Structured Preoperative Phone Counseling by Junior Medical Staff for Improving the Consent Process for Tonsillectomy

Kam, Jonathan; Harrop, Elizabeth; Parmar, Priscilla; Kim, Woojin; Leith, Nicholas; Gunawardena, Indunil

doi:10.1177/0194599816666069

Cited by 3 publications

(2 citation statements)

References 11 publications

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“… 4 , 5 , 8 – 11 , 13 – 16 , 19 – 24 , 27 , 30 , 31 , 33 , 37 – 43 , 48 – 50 , 52 – 57 , 60 – 62 , 65 , 67 – 70 , 72 , 73 The level of detail was variable and depended to some extent on the reporting nation; one study broke down education into 5 groups (6–9 years, 9–11 years, high school graduates, some college or vocational school, and college graduates), 70 to sole passage of a graduation exam. 33 In 3 trials, only maternal education was reported 12 , 65 , 67 and one study solely enrolled medical students. 72 …”

Section: What Has Been Tried To Measure and Improve Informed Consent?mentioning

confidence: 99%

“… 44 One group used a structured pre-op phone call by junior medical staff to amplify information given at the time of decision to operate. 12 One trial used a 3D model of a patient’s lung with pathology. 56 One trial provided patients with a review of their own images during the consent process.…”

Section: What Has Been Tried To Measure and Improve Informed Consent?mentioning

confidence: 99%

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Improving Surgical Informed Consent

Raper

Clapp

Fleisher

2021

Annals of Surgery Open

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Objective: This study reviews randomized clinical trials that have attempted to improve the process of informed consent. Consent should be guided by the ethical imperatives of autonomy, beneficence, and social justice. Summary Background: Informed consent is constantly evolving. Yet our review of the randomized trials done to improve the surgical informed consent process raises a number of questions: How does one define surgical informed consent? What interventions have been tried to measure and improve informed consent? Have the interventions in informed consent actually led to improvements? What efforts have been made to improve informed consent? And what steps can be taken to improve the process further? Methods: A literature search for randomized controlled trials (RCTs)on informed consent identified 70 trials. Demographics, interventions, assessments, and a semi-quantitative summary of the findings were tabulated. The assessments done in the RCTs, show the surrogate for patient autonomy was comprehension; for beneficence, satisfaction and mental state (anxiety or depression); and, for social justice, language, literacy, learning needs, and cost. Results: There were 4 basic categories of interventions: printed matter; non-interactive audiovisual tools; interactive multimedia; and a smaller group defying easy description. Improvement was documented in 46 of the 65 trials that studied comprehension. Thirteen of 33 trials showed improved satisfaction. Three of 30 studies showed an increase in anxiety. Few studies tried to assess primary language or literacy, and none looked at learning needs or cost. Conclusions: No single study improved all 3 principles of informed consent. Validated interventions and assessments were associated with greater impact on outcomes. All 3 ethical principles should be assessed; autonomy (as comprehension), beneficence (as satisfaction, anxiety), and social justice. Not enough consideration has been given to social justice; appropriate language translation, standardized reading levels, assessment of learning needs, and cost to the individual are all important elements worthy of future study.

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Section: What Has Been Tried To Measure and Improve Informed Consent?mentioning

confidence: 99%

Section: What Has Been Tried To Measure and Improve Informed Consent?mentioning

confidence: 99%

Improving Surgical Informed Consent

Raper

Clapp

Fleisher

2021

Annals of Surgery Open

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Patient quality of life fluctuates before and after Mohs micrographic surgery: A longitudinal assessment of the patient experience

Zhang

Miller

O’Malley

et al. 2018

Journal of the American Academy of Dermatology

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Preferences for Preoperative Education: A Qualitative Study of the Patient Perspective

Rockefeller

Jeppson

Komesu

et al. 2021

Female Pelvic Med Reconstr Surg

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Objectives The aim of this study is to identify and describe the information that is important to patients in preparation for surgery for pelvic floor disorders. Methods This qualitative study enrolled English- and Spanish-speaking patients who had undergone surgery for pelvic floor disorders in semistructured focus groups. We explored patients' attitudes and views regarding preoperative education, postoperative experiences, and quality of pain management. Focus groups were conducted until thematic saturation was reached. Deidentified focus group transcripts were analyzed with line-by-line coding and organized into themes using a team-based process. Results Four focus groups were conducted, 2 with English-speaking women (n = 14) and 2 with Spanish-speaking women (n = 10). Participants identified as non-Hispanic White 13/24 (54%) or Hispanic 11/24 (46%); 83% had at least a high school education and 50% had a bachelor's degree. Women reported 5 thematic domains of information that they deemed important for patients to know preoperatively: (1) preparation for surgery; (2) postoperative pain control expectations; (3) postoperative activity restrictions; (4) communication with care team; and (5) care experiences. Conclusions This study identifies information that is important to patients undergoing pelvic floor surgery. These patient-centered themes go beyond routine preoperative education and counseling. This information will aid future studies regarding the incorporation of patient-centered preoperative education and expectation setting with respect to improved pain control, patient satisfaction, and overall surgical experience.

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Structured Preoperative Phone Counseling by Junior Medical Staff for Improving the Consent Process for Tonsillectomy

Abstract: Preoperative phone counseling by junior medical staff closer to the time of surgery reinforces and clarifies the information previously provided by senior consultants at the time of initial consent for tonsillectomy.

Cited by 3 publications

References 11 publications

Improving Surgical Informed Consent

Improving Surgical Informed Consent

Patient quality of life fluctuates before and after Mohs micrographic surgery: A longitudinal assessment of the patient experience

Preferences for Preoperative Education: A Qualitative Study of the Patient Perspective

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