Patient perceptions of surgical informed consent: is repeat back helpful or harmful?

Allan V. Prochazka, Aaron S. Fink, Debra Bartenfeld, William G. Henderson, Carsie Nyirenda, Alexandra Webb, David H. Berger, Kamal Itani, Thomas Whitehill, James Edwards, Mark Wilson, Cynthia Karsonovich, Patricia Parmelee

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Informed consent (IC)comprehension is suboptimal. Repeat back (RB)-asking the patient to repeat in their own words key elements of the consent-is believed to improve the consent process. This study aims to assess the impact of RB on patient perceptions of surgical informed consent. Secondary analysis of a randomized trial. Elective surgical patients were consented using iMedConsent, the VA's computer-based IC platform. Patients were randomized to RB (IC could not be signed until the patient satisfactorily expressed key elements) or standard iMedConsent (no RB). A questionnaire was given immediately after IC assessing time for decision, satisfaction with and ease of understanding consent, and the amount of information provided about the proposed surgery (e.g., indications, benefits, risks, and alternatives). Groups were compared with Χ tests. We enrolled 575 subjects (276 RB and 299 no RB); 92% were men with a mean age of 61.6 years and high school level reading ability. The groups were comparable in their perceptions regarding time to make a decision (RB 88% Strongly Agree (SA), no RB 88% SA; P = 0.61), satisfaction with consent (RB 90% SA, no RB 87% SA; P = 0.27), ease of understanding (RB 69% SA, no RB 67% SA; P = 0.73) receipt of the right amount of information regarding the indications (RB 85% SA, no RB 87%; P = 0.61), the benefits (RB 87% SA, no RB 86% SA; P = 0.29), and the risks (RB 87% SA, no RB 84% SA; P = 0.19) of surgery. More of the RB group felt they received the right amount of information about alternatives to surgery (RB 80% SA) than did the no RB group (69% SA); P = 0.01. Patients were highly satisfied with RB during surgical IC RB is not detrimental to the consent process and may improve informed consent for surgery. Clinical Trials Identifier NCT00288899 http://www.clinicaltrials.gov.

Original languageEnglish (US)
Pages (from-to)140-145
Number of pages6
JournalJournal of Patient Safety
Volume10
Issue number3
StatePublished - 2014
Externally publishedYes

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Informed Consent
Time Perception
Aptitude
Reoperation
Reading
Clinical Trials

ASJC Scopus subject areas

  • Leadership and Management
  • Public Health, Environmental and Occupational Health

Cite this

Prochazka, A. V., Fink, A. S., Bartenfeld, D., Henderson, W. G., Nyirenda, C., Webb, A., ... Parmelee, P. (2014). Patient perceptions of surgical informed consent: is repeat back helpful or harmful? Journal of Patient Safety, 10(3), 140-145.

Patient perceptions of surgical informed consent : is repeat back helpful or harmful? / Prochazka, Allan V.; Fink, Aaron S.; Bartenfeld, Debra; Henderson, William G.; Nyirenda, Carsie; Webb, Alexandra; Berger, David H.; Itani, Kamal; Whitehill, Thomas; Edwards, James; Wilson, Mark; Karsonovich, Cynthia; Parmelee, Patricia.

In: Journal of Patient Safety, Vol. 10, No. 3, 2014, p. 140-145.

Research output: Contribution to journalArticle

Prochazka, AV, Fink, AS, Bartenfeld, D, Henderson, WG, Nyirenda, C, Webb, A, Berger, DH, Itani, K, Whitehill, T, Edwards, J, Wilson, M, Karsonovich, C & Parmelee, P 2014, 'Patient perceptions of surgical informed consent: is repeat back helpful or harmful?', Journal of Patient Safety, vol. 10, no. 3, pp. 140-145.
Prochazka AV, Fink AS, Bartenfeld D, Henderson WG, Nyirenda C, Webb A et al. Patient perceptions of surgical informed consent: is repeat back helpful or harmful? Journal of Patient Safety. 2014;10(3):140-145.
Prochazka, Allan V. ; Fink, Aaron S. ; Bartenfeld, Debra ; Henderson, William G. ; Nyirenda, Carsie ; Webb, Alexandra ; Berger, David H. ; Itani, Kamal ; Whitehill, Thomas ; Edwards, James ; Wilson, Mark ; Karsonovich, Cynthia ; Parmelee, Patricia. / Patient perceptions of surgical informed consent : is repeat back helpful or harmful?. In: Journal of Patient Safety. 2014 ; Vol. 10, No. 3. pp. 140-145.
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abstract = "Informed consent (IC)comprehension is suboptimal. Repeat back (RB)-asking the patient to repeat in their own words key elements of the consent-is believed to improve the consent process. This study aims to assess the impact of RB on patient perceptions of surgical informed consent. Secondary analysis of a randomized trial. Elective surgical patients were consented using iMedConsent, the VA's computer-based IC platform. Patients were randomized to RB (IC could not be signed until the patient satisfactorily expressed key elements) or standard iMedConsent (no RB). A questionnaire was given immediately after IC assessing time for decision, satisfaction with and ease of understanding consent, and the amount of information provided about the proposed surgery (e.g., indications, benefits, risks, and alternatives). Groups were compared with Χ tests. We enrolled 575 subjects (276 RB and 299 no RB); 92{\%} were men with a mean age of 61.6 years and high school level reading ability. The groups were comparable in their perceptions regarding time to make a decision (RB 88{\%} Strongly Agree (SA), no RB 88{\%} SA; P = 0.61), satisfaction with consent (RB 90{\%} SA, no RB 87{\%} SA; P = 0.27), ease of understanding (RB 69{\%} SA, no RB 67{\%} SA; P = 0.73) receipt of the right amount of information regarding the indications (RB 85{\%} SA, no RB 87{\%}; P = 0.61), the benefits (RB 87{\%} SA, no RB 86{\%} SA; P = 0.29), and the risks (RB 87{\%} SA, no RB 84{\%} SA; P = 0.19) of surgery. More of the RB group felt they received the right amount of information about alternatives to surgery (RB 80{\%} SA) than did the no RB group (69{\%} SA); P = 0.01. Patients were highly satisfied with RB during surgical IC RB is not detrimental to the consent process and may improve informed consent for surgery. Clinical Trials Identifier NCT00288899 http://www.clinicaltrials.gov.",
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AU - Nyirenda, Carsie

AU - Webb, Alexandra

AU - Berger, David H.

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