Surgical Consent of Children and Guardians for the Treatment of Adolescent Idiopathic Scoliosis is Incompletely Informed

Theologis, Alexander A.; Anaya, Andres; Sabatini, Coleen S.; Sucato, Daniel J.; Parent, Stefan; Erickson, Mark; Diab, Mohammad

doi:10.1097/brs.0000000000001162

Cited by 10 publications

(7 citation statements)

References 11 publications

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“…While potential benefits, indications, and minor risks associated with FB were reported as well understood, caregivers appeared less likely to comprehend major risks (such as air leak, airway hemorrhage) associated with FB 1 . This is in line with prior work evaluating informed consent for ophthalmic, spinal, and general surgeries 9,12,13 . Several explanations for this discrepancy exist.…”

Section: Discussionsupporting

confidence: 61%

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Caregiver comprehension and satisfaction associated with informed consent for pediatric flexible bronchoscopy: A single‐center experience

Simpson

McHendry

Müllen

et al. 2022

Pediatric Pulmonology

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Pediatric flexible bronchoscopy (FB) is a relatively common procedure performed in children with respiratory concerns. Despite this, there is no data examining the informed consent process for FB. A prospective study evaluating informed consent comprehension and satisfaction was conducted in 71 primary caregivers of children undergoing outpatient FB. Most caregivers (97%) were overall satisfied with the consent process and reported understanding the potential benefits (97%) and minor risks (94%) associated with the procedure. A smaller percentage (83%) reported understanding major risks associated with FB. Patient safety was reported as the most important aspect of the consent process. Caregivers of children undergoing FB for the first time were more likely to want additional FB-specific information when compared to caregivers of children who had previously undergone FB (53% vs 16%, odds ratio: 5.97). In general, caregivers of children undergoing outpatient FB are satisfied with the informed consent process. Areas for improvement include ensuring adequate understanding of major risks associated with the procedure and considering a tailored approach based on the caregiver's level of experience.

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Section: Discussionsupporting

confidence: 61%

“…1 This is in line with prior work evaluating informed consent for ophthalmic, spinal, and general surgeries. 9,12,13 Several explanations for this discrepancy exist. The first is that physicians may be more likely to downplay rare complications in an attempt to decrease caregiver anxiety.…”

Section: Discussionmentioning

confidence: 99%

Caregiver comprehension and satisfaction associated with informed consent for pediatric flexible bronchoscopy: A single‐center experience

Simpson

McHendry

Müllen

et al. 2022

Pediatric Pulmonology

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“…All surgical procedures require a written informed medical consent to present the expected outcome, therapeutic alternatives, the procedure associated specific potential complications as well as to meet legal aspects. To understand the complexity of surgical procedures is of great importance [ 1 , 2 ]. With the implicit understanding that patients have basic medical knowledge physicians explain the procedures to help the patients to take the decision made on information and knowledge and actively participate in their treatment.…”

Section: Introductionmentioning

confidence: 99%

A survey on patients’ knowledge and expectations during informed consent for spinal surgery: can we improve the shared decision-making process?

et al. 2016

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BackgroundThe informed medical consent in surgery requires to some point basic medical knowledge. The treating physicians while explaining the details and risks of the recommended procedure often imply this. We hypothesized, that patients do not have adequate medical understanding to decide about the ongoing therapy and its potential complications based on knowledge jeopardizing the patients’ safety.MethodsWe conducted a retrospective analysis of a prospective database using a multiple choice questionnaire with 10 basic questions about anatomy, clinical symptoms and therapies of spinal diseases in our spine clinic at a German university hospital. Included were all patients at the spine clinic who agreed to the study and to fill in the questionnaire. Furthermore the patients age, mother tongue, the past spinal surgical history, the length of duration of symptoms and the patients education were inquired. The data were analyzed descriptive.ResultsIncluded were 248 patients with an average age of 59 years (16–88 a). 70 % of all patients used German as their mother tongue. 30 % of the included patients already had spinal surgery and suffered on average for 13.4 years because of their spinal disorder. Overall 32.6 % of all questions were answered correctly (range 0.8–68 %). A correlation of correctly answered questions and the patients’ age, duration of symptoms, mother tongue, education and past surgical history could not be described.ConclusionThe percentage of correctly answered questions is almost as low as the likelihood of nearness in guessing. Having this in mind the patients do not choose any treatment option based on knowledge. The physicians need to provide more basic knowledge to the patients. This would increase the amount of successful therapies, content patients and the patients safety.Electronic supplementary materialThe online version of this article (doi:10.1186/s13037-016-0103-z) contains supplementary material, which is available to authorized users.

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“…The informed consent process can be divided into three stages: physician disclosure, patient understanding, and decision making [1]. The disclosure stage rarely meets existing criteria for proper consent due to improper explanations of treatment goals, benefits, or risks in a retainable manner [2][3][4][5][6][7][8]. Patient or family understanding is often subsequently assessed using only a single question such as "Do you understand?…”

Section: Introductionmentioning

confidence: 99%

Can a Checklist Improve the Informed Consent Process?

Shirley

Veronica

Neal

et al. 2021

Cureus

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Informed consent often fails to provide patients and families with a full understanding of the proposed procedure. We developed an informed consent checklist for identifying specific aspects of the surgical consent that were not fully understood by families. The purpose of this study was to measure the effect of using this checklist on families’ knowledge, satisfaction, experience, and decisional conflict during the consent process. The families of pediatric patients scheduled for an orthopaedic preoperative visit were prospectively randomized into one of two groups: checklist or traditional appointment. Families in the checklist group completed the informed consent checklist which was then used by the surgeon to further discuss aspects of the surgery that needed clarification. Those in the traditional group had similar discussions about surgery without the aid of a checklist. Sixty-one families participated in the study; 27 in the checklist group and 34 in the traditional group without a checklist. The checklist group reported no difference in mean scores for all satisfaction (P = 0.37), decisional conflict (P = 0.51), and knowledge items (P = 0.31). For patient experience, the traditional group reported the visits were significantly more relaxed (mean 4.9, 95% confidence interval (CI) 4.8-5.0) than the checklist group (mean 4.5, 95% CI 4.3-4.7). Our results suggest that having a family member complete the informed consent checklist prior to meeting with the surgeon did not improve, and may worsen, the consent experience for some families. Other methods need to be evaluated to determine the optimal consent process from the family’s perspective.

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Surgical Consent of Children and Guardians for the Treatment of Adolescent Idiopathic Scoliosis is Incompletely Informed

Abstract: Patients who undergo surgical intervention for AIS and their guardians understand approximately 60% of the surgical consent. The use of preoperative multimodal teaching techniques and "peer-support groups" may improve patient and guardian comprehension.

Cited by 10 publications

References 11 publications

Caregiver comprehension and satisfaction associated with informed consent for pediatric flexible bronchoscopy: A single‐center experience

Caregiver comprehension and satisfaction associated with informed consent for pediatric flexible bronchoscopy: A single‐center experience

A survey on patients’ knowledge and expectations during informed consent for spinal surgery: can we improve the shared decision-making process?

Can a Checklist Improve the Informed Consent Process?

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