Assessment Of The Quality Of Information Given To Patients Before Obtaining Informed Consent For Surgical Procedures At Kampala International University Teaching Hospital

ABSTRACT

Introduction - Informed consent is the process by which the health care provider discloses

appropriate information to a competent patient so that the patient can make a voluntary choice to

accept or refuse treatment (Appelbaum, 2007). . It is the fundamental mechanism whereby the

physician informs the patient about the options for the diagnosis and treatment of the patient's

illness (Bhurgri & Qidwai, 2004).The informed consent process should be seen as an invitation

for the patient to participate in health care decisions. Therefore, the concept of informed consent

in the practice of clinical medicine is vital for the ethical, legal and psychological purposes.

Objective – The aim of this study was to assess the quality of information given to patients

before obtaining informed consent for surgical procedures at KIU-TH.

Methodology – A descriptive cross- sectional study was carried out in KIU-TH between July-

November 2014. Self administered questionnaires were used to collect data from operated

patients above 18 years old and were at least 72 hours post operative who had undergone elective

surgery. Data was analyzed using SPSS and manually using a scientific calculator.

Results – Fifty respondents were recruited to participate in the study. Of these, 28 (56%) were

male, 22 (44%) were between the age of 31– 50. 14 (28%) were Catholics. 30 (60%) of the

respondents were peasant farmers and 25 (50%) had studied up to primary level of education. 23

(56%) were married and 35 (70%) of them were patients on the surgical ward.

Majority of the patients (58%) knew that one has to first consent before being operated. Of these,

21(72.4%) got to know from someone previously operated on.

Forty seven (94%) said they were informed about the disease they had, twenty nine (61.7%) of

these were informed by the doctors, 13 (27.7%) were informed by the nurses and 5 (10.6% )

were informed by the students. 33 (66%) patients were told about the treatment options, 44

(88%) knew the benefit of the surgery, 31 (62%) were aware of the risks of the surgery and 44

(88%) did not know the complications from the surgery. 39 (78%) were not informed about the

cost of the treatment while 45(90%) of the patients were informed about the surgical procedure

to be done. Twenty eight (56%) of the patients said they understood the information above fully

while thirty two (64%) think the information they were given was enough for them to give their

informed consent.

Forty nine (98%) consented for themselves. 36 (72%) respondents did not read or get an

explanation of the contents of the consent form they signed. However, majority 43 (86%) said

they knew the importance of signing the consent form.

Most respondents 35 (70%) did not ask any question during their interaction with the clinician

while 5(30%) asked questions, of these 66.7% were satisfactorily answered.

Most respondents 46 (92%) the consent was obtained in their local language which they

properly understood while 2 (4%) of the respondents were consented by the doctor who operated

them and 23 (46%) were consented by the doctor on the ward.38 (76%) of the respondents gave

their informed consent a day or days before the operation. None of the respondents felt forced to

give consent. However, most patients 38 (76%) think a patient has no right to change one’s mind

after he or she has given consent for a procedure.

Conclusion – Most patients know that one must consent before surgery but they do not know

what informed consent is and they do not know that the information provided by the clinician is

aimed at them understanding their health condition so as to make informed decisions and

consent.

Recommandation- The doctors should educate and empower the patients about their role in

their management by making them understand clearly that as they discuss with the patient about

their illness, the information is aimed to help the patient make an informed decision and give an

informed consent.