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YILMAZ H. Perkütanöz Karaciğer Biyopsisi Hasta Deneyimlerini Anlamak Hekimleri Yasal Yaptırımlardan Koruyabilir. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.30934/kusbed.1061033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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McNicholas DP, Yap LC, Haroon UM, Forde JC, Cheema IA, McLornan L. Does postal consent for flexible cystoscopy work? Ir J Med Sci 2021; 191:603-606. [PMID: 33818740 DOI: 10.1007/s11845-021-02613-3] [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: 02/21/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Informed consent is an integral part of the process prior to any surgical procedure [1]. Flexible cystoscopy is a common day case urological procedure and it is the gold standard investigation for visible haematuria [2]. AIM To assess if postal consent is a suitable form of gaining informed consent for flexible cystoscopy. METHODS Patients booked for a flexible cystoscopy are initially reviewed in clinic. An information leaflet with an attached consent form is then posted to their home 2 weeks prior to their procedure. We designed a short questionnaire, to assess patient's satisfaction and understanding of the literature, given to them after the procedure. RESULTS Sixty-seven questionnaires were completed. The mean age was 54. Sixty patients (93%) think that postal consent is of benefit to the patient. Sixty-one patients (91%) read the information sheet and felt that there was enough information regarding the procedure on it. Fifty-four patients (81%) had no difficulty understanding the consent form. Forty patients (60%) signed the form prior to arrival in the hospital. CONCLUSION Postal consent is commonly used for gastro-intestinal endoscopy procedures. Postal consent for flexible cystoscopy is not well reported in the literature. Our study shows postal consent to be a suitable form of gaining informed consent for flexible cystoscopy.
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Affiliation(s)
| | - Lee Chien Yap
- Department of Urology, James Connolly Memorial Hospital, Dublin, Ireland
| | - Usman M Haroon
- Department of Urology, James Connolly Memorial Hospital, Dublin, Ireland
| | - James C Forde
- Department of Urology, James Connolly Memorial Hospital, Dublin, Ireland
| | - Ijaz A Cheema
- Department of Urology, James Connolly Memorial Hospital, Dublin, Ireland
| | - Liza McLornan
- Department of Urology, James Connolly Memorial Hospital, Dublin, Ireland
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Gu L, Yao J, Cao Q, Wang SL, Xia T, Zhao SB, Wang ZJ, Wang D, Li ZS, Bai Y. Issues on informed consent for endoscopic retrograde cholangiopancreatography. Shijie Huaren Xiaohua Zazhi 2018; 26:1581-1585. [DOI: 10.11569/wcjd.v26.i27.1581] [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] [Indexed: 02/06/2023] Open
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic operation with potential therapeutic risks. With the development of endoscopic techniques, the rate of performing ERCP is more and more higher and as a result, the rate of complications is increasing. Unfortunately, quite a few patients have little comprehension about the process of ERCP and its complications. This paper gives a brief overview of some issues on informed consent for ERCP.
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Affiliation(s)
- Lun Gu
- Department of Gastroenterology, Changhai Hospital Affiliated to the Naval Medical University, Shanghai 200433, China
| | - Jun Yao
- Department of Gastroenterology, Shenzhen Municipal People's Hospital, Shenzhen 518020, Guangdong Province, China
| | - Qi Cao
- Department of Gastroenterology, Changhai Hospital Affiliated to the Naval Medical University, Shanghai 200433, China
| | - Shu-Ling Wang
- Department of Gastroenterology, Changhai Hospital Affiliated to the Naval Medical University, Shanghai 200433, China
| | - Tian Xia
- Department of Gastroenterology, Changhai Hospital Affiliated to the Naval Medical University, Shanghai 200433, China
| | - Sheng-Bin Zhao
- Department of Gastroenterology, Changhai Hospital Affiliated to the Naval Medical University, Shanghai 200433, China
| | - Zhi-Jie Wang
- Department of Gastroenterology, Changhai Hospital Affiliated to the Naval Medical University, Shanghai 200433, China
| | - Dong Wang
- Department of Gastroenterology, Changhai Hospital Affiliated to the Naval Medical University, Shanghai 200433, China
| | - Zhao-Shen Li
- Department of Gastroenterology, Changhai Hospital Affiliated to the Naval Medical University, Shanghai 200433, China
| | - Yu Bai
- Department of Gastroenterology, Changhai Hospital Affiliated to the Naval Medical University, Shanghai 200433, China
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Mason MC, Williamson JML. Readability of endoscopy information leaflets: Implications for informed consent. Int J Clin Pract 2018; 72:e13099. [PMID: 29726067 DOI: 10.1111/ijcp.13099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/04/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Valid consent for gastrointestinal endoscopy is required for ethical and legal reasons. Patients are frequently met by an endoscopist for the first time on the day of their procedure. For valid consent to be possible, the patient needs to have received and understood generic information regarding endoscopy in advance. Patient information leaflets (PILs) need to be easily understood by the majority of the population. METHOD PILs from 14 secondary care institutions and a sample PIL from the British Society of Gastroenterology were analysed using an online readability tool. Flesch reading ease, Flesch-Kincaid grade (F-K grade) and Simple Measure of Gobbledygook (SMOG) were calculated and compared against national recommendations and literacy standards. RESULT Average Flesch reading ease score was 57.5, below the threshold of 60 which indicates a document that is easy to read. Average F-K grade and SMOG were 9.7 and 9.4, respectively; both indicating a reading age of 14-15, the recommended reading age being 11-12. There is considerable variation when documents are analysed by institution. Flesch scores varying from 49.7 to 66.1, F-K grade 8.2-11.4 and SMOG 8.3-10.8 (reading ages 13-17). CONCLUSION All PILs analysed exceeded the recommended reading age for patient information. In the context of "straight to test" endoscopy where patients do not have a consultation with clinicians well versed in endoscopy prior to the day of the procedure, this risks invalidating consent. PILs need to be written carefully to ensure the information provided is accessible to patients, and that the language used is suitably aimed to achieve this.
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Affiliation(s)
- Matthew C Mason
- Department of General Surgery, Weston General Hospital, Weston-Super-Mare, UK
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Beg S, Ragunath K, Wyman A, Banks M, Trudgill N, Pritchard DM, Riley S, Anderson J, Griffiths H, Bhandari P, Kaye P, Veitch A. Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS). Gut 2017; 66:1886-1899. [PMID: 28821598 PMCID: PMC5739858 DOI: 10.1136/gutjnl-2017-314109] [Citation(s) in RCA: 193] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/26/2017] [Accepted: 07/12/2017] [Indexed: 12/18/2022]
Abstract
This document represents the first position statement produced by the British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, setting out the minimum expected standards in diagnostic upper gastrointestinal endoscopy. The need for this statement has arisen from the recognition that while technical competence can be rapidly acquired, in practice the performance of a high-quality examination is variable, with an unacceptably high rate of failure to diagnose cancer at endoscopy. The importance of detecting early neoplasia has taken on greater significance in this era of minimally invasive, organ-preserving endoscopic therapy. In this position statement we describe 38 recommendations to improve diagnostic endoscopy quality. Our goal is to emphasise practices that encourage mucosal inspection and lesion recognition, with the aim of optimising the early diagnosis of upper gastrointestinal disease and improving patient outcomes.
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Affiliation(s)
- Sabina Beg
- Department of Gastroenterology, NIHR Nottingham Digestive Diseases Biomedical Research Centre, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Krish Ragunath
- Department of Gastroenterology, NIHR Nottingham Digestive Diseases Biomedical Research Centre, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Andrew Wyman
- Department of Surgery, Sheffield Teaching Hospitals, Sheffield, UK
| | - Matthew Banks
- Department of Gastroenterology, University College London Hospitals, London, UK
| | - Nigel Trudgill
- Department of Gastroenterology, Sandwell General Hospital, West Bromwich, UK
| | - D Mark Pritchard
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Stuart Riley
- Department of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
| | - John Anderson
- Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Helen Griffiths
- Department of Gastroenterology, Wye Valley NHS Trust, Herefordshire, UK
| | - Pradeep Bhandari
- Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK
| | - Phillip Kaye
- Department of Histopathology, Nottingham University Hospitals NHS trust, Nottingham, UK
| | - Andrew Veitch
- Department of Gastroenterology, New Cross Hospital, Wolverhampton, UK
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Nasiri J, Khatib N, Kheiri S, Najafi M. The influence of escort during upper endoscopy and colonoscopy on patient satisfaction and anxiety. J Family Med Prim Care 2016; 5:134-8. [PMID: 27453858 PMCID: PMC4943120 DOI: 10.4103/2249-4863.184638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM Endoscopy, including esophagogastroduodenoscopy (EGD) and colonoscopy (CS), is a diagnostic and treatment method for various diseases. We aimed to evaluate the effects of the presence of an escort by the patient on patients' satisfaction and anxiety level before and after upper endoscopy and CS. SUBJECTS AND METHODS Patients who referred to the Hajar Hospital for elective EGD and CS were recruited. The patients were divided into two groups: The first group underwent endoscopy/CS with an escort beside the patient and the escort was waiting in the waiting room in the second group. After interventions, patients' and their escort's levels of anxiety and satisfaction were evaluated. Anxiety level was compared before and after endoscopy. RESULTS Of 211 patients, 106 were referred for EGD and 105 for CS. Anxiety was same in both groups before the interventions (P > 0.05), which decreased in both after the EGD or CS (P < 0.05). Anxiety reduction after CS was influenced by the presence of the escort and the level of anxiety was less in this group than other group (P < 0.05). Satisfaction of the EGD and CS in the group that had an escort by their side was more than the other (P < 0.05). Escorts had a moderate level of anxiety in both groups with a marked reduction after endoscopy and CS (P < 0.05). However, the level of anxiety before and after endoscopy was similar in both groups (P > 0.05). CONCLUSION Having an escort at the time of endoscopy or CS appears to be an effective costless complication-free measure for increasing satisfaction and reducing anxiety in patients.
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Affiliation(s)
- Jafar Nasiri
- Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Narges Khatib
- Department of Internal Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Soleiman Kheiri
- Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Mostafa Najafi
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Chandrasekhara V, Eloubeidi MA, Bruining DH, Chathadi K, Faulx AL, Fonkalsrud L, Khashab MA, Lightdale JR, Muthusamy VR, Pasha S, Saltzman JR, Shaukat A, Wang A, Cash B, DeWitt JM. Open-access endoscopy. Gastrointest Endosc 2016; 81:1326-9. [PMID: 25865387 DOI: 10.1016/j.gie.2015.03.1917] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 03/12/2015] [Indexed: 12/13/2022]
Abstract
OAE is commonly used. The majority of patients referred for OAE are considered appropriate for endoscopy according to ASGE guidelines. Most patients undergoing OAE procedures are knowledgeable about the study and are satisfied with the experience. Several potential problems have been identified, including inappropriate referrals, communication errors, and inadequately prepared or informed patients. OAE can be safely used if preprocedure assessment, informed consent, information transfer, patient safety, and satisfaction are addressed in all cases.
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Abstract
Informed consent and refusal for pediatric procedures involves a process in which the provider, child, and parents/guardians participate. In pediatric gastroenterology, many procedures are considered elective and the process generally begins with an office visit and ends with the signing of the consent document. If the process is emergent then this occurs more expeditiously and a formal consent may not be required. Information about the procedure should be shared in a way that allows a decision-making process to occur for both the parent/guardian and the child, if of assenting age.
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Affiliation(s)
- Joel A Friedlander
- Digestive Health Institute, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave, B290, Aurora, CO 80045, USA.
| | - David E Brumbaugh
- Digestive Health Institute, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave, B290, Aurora, CO 80045, USA
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Wong J, Chan DTM, Tam YH, Ng SSM, Ip PCT, Leung WW, Lai PBS. Audit on surgical patients' understanding of their informed consent. SURGICAL PRACTICE 2015. [DOI: 10.1111/1744-1633.12110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- John Wong
- Department of Surgery; The Chinese University of Hong Kong; Hong Kong
- Wong Tze Lam - Hing Tak Centre of Surgical Outcome Research; Prince of Wales Hospital; Hong Kong
| | - Danny Tat-Ming Chan
- Department of Surgery; The Chinese University of Hong Kong; Hong Kong
- Wong Tze Lam - Hing Tak Centre of Surgical Outcome Research; Prince of Wales Hospital; Hong Kong
| | - Yuk-Him Tam
- Department of Surgery; The Chinese University of Hong Kong; Hong Kong
- Wong Tze Lam - Hing Tak Centre of Surgical Outcome Research; Prince of Wales Hospital; Hong Kong
| | - Simon Siu-Man Ng
- Department of Surgery; The Chinese University of Hong Kong; Hong Kong
- Wong Tze Lam - Hing Tak Centre of Surgical Outcome Research; Prince of Wales Hospital; Hong Kong
| | - Philip Ching-Tak Ip
- Department of Surgery; The Chinese University of Hong Kong; Hong Kong
- Wong Tze Lam - Hing Tak Centre of Surgical Outcome Research; Prince of Wales Hospital; Hong Kong
| | - Wing-Wah Leung
- Department of Surgery; The Chinese University of Hong Kong; Hong Kong
- Wong Tze Lam - Hing Tak Centre of Surgical Outcome Research; Prince of Wales Hospital; Hong Kong
| | - Paul Bo-San Lai
- Department of Surgery; The Chinese University of Hong Kong; Hong Kong
- Wong Tze Lam - Hing Tak Centre of Surgical Outcome Research; Prince of Wales Hospital; Hong Kong
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Mohanaruban A, Flanders L, Dor R. Consent in the endoscopy department. Frontline Gastroenterol 2014; 5:291-296. [PMID: 28839786 PMCID: PMC5369752 DOI: 10.1136/flgastro-2013-100394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 01/13/2014] [Accepted: 01/14/2014] [Indexed: 02/04/2023] Open
Abstract
The demand for endoscopic procedures continues to increase and is likely to continue to do so for the foreseeable future. Alongside elective diagnostic procedures, the number of complex and therapeutic procedures is increasing. It is therefore vital that the consent process is comprehensive, and high standards in consenting patients are maintained. Consent is defined as a patient's agreement to treatment or an intervention proposed by a health professional. Careful patient selection is required when proposing endoscopic procedures with an appreciation of the risks and complications that are involved. This paper addresses the various components of gaining informed consent and the legal issues surrounding this process. Additionally, this article reviews legislation and focuses upon specific instances where further considerations have to be made; in a patient who lacks capacity, in children, in percutaneous endoscopic gastrostomy and in the patient who is a Jehovah's Witness.
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Affiliation(s)
| | - Lucy Flanders
- Department of Gastroenterology, North Middlesex University Hospital, London, UK
| | - Riaz Dor
- Department of Gastroenterology, North Middlesex University Hospital, London, UK
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Kopacova M, Bures J. Informed consent for digestive endoscopy. World J Gastrointest Endosc 2012; 4:227-30. [PMID: 22720123 PMCID: PMC3377864 DOI: 10.4253/wjge.v4.i6.227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 05/07/2012] [Accepted: 05/27/2012] [Indexed: 02/05/2023] Open
Abstract
Informed consent is necessary in good clinical practice. It is based on the patient´s ability to understand the information about the proposed procedure, the potential consequences and complications, and alternative options. The information is written in understandable language and is fortified by verbal discussion between physician and patient. The aim is to explain the problem, answer all questions and to ensure that the patient understands the problems and is able to make a decision. The theory is clear but what happens in daily practice?
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Affiliation(s)
- Marcela Kopacova
- Marcela Kopacova, Jan Bures, 2nd Department of Medicine, Faculty of Medicine at Hradec Králové, University Teaching Hospital, Sokolská 581, 500 05 Hradec Králové, Czech Republic
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Abstract
The views of the parents of children undergoing elective surgery are not well represented in the literature. The aim of this study was to identify the priorities of parents with a view to improve their satisfaction. A questionnaire-based survey was conducted among parents of children undergoing elective surgery between November 2007 and March 2008. A total of 337 completed questionnaires were received. A similar survey was conducted among 12 surgeons, and their views were compared. Forty-three percent of parents preferred to know about a procedure on the day of surgery while others wanted the information in advance. Parents were most concerned with the complications of surgery and least concerned with the scar. Most of the surgeons thought it was not essential to mention their level of experience and the detailed surgical procedure to the parents while obtaining consent for surgery. In contrast, the parents thought that knowing the experience of the operating surgeon and the detailed surgical procedure was more important than knowing the duration of operation and the surgical incision. Face-to-face discussion with a surgeon was the most preferred mode of communication. Although 82% of parents have access to the Internet, booklets were more popular among parents than online information. Twelve percent of parents wanted the information in a foreign language. This survey reveals the perspective of parents about their child's surgery and identifies the differences in opinion between patients and surgeons about the information to be provided before surgery. Tailoring information to the parents' priorities will improve parent satisfaction.
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Affiliation(s)
- A Niyogi
- Department of Paediatric Surgery, Chelsea and Westminster Hospital, London, England, UK.
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[Increasing efficiency and patient satisfaction by structured clinical processes in presurgical visits]. Unfallchirurg 2010; 114:1091-8. [PMID: 20706829 DOI: 10.1007/s00113-010-1840-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND In clinical routine the process of presurgical visit and signed informed consent is imperfectly realized in surgical patients. MATERIAL AND METHODS A total of 450 consecutive patients were interviewed after a presurgical visit for informed consent using a questionnaire. The aim of the study was to investigate the amount of knowledge gained by informed consent. Patient satisfaction with medical treatment and logistic workflow was correlated with real waiting times and process times. RESULTS Mean information duration was 36.1±0.8 min. In patients with no appointed time, waiting times and overall stay was shorter. Patient's satisfaction with medical treatment and time process was significantly higher in the elderly. Longer conversation with the surgeon was associated with a higher assessment of surgeons' medical experience irrespective of his specialist's state. Real waiting times did not affect patient's satisfaction. CONCLUSION A walk-in clinic for presurgical visit and signed informed consent can improve patient satisfaction. It allows an excellent patients information in an appropriate time-frame. Clinical pathways can improve patient satisfaction and information concerning the lining up operation and disease pattern.
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An investigation into the information received by patients undergoing a gastroscopy in a large teaching hospital in Ireland. Gastroenterol Nurs 2008; 31:212-22. [PMID: 18542022 DOI: 10.1097/01.sga.0000324113.01651.ab] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The purpose of this article is to examine the information received by patients undergoing a gastroscopy. The growing number and complexity of day-case endoscopy increases the need for quality patient information. Provision of patient information reduces anxiety, increases knowledge, improves cooperation during endoscopy and increases compliance with discharge instructions. The study used a descriptive survey with convenience sampling (response rate 66%, N = 137). Patients received most of the standard procedural information (how and why the procedure is carried out), but they received considerably less sensory information (information regarding what they would hear, feel, smell, etc.). In addition, age and gender appeared to affect the amount of information received. Older patients received more procedural information than younger patients, and male patients received more information than female patients. The nurse was the main source of information. The majority of patients (>80%) received adequate information and were satisfied with the information received. Patients also received most of the information verbally on the day of the procedure rather than before admission. This study identified the need for patient information leaflets. The role of the nurse and the effect of age and gender on information provision are important considerations for healthcare professionals.
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Felley C, Perneger TV, Goulet I, Rouillard C, Azar-Pey N, Dorta G, Hadengue A, Frossard JL. Combined written and oral information prior to gastrointestinal endoscopy compared with oral information alone: a randomized trial. BMC Gastroenterol 2008; 8:22. [PMID: 18522729 PMCID: PMC2430967 DOI: 10.1186/1471-230x-8-22] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2008] [Accepted: 06/03/2008] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about how to most effectively deliver relevant information to patients scheduled for endoscopy. Methods To assess the effects of combined written and oral information, compared with oral information alone on the quality of information before endoscopy and the level of anxiety. We designed a prospective study in two Swiss teaching hospitals which enrolled consecutive patients scheduled for endoscopy over a three-month period. Patients were randomized either to receiving, along with the appointment notice, an explanatory leaflet about the upcoming examination, or to oral information delivered by each patient's doctor. Evaluation of quality of information was rated on scales between 0 (none received) and 5 (excellent). The analysis of outcome variables was performed on the basis of intention to treat-analysis. Multivariate analysis of predictors of information scores was performed by linear regression analysis. Results Of 718 eligible patients 577 (80%) returned their questionnaire. Patients who received written leaflets (N = 278) rated the quality of information they received higher than those informed verbally (N = 299), for all 8 quality-of-information items. Differences were significant regarding information about the risks of the procedure (3.24 versus 2.26, p < 0.001), how to prepare for the procedure (3.56 versus 3.23, p = 0.036), what to expect after the procedure (2.99 versus 2.59, p < 0.001), and the 8 quality-of-information items (3.35 versus 3.02, p = 0.002). The two groups reported similar levels of anxiety before procedure (p = 0.66), pain during procedure (p = 0.20), tolerability throughout the procedure (p = 0.76), problems after the procedure (p = 0.22), and overall rating of the procedure between poor and excellent (p = 0.82). Conclusion Written information led to more favourable assessments of the quality of information and had no impact on patient anxiety nor on the overall assessment of the endoscopy. Because structured and comprehensive written information is perceived as beneficial by patients, gastroenterologists should clearly explain to their patients the risks, benefits and alternatives of endoscopic procedures. Trial registration: Current Controlled trial number: ISRCTN34382782.
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Affiliation(s)
- Christian Felley
- Division of Gastroenterology and Hepatology, University Hospitals, and University of Geneva, Geneva, Switzerland.
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Abstract
BACKGROUND AND AIM Although direct access colonoscopy is a common practice, some consider the level of informed consent as inadequate, and therefore a medico-legal concern. The aim of this study was to assess the adequacy of informed consent from a patient perspective in a direct access colonoscopy service. METHODS All patients having outpatient colonoscopy from May 2003 to February 2004 at a direct access colonoscopy service were considered for inclusion into the study. Information was obtained from patients by structured questionnaire administered either at the time of discharge from the day ward or mailed to their homes. RESULTS Information was obtained from 346 direct access colonoscopy patients (172 male, 159 female; 226 >or= 50 years, 103 < 50 years), 80% of whom were referred by their family doctor. Colonoscopy was done for investigation of symptoms in 220 patients, and for screening and surveillance in 115 patients, with an indication not specified in 11 patients. The majority of patients were either very satisfied (70.5%) or satisfied (25.1%) with the consent process, with no demographic characteristics found to predict dissatisfaction. Thirty-seven patients expressed a preference to have seen a gastroenterologist prior to colonoscopy, and four of these patients reported the consent process to be unsatisfactory. Seventy (20.2%) patients reported that the most useful information about colonoscopy was received after they had completed bowel preparation. CONCLUSION No demographic characteristics were found to predict the small fraction of patients dissatisfied with the informed consent process. Further medico-legal risk reduction may be facilitated by enhancing the provision of information prior to bowel preparation.
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Affiliation(s)
- Dev S Segarajasingam
- Department of Gastroenterology and Hepatology, Royal Perth Hospital, Perth, Western Australia, Australia.
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Zuckerman MJ, Shen B, Harrison ME, Baron TH, Adler DG, Davila RE, Gan SI, Lichtenstein DR, Qureshi WA, Rajan E, Fanelli RD, Van Guilder T. Informed consent for GI endoscopy. Gastrointest Endosc 2007; 66:213-8. [PMID: 17643691 DOI: 10.1016/j.gie.2007.02.029] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Ghulam AT, Kessler M, Bachmann LM, Haller U, Kessler TM. Patients' satisfaction with the preoperative informed consent procedure: a multicenter questionnaire survey in Switzerland. Mayo Clin Proc 2006; 81:307-12. [PMID: 16529133 DOI: 10.4065/81.3.307] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess patients' satisfaction with the preoperative informed consent procedure in obstetrics and gynecology. PATIENTS AND METHODS Between March 2001 and April 2002, patients from 11 Swiss hospitals, representing 3 linguistic areas of Switzerland, were given a questionnaire and a standardized operation-specific leaflet and engaged in a structured conversation. The questionnaire and operation-specific leaflet were designed in collaboration with the Swiss Patient Organization, the judiciary service of the Swiss Medical Association, and the Swiss Society of Obstetrics and Gynecology. RESULTS A total of 3888 (56%) of 6970 women received the questionnaire and were enrolled in the study. Most of the patients considered the written and oral information to be good or excellent, and more than 80% did not desire further written information. Forty-five percent would have preferred to receive this structured Information the same day the decision to undergo an invasive procedure was made, and mere than half of the patients were reassured by the information provided. However, in 7% anxiety increased. In the multivariate analysis, Turkish (odds ratio [OR], 6.7; 95% confidence Interval [CI], 2.0-22.4; P=-.002) and Serbo-Croat (OR, 8.0; 95% CI, 2.4-27.4; P=.001) language and a poor rating of the written description of the planned operation (OR, 3.1; 95% CI, 1.1-9.0; P=-.03) were the only variables significantly associated with discontent. CONCLUSIONS The combined written and oral preoperative information presented is well adapted to patients' Informative wishes and needs; it allows for a structured conversation, facilitates documentation, and offers valid legal proof that adequate information has been provided. Therefore, close collaboration between the national patient organization and the expert Judiciary and medical societies of the corresponding country is strongly recommended to Improve the Informed consent procedure.
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Affiliation(s)
- Amina T Ghulam
- Department of Gynecology, University Hospital Zürich, Zürich, Switzerland
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Parahoo K, Ridley T, Thompson K, Melby V, Humphreys G. A qualitative evaluation of information leaflets for gastroscopy procedure. J Eval Clin Pract 2003; 9:423-31. [PMID: 14758965 DOI: 10.1046/j.1365-2753.2003.00397.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Written information sent to patients prior to diagnostic gastroscopy is an important part of the process of informing and preparing them for the procedure. Yet there is ample evidence in the literature that information leaflets do not measure up to the required standard. In this study, information leaflets from a random sample of seven hospitals in Northern Ireland that carried out gastroscopy as a day procedure were evaluated using a checklist of items recommended by the British Society of Gastroenterology (BSG) for inclusion in leaflets for patients undergoing diagnostic gastroscopy. The results showed that the number of written materials sent to patients prior to the procedure varied between units. There were inconsistencies in the information given by the same unit, and overall, there was a lack of vital information in most of the leaflets. Some of the information was confusing and ambiguous. The potential risk of the procedure was explained in only one of the leaflets. Patients' right to choose to have a mild sedative was not made clear in most of the leaflets. More should be done to address these gaps and inconsistencies in the written information provided to patients prior to gastroscopy.
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Affiliation(s)
- Kader Parahoo
- Centre for Nursing Research, School of Nursing, University of Ulster, Coleraine, Northern Ireland, UK.
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Thompson K, Melby V, Parahoo K, Ridley T, Humphreys WG. Information provided to patients undergoing gastroscopy procedures. J Clin Nurs 2003; 12:899-911. [PMID: 14632983 DOI: 10.1046/j.1365-2702.2003.00810.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study aimed to investigate the information provided to patients undergoing gastroscopy procedures in Northern Ireland. Questionnaires were developed by the authors and were completed by 402 patients (RR = 43.8%) and 62 nurses (RR = 75.6%). Patients received most of the procedural information from nurses, and they recognized the importance of providing sensory information. Patients were generally satisfied with the information provided. There is clear evidence of fragmented care, and major changes are required to ensure that patients receive holistic information that includes procedural and sensory aspects. Nurses and doctors must realize that their role in information giving is to ensure that comprehensive information is provided by the appropriate professional at the appropriate time.
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Affiliation(s)
- Kate Thompson
- School of Nursing, University of Ulster, Coleraine, UK
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Abstract
INTRODUCTION Little is known about patients' perspectives on the amount of information they receive prior to diagnostic gastrointestinal endoscopies. Our unit's policy for obtaining consent consists of initially posting an information leaflet to the patient followed by subsequent explanation of the procedure on arrival for the test. The consent form is signed by the patient immediately prior to the test. METHODS A questionnaire survey was conducted to assess patient perception and satisfaction with the amount of information received before diagnostic endoscopy. RESULTS The information was obtained from 127 of the 175 questionnaires that were distributed. Whereas 97% had read the information leaflet, only 52% had read the consent form before signing it. 64/127(51%) felt dissatisfied because they would have wanted more information while 3% were dissatisfied because they would have liked less information relating to one or more aspects of the test. Dissatisfaction was higher in patients who had not read the consent form (p < 0.001) and those with some formal education (p = 0.01). CONCLUSIONS Patients who did not read the consent form were more dissatisfied. Strategies to improve the rate of reading this document may increase patient satisfaction.
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Affiliation(s)
- A Bassi
- Aintree Centre for Gastroenterology, University Hospital Aintree, Liverpool, UK.
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Eisen GM, Baron TH, Dominitz JA, Faigel DO, Goldstein JL, Johanson JF, Mallery JS, Raddawi HM, Vargo JJ, Waring JP, Fanelli RD, Wheeler-Harbaugh J. Open access endoscopy. Gastrointest Endosc 2002; 56:793-5. [PMID: 12447287 DOI: 10.1016/s0016-5107(02)70349-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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