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Who's afraid of informed consent?
D D Kerrigan1, R S Thevasagayam, T O Woods
1Royal Hallamshire Hospital, Sheffield.
Objective:
To test the assumption that patients will become unduly anxious if they are given detailed information about the risks of surgery in an attempt to obtain fully informed consent.
Design:
Preoperative anxiety assessed before and after patients were randomly allocated an information sheet containing either simple or detailed descriptions of possible postoperative complications.
Setting:
Four surgical wards at two Sheffield hospitals.
Subjects:
96 men undergoing elective inguinal hernia repair under general anaesthesia.
Main Outcome Measure:
Change in anxiety level observed after receiving information about potential complications.
Results:
Detailed information did not increase patient anxiety (mean Spielberger score at baseline 33.7 (95% confidence interval 31.3 to 36.2), after information 34.8 (32.1 to 37.5); p = 0.20, paired t test). A simple explanation of the facts provided a statistically significant degree of reassurance (mean score at baseline 34.6 (31.5 to 37.6), after information 32.3 (29.8 to 34.9); p = 0.012), although this small effect is likely to be clinically important only in those whose baseline anxiety was high (r = 0.27, p = 0.05).
Conclusions:
In men undergoing elective inguinal hernia repair a very detailed account of what might go wrong does not increase patient anxiety significantly and has the advantage of allowing patients a fully informed choice before they consent to surgery, thus reducing the potential for subsequent litigation.