Karan Abraar, Somasundaram Prashanth, Michael Haben, Shayegani Aryan, Mayer Hylton
David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Indian J Ophthalmol. 2014 Feb;62(2):171-5. doi: 10.4103/0301-4738.116488.
The provision of ocular surgical interventions for poorer, less educated populations is increasing as a result of increased globalization and outreach. However, these populations still have trouble understanding surgical concepts and are not always fully informed decision makers.
We aimed to test the effect that a multimedia addition to a traditional verbal informed consent would have on patient comprehension of relatively difficult cataract surgical concepts.
We conducted a randomized controlled trial with relatively uneducated patients reporting to a private surgical hospital in Chennai, India. 47 patients were placed into the intervention group and 50 patients were placed into the control group.
The intervention group was presented with a scripted verbal informed consent as well as a 3-fold pamphlet and a presentation with a 3-dimensional model of the eye. The control group was only presented with a scripted verbal informed consent. The two groups were tested using an 11 item "True/False/I don't know" quiz directly before the informed consent, directly after the informed consent, and one-day postoperatively.
Scores on the quiz were compared across groups and time-points using paired t-tests.
Patients in the both groups showed a significant improvement in scores between pre- and post-informed consent quizzes (P value on the order of 10(-6)) and the improvement in scores was significantly greater in the intervention group than the control group (P value on the order of 10(-16)). There was no significant difference observed in either group with regards to the change in scores between post-informed consent and post-operative quizzes.
Multimedia aids in addition to a standard informed consent process are effective in improving patient comprehension even for patients with low literacy and limited knowledge of surgical interventions.
随着全球化和外展服务的增加，为较贫困、受教育程度较低的人群提供眼科手术干预的情况日益增多。然而，这些人群在理解手术概念方面仍有困难，并非总是能充分知情的决策者。
我们旨在测试在传统口头知情同意基础上增加多媒体内容对患者理解相对复杂的白内障手术概念的影响。
我们在印度金奈一家私立外科医院对受教育程度相对较低的患者进行了一项随机对照试验。47名患者被纳入干预组，50名患者被纳入对照组。
干预组接受了书面口头知情同意书、一本三折页宣传册以及一个眼部三维模型的演示。对照组仅接受书面口头知情同意书。两组在知情同意前、知情同意后以及术后一天使用一份包含11个项目的“真/假/我不知道”测验进行测试。
使用配对t检验比较各组和各时间点的测验分数。
两组患者在知情同意前和知情同意后的测验分数均有显著提高（P值约为10^(-6)），且干预组的分数提高显著高于对照组（P值约为10^(-16)）。在知情同意后和术后测验之间，两组在分数变化方面均未观察到显著差异。
除标准的知情同意流程外，多媒体辅助手段对于提高患者理解能力是有效的，即使对于识字率低且对外科手术干预知识有限的患者也是如此。
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