Informed Consent In Patients Undergoing ENT Surgery: What Do Patients Want To Know?

Abstract

Objective: To determine patient satisfaction with the informed consent process in ear, nose and throat (ENT) diseases requiring surgery. Specifically, to determine relationships between educational levels of patients and their satisfaction with information given by doctors versus self-gathered information; whether complications of the operation were explained to, and could be listed by patients; the types of complications patients expected to be informed about and the importance of this information to them; their familiarity with the term “informed consent” and their preference for written or spoken information; and whether they were convinced about what they consented to.

Methods: 

Design: Cross-sectional Descriptive Study

Setting: Tertiary Public Hospital

Patients: One Hundred  

Results:  There were 55 males and 45 females (average age 26.7 years, range 4 - 74 years). Ten percent (all children) had no formal education, 56% had primary to high school education, 23% had certificate level education, and 11% had a baccalaureate or masters degree. Ninety-five percent claimed they knew what informed consent was. Ninety percent were satisfied with the information given to them by doctors. Eighty percent, mainly with educational levels of high school and above, preferred to receive written information from doctors. Twenty three percent accessed other sources of information. Those with certificate level education talked with previously operated patients (10%) or read magazines (2%), while the internet was favored by almost all of those with baccalaureate degrees (8%) and all those with masters degrees (2%). Of those who accessed self-gathered information, 21% were not satisfied while only 2% were satisfied. Seventy percent considered the information given by doctors very important. Similarly, seventy percent (mostly from the higher educational levels) considered the impact of information provided by the doctor completely convincing for decision making, while thirty percent (mostly from lower educational levels) only found the information partly convincing. Forty nine percent (again from the lower educational levels), could not list even a single complication. Nineteen percent, with educational levels of certificate and above, wanted to know all complications of surgery, including those that were very rare while fifty six percent wanted to know most of the complications.

 Conclusion: We should not underestimate the importance of the outpatient consultation, the importance of written material and non medical information sources as patients’ expectations are quite high and the majority of them wanted to be informed about most complications.  We should also find ways to improve the provision of patient information, and where possible and appropriate, as per specific patient groups.

Key words: Informed consent, otorhinolaryngology, surgical procedures