Predictors of Comprehension during Surgical Informed Consent
Journal of the American College of SurgeonsPublished 1 May 2010
Aaron S. Fink, Allan V. Prochazka, William G. Henderson, Debra Bartenfeld, Carsie Nyirenda, Alexandra L. Webb
Citations142
SJR quartileQ1
SJR score1.23
SNIP1.35
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TL;DR
Comprehension during informed consent discussions may be limited in individuals with potential language difficulty due to ethnicity or education, and Affording adequate time forinformed consent discussions and using informed consent adjuncts such as RB may enhance comprehension in such individuals.
Abstract
Comprehension during informed consent discussions may be limited in individuals with potential language difficulty due to ethnicity or education. Total consent time was the strongest predictor of patient comprehension. Affording adequate time for informed consent discussions and using informed consent adjuncts such as RB may enhance comprehension in such individuals.
Keywords
MedicineHealth Professions
Medical CareA 12-Item Short-Form Health Survey
17,142 Citations1996John E. Ware, Mark Kosinski +1 more
Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions.
British Journal of Clinical PsychologyThe development of a six‐item short‐form of the state scale of the Spielberger State—Trait Anxiety Inventory (STAI)
3,259 Citations1992Theresa M. Marteau, Hilary Bekker
Two studies are reported describing the development of a short-form of the state scale of the Spielberger State-Trait Anxiety Inventory (STAI) for use in circumstances where the full-form is inappropriate, and the six-item version offers a briefer and just as acceptable scale for subjects while maintaining results that are comparable to those obtained using the full form.
PubMedMaking health care safer: a critical analysis of patient safety practices.
1,630 Citations2001Kaveh G Shojania, Ben Duncan +3 more
This project aimed to collect and critically review the existing evidence on practices relevant to improving patient safety and identify practices with the strongest supporting evidence that decrease the risks associated with hospitalization, critical care, or surgery.
PubMedRapid estimate of adult literacy in medicine: a shortened screening instrument.
1,614 Citations1993Terry C. Davis, Sandra W. Long +5 more
The REALM provides an estimate of patient reading ability, displays excellent concurrent validity with standardized reading tests, and is a practical instrument for busy primary care settings.
Patient Education and CounselingDevelopment of a brief test to measure functional health literacy
1,533 Citations1999David W. Baker, Mark V. Williams +3 more
The development of an abbreviated version of the Test of Functional Health Literacy in Adults (TOFHLA) to measure patients' ability to read and understand health-related materials that can be used by health educators to identify individuals who require special assistance to achieve learning goals is described.
JAMAInterventions to Improve Research Participants' Understanding in Informed Consent for Research
1,027 Citations2004James Flory, Ezekiel J. Emanuel
Having a study team member or a neutral educator spend more time talking one-on-one to study participants appears to be the most effective available way of improving research participants' understanding; however, further research is needed.
Anesthesia & AnalgesiaThe Visual Analog Scale Allows Effective Measurement of Preoperative Anxiety and Detection of Patients’ Anesthetic Concerns
604 Citations2000Christoph Kindler, Christoph Harms +3 more
Different methods for measuring preoperative anxiety are compared, certain patient characteristics that predispose to high anxiety are identified, and the quantity and quality of anxiety that patients experience preoperatively are described.
PubMedThe role of health literacy in patient-physician communication.
571 Citations2002Mark V. Williams, Terry C. Davis +2 more
Professional and public awareness of the health literacy issue must be increased, beginning with education of medical students and physicians and improved patient-physician communication skills, as well as identifying the most-effective techniques to educate patients.
BMJStrategies to help patients understand risks
553 Citations2003John Paling
Doctors can now choose from a “toolbox” of simple, practical, time efficient techniques that benefit the widest possible variety of patients.
New England Journal of MedicineInformed Consent — Why Are Its Goals Imperfectly Realized?
530 Citations1980Barrie R. Cassileth, Robert V. Zupkis +2 more
Although most thought that consent forms were necessary and comprehensible and that they contained worthwhile information, the legalistic connotations of the forms appeared to lead to cursory reading and inadequate recall.
JAMAInfluence of Patient Literacy on the Effectiveness of a Primary Care–Based Diabetes Disease Management Program
391 Citations2004Russell L. Rothman
A diabetes disease management program that addresses literacy may be particularly beneficial for patients with low literacy, and increasing access to such a program could help reduce health disparities.
BMJFactors affecting quality of informed consent.
317 Citations1993C. Lavelle-Jones, D.J. Byrne +2 more
Elderly patients and patients with below average IQ, impaired cognitive functions, and an external locus of control have poor information recall and written information may be more useful if given before admission to hospital.
CA A Cancer Journal for CliniciansImproving comprehension for cancer patients with low literacy skills: strategies for clinicians
301 Citations1998Cecilia C. Doak, Leonard G. Doak +2 more
Strategies to improve communication between clinicians and patients, particularly patients who are among the 44 million adult Americans with low literacy skills are provided.
PubMedThe communication of information from physician to patient: a method for increasing patient retention and satisfaction.
254 Citations1977Klea D. Bertakis
Patients are more satisfied with their physicians when they are given and retain more information about their illnesses and are able to restate what they had been told, followed by physician feedback.
PubMedCommunicating with patients who have limited literacy skills. Report of the National Work Group on Literacy and Health.
240 Citations1998Barry D. Weiss
The current status of illiteracy in the United States is characterized, the relationship between poor literacy and poor health is described, and recommendations on how to deal with patients who have poor reading skills are made.
Journal of General Internal MedicineUse of a modified informed consent process among vulnerable patients
235 Citations2006Rebecca L. Sudore, C. Seth Landefeld +4 more
Lower literacy and minority status are important determinants of understanding consent information, regardless of literacy or language barriers using a modified consent process.
Journal of Clinical OncologyTelephone-based nursing intervention improves the effectiveness of the informed consent process in cancer clinical trials.
184 Citations1996N.K. Aaronson, E Visser-Pol +9 more
The use of a supplementary, telephone-based nursing intervention is a feasible and effective means to increase cancer patients' awareness and understanding of the salient issues that surround the clinical trials in which they are asked to participate.
BMJHow informed is signed consent?
160 Citations1988D.J. Byrne, Alex Napier +1 more
Although all the patients interviewed were fully aware that they had had an operation, 27 did not know which organ was operated on and 44 were unaware of the exact nature of the surgical procedure.
Journal of Bone and Joint SurgeryPatientsʼ recall of preoperative instruction for informed consent for an operation.
147 Citations1991M M Hutson, John Blaha
Thirty-eight consecutive patients who were admitted to the hospital for total joint replacement were studied to determine their understanding of the elements of informed consent at the time when they signed the consent document before the operation and their recall of those elements six months after the operation.
Gastrointestinal EndoscopyA randomized trial using videotape to present consent information for colonoscopy
139 Citations1994Patricia Agre, Robert C. Kurtz +1 more
If a videotaped presentation by a physician conveys information more effectively than an in-person discussion by the same physician using the identical script, this approach may work as well for other invasive medical procedures and could save physician time while laying a foundation for a more personalized discussion.
Anesthesia & AnalgesiaEducating Patients About Anesthesia: A Systematic Review of Randomized Controlled Trials of Media-Based Interventions
138 Citations2003Anna Lee, Po Tong Chui +1 more
This systematic review supports the use of video and printed information about general process and risks of anesthesia for patient education before surgery by comparing the effectiveness of media-based patient education about anesthesia.
Annals of SurgeryEnhancement of Surgical Informed Consent by Addition of Repeat Back
118 Citations2010Aaron S. Fink, Allan V. Prochazka +11 more
RB implemented within an electronic informed consent system improved patient comprehension and should be considered as an enhancement to surgical informed consent.
Plastic & Reconstructive SurgeryOBSERVATIONS ON THE MYTH OF “INFORMED CONSENT”
110 Citations1976DIANNE LEEB, David Bowers +1 more
A series of 100 patients in a general plastic surgery population were interviewed by standard format to determine their retention rate of preoperative information given to them, and an overall recall, or retention rate, of 35 percent was found.
PubMedInformed consent in head and neck surgery: how much do patients actually remember?
102 Citations1997Robert J. Hekkenberg, Jonathan C. Irish +3 more
A significant relationship exists between education level and patient age and the rate of patient recall of potential complications of surgery.
Issues in Comprehensive Pediatric NursingUsing the Teach-Back and Orem's Self-Care Deficit Nursing Theory to Increase Childhood Immunization Communication Among Low-Income Mothers
82 Citations2008Feleta L. Wilson, Lynda M. Baker +2 more
The inconsistency of the mothers' responses to communicate critical immunization information about vaccines indicates the need to further assess how best to increase parents' vaccine knowledge and communication skills.
NeurosurgeryInformed Consent
81 Citations1992David A. Herz, Janice E. Looman +1 more
The data in the current study suggest that the reasonable and prudent neurosurgeon making a concerted effort at patient education, with the assistance of a professional educator, cannot necessarily expect accurate patient or family recall or comprehension.
The Journal of Laryngology & OtologyInformed consent: the assessment of two structured interview approaches compared to the current approach
77 Citations1992Patrick Dawes, L. O'Keefe +1 more
A structured interview when obtaining informed consent increases the number of complications recalled without increasing pre-operative anxiety.
Experimental Aging ResearchThe elderly and informed consent: Effects of vocabulary level and corrected feedback
75 Citations1981Harvey A. Taub, Gary E. Kline +1 more
Results indicated that losses in performance increased with decreasing levels of vocabulary, and the use of corrected feedback provided a significant general improvement at all vocabulary levels but did not reduce the effects due to vocabulary levels.
Experimental Aging ResearchThe effect of repeated testing upon comprehension of informed consent materials by elderly volunteers
65 Citations1983Harvey A. Taub, Marilyn Baker
Results indicated that both comprehension and memory performance varied directly with vocabulary level, and the multi-trial approach improved comprehension scores at all vocabulary levels, but had no effect upon memory.
Archives of OphthalmologyInformed Consent in Senile Cataract Extraction
64 Citations1986Lindsey Morgan, Ivan R. Schwab
This study found retention of relevant information was only 37% when assessed by ten standard questions in patients after senile cataract surgery, and factors related to poor retention include advanced age and less than a high school education.
The Hastings Center ReportEmpirical Research on Informed Consent
55 Citations1999Jeremy Sugarman, Douglas C McCrory +5 more
An effort to ensure that patients and research subjects within the Veterans Affairs health care system give meaningful informed consent, a systematic retrieval of published empirical research on informed consent is conducted.
American Journal of RoentgenologyInformed consent for percutaneous lung biopsy: comparison of two consent protocols based on patient recall after the procedure.
53 Citations1995Charles S. White, Andrew C. Mason +2 more
The standard consent procedure for lung biopsy appears inadequate when patients' recall of procedure risks later is used as a measure of the patients' comprehension and may be improved substantially by teaching patients to recite the procedure risks to the physician as part of the informed consent protocol.
IRB Ethics and Human ResearchComprehension of Informed Consent for Research: Issues and Directions for Future Study
44 Citations1986Harvey A. Taub
Policy to protect the rights of human subjects participating in biomedical and behavioral research and increasingly specific requirements for presentation of written information and for signed documentation of voluntary informed consent.
Experimental Aging ResearchComprehension of informed consent information by young-old through old-old volunteers
42 Citations1987Harvey A. Taub, Marilyn Baker +2 more
It is suggested that the observed age-related differences may have been due to visual and not cognitive deficits, and readability did not affect performance either by itself or in combination with any other variable.
PubMedThe effectiveness of patient verbalization on informed consent.
40 Citations1997Veronica Wadey, Cy Frank
PubMedInformed consent: an evaluation of patients' understanding and opinion (with respect to the operation of transurethral resection of prostate).
39 Citations1994K C Saw, Alexander Wood +3 more
Seminars in Oncology NursingImproving understanding of the informed consent process and document
36 Citations1999Cathy D. Meade
Empirical research focuses on the nature of patient-provider interactions and the effectiveness of various delivery systems, and a need exists to overcome conceptual and methodologic limitations.
Journal of Clinical OncologyStability of Parental Understanding of Random Assignment in Childhood Leukemia Trials: An Empirical Examination of Informed Consent
34 Citations2006Rachel Neff Greenley, Dennis Drotar +2 more
Examining stability versus change in parental understanding of random assignment in randomized clinical trials for pediatric leukemia found factors that predicted understanding at diagnosis as well as sustained understanding over time may be important intervention targets.
Journal of Clinical AnesthesiaA risk-specific anesthesia consent form may hinder the informed consent process
28 Citations1991Scott K. Clark, Barbara L. Leighton +1 more
To improve the informed consent process, either a better method of presenting the preprinted, risk-specific consent form or another method of simultaneously conveying and documenting risk information is needed.
Journal of Psychosomatic ResearchPsychological preparation for surgery: Patient recall of information
26 Citations1981Anthony E. Reading
Level of recall compared favourably with those reported in general practice settings, with significantly more information recalled on immediate assessment, and a sex difference emerged, with male interviewers achieving significantly higher levels of patient recall.
American Heart JournalEffect of informed consent on anxiety in patients undergoing diagnostic electrophysiology studies
24 Citations1997Jeffrey J. Goldberger, Jane Kruse +2 more
Detailed informed consent is associated with increased anxiety relative to a consent that does not detail specific risks, however, the difference in anxiety is mild and its clinical impact requires further exploration.
Medicine Science and the LawPatients May Not Recall Disclosure of Risk of Death: Implications for Informed Consent
20 Citations1990Terence C. Wade
Faced with an inability to obtain informed consent from some patients, coupled with legal liability for failing to do so, surgeons are advised to obtain consent in writing, to provide comprehensive, multi-media counselling, and to be particularly conscientious with confused patients and those with complications.
Investigative RadiologyTake-Home Informed Consent for Intravenous Contrast Media
16 Citations1996STEVEN M. NEPTUNE, Kenneth D. Hopper +4 more
The providing of information 24 to 72 hours in advance of an invasive procedure does not have a beneficial effect over just providing the same information at the time of the study, and individuals experienced with contrast failed to outperform those who had never been given contrast.