The efficacy of mobile application use on recall of surgical risks in nasal bone fracture reduction surgery

Abstract

Background The number of surgical risks recalled by a patient after surgery can be used as a parameter for assessing how well the patient has understood the informed consent process. No study has investigated the usefulness of a self-developed mobile application in the traditional informed consent process in patients with a nasal bone fracture. This study aimed to investigate whether delivery of information, such as surgical risks, through a mobile application is more effective than delivery of information through only verbal means and a paper.Methods This prospective, randomized study included 60 patients with a nasal bone fracture. The experimental group (n=30) received preoperative explanation with the traditional informed consent process in addition to a mobile application, while the control group (n=30) received preoperative explanation with only the traditional informed consent process. Four weeks after surgery, the number of recalled surgical risks was compared for analysis. The following six surgical risks were explained: pain, bleeding, nasal deformity, numbness, nasal obstruction, and nasal cartilage necrosis.Results The mean number of recalled surgical risks among all patients was 1.58±0.56. The most frequently recalled surgical risk was nasal deformity in both groups. The mean number of recalled surgical risks was 1.72±0.52 in the experimental group and 1.49±0.57 in the control group. There was a significant association between mobile application use and the mean number of recalled surgical risks (p=0.047). Age, sex, and the level of education were not significantly associated with the mean number of recalled surgical risks.ConclusionThis study found that a mobile application could contribute to the efficient delivery of information during the informed consent process. With further improvement, it could be used in other plastic surgeries and other surgeries, and such an application can potentially be used for explaining risks as well as delivering other types of information.

How to effectively obtain informed consent in trauma patients: a systematic review

“…The remaining eight studies on informed consent in adult trauma patients were included in the review for narrative synthesis [40–47] (Table 2). One study was conducted in the United States [40], one in Turkey [42], one in Korea [45], one in Taiwan [46], three in the United Kingdom [41, 43, 44], and one in Ireland [47]. All studies were conducted to evaluate the informed consent process in adult trauma patients.…”

“…All studies were conducted to evaluate the informed consent process in adult trauma patients. Six studies involved orthopedic surgeries [40–44, 47], one involved surgery for nasal bone fracture [45], and one involved trauma-related debridement surgery [46]. Only one study was conducted in an emergency department [46].…”

“…The number of included patients was 48, 81, 142, 100, 100, 57, 142, and 97 respectively. Four studies provided information on patient age, gender, and level of education [40, 42, 45, 46]. Three studies provided information on patient age and gender alone [43, 44, 47].…”

“…In five studies, verbal and written/leaflet information were provided to patients [41–44, 47]; in one study, verbal and video information were provided to patients [40]; in one study, verbal description and paper permission with or without a mobile application were provided [45]; and in one study, written or laptop-based video information was provided to patients [46]. The timing of patient evaluation was immediately after receiving information and an average of 10 weeks later [40], on the first postoperative day [41, 43], on postoperative days 1 to 3 [42], on postoperative days 1 to 17 (mean 3.2 days) [44], at a follow-up visit 4 weeks after information was provided [45], before and immediately after receiving information [46], and immediately and one day later [47]. Five studies used a questionnaire [40, 41, 44, 46, 47], two used interview and questionnaire [42, 43], and one used open questioning to evaluate recall of surgical risks [45].…”

“…The timing of patient evaluation was immediately after receiving information and an average of 10 weeks later [40], on the first postoperative day [41, 43], on postoperative days 1 to 3 [42], on postoperative days 1 to 17 (mean 3.2 days) [44], at a follow-up visit 4 weeks after information was provided [45], before and immediately after receiving information [46], and immediately and one day later [47]. Five studies used a questionnaire [40, 41, 44, 46, 47], two used interview and questionnaire [42, 43], and one used open questioning to evaluate recall of surgical risks [45]. Two studies developed a multiple-choice questionnaire to evaluate the understanding of trauma patients about their surgery [40, 46]; the other six asked patients to recall the name of the procedure and risks or complications of the surgery [41–45, 47].…”