Effect of a Multimedia Patient Decision Aid to Supplement the Informed Consent Process of a Peripherally Inserted Central Venous Catheter Procedure: Pre-Post Quasi-Experimental Study

Abstract

BackgroundInformed consent is a complex process to help patients engage in care processes and reach the best treatment decisions. There are many limitations to the conventional consent process that is based on oral discussion of information related to treatment procedures by the health care provider. A conclusive body of research supports the effectiveness of multimedia patient decision aids (PtDAs) in the consent process in terms of patient satisfaction, increased knowledge about the procedure, reduced anxiety level, and higher engagement in the decision making. Little information is available about the effectiveness of multimedia PtDAs in the consent process of invasive therapeutic procedures such as the peripherally inserted central venous catheter (PICC).ObjectiveThe objective of this study was to examine the effectiveness of a multimedia PtDA in supplementing the consent process of the PICC for patients in 10 acute and intensive care units in terms of knowledge recall, knowledge retention, satisfaction with the consent process, and satisfaction with the PICC multimedia PtDA.MethodsThis pre-post quasi-experimental study included 130 patients for whom a PICC was ordered. Patients in the control group (n=65) received the conventional consent process for the PICC, while those in the intervention group (n=65) received the multimedia PtDA to support the consent process of a PICC. All patients were surveyed for knowledge recall and retention about the procedure and satisfaction with the consent process. Patients in the intervention group were also surveyed for their satisfaction with the multimedia PtDA.ResultsCompared with the control group, patients in the intervention group scored around 2 points higher on knowledge recall (t125=4.9, P<.001) and knowledge retention (t126=4.8, P<.001). All patients in the intervention group were highly satisfied with the multimedia PtDA, with a mean score of >4.5 out of 5 on all items. Items with the highest mean scores were related to the effect of the multimedia PtDA on knowledge retention (mean 4.9 [SD 0.2]), patient readiness to learn (mean 4.8 [SD 0.5]), complete understanding of the procedure-related complications (mean 4.8 [SD 0.4]), and patient role in maintaining the safety of the PICC (mean 4.8 [SD 0.5]). Patients in the two groups were highly satisfied with the consent process. However, 15% (10/65) patients in the control group reported that the following information was omitted from the discussion: patient and provider roles in the safety of the PICC, other treatment options, and common side effects. Furthermore, 2 patients commented that they were not ready to engage in the discussion.ConclusionsThe multimedia PtDA is an effective standardized, structured, self-paced learning tool to supplement the consent process of the PICC and improve patient satisfaction with the process, knowledge recall, and knowledge retention.

Potential Benefits of Multimedia-Based Home Catheter Management Education in Patients With Peripherally Inserted Central Catheters: Systematic Review

“…The other 2 studies come from the Google search engine. After removing duplicates and screening, 9 studies were considered potentially eligible [ 6 - 11 , 24 , 25 , 30 ]. After further evaluation, 6 studies met our inclusion criteria [ 8 - 11 , 24 , 25 ].…”

“…After removing duplicates and screening, 9 studies were considered potentially eligible [ 6 - 11 , 24 , 25 , 30 ]. After further evaluation, 6 studies met our inclusion criteria [ 8 - 11 , 24 , 25 ]. Two studies were excluded because of unclear educational interventions [ 6 , 7 ], and the other because of unrelated design [ 30 ].Three studies came from the United States [ 9 , 10 , 25 ], 1 from Canada [ 24 ], 1 from France [ 8 ], and 1 from Italy [ 11 ].…”

“…After further evaluation, 6 studies met our inclusion criteria [ 8 - 11 , 24 , 25 ]. Two studies were excluded because of unclear educational interventions [ 6 , 7 ], and the other because of unrelated design [ 30 ].Three studies came from the United States [ 9 , 10 , 25 ], 1 from Canada [ 24 ], 1 from France [ 8 ], and 1 from Italy [ 11 ]. In addition, 3 studies were randomized controlled trials [ 9 , 11 , 24 ], and 3 were quasi-experimental/case-control studies [ 8 , 10 , 25 ].…”

“…These studies included a total of 355 subjects, including 175 (49%) in the multimedia-based education group. The number of subjects in each study ranged from 11 [ 10 ] to 130 [ 25 ]. Follow-up for each study ranged from 1 day to 10 months.…”

“…However, the potential benefits of multimedia-based education remain unclear. To our understanding, the existing literature is conflicting, which can confuse clinicians when choosing effective approaches to meet patients' educational needs [ 9 - 11 , 25 ]. Moreover, during our literature search, we found no systematic review or meta-analysis study that could synthesize the existing evidence.…”