Patient Perception of Informed Consent and Its Associated Factors among Surgical Patients Attending Public Hospitals in Dessie City Administration, Northeast Ethiopia

Abstract

Background. Poor perception of informed consent compromises patients’ autonomy and self-determination; as a result, they feel powerless and unaccountable for their treatment. This study aimed to assess patients’ perception of informed consent and its associated factors among surgical patients attending public hospitals in Dessie City Administration, Northeast Ethiopia. Methods. Facility-based cross-sectional study was conducted on 422 surgical patients. A systematic sampling technique was used to select the study participants. Data were collected using a pretested structured interviewer-administered questionnaire. EpiData version 3.1 was used for data entry, and then data were exported to SPSS version 25 for analysis. Multivariable logistic regression analysis was done to identify factors associated with the outcome variable among the participants. Variables with p value less than 0.05 were considered statistically significant factors. Results. The prevalence of poor perception of informed consent for surgical procedures was found to be 33.2% (95% CI: 28.8–37.8). In multivariable analysis, educational status with inability to read and write (AOR = 5.71; 95% CI: 2.76–11.80) and basic ability to read and write (AOR = 6.03; 95% CI: 2.57–14.16), rural residence (AOR = 3.71; 95% CI: 1.94–7.07), marital status being widowed and divorced (AOR = 3.85; 95% CI: 1.83–8.08), language of written informed consent different from mother tongue (AOR = 4.196; 95% CI: 1.12–15.78), poor patient-physician relationship (AOR = 2.35; 95% CI: 1.31–4.24), and poor knowledge of surgical informed consent (AOR = 3.05; 95% CI: 1.56–5.97) were significantly associated with poor perception of surgical informed consent. Conclusion. In this study, one-third of surgical patients appear to have poor perceptions of informed consent for surgical procedures. Educational status, being rural residents, being widowed/divorced, language of written informed consent, poor patient-physician relationship, and poor knowledge of surgical informed consent were variables that are independent predictors of poor perception of informed consent for surgical procedures. The ministry of health and healthcare providers should develop a plan to raise patients’ awareness about the informed consent process for surgical procedures.

Surgical informed consent practices and influencing factors in sub-Saharan Africa: a scoping review of the literature

“…For ethical and legal reasons the duty to obtain patients’ consent typically rests on the physician. Yet, several studies9 40 44–46 54 55 in this review reported a range of healthcare providers obtaining SIC, including nurses or midwives not involved in the surgical procedure and not trained in SIC counselling 52…”

“…In general, the most frequently explored implications of SIC were patients’ understanding of the procedure and risks involved36–47 (including recall of information as proxy27 48 49), autonomy in decision-making9 27 36 37 40 42 43 47 49–51 and satisfaction with the process 21 27 41 44–46 49 52–55…”

“…For a consent process to be considered valid, it should be conducted timely and not under pressure. In Ethiopia, three studies reported patients spending less than 5 min with their responsible healthcare providers in the SIC process44 46 51; one study found SIC most often obtained immediately prior to the surgery, irrespective of the urgency of the procedure52; and in three studies patients explicitly mentioned not being given enough time to decide 36 43 46. In Nigeria, Grema et al 45 documented some patients being asked for SIC after the surgery.…”

“…In Ethiopia, quantitative assessments of the overall soundness of the patient–provider relationship, in both the obstetrics46 54 and other surgical subspecialties,44 found large shares of patients experiencing poor relationships with their providers. However, these studies were limited in number and inconsistent in measurement.…”

Women’s Involvement in Decision-Making and Associated Factors Among Women Who Underwent a Caesarean Section in Sidama Region, South Ethiopia: Cross-Sectional Study

“…This study is in line with the finding in Dessie. 31 Reducing the language barrier might be that providing health information in understandable language might increase interaction and communication between health care providers. In addition, women can understand the situation.…”