Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK; Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Polytechnic University of the Marche, Ancona, Italy.
Department of Urology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Eur Urol. 2024 Nov;86(5):457-469. doi: 10.1016/j.eururo.2024.04.009. Epub 2024 Apr 25.
Discussions surrounding urological diagnoses and planned procedures can be challenging, and patients might experience difficulty in understanding the medical language, even when shown radiological imaging or drawings. With the introduction of virtual reality and simulation, informed consent could be enhanced by audiovisual content and interactive platforms. Our aim was to assess the role of enhanced consent in the field of urology.
A systematic review of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, using informed consent, simulation, and virtual reality in urology as the search terms. All original articles were screened.
Thirteen original studies were included in the review. The overall quality of these studies was deemed good according to the Newcastle-Ottawa Scale. The studies analysed the application of different modalities for enhanced consent: 3D printed or digital models, audio visual multimedia contents, virtual simulation of procedures and interactive navigable apps. Published studies agreed upon a significantly improved effect on patient understanding of the diagnosis, including basic anatomical details, and surgery-related issues such as the aim, steps and the risks connected to the planned intervention. Patient satisfaction was unanimously reported as improved as a result of enhanced consent.
Simulation and multimedia tools are extremely valuable for improving patients' understanding of and satisfaction with urological procedures. Widespread application of enhanced consent would represent a milestone for patient-urologist communication.
围绕泌尿科诊断和计划手术的讨论可能具有挑战性,即使向患者展示放射影像学图像或绘图,他们也可能难以理解医学术语。随着虚拟现实和模拟技术的引入,视听内容和互动平台可以增强知情同意。我们旨在评估增强型同意在泌尿科领域的作用。
根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南,对文献进行系统综述,使用泌尿科中的知情同意、模拟和虚拟现实作为搜索词。筛选所有原始文章。
综述包括 13 项原始研究。根据纽卡斯尔-渥太华量表,这些研究的总体质量被认为是良好的。这些研究分析了增强型同意的不同方式的应用:3D 打印或数字模型、视听多媒体内容、程序的虚拟模拟和交互式可导航应用程序。已发表的研究一致认为,这对患者对诊断、包括基本解剖细节以及与计划干预相关的手术问题(如目标、步骤和风险)的理解有显著改善。患者满意度也因增强型同意而一致提高。
模拟和多媒体工具对于提高患者对泌尿科手术的理解和满意度非常有价值。增强型同意的广泛应用将代表医患沟通的一个里程碑。