardized mother of a child requiring surgery in two scenarios: a low-risk elective surgery (inguinal hernia repair - Video 1), and a high-risk emergency surgery (intestinal atresia - Video 2). All sessions were recorded. Families of children who had undergone minor or major surgery, families without medical or surgical background, and healthcare professionals were invited to view and evaluate the videos using a semi-structured questionnaire. RESULTS Out of 251 distributed surveys, 56 complete responses were received. Thirty two participants (57.1%) evaluated video 1 and 24 (42.9%) evaluated. Overall, 22 (69%) respondents to video 1 and 20 (84%) respondents to video 2 were "very satisfied" with the recorded consent conversation. Qualitative responses shared common themes of valuing surgeon empathy, good surgeon communication, patient engagement, and adequate time and information. Suggestions for improvement included additional resources and visual aids, improved patient engagement, and discussion of post-operative expectations. CONCLUSION Our data identifies strengths and gaps in the current consent process from the perspective of patient families and providers. Identified areas for improvement in the informed consent process based on multi-stakeholder input will guide the planned development of a consenting educational video resource. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Zoe Atsaidis
- McGill University Faculty of Medicine & Health Sciences, Montreal, Quebec, Canada.
| | - Stephan Robitaille
- Department of Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Elena Guadagno
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Jeffrey Wiseman
- Division of Internal Medicine, McGill University Health Center, Montreal, Quebec, Canada
| | - Sherif Emil
- McGill University Faculty of Medicine & Health Sciences, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
| | - Dan Poenaru
- McGill University Faculty of Medicine & Health Sciences, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada
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Understanding the effectiveness of consent processes and conversations in pediatric surgery: A systematic-scoping review. J Pediatr Surg 2022; 57:834-844. [PMID: 36031429 DOI: 10.1016/j.jpedsurg.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/21/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The consent conversation in pediatric surgery is an essential part of pre-operative care which, when inadequate, can lead to significant adverse consequences for the child, parents, surgeon, other healthcare workers and the healthcare system. We reviewed the published literature on what key stakeholders perceive are the components of effective and ineffective consenting processes in pediatric surgery. METHODS A medical librarian searched seven databases to retrieve articles looking at the informed consenting process in surgical care for the pediatric population. Two independent reviewers screened all publications and categorized them by stakeholder perspectives (patient/family, surgical team, other healthcare team, and hospital administration or policy maker). General study characteristics, interventions to improve consent and features of effective and ineffective consent conversations were extracted. RESULTS 5079 titles and abstracts were screened, resulting in 88 full-text studies and 43 articles included in the final review. Most publications (51%) discussed informed consent only from the patient/family perspective, while 21% added surgeon's perspective. No study approached the consenting process from the perspective of all stakeholder groups. Effective consent components identified included use of multimedia, presence of multiple conversations prior to surgery, and individualized communication catered to unique family knowledge and needs. In contrast, ineffective conversations did not include a clear assessment of parental understanding, delivered too much information, and did not address parental anxiety. CONCLUSIONS The literature on the consenting process in pediatric surgery is narrow in stakeholder perspectives. Our findings highlight gaps in the literature and opportunities to improve the informed consent processes prior to pediatric surgery.
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Parental Educational Intervention to Facilitate Informed Consent for Pediatric Procedural Sedation in the Emergency Department: A Parallel-Group Randomized Controlled Trial. Healthcare (Basel) 2022; 10:healthcare10122353. [PMID: 36553877 PMCID: PMC9778183 DOI: 10.3390/healthcare10122353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/14/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022] Open
Abstract
Obtaining valid parental informed consent for pediatric procedures in the emergency department (ED) is challenging. We compared a video-assisted informed consent intervention with conventional discussion to inform parents about pediatric procedural sedation in the ED. We conducted a prospective randomized controlled trial using a convenience sample including the parents of children in the ED in whom procedural sedation for facial laceration was recommended. The video group watched an informational video. Conventional group participants received information from physicians during conventional discussion. The primary outcome was knowledge improvement of the video intervention compared with conventional discussion. The secondary outcome was parental satisfaction. Video and conventional groups comprised 32 and 30 participants, respectively. Mean knowledge scores of parents after intervention [±standard deviation] were higher in the video group (91.67 ± 12.70) than in the conventional group (73.33 ± 19.86). Knowledge score differences were significantly bigger in the video group (coefficient: 18.931, 95% confidence interval: 11.146-26.716). Video group participants reported greater satisfaction than conventional group participants. Parents' comprehension of and satisfaction with the informed consent process for pediatric procedural sedation may be improved with the use of an educational video. Standardized approaches should be developed by healthcare institutions to better educate parents, facilitate treatment decisions, and boost satisfaction in the ED.
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Novel Way to Improve Satisfaction, Comprehension, and Anxiety in Caregivers: A Randomized Trial Exploring the Use of Comprehensive, Illustrated Children's Books for Pediatric Surgical Populations. J Am Coll Surg 2022; 234:263-273. [PMID: 35213488 DOI: 10.1097/xcs.0000000000000057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Surgery generates anxiety and stress, which can negatively impact informed consent and postoperative outcomes. This study assessed whether educational, illustrated children's books improve comprehension, satisfaction, and anxiety of caregivers in pediatric surgical populations. METHODS A prospective randomized trial was initiated at a tertiary care children's hospital. All patients ≤ 18 years old with caregiver and diagnosis of 1) uncomplicated appendicitis (English or Spanish speaking); 2) ruptured appendicitis; 3) pyloric stenosis; 4) need for gastrostomy tube; or 5) umbilical hernia were eligible. Conventional consent was obtained followed by completion of 17 validated survey questions addressing apprehension, satisfaction, and comprehension. Randomization (2:1) occurred after consent and before operative intervention with the experimental group (EG) receiving an illustrated comprehensive children's book outlining anatomy, pathophysiology, hospital course, and postoperative care. A second identical survey was completed before discharge. Primary outcomes were caregiver apprehension, satisfaction, and comprehension. RESULTS Eighty caregivers were included (55: EG, 25: control group [CG]). There were no significant differences in patient or caregiver demographics between groups. The baseline survey demonstrated no difference in comprehension, satisfaction, or apprehension between groups (all p values NS). After intervention, EG had significant improvement in 14 of 17 questions compared with CG (all p < 0.05). When tabulated by content, there was significant improvement in comprehension (p = 0.0009), satisfaction (p < 0.0001), and apprehension (p < 0.0001). CONCLUSION The use of illustrated educational children's books to explain pathophysiology and surgical care is a novel method to improve comprehension, satisfaction, and anxiety of caregivers. This could benefit informed consent, understanding, and postoperative outcomes.
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Nair T, Choo CSC, Abdullah NS, Lee S, Teo LLE, Chen Y, Nah SA, Chiang LW. Home-Initiated-Programme-to-Prepare-for-Operation: evaluating the effect of an animation video on peri-operative anxiety in children: A randomised controlled trial. Eur J Anaesthesiol 2021; 38:880-887. [PMID: 33186309 DOI: 10.1097/eja.0000000000001385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Hospital admissions and surgical operations commonly trigger anxiety in young children. Despite employing numerous support measures in our hospital, such as a pre-operative play room, the encouragement of parental companionship during induction of anaesthesia and distraction therapy, allaying the anxiety of our young surgical patients remains a challenge. OBJECTIVES To evaluate the effectiveness of a Home-Initiated-Programme-to-Prepare-for-Operation (HIPPO) on emotional manifestation and anxiety in children undergoing surgery. DESIGN, SETTING AND PATIENTS One hundred and thirty children were randomly assigned to either control or intervention group between February 2018 and April 2019 in a tertiary paediatric hospital in Singapore. INTERVENTION In addition to our standard pre-operative workflow, the intervention group received an additional home preparation kit consisting of an animated video on preoperative preparation and age-specific preoperative preparation activity sheets. MAIN OUTCOME MEASURES The primary outcome was the Children's Emotional Manifestation Scale score to evaluate behaviour and emotion in the children before and during induction of anaesthesia. Secondary outcomes evaluated anxiety levels in parents and children, the child's behaviour and degree of co-operation using the State-Trait Anxiety Inventory scores, State-Trait Anxiety Inventory Children scores, the Induction Compliance Checklist scores, the Visual Analogue Scale scores for anxiety and the feedback questionnaire. RESULTS The difference between the Children's Emotional Manifestation Scale score in control and intervention groups was not statistically significant. A promising difference was however observed in one of the secondary outcomes where the state-State-Trait Anxiety Inventory Children scores of 7 to 10-year olds in the intervention group almost reached significance; P = 0.067. CONCLUSION Despite being a child-friendly, easily accessible and affordable tool for patient education, HIPPO did not reduce anxiety experienced by children in the pre-operative waiting area or during induction of anaesthesia. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT04271553.
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Affiliation(s)
- Tanuja Nair
- From CHAMPs (Child Life, Art and Music Therapy Programmes) (TN, NSA)- Allied Health Specialities Division, Department of Pediatric Surgery (CSCC, YC, SAN, LWC), Department of Paediatric Anaesthesia (SL), Psychology Service (LLET)- Allied Health Specialities Division, KK Women's and Children's Hospital, Singapore and Division of Paediatric Surgery, Department of Surgery, Faculty of Medicine, University of Malaya (SAN)
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Metwally AM, Amer HA, Salama HI, Abd El Hady SI, Alam RR, Aboulghate A, Mohamed HA, Badran HM, Saadallah AA, El-Sonbaty MM, Eltahlawy E, Saad W, Mohsen A, Abdel-Latif GA, Fathy AM, Hassanain AI, Eldali A. Egyptian patients'/guardians' experiences and perception about clinical informed consent and its purpose: Cross sectional study. PLoS One 2021; 16:e0252996. [PMID: 34125842 PMCID: PMC8202917 DOI: 10.1371/journal.pone.0252996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 05/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Informed consent (IC) is a healthcare standard emphasizing the meaning of human dignity as clarified in the Universal Declaration of Human Rights. Data about IC practices in Egypt is insufficient. This study aimed to assess the Egyptian patients'/guardians' experiences about IC and their expectations about its practices' purposes in general and according to the type of the healthcare facility. METHODS Self-administered questionnaire was carried out for 1092 participants who had undergone or were scheduled to a procedure requiring an IC at three studied types for Egyptian health care facilities. Ten statements were ranked twice by the participants to reflect their perception of IC purpose as per what is currently practiced and what they believe should be practiced. RESULTS IC implementation varies significantly (p<0.05) across the health care facilities in Egypt. The percentage of its implementation at the non-governmental facilities, governmental facilities, and university hospital was 85.9%, 77.8%, and 63.8 respectively. The first three ranked purposes of the current IC practices were: "Helping patient/guardian decide (64.9%)", "Documenting patient's/guardian's decision (59.3%)", and "Having shared decision (57.3%)". The perceived purposes of IC to be practiced were: "Informing the patient/guardian (68.4%)", "Making sure patient/guardian understand (65.3%)" and "Documenting patients/guardians decisions (65.1%)". "Being a meaningless routine" was reported by the majority to be ranked as a low purpose for IC current and preferred practices. CONCLUSION The practice of IC is common within the Egyptian medical community. Participants believe that information disclosure "Making sure patients understand" has to help in IC decision making and its main purpose. However, unfortunately, this is not perceived as a current purpose of IC. There was consensus agreement that documenting the patient's/guardian's decision and informing the patient/guardian are perceived as both important current and preferred purposes for IC practices.
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Affiliation(s)
- Ammal M. Metwally
- Medical Research Division, Community Medicine Research Department, National Research Centre, Dokki, Cairo, Egypt
| | - Hala A. Amer
- Medical Research Division, Community Medicine Research Department, National Research Centre, Dokki, Cairo, Egypt
- Department of Infection Control, King Saud Medical City, Riyadh, KSA
| | - Hend I. Salama
- National Blood Transfusion Services Mansoura Region, Ministry of Health and Population, Egypt
| | | | - Raefa R. Alam
- Faculty of Nursing, Mansoura University, Mansoura, Egypt
- Egyptian Liver Research Institute And Hospital (ELRIAH), Mansoura, Egypt
| | - Ahmed Aboulghate
- Medical Research Division, Community Medicine Research Department, National Research Centre, Dokki, Cairo, Egypt
| | - Hanan A. Mohamed
- Faculty of Nursing, Mansoura University, Mansoura, Egypt
- Egyptian Liver Research Institute And Hospital (ELRIAH), Mansoura, Egypt
| | - Hanan M. Badran
- Faculty of Nursing, Mansoura University, Mansoura, Egypt
- Egyptian Liver Research Institute And Hospital (ELRIAH), Mansoura, Egypt
| | - Amal A. Saadallah
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Marwa M. El-Sonbaty
- Medical Research Division, Child Health Department, National Research Centre, Cairo, Egypt
- Department of Pediatrics, College of Medicine, Taibah University, Madinah, K.S.A
| | - Eman Eltahlawy
- Environmental Research Division, Environmental Health and Occupational Medicine, National Research Centre, Egypt
| | - Walaa Saad
- Department of biological anthropology, National Research Centre, Egypt, Cairo, Egypt
| | - Amira Mohsen
- Medical Research Division, Community Medicine Research Department, National Research Centre, Dokki, Cairo, Egypt
| | - Ghada A. Abdel-Latif
- Medical Research Division, Community Medicine Research Department, National Research Centre, Dokki, Cairo, Egypt
| | - Asmaa M. Fathy
- Medical Research Division, Community Medicine Research Department, National Research Centre, Dokki, Cairo, Egypt
| | - Amal I. Hassanain
- Medical Research Division, Child Health Department, National Research Centre, Cairo, Egypt
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Metwally AM, Amer HA, Salama HI, Abd El Hady SI, Alam RR, Aboulghate A, Mohamed HA, Badran HM, Saadallah AA, El-Sonbaty MM, Eltahlawy E, Saad W, Mohsen A, Abdel-Latif GA, Fathy AM, Hassanain AI, Eldali A. Egyptian patients’/guardians’ experiences and perception about clinical informed consent and its purpose: Cross sectional study. PLoS One 2021; 16:e0252996. [DOI: https:/doi.org/10.1371/journal.pone.0252996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023] Open
Abstract
Background
Informed consent (IC) is a healthcare standard emphasizing the meaning of human dignity as clarified in the Universal Declaration of Human Rights. Data about IC practices in Egypt is insufficient. This study aimed to assess the Egyptian patients’/guardians’ experiences about IC and their expectations about its practices’ purposes in general and according to the type of the healthcare facility.
Methods
Self-administered questionnaire was carried out for 1092 participants who had undergone or were scheduled to a procedure requiring an IC at three studied types for Egyptian health care facilities. Ten statements were ranked twice by the participants to reflect their perception of IC purpose as per what is currently practiced and what they believe should be practiced.
Results
IC implementation varies significantly (p<0.05) across the health care facilities in Egypt. The percentage of its implementation at the non-governmental facilities, governmental facilities, and university hospital was 85.9%, 77.8%, and 63.8 respectively. The first three ranked purposes of the current IC practices were: “Helping patient/guardian decide (64.9%)”, “Documenting patient’s/guardian’s decision (59.3%)”, and “Having shared decision (57.3%)”. The perceived purposes of IC to be practiced were: “Informing the patient/guardian (68.4%)”, “Making sure patient/guardian understand (65.3%)” and “Documenting patients/guardians decisions (65.1%)”. “Being a meaningless routine” was reported by the majority to be ranked as a low purpose for IC current and preferred practices.
Conclusion
The practice of IC is common within the Egyptian medical community. Participants believe that information disclosure “Making sure patients understand” has to help in IC decision making and its main purpose. However, unfortunately, this is not perceived as a current purpose of IC. There was consensus agreement that documenting the patient’s/guardian’s decision and informing the patient/guardian are perceived as both important current and preferred purposes for IC practices.
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ALAN S, ECEVİT ALPAR Ş. Maternal Anxiety Associated with Newborn Screening. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2020. [DOI: 10.33808/clinexphealthsci.570626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Ayenew NT, Endalew NS, Agegnehu AF, Bizuneh YB. Prevalence and factors associated with preoperative parental anxiety among parents of children undergoing anesthesia and surgery: A cross-sectional study. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Book F, Goedeke J, Poplawski A, Muensterer OJ. Access to an online video enhances the consent process, increases knowledge, and decreases anxiety of caregivers with children scheduled for inguinal hernia repair: A randomized controlled study. J Pediatr Surg 2020; 55:18-28. [PMID: 31685270 DOI: 10.1016/j.jpedsurg.2019.09.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 09/29/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND There is limited time within the clinical workflow of most pediatric surgeons to obtain a comprehensive, well informed consent. This study evaluates whether ad-lib access to an online video on the consent dialogue enhances the consent process for inguinal hernia repair (IHR) in children. METHODS The study was approved by the state ethics board. A 6-min video of a consent speech on IHR was produced and uploaded to a nonpublic online channel, explaining the condition, procedure, complications, and postoperative expectations. A total of 50 families were randomized to conventional, face-to-face consenting in clinic either with (intervention) or without (control) access to the online video. During their child's IHR, the parents were asked to complete the State-Trait-Anxiety Inventory (STAI), a modified Friedlander questionnaire on assessing knowledge sufficient to provide informed consent, and a validated satisfaction survey. Scores of the intervention and control group were statistically compared. RESULTS The intervention group demonstrated significantly decreased anxiety measured with the STAI (p = 0,026) and increased knowledge (p = 0,016) compared to controls. There was no difference in satisfaction (p = 0,557). CONCLUSION Preoperatively providing access to an online consent video regarding IHR reduces anxiety and enhances knowledge without altering satisfaction level. Adjunct online videos are a useful tool to enhance the consent process. TYPE OF STUDY Prospective randomized controlled trial. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Friederike Book
- Department of Pediatric Surgery, University Medicine of the Johannes Gutenberg University, Mainz, Germany
| | - Jan Goedeke
- Department of Pediatric Surgery, University Medicine of the Johannes Gutenberg University, Mainz, Germany
| | - Alicia Poplawski
- IMBEI Institute of Medical Biostatistics, Epidemiology and Informatics University Medicine of the Johannes Gutenberg University, Mainz, Germany
| | - Oliver J Muensterer
- Department of Pediatric Surgery, University Medicine of the Johannes Gutenberg University, Mainz, Germany.
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