- The total number of major surgical procedures performed worldwide is estimated to be 234.2 million every year.
- About 51.4 million surgeries are performed in the US every year.
- Understanding surgical procedures can be difficult for a patient due to various reasons like the use of medical jargon, patients' nervousness or doctors' not spending enough time with the explanation.
- For good recovery and giving informed consent, it is important for a patient to understand the surgical procedure well.
- Tablets like iPad maybe better than doctors in providing an explanation of the procedures to the patient.
A patient undergoing surgery requires an explanation of the complete procedure by the doctor. However, such interviews with doctors often lack clarity. Very often, it is done hurriedly due to lack of time and at other times even if the doctor explains it well, the patients are so nervous that they are barely listening. Most of the patients who go for a face-to-face interview with their doctors about a surgical procedure do not understand what to expect and what they might have agreed to. Understanding the surgical procedure is important as it helps the patient to cope better with the procedure, and provides a fully informed consent for it.
‘Video of a surgical procedure on tablets like iPad are better than doctors when it comes to understanding a surgical procedure and may be the way forward in getting a fully informed consent from a patient.’
AdvertisementA recent presentation at the 'EUROPEAN ASSOCIATION OF UROLOGY CONGRESS' at Munich by a group of Australian doctors describes how patients were prepared for surgical procedures using iPads, and they found that patients' understanding was much better than a face-to-face consultation.
"Patients often find it difficult to understand the medical language used by doctors during face-to-face standard verbal communication, and they often feel intimidated by the interaction," said lead researcher, Dr Matthew Winter (Royal North Shore Hospital, Sydney, Australia). "Often doctors work within busy practices and clinical environments with time limiting the quality of a consult and or verbal consent for a procedure. Patients often find it difficult to comprehend their planned procedure. We have found that a patient's knowledge is greatly improved through the use of portable video media and is their overall preferred method of information delivery compared with standard verbal communication."
The researchers recruited 88 patients facing surgery for acute renal colic the abdominal pain often caused by kidney stones. Prior to the procedure, 45 of the patients discussed the forthcoming surgery with their doctor as normal, while the other 43 patients were given a video presentation with cartoon animation narrated by a doctor using an iPad. The patients' knowledge about the surgical procedure was tested using a questionnaire. After this, they were switched, with those who had received face-to-face counseling receiving the video, and vice versa, followed by the same questionnaire. The participants were then asked to give their overall preference for information delivery.
The researchers found that that use of the video presentation increased patients' understanding by 15.5% compared to the direct consultation. Also, 71 patients (80.7%) preferred the video tutorial compared to 17 (19.3%) who preferred the face-to-face meeting.
"Informed consent for patients undergoing procedures is both an ethical and legal responsibility and also crucially important for optimizing treatment. Patients should be actively involved in decisions regarding their treatment, and understanding their treatment is often vital to a good recovery. Although medicine has advanced by leaps and bounds, there has been little change to the informed consent procedure and how a doctor explains the treatment to the patient. Through the use of portable video media, a doctor can present his/her own practice and procedural technique in an innovative, dynamic and engaging manner," said Dr Winter.
"We are not saying that using portable video media should replace consent. Our work shows that there are alternatives to interviews, which can help significantly, improve patient understanding and satisfaction. Most patients prefer being able to use the portable media devices to a face-to-face consultation which benefits both clinician and patient through improved quality of care. Portable video media is a useful addition to the informed consent process and I predict will form a crucial component of this process in years to come," he added.
Professor Fiona Burkhard, Chairman of the EAU Guidelines panel for Urinary Incontinence said, "This innovative approach to patient information, using a cartoon animation narrated by a doctor, allows each individual patient as much time as needed to understand the proposed procedure. It should not replace a face-to-face discussion with the physician, but will allow patients to meet the physician already informed and prepared, thus benefiting both the physician and the patient."
- Kinnersley, P., et al., Interventions to promote informed consent for patients undergoing surgical and other invasive healthcare procedures. Cochrane Database Syst Rev, 2013. 7: p. CD009445.
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