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Informed consent for elective and emergency surgery: questionnaire study
Andrea Akkad1, Clare Jackson, Sara Kenyon
1Division of Obstetrics and Gynaecology, University of Leicester, UK.
BJOG : an International Journal of Obstetrics and Gynaecology
|September 24, 2004
Summary
Women undergoing emergency surgery reported poorer consent experiences, feeling less informed and more pressured than those with elective procedures. Current guidelines may not adequately meet patient needs, especially in urgent situations.
Area of Science:
- Obstetrics and Gynaecology
- Medical Ethics
- Patient Experience Research
Background:
- Informed consent is a cornerstone of medical ethics and patient autonomy.
- National guidelines and standardized consent forms have been introduced for obstetric and gynaecological surgery.
- Understanding patient experiences with consent is crucial for improving care.
Purpose of the Study:
- To evaluate women's experiences with the consent process for obstetric and gynaecological surgery.
- To identify differences in consent experiences between elective and emergency surgical procedures.
Main Methods:
- Prospective questionnaire study conducted in a large teaching hospital.
- 1006 consecutive patients undergoing elective or emergency obstetric and gynaecological surgery participated.
- Data collected on recall, understanding, satisfaction, and perceived choice regarding consent.
Main Results:
- Emergency surgery patients were less likely to read or understand consent forms and more likely to feel frightened and without choice.
- Despite differences, satisfaction with the consent process was higher in elective (80%) versus emergency (63%) surgery patients.
- Patient satisfaction correlated with reading, agreeing with, and understanding the consent form.
Conclusions:
- Current consent guidelines may inadequately address patient needs, particularly in emergency obstetric and gynaecological surgery.
- Complex forms may hinder personal communication, impacting the ethical and legal aspects of consent.
- Enhanced communication and advocacy are needed to improve the consent process for all patients.
