Patients' Experiences of Informed Consent and Preoperative Education

Valid consent in the acute hospital setting: perspectives of patients and members of the public

BACKGROUND

People who interact with healthcare services have an ethical and legal right to control their own lives, to make informed decisions, and to consent to what happens to them. For consent to be considered ethically and legally valid, three key criteria must be met: consent must be given voluntarily; people must be sufficiently informed of all options; and people should have capacity to make the decision to give or withhold their consent.

AIM

This study set out to explore, through the use of surveys, the perspectives of patients and public in relation to consent.

METHOD

Surveys were developed for patients and the public and administered paper based (patients) and through social media (public).

RESULTS

One hundred and forty surveys were posted to patients, with a 38% response rate; 104 responses were received from the public. Ninety-six percent of patients were satisfied that the decision they made was informed; 100% felt they had made a voluntary decision; 98% felt the clinician seemed knowledgeable about the procedure. What matters most to the public were being informed about the risks associated with the proposed procedure and being assured that whatever choice they make they will receive the best care possible.

CONCLUSIONS

The results highlight interesting similarities and differences in relation to consent between members of the public thinking about a possible treatment, surgery, or procedure and those patients who have actually been through the process in the past 12 months. Recommendations have been developed on the basis of these findings to co-design improvements in consent practices.

Usage of Object Matching Algorithms Combined with Mixed Reality for Enhanced Decision Making in Orbital Reconstruction-A Technical Note

This technical note describes the usage of object matching to virtually compare different modes of reconstruction in orbital trauma and display the results to the surgeon and the patient pre-operatively via mixed reality devices for enhanced surgical decision making and immersive patient education. A case of an orbital floor fracture is presented for which surface and volume matching were implemented to compare orbital reconstruction utilizing pre-fabricated titanium meshes versus patient-specific implants. The results could be visualized by mixed reality devices to further enhance surgical decision-making. The data sets were demonstrated to the patient in mixed reality for immersive patient education and enhanced shared decision making. The advantages of the new technologies are discussed in view of the new possibilities of improved patient education and informed consent processes, as well as new ways of teaching medical trainees.

Does the standard medical procedure consent process meet the criteria required for informed consent? - A concept analysis

BACKGROUND

Informed consent is a complex process that is legally required before any surgical procedure.

PURPOSE

The purpose of this manuscript was to perform a concept analysis of the informed consent process.

METHODS

The use of dimensional analysis identified three separate yet related perspectives of the informed consent process: legal, health care, and patients. A database search using the Cumulative Index to Nursing and Allied Health Literature and PubMed were performed.

FINDINGS

A total of 27 publications were reviewed. The legal perspective addresses the requirement of informed consent, which starts with the discussion between the health care provider and the patient undergoing the surgical procedure and ends with a signature on a piece of paper. The health care perspective also addresses the legal requirement but incorporates the goals and objectives of the individual initiating the informed consent discussion. The patients' perspectives also incorporate goals and objectives; however, they differ from that of the health care provider in that they go beyond what happens in the operating room or during hospitalization.

DISCUSSION

Viewing informed consent through these different yet related perspectives provides insight into this complex process and may enhance the researcher's ability to understand and improve the informed consent process.

Patientenprofit einer präoperativen urologischen Sprechstunde

Hintergrund

Angesichts der Zunahme von chronischen Erkrankungen und Polymorbidität besteht ein Optimierungsbedarf in Bezug auf die Früherkennung von potenziellen Risiken und Prävention in der präoperativen Abklärung vor einer urologischen Hospitalisierung.

Ziel

Durch die Interprofessionalisierung mit einer präoperativen urologischen Sprechstunde sollen potenzielle Risiken vor einer Operation erkannt und passende präventive Massnahmen eingeleitet werden.

Fragestellung

Welchen Nutzen der Bedarfsabklärung können Patient*innen aus einer solchen präoperativen urologischen Sprechstunde ziehen?

Methode

Es wurden eine Ist- und Soll-Analyse durchgeführt und darauf aufbauend das Konzept erstellt und umgesetzt. Zu Auswertungszwecken wurden die erhobenen Daten kontinuierlich in einer Accessdatenbank dokumentiert. Nach 9 Monaten wurden diese ausgewertet.

Ergebnisse

Früherkennung und Prävention wurden nach Bedarf bei 73 Patient*innen erfolgreich umgesetzt und dadurch folgende Schritte eingeleitet: 5 Beratungsgespräche zur psychischen Unterstützung (7 %), 11 Empfehlungen für Nahrungsergänzungen (15 %), 9 Angehörigeninstruktionen (12 %), 3 Case-Management-Anmeldungen (4 %), 4 sexologische Beratungsgespräche (5 %) und 3 spezifische urotherapeutische Angebote (4 %).

Schlussfolgerung

Eine prästationäre urologische Sprechstunde eignet sich, um die Risiken und Bedürfnisse der Patient*innen frühzeitig zu erkennen und präventive und beratende Massnahmen einzuleiten.

Satisfaction with preoperative education and surgical services among adults elective surgical patients at selected public hospitals in Addis Ababa, Ethiopia

Objectives:

The purpose of this study was to determine the level of satisfaction with preoperative education and surgical services among adult elective surgical patients at governmental hospitals in Addis Ababa, Ethiopia.

Methods:

Four hundred and twenty-two elective surgical patients at Addis Ababa’s governmental hospitals took part in a facility-based cross-sectional study from 8 October to 8 November 2021. Based on past experiments, an instrument for structured data collection was modified and employed. The data were cleaned and sent to Epidata version 4.2 before being exported and analysed in SPSS version 25. Descriptive statistics were used to describe the participant characteristics, and logistic regression, which also included bivariate and multivariate analysis, was used to evaluate the association between the independent and outcome variables. The level of statistical significance was indicated by a p value of 0.05.

Results:

84.6% of the participants reported feeling very satisfied with their preoperative education. Preoperative education about surgery (adjusted odds ratios (AOR) = 0.005; 95% confidence interval (CI): (0.000, 0.061)), previous surgery (AOR = 2.7; 95% CI: (2.51, 6.85)), and preoperative anxiety (AOR = 0.013; 95% CI: (0.003, 0.06)) were all significantly associated.

Conclusions:

About 84% of survey participants reported being satisfied with preoperative education and services. Preoperative patient satisfaction was negatively predicted by preoperative anxiety, prior surgery, and preoperative information about surgery. The decrease of anxiety and enhancement of surgical patient satisfaction may be significantly impacted by proper preoperative education.