Pomeroy Eoghan, Shaarani Shahril, Kenyon Robert, Cashman James
From Cappagh National Orthopaedic Hospital, Dublin, Ireland.
J Patient Saf. 2021 Sep 1;17(6):e575-e581. doi: 10.1097/PTS.0000000000000412.
Informed consent plays a pivotal role in the operative process, and surgeons have an ethical and legal obligation to provide patients with information to allow for shared decision-making. Unfortunately, patient recall after the consent process is frequently poor. This study aims to evaluate the effect of procedure-specific consent forms on patient's recall four weeks after total hip replacement (THR).
This is a prospective study using a posttest-only control group design. Sixty adult patients undergoing total hip replacement were allocated to be consented using either the generic or the surgery-specific consent form. Four weeks after surgery, a phone interview was conducted to assess patient's recall of risk of surgical complications.
Patient demographic characteristics and educational attainment were similar in both groups. There was a statistically significant increase in the mean number of risks recalled in the study group at 1.43 compared with 0.67 in the control group (P = 0.0131).
Consent is a complex process, and obtaining informed consent is far from straightforward. A statistically significant improvement in patient's recall with the use of procedure-specific consent forms was identified, and based on this, we would advocate their use. However, overall patient recall in both groups was poor. We believe that improving the quality of informed consent may require the sum of small gains, and the use of procedure-specific consent forms may aid in this regard.
知情同意在手术过程中起着关键作用,外科医生有道德和法律义务向患者提供信息,以便共同做出决策。不幸的是,同意过程后患者的记忆往往很差。本研究旨在评估特定手术同意书对全髋关节置换术(THR)四周后患者记忆的影响。
这是一项前瞻性研究,采用仅后测对照组设计。60名接受全髋关节置换术的成年患者被分配使用通用同意书或特定手术同意书进行同意程序。术后四周,进行电话访谈以评估患者对手术并发症风险的记忆。
两组患者的人口统计学特征和教育程度相似。研究组回忆的平均风险数量有统计学显著增加,为1.43,而对照组为0.67(P = 0.0131)。
同意是一个复杂的过程,获得知情同意绝非易事。使用特定手术同意书后,患者的记忆有统计学显著改善,基于此,我们提倡使用。然而,两组患者的总体记忆都很差。我们认为,提高知情同意的质量可能需要积小胜为大胜,使用特定手术同意书可能在这方面有所帮助。