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Bremer K, Brown E, Schenkel R, Walters RW, Nandipati KC. Video consent significantly improves patient knowledge of general surgery procedures. Surg Endosc 2024; 38:4641-4647. [PMID: 38926236 PMCID: PMC11289049 DOI: 10.1007/s00464-024-10975-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Informed consent is essential in ensuring patients' understanding of their medical condition, treatment, and potential risks. The objective of this study was to investigate the impact of utilizing a video consent compared to standard consent for patient knowledge and satisfaction in selected general surgical procedures. METHODS AND PROCEDURES We included 118 patients undergoing appendectomy, cholecystectomy, inguinal hernia repair, and fundoplication at two hospitals in Omaha, NE. Patients were randomized to either a standard consent or a video consent. Outcomes included a pretest and posttest objective knowledge assessment of their procedure, as well as a satisfaction survey which was completed immediately after consent and following discharge. Given the pre-post design, a linear mixed-effect model was estimated for both outcomes. A two-way interaction effect was of primary interest to assess whether pre-to-post change in the outcome differed between patients randomized to standard or video consent. RESULTS Baseline characteristics were mostly similar between groups except for patient sex, p = 0.041. Both groups showed a statistically significant increase in knowledge from pretest to posttest (standard group: 0.25, 95% CI 0.01 to 0.51, p = 0.048; video group: 0.68, 95% CI 0.36 to 1.00, p < 0.001), with the video group showing significantly greater change (interaction p = 0.043) indicating that incorporating a video into the consent process resulted in a better improvement in patient's knowledge of the proposed procedure. Further, both groups showed a decrease in satisfaction post-discharge, but no statistically significant difference in the magnitude of decrease between the groups (interaction p = 0.309). CONCLUSION Video consent lead to a significant improvement in a patient's knowledge of the proposed treatment. Although the patient satisfaction survey didn't show a significant difference, it did show a trend. We propose incorporating videos into the consent process for routine general surgical procedures.
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Affiliation(s)
- Kristin Bremer
- Department of Surgery, Creighton University School of Medicine, Creighton University, 7710 Mercy Road, Education Building, Suite 501, Omaha, NE, 68124, USA
| | - Emily Brown
- Department of Surgery, Creighton University School of Medicine, Creighton University, 7710 Mercy Road, Education Building, Suite 501, Omaha, NE, 68124, USA
| | - Rachel Schenkel
- Department of Surgery, Creighton University School of Medicine, Creighton University, 7710 Mercy Road, Education Building, Suite 501, Omaha, NE, 68124, USA
| | - Ryan W Walters
- Department of Clinical Research and Public Health, Creighton University, Omaha, NE, USA
| | - Kalyana C Nandipati
- Department of Surgery, Creighton University School of Medicine, Creighton University, 7710 Mercy Road, Education Building, Suite 501, Omaha, NE, 68124, USA.
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Chan WT, Wu D, Lim XH, Du R, Jeyabal P, Ng L, Nabhan TI, Lim DKA, Stapleton F, Lim HL. Visual supplementation is an effective tool in cataract surgery counselling by eye-care practitioners. J Fr Ophtalmol 2024; 47:104175. [PMID: 38603893 DOI: 10.1016/j.jfo.2024.104175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/18/2023] [Accepted: 10/04/2023] [Indexed: 04/13/2024]
Abstract
BACKGROUND Informed consent constitutes an important aspect of eye care. However, patients often experience difficulties understanding and retaining information presented to them during consultations. This study investigates the efficacy of pictorial aids in supplementing preoperative counselling of patients undergoing cataract surgery. METHODS Patients attending routine pre-cataract surgery counselling were randomized to receive either a standard verbal consultation (control) or a verbal consultation with a digitalized pictorial aid illustrating key surgical steps (intervention). Patients were assessed after the consultation on their knowledge, satisfaction, anxiety and preparedness using an anonymous questionnaire. RESULTS Seventy-six patients were recruited and randomized into the control and intervention groups. The intervention group attained better Knowledge Scores (control: 5 [2-6] vs. intervention: 6 [6]), and more patients "strongly agreed" that they were more prepared (control: 78.9% vs. intervention: 97.4%, P=0.028). A higher proportion of patients in the control group either "disagreed" or "neither disagree nor agreed (neutral)" that they were less worried (control: 15.8% vs. intervention: 0.0%, Fisher's Exact Test P=0.025). Although the consultation duration was shorter in the intervention group (21±4mins vs. 27±6mins, P<0.001), the use of digital pictorial aids during consultation resulted in more effective counselling with increased patient knowledge, easier decision-making process and reduced patient anxiety. CONCLUSION Pictorial aids add to the repository of tools available to eye-care practitioners and are low-cost, easy to implement, and can effectively augment existing preoperative counselling processes to ensure accurate and effective preoperative counselling of patients.
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Affiliation(s)
- W T Chan
- Department of Ophthalmology, National University Hospital, NUHS Tower Block, Level 7, 119228 Singapore
| | - D Wu
- Department of Ophthalmology, National University Hospital, NUHS Tower Block, Level 7, 119228 Singapore
| | - X H Lim
- Department of Ophthalmology, National University Hospital, NUHS Tower Block, Level 7, 119228 Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - R Du
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - P Jeyabal
- Department of Ophthalmology, National University Hospital, NUHS Tower Block, Level 7, 119228 Singapore
| | - L Ng
- Department of Ophthalmology, National University Hospital, NUHS Tower Block, Level 7, 119228 Singapore
| | - T I Nabhan
- College of Optometry, University of Missouri-St. Louis, St. Louis, USA
| | - D K-A Lim
- Department of Ophthalmology, National University Hospital, NUHS Tower Block, Level 7, 119228 Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - F Stapleton
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - H L Lim
- Department of Ophthalmology, National University Hospital, NUHS Tower Block, Level 7, 119228 Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; Singapore Eye Research Institute, Singapore, Singapore.
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Hood B, Finch T. Implementing an educational resource for patients participating in cancer clinical trials during the pandemic. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S22-S32. [PMID: 38780984 DOI: 10.12968/bjon.2024.33.10.s22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
This research is centred in the specialty of early phase cancer research - the branch of clinical research that focuses on phase one and phase two clinical trials. The aim was to gain an understanding of the complexity of work involved in implementing an educational intervention within the clinical pathway for newly referred early phase cancer clinical trial patients. The May and Finch Normalisation Process Theory (NPT) was used to understand, develop and evaluate the process of embedding an educational resource at referral hospital sites. Elements emerged from the evaluation that provide insights into the complexity of the implementation work that took place. The main elements were: pandemic-related challenges, change management, leadership, shared purpose, teamwork, workforce capacity and patient outcomes. The findings shed light on the barriers to or facilitators of the implementation of the educational resource.
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Affiliation(s)
- Ben Hood
- Consultant Nurse, Newcastle Hospitals NHS Foundation Trust
| | - Tracy Finch
- Professor, Northumbria University, Newcastle upon Tyne
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Srifuengfung M, Abraham J, Avidan MS, Lenze EJ. Perioperative Anxiety and Depression in Older Adults: Epidemiology and Treatment. Am J Geriatr Psychiatry 2023; 31:996-1008. [PMID: 37482501 PMCID: PMC10592367 DOI: 10.1016/j.jagp.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023]
Abstract
The intervals before and after major surgery is a high-risk period for older adults; in this setting, anxiety and depression are common and serious problems. We comprehensively reviewed current evidence on perioperative anxiety and depression in older adults, focusing on epidemiology, impact, correlates, medication risks, and treatment. Principles of perioperative mental healthcare are proposed based on the findings. Prevalence estimates of clinically significant anxiety and depression range from 5% to 45% for anxiety and 6% to 52% for depression, depending on surgical populations and measurement tools. Anxiety and depression may increase risk for surgical complications and reduce patient participation during rehabilitation. Medical comorbidities, pain, insomnia, cognitive impairment, and delirium are common co-occurring problems. Concomitant uses of central nervous system acting medications (benzodiazepines, anticholinergics, and opioids) amplify the risks of delirium and falls. Based on these findings, we propose that anxiety and depression care should be part of perioperative management in older adults; components include education, psychological support, opioid-sparing pain management, sleep management, deprescribing central nervous system active medications, and continuation and optimization of existing antidepressants. More research is needed to test and improve these care strategies.
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Affiliation(s)
- Maytinee Srifuengfung
- Department of Psychiatry (MS, EJL), Washington University School of Medicine, St. Louis, MO; Department of Psychiatry (MS), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Joanna Abraham
- Department of Anesthesiology (JA, MSA), Washington University School of Medicine, St. Louis, MO; Institute for Informatics (JA), Washington University School of Medicine, St. Louis, MO
| | - Michael S Avidan
- Department of Anesthesiology (JA, MSA), Washington University School of Medicine, St. Louis, MO
| | - Eric J Lenze
- Department of Psychiatry (MS, EJL), Washington University School of Medicine, St. Louis, MO
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Hood B, Plummer R, Hogarth L, Brown G, Porteous H, Armstrong A, Grice C, Barron C. Impact of an educational intervention for advanced cancer patients referred for early phase clinical trials. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:748-753. [PMID: 37596084 DOI: 10.12968/bjon.2023.32.15.748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
A 2017 service evaluation identified a lack of information and knowledge among patients who were referred on to early phase oncology clinical trials (Hood, 2020). An educational booklet was developed to improve patients' knowledge and experience. To build upon this work, a patient co-designed website was developed. This study examined the impact, if any, of a patient co-designed educational intervention within the clinical pathway for patients who are referred for an early phase oncology clinical trial at an experimental cancer medicine centre (ECMC). AIMS 1. To understand the experiences of patients who have been referred to an ECMC for an early phase clinical trial pre- and post-intervention. 2. To investigate if the intervention reduced anxiety levels in newly referred patients. METHOD A convergent mixed-methods design was used in this study, to collect quantitative and qualitative data in parallel. OUTCOMES This study examined the experiences of advanced cancer patients who attended their initial research outpatient appointment to discuss the possibility of taking part in an early phase clinical trial and the impact of an educational resource.
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Affiliation(s)
- Ben Hood
- Nurse Consultant, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne
| | - Ruth Plummer
- Professor, Newcastle University, Newcastle upon Tyne
| | - Linda Hogarth
- Project Manager, Newcastle University, Newcastle upon Tyne
| | - Gary Brown
- Specialist Psychological Therapist, Northumbria Healthcare NHS Trust, Ashington
| | - Helen Porteous
- Clinical Trial Coordinator, Newcastle University, Newcastle upon Tyne
| | | | - Carole Grice
- Research Administrator, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne
| | - Chris Barron
- Clinical Trials Unit Manager, Newcastle University, Newcastle upon Tyne
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Esperto F, Cacciatore L, Tedesco F, Brassetti A, Testa A, Raso G, Iannuzzi A, Papalia R, Scarpa RM. Video Consensus and Radical Prostatectomy: The Way to Chase the Future? J Pers Med 2023; 13:1013. [PMID: 37374002 DOI: 10.3390/jpm13061013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/16/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
In the age of information, new platforms are consulted by patients to acquire consciousness about medical treatments. The aim of this study was to assess the level of understanding and feasibility of video consensus (VC) administration in patients scheduled for radical prostatectomy (RP), comparing it with standard informed consensus (SIC). According to the European Association of Urology Patient Information, we set up a video content for RP that was translated in Italian and implemented with information about possible perioperative and postoperative complications, days of hospitalization etc. From 2021 to 2022, all patients undergoing RP at our institution were prospectively included in this study. Patients received an SIC and after that, a VC about RP. After two consensuses were administered, patients received a preformed Likert 10 scale and STAI questionnaires. On the RP dataset, 276 patients were selected and 552 questionnaires for both SIC and VC were evaluated. Out of these, the median age was 62 years (IQR 60-65). Patients reported a higher overall satisfaction for VC (8.8/10) compared to the traditional informed consent (6.9/10). Therefore, VC may play a role in the future of surgery, improving the consciousness and satisfaction of patients and reducing preoperative anxiety.
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Affiliation(s)
- Francesco Esperto
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Loris Cacciatore
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Francesco Tedesco
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Aldo Brassetti
- Department of Urology, IRCCS "Regina Elena" National Cancer Institute, 00128 Rome, Italy
| | - Antonio Testa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Gianluigi Raso
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Andrea Iannuzzi
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Rocco Papalia
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
| | - Roberto Mario Scarpa
- Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, 00128 Rome, Italy
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Surgical informed consent: new challenges. Curr Probl Surg 2023; 60:101258. [PMID: 36813352 DOI: 10.1016/j.cpsurg.2022.101258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022]
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Kiernan A, Fahey B, Guraya SS, Boland F, Moneley D, Doyle F, Harkin DW. Digital technology in informed consent for surgery: systematic review. BJS Open 2023; 7:7000436. [PMID: 36694387 PMCID: PMC9874030 DOI: 10.1093/bjsopen/zrac159] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/03/2022] [Accepted: 10/26/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Informed consent is an ethical and legal requirement in healthcare and supports patient autonomy to make informed choices about their own care. This review explores the impact of digital technology for informed consent in surgery. METHODS A systematic search of EBSCOhost (MEDLINE/CINAHL), Embase, Cochrane Central Register of Controlled Trials and Web of Science was performed in November 2021. All RCTs comparing outcomes of both digital and non-digital (standard) consent in surgery were included. Each included study underwent an evaluation of methodological quality using the Cochrane risk of bias (2.0) tool. Outcomes assessed included comprehension, level of satisfaction and anxiety, and feasibility of digital interventions in practice. RESULTS A total of 40 studies, across 13 countries and 15 surgical specialties were included in this analysis. Digital consent interventions used active patient participation and passive patient participation in 15 and 25 studies respectively. Digital consent had a positive effect on early comprehension in 21 of 30 (70 per cent) studies and delayed comprehension in 9 of 20 (45 per cent) studies. Only 16 of 38 (42 per cent) studies assessed all four elements of informed consent: general information, risks, benefits, and alternatives. Most studies showed no difference in satisfaction or anxiety. A minority of studies reported on feasibility of digital technology in practice. CONCLUSION Digital technologies in informed consent for surgery were found to have a positive effect on early comprehension, without any negative effect on satisfaction or anxiety. It is recommended that future studies explore the feasibility of these applications for vulnerable patient groups and busy surgical practice.
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Affiliation(s)
- Aoife Kiernan
- Correspondence to: Aoife Kiernan, RCSI Main Building, 123 St Stephen’s Green, Dublin 2, Ireland (e-mail: )
| | - Brian Fahey
- Faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Shaista S Guraya
- Faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland—Bahrain, Busaiteen, Bahrain
| | - Fiona Boland
- Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Daragh Moneley
- Department of Vascular Surgery, Beaumont Hospital, Dublin, Ireland
| | - Frank Doyle
- Department of Health Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Denis W Harkin
- Faculty of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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Ullrich M, Findl O, Kefer K, Döller B, Varsits R, Hienert J, Hirnschall N. An evaluation of the efficacy of a supplemental computer-based tutorial to enhance the informed consent process for cataract surgery: an exploratory randomized clinical study. BMC Ophthalmol 2022; 22:430. [PMID: 36368980 PMCID: PMC9650904 DOI: 10.1186/s12886-022-02652-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background To assess whether informing patients with a computer-based tutorial in addition to standard informed consent influences the patient’s attitude towards surgery and increases patient’s knowledge. Methods In this prospective, exploratory, randomized clinical study, patients scheduled for their first eye cataract surgery were randomly allocated to two groups, receiving standard face-to-face informed consent (control group) or additionally using an interactive computer-based tool (CatInfo) containing an audiovisual presentation about cataract and its treatment (study group). Cataract-related knowledge and decisional confidence (decisional conflict scale (DCS)) were assessed as well as one-month postoperatively decisional regret (decision regret scale (DRS)) and willingness to exchange face-to-face discussion time for the use of such a tool. Results The study comprised 134 patients, 64 patients in the study group and 70 in the control group. Patients in the study group answered more questions correctly, 16.3 ± 2.0 (median 16.5, 11.0–19.0) versus 15.5 ± 1.9 (median 16.0, 8.0–19.0; p = 0.01). Patients showed a high decisional confidence with a study group mean DCS score of 92.4 ± 9.8 (median 96.9, 65.6–100) and control group score of 91.6 ± 10.9 (median 95.3, 43.3–100; p = 0.52). Mean DRS score in the study group was 2.5 ± 8.0 (median 0, 0–40) and 4.3 ± 12.5 (median 0, 0–75) in the control group (p = 0.14). Of study group patients 23 (67.6%) were willing to trade time, on average 158 ± 180 s (median 120 s, 45–900). Satisfaction with the tool was high with a mean of 9.1 ± 1.3 out of 10 (median 9.7, 5.0–10). Conclusions Cataract-related knowledge was generally good, with slightly higher scores in the study group. In both groups, decisional confidence was high and regret after surgery was low. A tendency towards slightly higher decisional confidence and lower regret was found in the study group, although these differences were not statistically significant. Additional use of an interactive computer-based tool may prove useful in the informed consent process in a high-volume cataract outpatient setting. Trial registration ClinicalTrials.gov, NCT04975126. Retrospectively registered – July 23, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02652-z.
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Sasajima H, Zako M, Ueta Y, Murotani K. Effects of Low-Concentration Nitrous Oxide Anesthesia on Patient Anxiety During Cataract Surgery: A Retrospective Cohort Study. Clin Ophthalmol 2022; 16:2803-2812. [PMID: 36042911 PMCID: PMC9420443 DOI: 10.2147/opth.s382476] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose We investigated the effects of 30% low-concentration nitrous oxide (N2O) anesthesia on anxiety, pain, and vital signs and the patient population that would benefit from low-concentration N2O anesthesia during cataract surgery. Patients and Methods Sixty-three patients who underwent cataract surgery due to visual impairment from cataracts were included in this single-center retrospective cohort study conducted at the Ophthalmology Department of Shinseikai Toyama Hospital, Japan. Fifty eyes of 39 patients received a combination of local and N2O anesthesia (N2O group), and 30 eyes of 24 patients received local anesthesia without N2O anesthesia (Air group). The primary outcome measures were visual analogue scale (VAS) scores for patient anxiety, pain, and vital signs. The secondary outcome measures were the patient population. Results The change in the VAS scores for anxiety and pain decreased significantly (p = 0.002 and p = 0.014, respectively) in the N2O group (−15.6 ± 22.9 and 12.4 ± 14.9, respectively) compared with that in the Air group (1.2 ± 20.6 and 24.2 ± 22.4, respectively). The systolic and diastolic blood pressure changes did not significantly differ between both groups (p = 0.093 and p = 0.23, respectively). The change in heart rate decreased significantly (p = 0.001) in the N2O group (−4.8 ± 4.8 bpm) compared with that in the Air group (−0.6 ± 5.8 bpm). Multivariate analyses demonstrated that the change in anxiety level in the N2O group correlated significantly with patient age (p = 0.045) and preoperative VAS score for anxiety (p = 0.0001), whereas the change in anxiety level in the Air group did not correlate with any factor. Conclusion Low-concentration N2O anesthesia showed beneficial effects on intraoperative anxiety and pain during cataract surgery; this may aid the stabilization of intraoperative vital signs. Moreover, low-concentration N2O anesthesia during cataract surgery could benefit young patients and patients with high levels of preoperative anxiety.
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Affiliation(s)
- Hirofumi Sasajima
- Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, 939-0243, Japan
- Correspondence: Hirofumi Sasajima, Department of Ophthalmology, Shinseikai Toyama Hospital, 89-10 Shimowaka, Imizu, Toyama, 939-0243, Japan, Tel +81-766-52-2156, Email
| | - Masahiro Zako
- Department of Ophthalmology, Asai Hospital, Seto, 489-0866, Japan
| | - Yoshiki Ueta
- Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, 939-0243, Japan
| | - Kenta Murotani
- Biostatistics Center, Kurume University, Kurume, 830-0011, Japan
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Animation Supported Consent Before Elective Laparoscopic Cholecystectomy. World J Surg 2022; 46:2350-2354. [PMID: 35763103 PMCID: PMC9244138 DOI: 10.1007/s00268-022-06628-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
Background Patient understanding of surgical procedures is often incomplete at the time they are performed, invalidating consent, and exposing healthcare providers to complaints and claims of failure to inform. Remote consultations, language barriers and patient factors can hinder an effective consent pathway. New approaches are needed to support communication and shared decision-making. Methods Multi-language digital animations explaining laparoscopic cholecystectomy were introduced at The Royal London Hospital for patients who attended for elective surgery (www.explainmyprocedure.com/lapchole). Patients completed questionnaires on the day of their procedure both before and after introduction of the animations. We assessed patient-reported understanding of the procedure, its intended benefits, the possible risks, and alternatives to treatment in 72 consecutive patients, 37 before (no animation group) and after 35 after introducing the animations into the consent pathway (animation group). Patient understanding in the two groups was compared. Results The two groups were well matched in respect of age, sex and whether English was their first spoken language. The proportions of patients who reported they completely understood the procedure, its benefits, risks, and alternatives in the no animation group were 54, 57, 38 and 24% and in the animation group, 91, 91, 74 and 77%, respectively; p < 0.01 for each comparison. Conclusion The integration of multi-language laparoscopic cholecystectomy video animations into the patient consent pathway was associated with substantial improvement in reported understanding of the procedure, benefits, risks, and alternatives to treatment. This approach can be applied across all surgical disciplines in a standardised manner in an era of accelerated elective work and remote consultations. Supplementary Information The online version contains supplementary material available at 10.1007/s00268-022-06628-4.
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Penn JP, Nallani R, Dimon EL, Daniels TC, Sykes KJ, Chiu AG, Villwock MR, Villwock JA. Educational Informed Consent Video Equivalent to Standard Verbal Consent for Rhinologic Surgery: A Randomized Controlled Trial. Am J Rhinol Allergy 2021; 35:739-745. [PMID: 33530693 PMCID: PMC9793427 DOI: 10.1177/1945892421992659] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Informed consent is an integral part of pre-operative counseling. However, information discussed can be variable. Recent studies have explored the use of multimedia in providing informed consent for rhinologic surgery. OBJECTIVE To measure impact of an educational video (Video) compared to verbal informed consent (Verbal) on knowledge gained, alleviation of concerns, and efficiency. METHODS Patients undergoing endoscopic sinus surgery (ESS), septoplasty, or ESS+septoplasty were prospectively enrolled and randomized to receive Video or Verbal consent. The Video group watched an educational video; the Verbal group received standard verbal consent from an Otolaryngology resident per institutional protocol. Both groups had the opportunity to discuss questions or concerns with their attending surgeon. Prior to, and after, consent was signed, both groups completed surveys regarding knowledge of purpose, risks, and benefits of surgery as well as surgical concerns. Decision regret and patient satisfaction were also assessed post-operatively. RESULTS 77 patients were enrolled (39 Video, 38 Verbal). Demographics were not significantly different between groups. Overall knowledge significantly improved (p < 0.005) and concerns significantly decreased (p < 0.001) following consent in both groups. Improvements in these metrics were equivalent between groups (p < 0.02). Furthermore, resident time to complete consent, patient satisfaction, and decision regret were not significantly different between groups. CONCLUSION Use of an educational video was equivalent to standard verbal informed consent for patients undergoing rhinologic surgery. Otolaryngologists can consider developing procedure-specific videos to allow allocation of time to other tasks, standardized education of patients, and streamlining of the informed consent process.
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Affiliation(s)
- Joseph P. Penn
- Department of Otolaryngology-Head and Neck Surgery, University
of Kansas, Medical Center, Kansas City, Kansas,Joseph P. Penn, Department of
Otolaryngology—Head and Neck Surgery, University of Kansas Medical Center,
Rainbow Blvd, MS 3010, 3901, Kansas City, KS 66160, USA.
| | - Rohit Nallani
- Department of Otolaryngology-Head and Neck Surgery, University
of Kansas, Medical Center, Kansas City, Kansas
| | - Erin L. Dimon
- School of Medicine, University of Kansas, Kansas City,
Kansas
| | | | - Kevin J. Sykes
- Department of Otolaryngology-Head and Neck Surgery, University
of Kansas, Medical Center, Kansas City, Kansas
| | - Alexander G. Chiu
- Department of Otolaryngology-Head and Neck Surgery, University
of Kansas, Medical Center, Kansas City, Kansas
| | - Mark R. Villwock
- Department of Otolaryngology-Head and Neck Surgery, University
of Kansas, Medical Center, Kansas City, Kansas
| | - Jennifer A. Villwock
- Department of Otolaryngology-Head and Neck Surgery, University
of Kansas, Medical Center, Kansas City, Kansas
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Sayin O, Altinkaynak H, Adam M, Dirican E, Agca O. Reliability of YouTube Videos in Vitreoretinal Surgery. Ophthalmic Surg Lasers Imaging Retina 2021; 52:478-483. [PMID: 34505804 DOI: 10.3928/23258160-20210817-01] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To investigate the reliability and quality of vitreoretinal surgery videos posted on YouTube. PATIENTS AND METHODS A search was made using the keywords "vitrectomy," "retinal surgery," and "vitreoretinal surgery" on YouTube. Total view counts, numbers of comments, likes and dislikes, publishing dates, and source of videos were recorded. Educational quality and accuracy of the video content were evaluated using the DISCERN score, Journal of the American Medical Association (JAMA) scoring system, and Global Quality Scores (GQS). RESULTS There were 208 videos included in the study; 152 (73.1%) videos were uploaded by doctors and 56 (26.9%) videos uploaded by non-doctors. Mean DISCERN, JAMA, and GQS scores were 37.65 ± 10.49 (20-69), 0.82 ± 0.52 (0-4), 2.86 ± 0.86 (1-5), respectively. CONCLUSIONS Vitreoretinal surgery videos on YouTube were of low quality and reliability. Those who want to use YouTube videos as a reference for vitreoretinal surgery should pay extra attention to selection of content. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:478-483.].
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Obuchowska I, Konopinska J. Fear and Anxiety Associated with Cataract Surgery Under Local Anesthesia in Adults: A Systematic Review. Psychol Res Behav Manag 2021; 14:781-793. [PMID: 34177276 PMCID: PMC8219311 DOI: 10.2147/prbm.s314214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022] Open
Abstract
Cataract surgery is one of the most frequently performed surgical procedures worldwide. Patients usually experience strong negative emotions, such as fear and anxiety. A systematic review of the recent literature regarding the emotional states experienced during cataract surgery under local anaesthesia was performed based on the PubMed and Scopus databases. The objective of this review was to determine the causes and frequency of fear and anxiety, as well as methods for improving intraoperative experience and supporting the patient prior to surgery. Anxiety is mainly caused by fear of the surgery itself, fright of pain, and loss of vision. Abstaining and visual sensations experienced during cataract surgery also increased the preoperative anxiety. Women and hypochondriacs showed higher levels of anxiety. The greatest intensity of negative emotions occurred on the day of the cataract surgery. Patients operated on both eyes experienced greater fear and anxiety before the operation of the first eye surgery. In order to reduce patients’ negative experiences, pharmacological sedation, preoperative education and counselling, manual massage immediately before surgery, and listening to music during surgery are used. Taking this information into consideration allows the introduction of effective methods of eliminating the patient’s negative feelings in connection with cataract surgery, which leads to an improvement in the results of the operation and an increase in the patients’ sense of satisfaction and quality of life.
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Affiliation(s)
- Iwona Obuchowska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Konopinska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland
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Sacco G, Noublanche F, Blazek F, Hue C, Carballido L, Asfar M, Allain P, Annweiler C. How to deal with the consent of adults with cognitive impairment involved in European geriatric living labs? Philos Ethics Humanit Med 2021; 16:3. [PMID: 34130730 PMCID: PMC8207703 DOI: 10.1186/s13010-021-00101-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 05/25/2021] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Living labs are realistic environments designed to create links between technology developers and end-users (i.e. mostly older adults). Research in LLH (Living labs in health) covers a wide range of studies from non-interventional studies to CT (clinical trials) and should involve patients with neurocognitive disorders. However, the ethical issues raised by the design, development, and implementation of research and development projects in LLH have been the subject of only little interest thus far. OBJECTIVE Our aim was to determine a pragmatic, ethical and regulatory correct approach to seek the informed consent of patients with neurocognitive disorders according to the different types of studies carried out in European LLH, with a focus on the French context. METHODS A narrative review of regulatory texts and clinical articles was conducted, and a pragmatic procedure to determine the decision-making capacity of older adults in LLH was proposed. RESULTS Individuals must be adequately informed and freely agree to participate in CT. The capacity to consent should be assessed in CT including cognitively impaired older adults. We propose the following steps: first to assess for delirium using the 4 'A's Test (4AT) or the 3-min Diagnostic interview for Confusion Assessment Method (3D-CAM), second to search for medical history of major neurocognitive disorder, and third to assess the decision capacity using the University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). CONCLUSIONS Including individuals with neurocognitive disorders in research implies using an efficient and pragmatic strategy to inform participants and obtain their consent. The tool we offer here may be useful in the routine operation of LLH but can also be extended to all CT with this population.
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Affiliation(s)
- Guillaume Sacco
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France.
- Univ Angers, Université de Nantes, LPPL, SFR CONFLUENCES, F-49000, Angers, France.
- Université Côte d'Azur, CoBTek, Nice, France.
| | - Frédéric Noublanche
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
- Univ Angers, Université de Nantes, LPPL, SFR CONFLUENCES, F-49000, Angers, France
| | | | | | | | - Marine Asfar
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Philippe Allain
- Univ Angers, Université de Nantes, LPPL, SFR CONFLUENCES, F-49000, Angers, France
| | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France.
- Univ Angers, Université de Nantes, LPPL, SFR CONFLUENCES, F-49000, Angers, France.
- Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, Canada.
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Raper SE, Clapp JT, Fleisher LA. Improving Surgical Informed Consent: Unanswered Questions. ANNALS OF SURGERY OPEN 2021; 2:e030. [PMID: 37638239 PMCID: PMC10455139 DOI: 10.1097/as9.0000000000000030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 11/28/2020] [Indexed: 01/11/2023] Open
Abstract
Objective This study reviews randomized clinical trials that have attempted to improve the process of informed consent. Consent should be guided by the ethical imperatives of autonomy, beneficence, and social justice. Summary Background Informed consent is constantly evolving. Yet our review of the randomized trials done to improve the surgical informed consent process raises a number of questions: How does one define surgical informed consent? What interventions have been tried to measure and improve informed consent? Have the interventions in informed consent actually led to improvements? What efforts have been made to improve informed consent? And what steps can be taken to improve the process further? Methods A literature search for randomized controlled trials (RCTs)on informed consent identified 70 trials. Demographics, interventions, assessments, and a semi-quantitative summary of the findings were tabulated. The assessments done in the RCTs, show the surrogate for patient autonomy was comprehension; for beneficence, satisfaction and mental state (anxiety or depression); and, for social justice, language, literacy, learning needs, and cost. Results There were 4 basic categories of interventions: printed matter; non-interactive audiovisual tools; interactive multimedia; and a smaller group defying easy description. Improvement was documented in 46 of the 65 trials that studied comprehension. Thirteen of 33 trials showed improved satisfaction. Three of 30 studies showed an increase in anxiety. Few studies tried to assess primary language or literacy, and none looked at learning needs or cost. Conclusions No single study improved all 3 principles of informed consent. Validated interventions and assessments were associated with greater impact on outcomes. All 3 ethical principles should be assessed; autonomy (as comprehension), beneficence (as satisfaction, anxiety), and social justice. Not enough consideration has been given to social justice; appropriate language translation, standardized reading levels, assessment of learning needs, and cost to the individual are all important elements worthy of future study.
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Affiliation(s)
- Steven E. Raper
- From the Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Justin T. Clapp
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Lee A. Fleisher
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Schrenk K, Khoramnia R, Feltgen N, Bachmann W, Ziemssen F, Rohrbach JM, Dimopoulos S. [Advertising or information in ophthalmology? : Scientific evaluation of a YouTube sample]. Ophthalmologe 2021; 118:30-41. [PMID: 32350611 PMCID: PMC7808978 DOI: 10.1007/s00347-020-01105-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite the liberalization of the Therapeutic Products Advertising Act, advertising that praises, misleads or compares is still contrary to the German professional conduct. In view of the increasing commitment of financial investors and the economization in ophthalmology, this study was initiated to examine and check which (advertising) statements are affected in openly accessible videos on the YouTube platform. METHODS Using the search terms "ophthalmologist" and "eye center" as well as predefined criteria (German origin, audio track with spoken text, duration >1 min), videos were identified and transcribed into an anonymized text version. Using a self-developed predefined questionnaire, the individual statements were then subjected to a critical review by three experts and clarity, relevance and completeness of the information were also assessed. At the same time, laypersons were asked how convincingly, comprehensibly and completely they assessed the information and whether they would want to be treated by the physicians. RESULTS Out of 68 videos 30 met the defined inclusion criteria. Of the videos 46% focused on procedures for refractive surgery. From the experts' point of view, at least 11.8% of the individual statements were completely wrong or only slightly correct. Over 80% of the videos presented information incompletely. Perioperative and postoperative complications were only mentioned by three films. Laypersons evaluated the texts very inconsistently and could not identify the videos that contained problematic statements as assessed by the ophthalmologists. Conflicts with the legal requirements for advertising, e.g. the use of lurid superlatives were found. A balanced presentation, such as alternatives to treatment procedures was rare. There was a great need to improve the comprehensibility for laymen. CONCLUSION Only a very small number of freely accessible videos provide scientifically founded and correct information. Until now, many ophthalmologists do not sufficiently consider the legal and moral requirements for advertising statements. Therefore, there may be negative effects on the professional image in the public eye and opportunities for health promotion remain unused.
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Affiliation(s)
- Kilian Schrenk
- Department für Augenheilkunde, Eberhard-Karl Universität Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland
| | - Ramin Khoramnia
- Universitätsaugenklinik Heidelberg, 69120, Heidelberg, Deutschland
| | - Nicolas Feltgen
- Augenklinik der Universitätsmedizin Göttingen, Göttingen, Deutschland
| | | | - Focke Ziemssen
- Department für Augenheilkunde, Eberhard-Karl Universität Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland.
| | - Jens Martin Rohrbach
- Department für Augenheilkunde, Eberhard-Karl Universität Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland
| | - Spyridon Dimopoulos
- Department für Augenheilkunde, Eberhard-Karl Universität Tübingen, Elfriede-Aulhorn-Str. 7, 72076, Tübingen, Deutschland
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Getting animated about trauma - Using video animation as part of informed consent. Injury 2020; 51:2479-2482. [PMID: 32711935 DOI: 10.1016/j.injury.2020.07.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/18/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Trauma patients are often required to make an informed decision about surgery within a short space of time. Coming to terms with their injury may mean they have limited bandwidth for absorbing information, and it may be that they don't appreciate the risks and benefits of surgery discussed during consent. Current consent practice puts the emphasis on the clinician to ensure that all reasonable steps have been taken to explain risks and benefits to patients. We propose the use of video animations that patients can watch prior to surgery as a means of improving their understanding and overall experience. METHODS The video script was written and evaluated so that a high standard was achieved using the "Discern" instrument. The experiences of a focus group of 5 patients were used to guide script content. Using GoAnimate (GoAnimate Inc., San Mateo) a video was made with voice over provided by local drama students. The video was shown to 30 consecutive patients over a 2 month period. We included any patient with an ankle fracture managed operatively who had been consented (form 1). Evaluation consisted of interview with patients consisting of 2 focussed questions and one open. Responses to the questions were collated and grouped into positive and negative descriptors. RESULTS 68 (81%) positive descriptors were recorded from patients' interviews versus 16 (19%) negative. Positive descriptors related to improved retention, information giving, technical detail, consolidations of information given during consent. Negatives were caveats that video couldn't replace face-to-face consent, the degree of detail being off-putting and not adding anything to standard consent. CONCLUSION The video was well received by patients with subjective improvements being made to their understanding, retention and sharing of technical detail. The face-to-face discussion between patient and doctor remains very important to them and the video should look to augment this.
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Wisely CE, Robbins CB, Stinnett S, Kim T, Vann RR, Gupta PK. Impact of Preoperative Video Education for Cataract Surgery on Patient Learning Outcomes. Clin Ophthalmol 2020; 14:1365-1371. [PMID: 32546944 PMCID: PMC7246322 DOI: 10.2147/opth.s248080] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/17/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess the effect of an educational video on 1) patient knowledge about cataract surgery, 2) patient perception of preoperative assessment visit quality, 3) face-to-face time with the surgeon, and 4) choices regarding premium intraocular lenses (IOLs) or laser-assisted cataract surgery (LACS). Setting Eye clinic in an academic medical center. Design Prospective survey of patients who randomly viewed or did not view an educational video. Methods Patients of three cataract surgeons completed a survey during cataract surgery preoperative visits. One group viewed an educational video about cataract surgery, while the other did not. All patients received their surgeon’s typical preoperative counseling. Results A total of 101 patients were surveyed. Out of 101 patients, 58 viewed the educational video. Patients who viewed the video exhibited stronger learning outcomes; in particular, patients who viewed the video scored higher on cataract surgery educational assessments than those who did not (83% vs 76%, p=0.032), particularly on the assessment of postoperative visual expectations (98% vs 80%, p=0.003). Differences in educational assessment scores between groups were not affected by which surgeon patients saw (p=0.807). Patients who watched the video were more likely to agree their surgeon provided quality explanations (93% vs 74% strongly agreed, p=0.025) and trended toward greater perception the surgeon spent enough time with them (p=0.067). Video education did not affect face-to-face surgeon time with patients (p=0.212) or choices of multifocal IOLs (p=0.795), toric IOLs (p=0.321), or LACS (p=0.940). Conclusion Video education during preoperative cataract surgery assessments improved patient understanding of cataract surgery and perception of preoperative visits. Video education is easily integrated into preoperative visits and can enhance the preoperative experience.
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Affiliation(s)
- C Ellis Wisely
- Duke University, Department of Ophthalmology, Durham, NC, USA
| | | | - Sandra Stinnett
- Duke University, Department of Ophthalmology, Durham, NC, USA
| | - Terry Kim
- Duke University, Department of Ophthalmology, Durham, NC, USA
| | - Robin R Vann
- Duke University, Department of Ophthalmology, Durham, NC, USA
| | - Preeya K Gupta
- Duke University, Department of Ophthalmology, Durham, NC, USA
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Saglam K, Kayaalp C, Aktas A, Sumer F. Educational Video Addition to the Bariatric Surgery Informed Consent Process: a Randomized Controlled Trial. Obes Surg 2020; 30:2693-2699. [PMID: 32279184 DOI: 10.1007/s11695-020-04552-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Bariatric surgery is not a risk-free procedure and requires lifelong patient compliance in the postoperative period. Although the risks involved in bariatric surgery and the importance of lifelong follow-ups in the postoperative period are explained to patients in detail through verbal and written informed consent, the strong desire for weight loss can sometimes cause patients and their families to be ignorant of the mentioned issues preoperatively. The objective of this study is to evaluate the effectiveness of preoperative informational videos at improving the comprehension of informed consent content in bariatric surgery candidates. MATERIALS AND METHODS A total of 74 bariatric surgery candidates were randomized into two groups. The first group was given a usual verbal-written informed consent. The second group got an additional informing video presentation informed consent, in addition to the usual verbal-written informed consent. Then, both groups got a questionnaire evaluating their knowledge of bariatric surgery informed consent. The correct response scores and their relationship with patient demographics were analyzed. RESULTS Both groups had similar demographic features. Video-presented group had higher scores in questionnaire (11.3 ± 2.3 versus 9.4 ± 1.7, p = 0.001). Subgroup analysis showed that health care workers (12.5 ± 1.9 versus 10.3 ± 2.2, p = 0.005) and university graduates (11.6 ± 2.4 versus 10.1 ± 2.1, p = 0.03) got better results in the questionnaire. In multivariate analysis, video-assisted informing was found to be the only independent variable for high questionnaire scores (p = 0.0001). CONCLUSIONS This study showed that video-assisted informed consent improves patients' comprehension prior to bariatric surgery. We recommend routine preoperative video-assisted informing for bariatric surgery candidates in addition to usual verbal-written informed consent.
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Affiliation(s)
- Kutay Saglam
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey.
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey
| | - Aydin Aktas
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey
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Socea SD, Abualhasan H, Magen O, Zayit-Soudry S, Blumenthal EZ, Duvdevan N, Mimouni M. Preoperative Anxiety Levels and Pain during Cataract Surgery. Curr Eye Res 2019; 45:471-476. [DOI: 10.1080/02713683.2019.1666996] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sergiu D. Socea
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hamza Abualhasan
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Or Magen
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Shiri Zayit-Soudry
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Eytan Z. Blumenthal
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Nitsan Duvdevan
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
- Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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