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通过使用个性化患者文献改善足踝外科手术中的知情同意过程。

Improving the Consent Process in Foot and Ankle Surgery With the Use of Personalized Patient Literature.

作者信息

Howard Nicholas, Cowan Christopher, Ahluwalia Raju, Wright Andrew, Hennessy Michael, Jackson Gillian, Platt Simon

机构信息

Specialist Trainee Trauma and Orthopaedics, Orthopaedic Department, Arrowe Park Hospital, Wirral University Teaching Hospital NHS Trust, Wirral, UK.

Core Trainee Trauma and Orthopaedics, Orthopaedic Department, Arrowe Park Hospital, Wirral University Teaching Hospital NHS Trust, Wirral, UK.

出版信息

J Foot Ankle Surg. 2018 Jan-Feb;57(1):81-85. doi: 10.1053/j.jfas.2017.08.011.

Abstract

A patient-specific letter was introduced to the consent process to observe the effect, if any, on information recall and satisfaction for patients undergoing elective foot and ankle surgery. The patients attending the clinic were written a personalized letter-this was a simple personalized letter that outlined their treatment options, the proposed management plan, likely treatment course, and the benefits, risks, and likely period required for recovery. The personalized letter system was compared with the 2 existing methods of consent process: signing for consent at their outpatient encounter at which they were scheduled for surgery and a separate consent clinic without the personalized letter. A total of 111 patients (87 females, 24 males) undergoing elective foot and ankle surgery were assessed on the day of surgery for recall of the procedure, risks, postoperative course, and satisfaction with the consent process. Patients receiving a personalized letter recalled more than those who had attended a routine preoperative consent clinic visit and significantly more than those who had provided consent at their last clinic visit. Patient satisfaction with the consent process was also greater in the personalized group. Our results suggest that the consent process is improved using routine preoperative consent clinics and, most notably, with patient-specific information to improve patient recall and satisfaction.

摘要

在同意过程中引入了一份针对患者的信件,以观察其对接受择期足踝手术患者的信息回忆和满意度是否有影响(若有影响)。为前来诊所就诊的患者撰写了个性化信件——这是一封简单的个性化信件,概述了他们的治疗选择、拟议的管理计划、可能的治疗过程以及益处、风险和可能的恢复所需时间。将个性化信件系统与现有的两种同意过程方法进行了比较:在安排手术的门诊就诊时签署同意书,以及在没有个性化信件的单独同意诊所签署同意书。在手术当天,对总共111名接受择期足踝手术的患者(87名女性,24名男性)进行了评估,以了解他们对手术过程、风险、术后过程的回忆以及对同意过程的满意度。收到个性化信件的患者比那些参加常规术前同意诊所就诊的患者回忆得更多,且显著多于那些在上次诊所就诊时签署同意书的患者。个性化组患者对同意过程的满意度也更高。我们的结果表明,使用常规术前同意诊所,尤其是提供针对患者的信息,可改善同意过程,提高患者的回忆和满意度。

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