Eggers Carsten, Obliers Rainer, Koerfer Armin, Thomas Walter, Koehle Karl, Hoelscher Arnulf H, Bollschweiler Elfriede
Department of Visceral and Vascular Surgery, University of Cologne, Cologne, Germany.
Obesity (Silver Spring). 2007 Nov;15(11):2866-73. doi: 10.1038/oby.2007.340.
Severe obesity is a clear indication for appropriate, effective weight loss therapy. One option is operative intervention, e.g., gastric banding. Risks of the operation and therapeutic alternatives need to be comprehensibly presented to the patient. The literature has shown that better informed consent is obtained using information presented in a multimedia/video-based format. The current study developed and evaluated a multimedia program aimed at obtaining informed consent from obese patients before gastric banding.
An interactive multimedia program was developed with information about preoperative examinations, the operation itself, hospital stay, operative risks, alternative therapies, and the pathophysiology and health risks of obesity. Two groups (Group 1, n = 20, mean age 38 years, informed consent attained with conventional document information; Group 2, n = 20, mean age 37 years, informed consent attained with additional multimedia information) were interviewed regarding comprehensibility of the information presented, personal satisfaction, and anxiety levels during the informed consent process.
Group 2 showed significantly better (p < 0.05) understanding of the presented information and higher levels of satisfaction with the informed consent process. Anxiety levels did not significantly differ between the two groups.
Because patient satisfaction with the informed consent process and understanding of the presented information significantly improved, the multimedia program clearly benefits both surgeons and patients. Personal contact from the surgeon remains essential. High volumes of information presented in multimedia format do not alleviate patient anxiety, and personal contact may be beneficial.
重度肥胖是进行适当、有效减肥治疗的明确指征。一种选择是手术干预,例如胃束带术。手术风险和治疗替代方案需要全面地告知患者。文献表明,使用基于多媒体/视频的形式呈现信息能获得更好的知情同意。本研究开发并评估了一个多媒体程序,旨在让肥胖患者在接受胃束带术之前获得知情同意。
开发了一个交互式多媒体程序,内容包括术前检查、手术本身、住院情况、手术风险、替代疗法以及肥胖的病理生理学和健康风险。对两组(第1组,n = 20,平均年龄38岁,通过传统文档信息获得知情同意;第2组,n = 20,平均年龄37岁,通过额外的多媒体信息获得知情同意)就所呈现信息的可理解性、个人满意度以及知情同意过程中的焦虑水平进行了访谈。
第2组对所呈现信息的理解明显更好(p < 0.05),对知情同意过程的满意度更高。两组之间的焦虑水平没有显著差异。
由于患者对知情同意过程的满意度和对所呈现信息的理解显著提高,该多媒体程序显然对外科医生和患者都有益。外科医生的个人接触仍然至关重要。以多媒体形式呈现大量信息并不能减轻患者的焦虑,个人接触可能会有帮助。