Cornoiu Andrei, Beischer Andrew D, Donnan Leo, Graves Stephen, de Steiger Richard
Department of Orthopaedics, Royal Melbourne Hospital, Parkville, Melbourne, Australia.
ANZ J Surg. 2011 Mar;81(3):176-80. doi: 10.1111/j.1445-2197.2010.05487.x. Epub 2010 Oct 1.
In contemporary clinical practice, the ability for orthopaedic surgeons to obtain true 'informed consent' is becoming increasingly difficult. This problem has been driven by factors including increased expectations of surgical outcome by patients and increasing complexity of surgical procedures. Surgical pamphlets and computer presentations have been advocated as ways of improving patient education, but evidence of their efficacy is limited. The aim of this study was to compare the efficacy of a computer-based multimedia (MM) presentation against standardized verbal consent and information pamphlets for patients considering knee arthroscopy surgery.
A randomized, controlled prospective trial was conducted, comparing the efficacy of three methods of providing preoperative informed consent information to patients. Sixty-one patients were randomly allocated into MM, verbal consent or pamphlet groups 3-6 weeks prior to knee arthroscopy surgery. Information recall after the initial consent process was assessed by questionnaire. Retention of this information was again assessed by questionnaire at the time of surgery and 6 weeks after surgery.
The MM group demonstrated a significantly greater proportion of correct responses, 98%, in the questionnaire at the time of consent, in comparison with 88% for verbal and 76% for pamphlet groups, with no difference in anxiety levels. Information was also better retained by the MM group up to 6 weeks after surgery. Patient satisfaction with information delivery was higher in the MM group.
MM is an effective tool for aiding in the provision and retention of information during the informed consent process.
在当代临床实践中，骨科医生获得真正“知情同意”的能力正变得越来越困难。这个问题是由多种因素导致的，包括患者对手术结果的期望增加以及手术程序日益复杂。手术宣传册和计算机演示文稿被提倡作为改善患者教育的方式，但它们有效性的证据有限。本研究的目的是比较基于计算机的多媒体（MM）演示文稿与标准化口头同意及信息宣传册对考虑膝关节镜手术患者的有效性。
进行了一项随机对照前瞻性试验，比较向患者提供术前知情同意信息的三种方法的有效性。在膝关节镜手术前3至6周，将61名患者随机分为MM组、口头同意组或宣传册组。通过问卷评估初始同意过程后的信息回忆情况。在手术时和手术后6周再次通过问卷评估该信息的保留情况。
在同意时的问卷中，MM组正确回答的比例显著更高，为98%，相比之下，口头同意组为88%，宣传册组为76%，焦虑水平无差异。MM组在术后6周内对信息的保留也更好。MM组患者对信息传递的满意度更高。
MM是在知情同意过程中帮助提供和保留信息的有效工具。
