1
|
Aynaszyan S, Lonza GC, Sambare TD, Son SJ, Alvarez I, Tomasek G, Bryman J, Shymon SJ, Andrawis JP. Limited Health Literacy Among Patients With Orthopedic Injuries: A Cross-sectional Survey of Patients Who Underwent Orthopedic Trauma Surgery in a County Hospital Setting. Orthopedics 2024:1-7. [PMID: 38810131 DOI: 10.3928/01477447-20240520-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND Patients with limited health literacy have difficulty understanding their injuries and postoperative treatment, which can negatively affect their outcomes. MATERIALS AND METHODS This cross-sectional questionnaire-based study of 103 adult patients sought to quantify patients' health literacy at a single county hospital's orthopedic trauma clinic and to examine their ability to understand injuries and treatment plans. Demographics, Newest Vital Sign (NVS) health literacy assessment, and knowledge scores were used to assess patients' comprehension of their injuries and treatment plan. Patients were grouped by NVS score (NVS <4: limited health literacy). Fisher's exact tests and t tests were used to compare demographic and comprehension scores. Multivariate logistic regression analysis was used to examine the association among low health literacy, sociodemographic variables, and knowledge scores. RESULTS Of the 103 patients, 75% were determined to have limited health literacy. Patients younger than 30 years were more likely to have adequate literacy (50% vs 23%, P=.01). Patients who spoke Spanish as their primary language were 8.77 times more likely to have limited health literacy with respect to sociodemographic factors (odds ratio, 8.77; 95% CI, 1.03-76.92; P=.04). Low health literacy was 3.52 and 4.14 times more likely to predict discordance in answers to specific bone fractures and the narcotics prescribed (P=.04 and P=.02, respectively). CONCLUSION Spanish-speaking patients have demonstrated limited health literacy and difficulty understanding their injuries and postoperative treatment plans compared with English-speaking patients. Patients with low health literacy are more likely to be unsure regarding which bone they fractured or their prescribed opiates. [Orthopedics. 202x;4x(x):xx-xx.].
Collapse
|
2
|
Berry P, Kotha S. Challenge of achieving truly individualised informed consent in therapeutic endoscopy. Frontline Gastroenterol 2024; 15:183-189. [PMID: 38665798 PMCID: PMC11042451 DOI: 10.1136/flgastro-2023-102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/24/2023] [Indexed: 04/28/2024] Open
Abstract
Objective Guidance covering informed consent in endoscopy has been refined in the UK following the obstetric case of Nadine Montgomery, and in light of updated General Medical Council guidance. All risks likely to be material to the patient must be explored, as well as alternatives to the procedure. Despite this, departments and endoscopists still struggle to meet the current standards. In this article, we explore the challenges encountered in achieving individualised consent in therapeutic endoscopy through real-life scenarios. Methods Five realistic therapeutic endoscopy (hepatobiliary) scenarios are described, followed by presentation of possible or ideal approaches, with references related to existing literature in this field. Results The vignettes allow consideration of how to approach difficult consent challenges, including anxiety and information overload, urgency during acute illness, failure to disclose the risk of death, the role of trainees and intraprocedural distress under conscious sedation. Conclusions The authors conclude that a high degree of transparency is required while obtaining consent for therapeutic endoscopy accompanied by full documentation, involvement of relatives in nearly all cases, and clarity around the presence of trainees who may handle the scope. A greater focus on upskilling trainees in the consent process for therapeutic endoscopy is required.
Collapse
Affiliation(s)
- Philip Berry
- Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | | |
Collapse
|
3
|
Maxwell L, Chamorro JB, Leegstra LM, Laguna HS, Miranda Montoya MC. "How about me giving blood for the COVID vaccine and not being able to get vaccinated?" A cognitive interview study on understanding of and agreement with broad consent for future use of data and samples in Colombia and Nicaragua. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001253. [PMID: 37195974 DOI: 10.1371/journal.pgph.0001253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/28/2023] [Indexed: 05/19/2023]
Abstract
Broad consent for future use, wherein researchers ask participants for permission to share participant-level data and samples collected within the study for purposes loosely related to the study objectives, is central to enabling ethical data and sample reuse. Ensuring that participants understand broad consent-related language is key to maintaining trust in the study and public health research. We conducted 52 cognitive interviews to explore cohort research participants' and their parents' understanding of the broad consent-related language in the University of California at Berkeley template informed consent (IC) form for biomedical research. Participants and their parents were recruited from long-standing infectious disease cohort studies in Nicaragua and Colombia and interviewed during the COVID-19 pandemic. We conducted semi-structured interviews to assess participants' agreement with the key concepts in the IC after clarifying them through the cognitive interview. Participants did not understand abstract concepts, including collecting and reusing genetic data. Participants wanted to learn about incidental findings, future users and uses. Trust in the research team and the belief that sharing could lead to new vaccines or treatments were critical to participant support for data and sample sharing. Participants highlighted the importance of data and sample sharing for COVID-19 response and equitable access to vaccines and treatments developed through sharing. Our findings on participants' understanding of broad consent and preferences for data and sample sharing can help inform researchers and ethics review committees working to enable ethical and equitable data and sample sharing.
Collapse
Affiliation(s)
- Lauren Maxwell
- Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Luz Marina Leegstra
- Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | | |
Collapse
|
4
|
Mitra K, Mondal S, Bhattacharya S, Jana P. A comparative study on comprehension of informed consent before emergency and elective surgical operative procedures. ACTA MEDICA INTERNATIONAL 2022. [DOI: 10.4103/amit.amit_90_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
|
5
|
Solano MA, Ramcharran KK, Jones LC, Sterling RS, Samaroo DR, Khanuja HS. Preoperative Patient Education Class During an Orthopedic Mission Trip: Effects on Knowledge, Anxiety, and Informed Consent. J Arthroplasty 2020; 35:2410-2417. [PMID: 32451279 DOI: 10.1016/j.arth.2020.04.084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/03/2020] [Accepted: 04/24/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Patient knowledge about arthritis and risks, benefits, and outcomes of joint arthroplasty in developing countries is unknown. We evaluated the effectiveness of a preoperative class on improving knowledge and decreasing anxiety during a surgical mission trip offering total joint arthroplasty. METHODS A team of US health care providers taught a preoperative class to 41 patients selected for total joint arthroplasty during a surgical mission trip to Guyana. Participants completed a 32-point survey about arthritis; indications, risks, and benefits of joint arthroplasty; and postoperative, in-patient rehabilitation expectations. The State-Trait Anxiety Inventory was used to measure participant anxiety. Participants completed identical surveys before and after class. Matched-pairs Student t tests were used to compare means between preclass and postclass surveys. Significance was accepted at P < .05. RESULTS Seventy-eight percent of patients (31 of 41) scored less than 12 of 32 possible points (40%) on the preclass knowledge questionnaire. Mean ± standard deviation knowledge scores improved from 14.0 ± 4.5 before the class to 16.5 ± 6.5 after the class (P = .008). Anxiety scores (n = 33) improved from 35 ± 13 before the class to 33 ± 12 after the class (P = .047). CONCLUSION On this surgical mission trip, underserved patients' knowledge about total joint arthroplasty increased only modestly after taking a preoperative class. Greater understanding of how to educate patients and reduce their anxiety on medical missions is needed.
Collapse
Affiliation(s)
- Mitchell A Solano
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD; Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - Lynne C Jones
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD
| | - Robert S Sterling
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD
| | - David R Samaroo
- Department of Orthopaedic Surgery, Georgetown Public Hospital, Georgetown, Guyana
| | - Harpal S Khanuja
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD
| |
Collapse
|
6
|
Effect of Consent and Educational Adjuncts to Consent on Patient Perceptions About Colonoscopy. J Clin Gastroenterol 2019; 53:e316-e321. [PMID: 30001290 PMCID: PMC6329678 DOI: 10.1097/mcg.0000000000001093] [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: 12/10/2022]
Abstract
BACKGROUND AND AIMS Informed consent is a vital preprocedural step for endoscopy but there are substantial variations in its delivery. We therefore sought to assess a multifaceted intervention to improve the consent process. METHODS Gastroenterologists at a tertiary center were educated on the recommended components of informed consent. Following this, 3 cohorts of patients undergoing colonoscopy were surveyed before and after consent. In one cohort, the effect of optimized verbal consent alone was assessed. In the second and third groups, the effects of the addition of either a handout or a video describing colonoscopy and its risks were evaluated. The primary outcomes were the changes between preconsent and postconsent survey responses regarding confidence in understanding the procedure's purpose, likelihood of adverse events, and levels of anxiety. RESULTS In total, 240 patients were included with 79 to 81 patients per group. There were no significant differences among the groups' survey responses. Compared with patients receiving verbal consent alone, fewer patients in the handout and video groups increased their perceived risk of adverse events following consent, but this difference did not reach significance (P=0.08). Examining all groups together, anxiety levels changed significantly after consent (P=0.003), with 31% of patients reducing their anxiety level, 8% increasing it, and 62% having no change. CONCLUSIONS The consent process appears to decrease patient anxiety about colonoscopy. When used in conjunction with a high-quality verbal consent, written or video educational adjuncts provided on the day of colonoscopy likely have no effect on patient perceptions.
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Consentimiento informado en endoscopia. ENDOSCOPIA 2014. [DOI: 10.1016/j.endomx.2014.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
9
|
Siao D, Sewell JL, Day LW. Assessment of delivery methods used in the informed consent process at a safety-net hospital. Gastrointest Endosc 2014; 80:61-8. [PMID: 24518119 DOI: 10.1016/j.gie.2013.12.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 12/31/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Informed consent is legally and ethically required before a patient undergoes an endoscopic procedure, yet current literature suggests that patient comprehension of key components of informed consent is poor. OBJECTIVE To evaluate specific aspects of and patient satisfaction with the informed consent process in patients who attended an endoscopy education class versus gastroenterology clinic. DESIGN Prospective survey that examined all components of the informed consent process. SETTING Safety-net hospital. PATIENTS Outpatients undergoing endoscopy. INTERVENTION Endoscopy education class versus gastroenterology clinic. MAIN OUTCOME MEASUREMENTS Patient recall of the components of and satisfaction with the informed consent process. RESULTS A total of 301 patients completed the survey, 52.0% of whom attended and were consented in an endoscopy education class. Patients who attended an endoscopy education class reported that a greater number of individual components of the informed consent process were explained to them as compared with patients who were consented in clinic. In multivariate analysis, patients who attended an education class were more likely to recall having had the alternatives (odds ratio [OR] 4.8; 95% confidence interval [CI], 2.0-11.8), details of the procedure (OR 3.0; 95% CI, 1.3-6.8), and what to expect after the procedure (OR 3.0; 95% CI, 1.5-5.6) explained to them by a provider. These patients were more likely to know they could refuse the procedure (OR 4.1; 95% CI, 1.0-16.8), compared with patients consented in the gastroenterology clinic. LIMITATIONS Non-randomized trial. CONCLUSION Patients from a diverse, urban population who attended a multilingual endoscopy education class reported having more elements of the informed consent process explained to them compared with patients who were consented in gastroenterology clinic.
Collapse
Affiliation(s)
- Derrick Siao
- Division of Gastroenterology, Department of Medicine, University of California, San Francisco, California, USA
| | - Justin L Sewell
- Division of Gastroenterology, Department of Medicine, San Francisco General Hospital and Trauma Center, San Francisco, California, USA
| | - Lukejohn W Day
- Division of Gastroenterology, Department of Medicine, San Francisco General Hospital and Trauma Center, San Francisco, California, USA
| |
Collapse
|
10
|
Sherlock A, Brownie S. Patients' recollection and understanding of informed consent: a literature review. ANZ J Surg 2014; 84:207-10. [DOI: 10.1111/ans.12555] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anne Sherlock
- Operating Theatre Suite; St Andrew's Hospital; Adelaide South Australia Australia
| | - Sonya Brownie
- School of Health and Human Sciences; Southern Cross University; Lismore New South Wales Australia
| |
Collapse
|
11
|
Kim S, Jabori S, O'Connell J, Freeman S, Fung CC, Ekram S, Unawame A, Van Norman G. Research methodologies in informed consent studies involving surgical and invasive procedures: time to re-examine? PATIENT EDUCATION AND COUNSELING 2013; 93:559-566. [PMID: 24021416 DOI: 10.1016/j.pec.2013.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 07/20/2013] [Accepted: 08/13/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE We conducted a review of informed consent studies involving surgical and invasive procedures and report the degree to which current research targets a broader scope of patient outcomes beyond comprehension. METHODS Using PubMed, Cumulative Index to Nursing and Allied Health Literature, and Excerpta Medical Database, we identified 97 articles for review. Six members coded articles and generated scores of study design quality. RESULTS The mean quality score (10.7 out of a total score of 20) was low. Most studies were single institution-based, relying on one-time data collections. Randomly assigning subjects to study conditions, using power analysis to determine subject numbers, and reporting psychometric evidence, such as reliability and validity, were not widely reported. Most frequently targeted patient outcomes were knowledge, understanding and satisfaction. Core informed consent outcomes (e.g. capacity, voluntariness, decision making) and emotional factors (e.g. anxiety) were not extensively addressed. CONCLUSION Informed consent research may benefit from applying qualitative methods to more directly tap into patients' beliefs and decisions by eliciting in patients' own words their emotions and reasoning around processing informed consent content. PRACTICE IMPLICATIONS Research that addresses patient perspectives toward surgical interventions should tap into underexplored ethical and emotional factors that shape decision making.
Collapse
Affiliation(s)
- Sara Kim
- ISIS (Institute of Simulation and Interprofessional Studies), Department of Surgery, School of Medicine, University of Washington, Seattle, USA.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Jeong I, Park S, Jeong JS. Understanding of Technical Terms and Contents of Informed Consent Forms for Sedative Gastrointestinal Endoscopy Procedures. Asian Nurs Res (Korean Soc Nurs Sci) 2013; 7:33-7. [PMID: 25031213 DOI: 10.1016/j.anr.2013.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 12/02/2012] [Accepted: 12/19/2012] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This was a cross-sectional study designed to evaluate the subjective understanding of technical terms and contents of the informed consent forms given to patients about to undergo conscious sedative upper gastrointestinal endoscopy. METHODS A group of conveniently selected 180 patients, who were undergoing sedative endoscopy were recruited in the endoscopy procedure room in a tertiary hospital from June to July 2011. Data were collected with a structured questionnaire. RESULTS The average number of terms exposed was 8.12 out of 10 items, the average number of terms understood well by the patients was 5.53 out of 10 items, and the average number of right answers was 3.30 out of 5 items, and the percent of correct answers ranged from 26.1% to 90.0%. The exposure to terms differed by gender, education, and previous exposure to sedative endoscopy procedures. The number of "understanding of the terms well" responses differed according to age and previous exposure to sedative endoscopy procedures, and the correct answer rate was differed by education. CONCLUSION The understanding of the terms and knowledge about the procedures were disappointing. Therefore, sufficient explanations should be provided to the patients. While the informed consent was taken by doctors, the level of understanding should be monitored by nurses. In particular, subjects who did not have any previous experience with endoscopy procedures showed relatively lower level of understanding. We recommend that medical terms should be replaced with more common and nontechnical words in consent forms.
Collapse
Affiliation(s)
- Ihnsook Jeong
- College of Nursing, Pusan National University, Yangsan, South Korea.
| | - Sunmi Park
- Department of Pediatric Nursing, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jae Sim Jeong
- Department of Clinical Nursing, University of Ulsan, Seoul, South Korea
| |
Collapse
|
13
|
Luo YY. Effects of written plus oral information vs. oral information alone on precolonoscopy anxiety. J Clin Nurs 2012; 22:817-27. [PMID: 22845184 DOI: 10.1111/j.1365-2702.2011.04053.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIMS AND OBJECTIVES To determine the effect of written plus oral information vs. oral information alone on precolonoscopy anxiety. BACKGROUND Information provision has been considered to reduce precolonoscopy anxiety. However, the best means to provide information before colonoscopy has not yet been determined as there is inconsistency in the outcomes of the clinical trials. DESIGN A two-group, pretest, post-test, prospective, quasi-experimental design with non-random assignment. METHODS Participants were assigned to group 1 or 2 in the study. In the enrolment all the participants completed the questionnaires to collect personal characteristics data and assessed subjects' anxiety level by the Chinese version of the State Scale of State-Trait Anxiety Inventory as baseline data. After that, subjects in group 1 received written plus oral information before colonoscopy, while those in group 2 received oral information before colonoscopy. On the day for colonoscopy all subjects completed the Chinese version of the State Scale of State-Trait Anxiety Inventory again. RESULTS There was no difference in state anxiety and personal characteristic between the two groups at enrolment. After the intervention, although the state anxiety scores were dropped, there were no statistical significant differences between two groups or within groups 1 and 2. CONCLUSIONS Information provision before colonoscopy did not reduce the anxiety level in patients directly before colonoscopy. RELEVANCE TO CLINICAL PRACTICE There was a trend that information had a positive effect on patients' state anxiety. Future information provision studies may need to add more interactive methods appropriately and take patients' gender, educational level and coping style into consideration.
Collapse
Affiliation(s)
- Yuan-Yuan Luo
- School of Medicine, Jianghan University, Wuhan, Hubei, China.
| |
Collapse
|
14
|
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?
Collapse
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
| | | |
Collapse
|
15
|
Fernández Garrido C, Lopera Uribe G, Albar Marín M, Morano Báez R, Lagoa Elías C, Gallardo Abril M. Características de la información en el proceso quirúrgico y satisfacción de los pacientes. ACTA ACUST UNITED AC 2011; 26:315-9. [DOI: 10.1016/j.cali.2011.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 03/23/2011] [Accepted: 03/29/2011] [Indexed: 10/17/2022]
|
16
|
Eran A, Erdmann E, Er F. Informed consent prior to coronary angiography in a real world scenario: what do patients remember? PLoS One 2010; 5:e15164. [PMID: 21188151 PMCID: PMC3004853 DOI: 10.1371/journal.pone.0015164] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 10/27/2010] [Indexed: 11/18/2022] Open
Abstract
Background Patients' informed consent is legally essential before elective invasive cardiac angiography (CA) and successive intervention can be done. It is unknown to what extent patients can remember previous detailed information given by a specially trained doctor in an optimal scenario as compared to standard care. Methodology/Principal Findings In this prospective cohort study 150 consecutive in-patients and 50 out-patients were included before elective CA was initiated. The informed consent was provided and documented in in-patients by trained and instructed physicians the day before CA. In contrast, out-patients received standard information by different not trained physicians, who did not know about this investigation. All patients had to sign a form stating that enough information had been given and all questions had been answered sufficiently. One hour before CA an assessment of the patients' knowledge about CA was performed using a standard point-by-point questionnaire by another independent physician. The supplied information was composed of 12 potential complications, 3 general, 4 periprocedural and 4 procedural aspects. 95% of the patients felt that they had been well and sufficiently informed. Less than half of the potential complications could be remembered by the patients and more patients could remember less serious than life-threatening complications (27.9±8.8% vs. 47.1±11.0%; p<0.001). Even obvious complications like local bleeding could not be remembered by 35% of in-patients and 36% of out-patients (p = 0.87). Surprisingly, there were only a few knowledge differences between in- and out-patients. Conclusions The knowledge about CA of patients is vague when they give their informed consent. Even structured information given by a specially trained physician did not increase this knowledge.
Collapse
Affiliation(s)
- Aslihan Eran
- Department of Internal Medicine III, University of Cologne, Cologne, Germany
| | - Erland Erdmann
- Department of Internal Medicine III, University of Cologne, Cologne, Germany
| | - Fikret Er
- Department of Internal Medicine III, University of Cologne, Cologne, Germany
- * E-mail:
| |
Collapse
|
17
|
Armstrong A, Alikhan A, Cheng L, Schupp C, Kurlinkus C, Eisen D. Portable video media for presenting informed consent and wound care instructions for skin biopsies: a randomized controlled trial. Br J Dermatol 2010; 163:1014-9. [DOI: 10.1111/j.1365-2133.2010.10067.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|