Factors associated with nurses’ opinions and practices regarding information and consent

Assessment of the knowledge, attitude and practices of the informed consent process in oral healthcare among dental students in Makerere University Dental Hospital, Uganda

INTRODUCTION

Informed consent is an ethical and legal component of healthcare. It ensures patient autonomy and allows patients to make decisions regarding their treatment. In dental care, informed consent is particularly important because most dental procedures are invasive. Since dental students are future dentists, they need to learn about their ethical obligations and accountability through the informed consent process as this is critical to patients' well-being. This study aimed to determine dental students' knowledge, attitudes, and practices of the informed consent process for oral health care in Makerere University Dental Hospital, Uganda.

STUDY METHODOLOGY

This was a descriptive cross-sectional study using quantitative methods. It was carried out at Makerere University Dental Hospital and third, fourth, and fifth-year students (n = 102) pursuing a Bachelor of Dental Surgery program took part in the survey. A self-administered structured questionnaire was used to assess their knowledge, attitudes, and practices of informed consent for oral health care. Collected data were entered into Epi-data version 3.1, where it was cleaned, coded, and imported to STATA version 14 software for statistical analysis.

RESULTS

About two-thirds 67 (65.7%) of the participants were males. The mean age was 25 (SD = 3.21) years. The majority (90%) of the students had a high level of knowledge of the informed consent process. About (80%) had a positive attitude towards informed consent and (85%) most often practiced the informed consent process. Based on bi-variate analysis, training on informed consent, year of study, age, and sex were significantly associated with the informed consent process. However, there was no significant risk factor associated with informed consent in multiple logistic regression analysis.

CONCLUSION

The study findings highlighted high levels of knowledge, positive attitude, and practice of the informed consent process among the clinical dental students. Continuous training is necessary to remind dental students about the importance of informed consent in healthcare, not only for complex procedures.

Quality of Informed Consent Practices around the Time of Childbirth: A Cross-Sectional Study in Italy

BACKGROUND

Few studies have explored consent request practices during childbirth.

OBJECTIVE

We explored consent request practices during childbirth in a referral hospital and research centre in Italy, capturing both women and health workers' perspectives.

METHODS

Data were collected using self-administrated questionnaires between December 2016 and September 2018. Nine key maternal and newborn procedures were analysed. Associations between consent requests and women characteristics were explored by multiple logistic regression.

RESULTS

Among 1244 women, the rate of consent requests varied widely, with caesarean section (CS) showing the highest rate (89.1%) and neonatal conjunctivitis prophylaxis presenting the lowest rate (11.4%). Information provided on "risks/benefits" and "reasons" for procedures by health staff was most often not comprehensive for procedures of interest (range 18.6-87.4%). The lack of informed consent is not specifically linked to any pattern of women characteristics. According to 105 health workers, adequate protocols and standard forms for consent requests were available in 67.6% and 78.1% of cases, respectively, while less than one third (31.4%) reported having received adequate training and supportive supervision on how to deliver informed consent.

CONCLUSIONS

Study findings align with previous evidence showing that consent request practices during childbirth need to be largely improved. More research is needed to investigate effective strategies for improvement.

Practice and Factors Associated with Informed Consenting Process for Major Surgical Procedures Among Health-Care Workers, South Eastern Ethiopia

Background

Medical malpractice, poor patient outcome and medical suits among health-care workers result from improper consenting practices. Therefore, this study aimed to assess practice and factors associated with the informed consenting process for major surgical procedures among health-care workers in public hospitals of Bale Zone, South Eastern Ethiopia.

Methods

An institutional-based cross-sectional study was conducted from March 9 to 24, 2020, among all nurses, midwives, doctors (general physicians, surgeons, gynecologists), emergency surgery officers, anesthetists) who were working at Bale Zone public hospitals during the study period. A self-administered pretested questionnaire was employed. Variables with a p-value of less than 0.25 (age group, sex, educational profession, working unit, work experience, adequate content of consent form, training on informed consent, policy/regulation in institution, administrative support, average number of patient cared per shift, time spent for consent process, knowledge, attitude) at 95% confidence interval in the binary logistic regression analysis were considered for multivariable regression model to control for possible confounding effect.

Results

Of the total sample size (639 health-care workers), 621 (97.2%) were included in this study, of which 311 (50.1%, 95% CI: 46.1-53.8) practiced proper informed consent during major surgical procedures. Being age above 35 (AOR: 3.032, 95% CI: 1.148-8.010), male (AOR: 1.607, 95% CI: 1.047-2.465), above 10 years of working experience (AOR: 2.339, 95% CI: 1.104-4.955), adequate content of consent form (AOR: 2.785, 95% CI: 1.772-4.377), having training on informed consent (AOR: 2.305, 95% CI: 1.204-4.414), spending more time (>30minutes) for consent process (AOR: 3.014, 95% CI: 1.095-8.298), having good knowledge (AOR: 1.808, 95% CI: 1.195-2.737) and favorable attitude (AOR: 2.188, 95% CI: 1.456-3.287) were significantly associated with good informed consent practice.

Conclusion

Only half of health-care workers practiced good informed consent. Further emphasis needs to be given to improve consent practice.

The Role of the Nurse in Informed Consent to Treatments: An Observational-Descriptive Study in the Padua Hospital

BACKGROUND

The process to obtain valid informed consent in healthcare reflects many aspects. Healthcare professionals that take care of the patient must provide him all the necessary information and verify his understanding, considering individual characteristics. Nurses are one of the main participants in this process.

OBJECTIVE

This study assesses nurses' perceptions of their role in the informed consent process.

MATERIAL AND METHODS

An observational study involving 300 nurses operating in 13 wards of the Padua Hospital, through the submitting of a questionnaire in the period November-December 2018.

RESULTS

The final sample is made up of 206 nurses-27 males (13.11%) and 179 females (86.89%). Work experience, on average 15 years, is significant in determining the answers to questions about opinions and experiences. Age is significant in determining how often nurses provide information to the patient's family members about the actions to be taken after discharge. The ward was decisive in the responses related to information provided to patients on the nursing care level and the actions to be taken after discharge, and the definition of the nurse's duties.

CONCLUSIONS

The data collected show the need for interventions to reduce the causes of difficult that the nurse has in informing patients.

Difficulties and practices regarding information provision among Korean and Italian nurses

AIM

To investigate nurses' opinions and practices of providing information in a global context through cultural comparison.

BACKGROUND AND INTRODUCTION

Providing sufficient information to patients about nursing interventions and plans is essential for patient-centred care. While many countries have specific legislation making information delivery to patients a legal duty of nurses, no such legislation exists in both the Republic of Korea and Italy; nurses' only guidance is the deontological code.

METHODS

This was a cross-sectional survey study involving a convenience sample of 174 Korean nurses and 121 Italian nurses working in internal medicine and surgery at university hospitals. Data were collected using a self-administered questionnaire between February and November 2014. The questionnaire assessed demographic and professional characteristics, and difficulties and practices regarding information provision.

RESULTS

Korean and Italian nurses significantly differed in all demographic and professional characteristics. More Korean than Italian participants reported that their role in providing information was well explained within their teams, but both groups reported the same level and type of difficulties in delivering information. Nurses in both countries regularly informed patients about medications and nursing procedures, but provided information about nursing care plans less frequently. Few nurses frequently provided information to relatives instead of patients.

CONCLUSIONS

Despite cultural, demographic and professional differences between Korean and Italian nurses, their difficulties and practices in information delivery to patient were similar.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Hospital managers and policymakers should be aware that nurse-patient communication can be impaired by organizational factors, patient characteristics or the interaction among providers. Educational interventions and strategies are needed to increase information provision to patients about nursing care plans.

Nurses’ and patients’ perceptions of privacy protection behaviours and information provision

Background:

With increased attention to patient privacy and autonomy, privacy protection and information provision for patients are becoming increasingly important.

Objectives:

The aim of this study was to identify and analyse nurses’ and patients’ perceptions of the importance and performance of protecting patients’ privacy and providing them with relevant information.

Research design:

This study is a descriptive cross-sectional investigation. Participants and research context: Participants were 168 patients hospitalised in medical and surgical wards and 176 nurses who cared for them.

Ethical consideration:

This study was approved by the Chung-Ang University Bioethics Committee, and informed written consent was collected from all participants.

Findings:

Nurses’ recognition of the importance of protecting patients’ privacy and providing adequate information was higher compared to their actual performance, and the nurses’ level of performance was higher in comparison with the patients’ recognition of its importance.

Discussion:

Although a holistic approach to patient privacy protection and information provision is needed, the medical field has not embraced this model of care.

Conclusions:

These findings provide empirical data to create an ethical environment for the future, as considerable attention has been devoted to patients’ rights and medical institutions’ liability for providing explanations to patients.