[Preoperative education consultation from the viewpoint of the patient]

By means of semi-standardized interviews 64 patients at a university orthopedic clinic were asked about the information supply and decision-taking process, in particular concerning their impressions of the consultation which takes place just prior to surgery (usually on the preceding day) and leads to the formal declaration of consent. It was found that this discussion does not have the central significance in the information and decision process which is often ascribed to it. Nevertheless, in addition to the legal aspect, it fulfills a number of important psychological functions: - The patient is given supplementary information, in particular concerning events surrounding the operation. - Immediately prior to the operation and its risks, the patient's binding consent is confirmed: this represents a formal termination of the decision process. - Considering the anxiety and doubt associated with the operation (cognitive dissonance) the patients needs emotional support. - The talk provides an opportunity to establish or consolidate a personal relationship between the patient and the responsible physician. Contrary to widely-held opinion almost all the patients were highly interested in detailed information and demonstrated considerable knowledge of their complaints, the surgical method and the risks involved. Though the preoperative talk was positively assessed by most patients, it was nonetheless apparent that current practices in furnishing medical information require correction in a number of respects. Above all, the provision of information simply by listing points, and in the form of a monologue, should be abandoned; instead, the patient should be involved as an active partner in an exchange of information and a decision-making process.(ABSTRACT TRUNCATED AT 250 WORDS)