National Orthopaedic Hospital Cappagh, Dublin, Ireland.
Ir J Med Sci. 2023 Aug;192(4):1917-1922. doi: 10.1007/s11845-022-03158-9. Epub 2022 Sep 14.
Informed consent plays a vital role in managing patients undergoing knee arthroplasty (KA). Unfortunately, patient recall of informed consent remains poor. Evidence has suggested that telemedicine and teleconsent can be safe, cost-effective, and well-received by patients. The primary aim of this study was to evaluate the effect of an additional preoperative teleconsent session on patient recall of surgical risks 1 month after knee arthroplasty. The secondary aim was to assess its impact on patient satisfaction.
Sixty adult patients awaiting knee arthroplasty were randomly allocated to receive an additional preoperative teleconsent consultation (intervention group) or not (control group), along with the standard informed consent on the day of surgery. Participants were contacted 1 month after surgery to assess recall of surgical risks and satisfaction with the process. Demographics and education levels were recorded for each patient.
The mean recall rates were 16% and 12% in the study and control groups, respectively, with no significant difference (p = 0.42). There was a significant difference between the mean satisfaction scores in the intervention group and the control group (9.8/10 vs 9/10, p = 0.0004). Lastly, there was a significant positive correlation between the education level and the number of risks recalled in the study (p = 0.05) and control groups (p = 0.04).
The additional preoperative teleconsent session had no significant effect on the risk recall rate but improved patient satisfaction. Our findings suggest education level may play a role in information recall. We can advocate for the increased use of teleconsent and telemedicine in patients undergoing KA or any elective orthopaedic procedure due to its perceived positive effects on patient satisfaction rates.
知情同意在管理接受膝关节置换术（KA）的患者中起着至关重要的作用。不幸的是，患者对知情同意的回忆仍然很差。有证据表明，远程医疗和远程同意可以是安全、具有成本效益的，并且受到患者的欢迎。本研究的主要目的是评估额外的术前远程同意会议对膝关节置换术后 1 个月患者对手术风险的回忆的影响。次要目的是评估其对患者满意度的影响。
60 名等待膝关节置换的成年患者被随机分配接受额外的术前远程同意咨询（干预组）或不接受（对照组），同时在手术当天接受标准的知情同意。在手术后 1 个月联系参与者，以评估对手术风险的回忆和对手术过程的满意度。记录每位患者的人口统计学和教育水平。
研究组和对照组的平均回忆率分别为 16%和 12%，差异无统计学意义（p=0.42）。干预组和对照组的平均满意度评分之间存在显著差异（9.8/10 与 9/10，p=0.0004）。最后，研究组和对照组的教育水平与回忆的风险数量之间存在显著正相关（p=0.05 和 p=0.04）。
额外的术前远程同意会议对风险回忆率没有显著影响，但提高了患者的满意度。我们的发现表明，教育水平可能在信息回忆中起作用。我们可以倡导在接受 KA 或任何择期骨科手术的患者中增加使用远程同意和远程医疗，因为它对患者满意度有积极的影响。
