Patients' perception of quality of pre-operative informed consent in athens, Greece: a pilot study

• Published in: PloS one Vol. 4; no. 11; p. e8073
• Main Authors: Falagas, Matthew E, Akrivos, Patrick D, Alexiou, Vangelis G, Saridakis, Vasilios, Moutos, Theofanis, Peppas, George, Kondilis, Barbara K
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 26.11.2009; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Analysis; Collaboration; Correlation coefficient; Correlation coefficients; Decision making; Ethical aspects; Evidence-Based Healthcare/Health Services Research and Economics; Female; Greece; Health aspects; Humans; Informed consent; Informed Consent - legislation & jurisprudence; Joint surgery; Male; Males; Medical personnel; Medical research; Middle Aged; Non-Clinical Medicine/Bioethics; Patient Education as Topic; Patient Participation; Patients; Perception; Physician-Patient Relations; Physicians; Pilot Projects; Prospective Studies; Public Health and Epidemiology/Social and Behavioral Determinants of Health; Standard deviation; Surgeons; Surgery; Surveys; Surveys and Questionnaires; Greece
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0008073

We sought to perform a study to record and evaluate patients' views of the way surgeons communicate informed consent (IC) in Greece. A prospective pilot study was carried out in Athens from 9/2007 to 4/2008. The study sample was extracted from patients, operated by eight different surgeons, who volunteered to fill in a post-surgery self-report questionnaire on IC. A composite delivered information index and a patient-physician relationship index were constructed for the purposes of the analysis. In total, 77 patients (42 males) volunteered to respond to the questionnaire. The delivered information index scores ranged from 3 to 10, the mean score was 8, and the standard deviation (SD) was 1.9. All patients were aware of their underlying diagnosis and reason for surgery. However, a considerable proportion of the respondents (14.3%) achieved a score below or equal to 5. The patient-physician relationship scores ranged from 0 to 20, the mean score was 16 and the standard deviation (SD) was 4.3. The better the patient-physician relationship, the more information was finally delivered to the patient from the physician (Spearman's rank-order correlation coefficient was 0.4 and p<0.001). Delivered information index was significantly higher among participants who comprehended the right to informed consent, compared to participants who did not (p<0.001), and among participants who were given information regarding other possible therapeutic options (p = 0.001). 43% of the respondents answered that less than 10 minutes were spent on the consent process, 58.4% of patients stated that they had not been informed about other possible therapeutic choices and 28.6% did not really comprehend their legal rights to IC. Despite the inherent limitations and the small sample size that do not permit to draw any firm conclusions, results indicate that a successful IC process may be associated with specific elements such as the patient-physician relationship, the time spent by the physician to inform the patient, a participant's comprehension of the right to IC and the provision of information regarding other possible therapeutic options.