Improving Informed Consent of Surgical Patients Using a Multimedia-Based Program?

Bollschweiler, Elfriede; Apitzsch, Jonas; Obliers, Rainer; Koerfer, Armin; Mönig, Stefan P.; Metzger, Ralf; Hölscher, Arnulf H.

doi:10.1097/sla.0b013e318180a3a7

Cited by 105 publications

(39 citation statements)

References 18 publications

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“…As a study by Bollschweiler et al (2008) demonstrated, adding a multimedia-based information system prior to cholecystectomy significantly increased patient perceived understanding of pathophysiology and the planned procedure. 27 In this aspect it is clear that in the survey setting, the respondents’ perception of the different considerations was limited at best. In addition, our respondents were primarily college educated Caucasians, and we would recommend that future studies include a more heterogeneous population.…”

Section: Discussionmentioning

confidence: 99%

A Survey of Preferences Regarding Surgical Approach to Thyroid Surgery

et al. 2013

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Background Transaxillary thyroidectomy (TAT) has gained popularity in East Asian countries; however, to date there have been no attempts to evaluate the preferences regarding TAT in the United States population. The aim of this study is to assess the preferences and considerations associated with TAT in an American cohort. Methods Self-administered surveys were distributed to 966 adults at various locations in a single state. Questions assessed preferences for the surgical approach, acceptable risks and extra costs, and willingness to pursue TAT despite reduced cancer treatment efficacy. Results The response rate was 84% with a mean age of 40±17 years. The majority of respondents were female. Eighty-two percent of the respondents preferred TAT to a cervical thyroidectomy (CerT), all risks being equal. Fifty-one percent of the respondents were willing to accept a 4% complication rate with TAT. Sixteen percent of the respondents stated they would agree to pay up to an additional $5,000 for the TAT approach. When presented with thyroid cancer, 20% of all respondents still preferred TAT even if it would not cure their disease. Patients preferring TAT over CerT were younger, female, more willing to accept complications and spend additional money, and most significantly, preferred the TAT approach even if it was less likely to cure their cancer. Conclusions Although this survey presents a hypothetical question for people who do not have thyroid disease, the majority of respondents preferred TAT over CerT. Furthermore, a substantial number were willing to accept higher complication rates and increased costs for TAT.

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Section: Discussionmentioning

confidence: 99%

A Survey of Preferences Regarding Surgical Approach to Thyroid Surgery

et al. 2013

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“…The results correlate with research performed in other countries. Some previous studies revealed that providing the patient with audiovisual information is effective in giving the patient knowledge and understanding before signing the statement of informed consent [4,5] in many different kinds of surgeries such as; laparoscopic cholecystectomies [6,7], gastric banding, knee arthroscopies, and central venous catheterizations. These studies found that the use of multimedia help the patient to gain a better understanding of the disease process and the surgical proce-dure, without experiencing any more anxiety that those not receiving the information materials [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Audiovisual Multimedia Combined with Standard, Verbal, Informed Consent; Enhancing the Satisfaction and Comprehension of Surgical Patients: A Comparative Trial in Patients Undergoing Laparoscopic Cholecystectomies at the HRH Princess Maha Chakri Sirindhorn Medical Center, Thailand

Thanapongsathorn¹,

Imchit²,

Phunya³

2012

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Objective: A comparative study of the audiovisual, multimedia, informed consent procedure enhancing the satisfaction and comprehension in laparoscopic cholecystectomy patients within the contexts of the Thai culture. Methods: A prospective, comparative trial was done in patients undergoing laparoscopic cholecystectomies at the HRH Princess Maha Chakri Sirindhorn Medical Center in Thailand. Before the procedure, all patients who met the selection criteria and agreed to participate in the study by signing the proper consent forms were placed into 2 groups. G1 (group 1) was informed with the standard verbal informed consent and G2 (group 2) was informed with audiovisual multimedia in the form of a DVD in collaboration with the standard, verbal, informed consent procedure. The patients were interviewed by a nurse, using a checklist type of questionnaire, as to their satisfaction and comprehension of the procedure on the day of discharge. Results: In the period of June 2010 through December 2010, 60 patients undergoing laparoscopic cholecystectomies and who had met the conditions of research were included in our study. There were 30 patients in each group. The average satisfaction score in G1 was 3.12 out of a total of 5 and in G2 was 4.51 of 5 (P < 0.001). The percentage of patients that had an understanding of the operative information: 1) Understood ≥ 50% of information; G1 was at 13.33% and G2 was at 70.00%; 2) comprehension of 1% -49% of the information; G1 was at 20.00% and G2 was at 26.67%; 3) No comprehension; G1 was measured at 66.67% and G2 was at 3.33%. The subgroup included the analysis of 7 items of information (operative indications, operative process, operative results, possible complications, wound care, diet, conditions for returning to work) and these were understood at a higher level in G2 than those in G1 (P < 0.001). Conclusions: In the context of the Thai culture; high technology, audiovisual multimedia combined with the standard, verbal, informed consent process enhanced the satisfaction and the comprehension of patients undergoing a laparoscopic cholecystectomy. Audiovisual multimedia should have the appropriate content, be clear, comprehensive and should include images and the voice of the surgeon who will be performing the operation to help the patient feel confident in the surgeon and in their decision to proceed with the surgery. Providing information in DVD form will benefit patients as they can examine it by themselves in the comfort of their home before the surgery and review the material as many times as may be required to provide a full understanding.

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“…The more interactive information is provided, the more a patient remembers (Table 1) [11, 13, 24, 34, 40, 42, 58–76]. Nonetheless, the amount of information that is transferred during a preoperative consultation in an outpatient environment can be overwhelming [41].…”

Section: Future Improvements Of Surgical Informed Consentmentioning

confidence: 99%

A Review of Surgical Informed Consent: Past, Present, and Future. A Quest to Help Patients Make Better Decisions

et al. 2010

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BackgroundInformed consent (IC) is a process requiring a competent doctor, adequate transfer of information, and consent of the patient. It is not just a signature on a piece of paper. Current consent processes in surgery are probably outdated and may require major changes to adjust them to modern day legislation. A literature search may provide an opportunity for enhancing the quality of the surgical IC (SIC) process.MethodsRelevant English literature obtained from PubMed, Picarta, PsycINFO, and Google between 1993 and 2009 was reviewed.ResultsThe body of literature with respect to SIC is slim and of moderate quality. The SIC process is an underestimated part of surgery and neither surgeons nor patients sufficiently realize its importance. Surgeons are not specifically trained and lack the competence to guide patients through a legally correct SIC process. Computerized programs can support the SIC process significantly but are rarely used for this purpose.ConclusionsIC should be integrated into our surgical practice. Unfortunately, a big gap exists between the theoretical/legal best practice and the daily practice of IC. An optimally informed patient will have more realistic expectations regarding a surgical procedure and its associated risks. Well-informed patients will be more satisfied and file fewer legal claims. The use of interactive computer-based programs provides opportunities to improve the SIC process.

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Improving Informed Consent of Surgical Patients Using a Multimedia-Based Program?

Abstract: Use of the multimedia-based program was positively evaluated by patients, and significantly improved patients' perceived understanding of their disease and its treatment. It is, therefore, valuable in the informed consent process.

Cited by 105 publications

References 18 publications

A Survey of Preferences Regarding Surgical Approach to Thyroid Surgery

A Survey of Preferences Regarding Surgical Approach to Thyroid Surgery

Audiovisual Multimedia Combined with Standard, Verbal, Informed Consent; Enhancing the Satisfaction and Comprehension of Surgical Patients: A Comparative Trial in Patients Undergoing Laparoscopic Cholecystectomies at the HRH Princess Maha Chakri Sirindhorn Medical Center, Thailand

A Review of Surgical Informed Consent: Past, Present, and Future. A Quest to Help Patients Make Better Decisions

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