Informed consent in pediatric anesthesiology
| Autor: | Katherine Lepere, Katherine R. Gentry, Douglas J. Opel |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Parents Risk Pediatrics medicine.medical_specialty 03 medical and health sciences 0302 clinical medicine Anesthesiology 030202 anesthesiology Informed consent Surveys and Questionnaires Humans Medicine Parental Consent 030212 general & internal medicine Elective surgery Child Referral and Consultation Informed Consent Recall business.industry Communication Infant Comprehension Cross-Sectional Studies Anesthesiology and Pain Medicine Socioeconomic Factors Patient Satisfaction Child Preschool Family medicine Pediatrics Perinatology and Child Health Female Observational study Parental consent business Pediatric anesthesia Inclusion (education) |
| Zdroj: | Pediatric Anesthesia. 27:1253-1260 |
| ISSN: | 1155-5645 |
| DOI: | 10.1111/pan.13270 |
| Popis: | SummaryBackground Informed consent for pediatric anesthesia is unique because it is (1) obtained from surrogates (ie, parents) rather than from the patient and (2) sought after parents have authorized the surgical intervention. There are limited data on how pediatric anesthesia informed and consent discussions are conducted. The purpose of this study was to characterize the content of preanesthesia informed consent discussions and assess their impact on parent recall and understanding. Methods We conducted a cross-sectional observational study at a tertiary pediatric hospital. We audio-recorded and transcribed preanesthesia consent discussions between pediatric anesthesia providers and parents of children undergoing elective surgery. Parents were recruited on the day of surgery and completed a survey postdiscussion to assess their recall and perceived understanding. We used directed content analysis to identify 7 informed consent elements: (i) description of the plan; mention of (ii) alternatives, (iii) risks, and (iv) benefits; (v) discussion of uncertainties; (vi) assessment of comprehension; and (vii) solicitation of a decision. We used multivariable logistic regression to explore the association between discussions that included 3 informed consent elements (description of plan, mention of risks, and mention of benefits) and parent recall and understanding of these elements. Results We analyzed 97 discussions involving 41 different anesthesia providers. The element most frequently included in preanesthesia discussions was a description of the plan (100%); the least frequently included was decision solicitation (18%). Seventy-one percent of discussions included ≥5 informed consent elements and 70% included a description of the plan, mention of risks, and mention of benefits. Parental recall of these 3 informed consent elements was associated with their inclusion in the preanesthesia discussion (75% vs 34%), and more parents understood all 3 elements if they had reported (vs not reported) recall of all 3 elements (97% vs 53%). Conclusion Most pediatric preanesthesia discussions include ≥5 informed consent elements and describe the plan, mention risks, and mention benefits. Inclusion of these latter 3 consent elements was associated with parental recall of these elements but not understanding. |
| Databáze: | OpenAIRE |
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