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Informed Consent in Pediatric Otolaryngology: What Risks and Benefits Do Parents Recall?
Kiersten Pianosi1, Ayala Y Gorodzinsky2, Jill MacLaren Chorney3
1Division of Otolaryngology-Head and Neck Surgery, IWK Health Centre, Halifax, Canada.
Insights
Parents often forget surgical risks and benefits discussed for pediatric otolaryngology procedures. This poor recall may affect decision-making and expectations, highlighting a need for improved communication strategies.
Area of Science:
- Pediatric Otolaryngology
- Medical Communication
- Patient Education
Background:
- Informed consent requires patients to understand surgical risks and benefits.
- Parental comprehension of complex medical information can be challenging.
Purpose of the Study:
- To assess parental recall of surgical risks and benefits in pediatric otolaryngology.
- To identify factors influencing parental recall of this information.
Main Methods:
- Prospective cohort study involving 84 parents of children under 6.
- Video recording of consultations for adeno/tonsillectomy and/or tympanostomy tube insertion.
- Parental recall assessed two weeks post-consultation.
Main Results:
- Parents recalled only one-third of surgical risks discussed.
- Benefits were recalled more often than risks (P < .001).
- Parents proceeding with surgery recalled fewer risks than those who did not (P < .001).
Conclusions:
- Parental recall of risks and benefits for common pediatric otolaryngology procedures is inadequate.
- Poor recall may impact parental decision-making and expectations.
- Further research is needed to develop methods for enhancing parental recall.
Objective:
To evaluate parental recall of surgical risks and benefits in pediatric otolaryngology and to assess for factors that may influence recall.
Study Design:
Prospective cohort study.
Setting:
Academic pediatric otolaryngology clinic.
Subjects And Methods:
Eighty-four parents of children <6 years of age who underwent consultation for adeno/tonsillectomy and/or tympanostomy tube insertion were prospectively enrolled. Consultation visits were video recorded and the benefits and risks of surgery documented. Two weeks following the consultation, parents were contacted for assessment of recall of information discussed during the consultation.
Results:
Overall, parents recalled only one-third of the risks of surgery mentioned by the surgeons. Parents were significantly more likely to recall the benefits of surgery as opposed to the risks (P < .001). Nine parents (10.7%) reported that no benefits were discussed during the consultation, and 10 (11.9%) reported no mention of any risks. Inconsistencies were present in which risks and benefits were mentioned by the providers. Parents who decided to proceed with surgery (58.3%) were significantly less likely to recall the surgical risks than those who did not (P < .001). The specific surgeon involved, the number of caregivers present, parental education level, and prior surgical history did not influence recall.
Conclusion:
Parental recall of benefits and risks associated with common pediatric otolaryngology procedures was poor. This information is important because a low rate of recall may influence parents' perspectives of the procedure and could alter their decision-making processes or expectations. Methods to improve parental recall should be further studied.
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