+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

The role of informed consent in risks recall in otorhinolaryngology surgeries: verbal (nonintervention) vs written (intervention) summaries of risks

The role of informed consent in risks recall in otorhinolaryngology surgeries: verbal (nonintervention) vs written (intervention) summaries of risks

American Journal of Otolaryngology 32(6): 485-489

Informed consent is a phrase often used in the law to indicate that the consent a person gives meets certain minimum standards. It relies on patients' ability to understand risk information. Evidence suggests that people may extract the gist of any risk information to make medical decisions. Existing evidence also suggests that there is an inverse relationship between the perception of risk and the perception of benefit. Informed consent is the method by which fully informed, rational persons may be involved in choices about their health care. The aims of this study were to study how much patients remember of the risks discussed with them about their otolaryngologic surgery and to evaluate whether a simple intervention, the addition of an information handout, improves their recall. This was a prospective study carried out between January and December 2009 in the Department of Otorhinolaryngology, University of Ilorin teaching hospital. Fifty patients undergoing a variety of otorhinolaryngologic procedures, including mastoidectomy, tympanoplasty, nasal polypectomy, rhinotomy, maxillectomy, and laryngoscopy, were verbally consented by the operating surgeon with a standard checklist of potential surgical complications and adverse effects. Three surgeons participated in the study. Patients were stratified into 2 groups: a higher education group and a lower education group. Within each group, patients were randomized to either a control group, consisting of a verbal explanation only, or an intervention group, which added a written handout to the verbal explanation. A follow-up telephone interview was conducted at an average of 20.6 days (range, 14-53 days) to survey for recall of the complications discussed. The main outcome measure is risk recall. This was analyzed by education level and written sheet intervention. Other parameters examined were patient demographics and time elapsed from when the consent was obtained. Of the 50 patients involved in the study, 30 were men and 20 were women, with male/female ratio of 1.5:1.0. The average age was 43 years (range, 16-76 years). With respect to educational status, 26 patients had the equivalent of high school or less (group 1), and 24 had some degree of postsecondary training (group 2). Overall recall of potential complications was 56%. Those who received the handout recalled 67% of the complications overall, whereas those who did not receive the handout remembered 51% of the complications. The difference was significant recall of the specific risks varied considerably. For those with potential risk of facial nerve paralysis, 88% of them recalled, which was the highest in the study. This was followed by hearing loss (85%) and nasal adhesion (23%). The least were anesthetic reactions (4%) and hoarseness (2%). Those who received the handout recalled 62% of the complications overall, whereas those who did not receive the handout remembered 51% the complications. The addition of a handout significantly alters recall of potential complications of otorhinolaryngologic surgery with the recall of specific risk highest for facial nerve paralysis.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 056478963

Download citation: RISBibTeXText

PMID: 21093107

DOI: 10.1016/j.amjoto.2010.09.012

Related references

Informed consent in trauma: does written information improve patient recall of risks? A prospective randomised study. Injury 43(9): 1534-1538, 2013

Informed consent in rhinoplasty: prospective randomized study of risk recall in patients who are given written disclosure of risks versus traditional oral discussion groups. Journal of Otolaryngology - Head & Neck Surgery 38(3): 369-374, 2009

Recall of the risks of forefoot surgery after informed consent. Foot & Ankle International 24(12): 904-908, 2004

Recall of the Risks of Forefoot Surgery After Informed Consent. Foot & Ankle International 24(12): 904-908, 2003

PLD.05 Audit of Informed Consent and Recall of Risks for Caesarean Section. Archives of Disease in Childhood - Fetal and Neonatal Edition 99(Suppl 1): A107-A107, 2014

Informed consent in otologic surgery: prospective study of risk recall by patients and impact of written summaries of risk. Journal of Otolaryngology 32(6): 368-372, 2004

Adult Spinal Deformity Patients Recall Fewer Than 50% of the Risks Discussed in the Informed Consent Process Preoperatively and the Recall Rate Worsens Significantly in the Postoperative Period. Spine 40(14): 1079-1085, 2016

Informed Consent in Pediatric Otolaryngology: What Risks and Benefits Do Parents Recall?. Otolaryngology--Head and Neck Surgery 155(2): 332-339, 2016

When consent isn't informed enough: what's the nurse's role when a patient has given consent but doesn't fully understand the risks?. American Journal of Nursing 105(4): 79-84, 2005

Adequacy of Traditional Verbal Informed Consent versus Patient-Directed Standardized Written Consent. Annals of Emergency Medicine 62(4): S48-S49, 2013

Informed Consent for Comparative Effectiveness Research Should Not Consider the Risks of the Standard Therapies That Are Being Studied as Risks of the Research. Journal of Law, Medicine & Ethics 45(3): 365-374, 2017

Effects of readability on the impact and recall of written informed consent material. Professional Psychology, Research and Practice 23(6): 500-503, 1992

Knowledge/access/risks/benefits/choice: informed consent versus informed non-compliance. Health Care for Women International 30(10): 855-856, 2009

Informed consent for total hip arthroplasty: does a written information sheet improve recall by patients?. Annals of the Royal College of Surgeons of England 84(6): 404-408, 2002

Informed consent for cataract surgery: patient understanding of verbal, written, and videotaped information. Journal of Cataract and Refractive Surgery 38(1): 80-84, 2012