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

Abstract

Background: Informed consent (IC) is linked to the ethical principle of respecting patient autonomy, respect for human rights and ethical practice, while in many countries it is a standard procedure. Anecdotally, it should be noted that in the Democratic Republic of Congo (DRC) in many instances ICs are not obtained systematically. To date, no research appears to have been conducted on this matter. This study aimed to assess the knowledge and practice of obtaining IC from patients among health care providers (HCP) in the DRC.
 Methods: This was a cross-sectional study, with a convenient sampling of 422 participants. Data from the questions were collected on an imported Microsoft Excel spreadsheet for review at INSTAT.TM The authors set IC's accurate knowledge and practice at 80% or higher. The Fisher Exact test was used to compare categorical association results, and a p-value < 0.05 was considered statistically significant.
 Results: Results showed that giving information in detail to patients on their medical condition was associated with formal training on medical ethics and IC (p: 0.0028; OR: 1.894; CI: 1.246 to 2.881), which was also associated with answering the patient’s questions in detail (p: 0.0035; OR: 1.852; CI: 1.236 to 2.774). About 127(30.09 %) of participants scored 80% or higher. Extracurricular training was associated with withholding information from patients, up to 27 times more than other factors (p< 0.0001; OR: 27.042; CI: 13.628 to 53.657). when it comes to get IC, HCP with many years of practice scored better than others, in one of the question the odd ratio was closer to 7 ( p< 0.0001; OR: 6.713; CI: 4.352 to 10.356). Only 47(11.14%) of the participants scored 80% or more of the questions about practice of IC.
 Conclusion: For a variety of reasons, knowledge and practice of IC among HCPs was very low. A common programme for the country as part of formal training might lead to an improvement. In addition, patients’ education on IC should be displayed in waiting areas at all medical centres.
 Keywords: Informed consent; medical examinations; procedures by health workers in the Democratic Republic of Congo.

Practices and attitudes of herbalists regarding informed consent in Uganda: A qualitative study

“…These ndings resonate with those of Nzaumvila et al, who examined the knowledge and of seeking consent by healthcare in the Congo, and Langworthy, who explored the procedures for providing consent among chiropractors in the United Kingdom. (5,7,19) Their results further align with Uganda's constitutional right information and the Uganda Patient Charter (20,21).…”

“…This study revealed various sources of herbal medicine knowledge among herbalists, in uencing their attitudes and practices toward IC. According to Nzaumvila et al's research in the Congo, among practitioners, informed consent associates their ability to exercise information disclosure with having formal training in medical ethics and IC (7). Herbalists with formal education who obtained herbal medicine knowledge through structured programs may tend to exhibit more positive attitudes toward informed consent than those with informal education, those who rely on internet sources or those who have experiential knowledge acquisition.…”

“…This type of consent aligns with common in healthcare, such as patients extending their arms for routine procedures such as blood drawing or blood pressure checks. In such cases, patients are presumed to be aware of the procedure's implications, obviating the need for additional explanations (7,18,30). should we consider this kind of consent adequate in herbal medicine?…”

“…Herbal medicines in Uganda are generally sold by herbalists with little or no formal education or in-service training in IC or medical ethics (11). The ability of practitioners to effectively execute IC has been shown to be associated with having had some training in this topic or medical ethics (7). A study by Caspi et al reported variance and a lack of standards in the conduct of IC practices among complementary and alternative medicine (CAM) therapies (12), and these practices have been reported to vary based on different jurisdictions and cultures.…”

Informed consent practice and associated factors among healthcare professionals in public hospitals of Southern Ethiopia, 2023: a mixed-method study

“…There are many contributing factors affecting the practice of informed consent. Excessive workload, language barriers, medical terminologies, educational differences, cultural/traditional differences, patient comprehension, use of disclosed information, autonomy, insufficient time allocation, and the degree to which health care providers adhere to the minimal standards for disclosure all have an impact on the practice of proper informed consent [ 12 , 19 ]Other challenges to informed consent implementation include poverty, a lack of educational advancement, lack of familiarity with autonomy and individual freedom of patient, and power imbalance [ 20 , 21 ]. Similarly, a cross-sectional study conducted in among surgical patients attending public hospitals in Dessie city administration showed that educational status, rural residence, marital status, language variation, poor patient-physician relationship, and poor knowledge of surgical informed consent had significant effect on practice of informed consent [ 10 ].…”