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Parental comprehension following informed consent for pediatric cataract surgery
Vasudha Erraguntla1, Irina De la Huerta, Sunita Vohra
1Department of Ophthalmology, University of Saskatchewan, Saskatoon, Canada.
Insights
Parents often overestimate their understanding of pediatric cataract surgery information. Follow-up discussions significantly improve parental comprehension of risks and outcomes.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Medical Communication
Background:
- Informed consent is crucial in pediatric surgery.
- Effective information transfer ensures patient safety and adherence to treatment.
Purpose of the Study:
- To evaluate how well pediatric cataract surgeons transfer information to parents during informed consent.
- To identify gaps in parental understanding of the procedure, risks, and outcomes.
Main Methods:
- Prospective observational study of 31 children's parents undergoing cataract surgery.
- Parents completed questionnaires assessing recall post-discussion.
- Surgeons provided follow-up communication addressing misunderstood information.
Main Results:
- 58% of parents overestimated their understanding.
- Recall was lower for surgical risks and outcomes compared to disease nature.
- Barriers included information overload, stress, and child preoccupation.
Conclusions:
- Parents may overestimate comprehension of informed consent for pediatric cataract surgery.
- Optimism bias regarding risks and outcomes is common.
- Targeted follow-up communication enhances parental understanding.
Objective:
To investigate the effectiveness of information transfer by the pediatric cataract surgeon to the parents or guardians of children during the informed-consent process.
Design:
Prospective observational case series.
Participants:
Parents of 31 children undergoing cataract surgery.
Methods:
Parents were enrolled from the clinical practice of 1 pediatric cataract surgeon. Using a checklist developed in consultation with other pediatric cataract surgeons, the surgeon discussed the nature of the disease, the course without surgical intervention, the surgical procedure, the risks and benefits, and the postoperative care. Immediately after the discussion, parents were invited to complete a questionnaire assessing information recall. Analysis of variance and the t test were used to determine associations between questionnaire scores and demographic variables. The surgeon subsequently called parents and discussed again the issues that they had not remembered correctly, as identified by the questionnaire responses. The study and data accumulation were carried out with the approval of the Research Ethics Board at The Hospital for Sick Children, Toronto, Ont. Informed consent for the research was obtained from the parents or legal guardians of the children enrolled in the study. The study adhered to the tenets of the Declaration of Helsinki.
Results:
Of 31 parents, 18 (58%) overestimated their understanding of the informed-consent discussion. Parents scored well on questions about the nature of the disease and the postoperative follow-up but scored lower on questions regarding surgical risks and outcomes. Parents identified several barriers to understanding, including the large amount of information, stress, and preoccupation with the child. No association was noted between the level of understanding and demographic factors.
Conclusions:
Parents may overestimate their understanding of informed-consent discussions. Some parents may be overly optimistic about risks and outcomes. The surgeon's follow-up communication with parents that addressed aspects insufficiently understood during the initial discussion provided a way of improving comprehension.
