Knowledge and practice of informed consent by physiotherapists and therapy assistants in KwaZulu-Natal Province, South Africa

Abstract

BackgroundInformed consent is a doctrinal prerequisite in accordance with the National Health Act 2003 and professional ethical guidelines. Current regulations stipulate that healthcare professionals obtain informed consent from patients prior to treatment. Misconduct charges relating to inadequate information disclosure have been recorded against South African physiotherapists.ObjectivesThis study evaluated knowledge and barriers to informed consent practice among physiotherapists and assistants at Ethekwini District public health institutions.MethodsThis cross-sectional study utilised self-administered questionnaires. Statistical Package for Social Sciences was used to analyse variables. Significance level and attitude correlation was determined using chi-squared tests, Pearson’s correlation and Spearman’s coefficient.ResultsForty-nine respondents (43 physiotherapists, 3 technicians, 3 assistants) completed this study. Mean age and professional experience of respondents were 38 and 14 years, respectively. The majority were female (93%); 56% spent 5 to 10 min obtaining informed consent, mostly verbally (89%); while 47% correctly identified age of consent to routine treatment (12 years). Information provided to patients by respondents included treatment benefits (100%), common risks (81%) and ‘all material risks’ (31%). Fifty per cent of respondents showed positive attitudes to informed consent.ConclusionsSome practising physiotherapists and assistants in KwaZulu-Natal public healthcare institutions had only partial knowledge of informed consent regulations and local laws. Barriers to informed consent included language and excessive workload.Clinical implicationsPatient-centred care is quality healthcare, and adequate informed consent knowledge improves clinical outcomes, respects patients’ dignity and autonomy. Continued professional education on healthcare law and ethics should be provided to practising physiotherapists and assistants.

South African traditional values and beliefs regarding informed consent and limitations of the principle of respect for autonomy in African communities: a cross-cultural qualitative study

“…Furthermore, we found that biomedical researchers working in South Africa perceived informed consent as a process that research participants and patients must follow to make research valid. The legal and ethical requirements for the informed consent process in South Africa stipulate that informed consent must involve full disclosure of information [ 16 , 63 , 64 , 67 ]. There must be complete comprehension of the information disclosed to research participants or subjects.…”

“…As a researcher, one must disclose all of the benefits that may accrue from participating in the research study; further, one must minimise the risks of research as much as possible. The rights to privacy of the individual participants also have to be protected [ 16 , 22 , 64 , 67 ]. All these processes are supported by the South African Constitution [ 68 ], common law, the National Health Act 2003 [ 63 ], and international ethical guidelines like the Declaration of Helsinki [ 69 ].…”

Knowledge and practices of seeking informed consent for medical examinations and procedures by health workers in the Democratic Republic of Congo

“…Our study showed that among HCPs there are slightly more males than females ( Table I ), statistically in keeping with other studies done among HCPs.4,18,19 However, other studies have presented another figure of distribution between males and females. 3 , 20 This difference related to the type of study done by researchers. This seems to rely on HCP's willingness to participate in this study instead of a survey distribution of healthcare workers.…”

“…In other words, IC is closely linked to the ethical principle of respecting patient autonomy, respect of human rights and ethical practice. 2 , 3 Furthermore, the constitutions of many countries today, at different levels, protect and guarantee universal basic human rights. That makes IC a legal requirement for any HCP before any medical examination or procedure takes place.…”

“… 1 , 2 IC is therefore a professional and ethical issue emanating from the fiduciary responsibility of the HCP towards his/her patient. 3 , 4 …”