A comparative study on comprehension of informed consent before emergency and elective surgical operative procedures

Abstract

introduction: A health-care beneficiary should comprehend different aspects of medical and surgical interventions before giving consent to perform those. There is no defined way to find out adequate patient comprehension as part of the decision-making procedure to give consent. This study was conducted to find out the disparity of comprehensiveness between emergency and elective surgical operative procedures both in terms of knowledge dissemination and knowledge comprehension. Materials and Methods: A cross-sectional comparative study was conducted at the General Surgery Department of Medical College, Kolkata, during September and October 2021. An interviewer-administered questionnaire was used on patients undergoing emergency and elective surgical procedures. The comprehension level of informed consent (IC) form was scored as 1, 2, and 3 and compared between two groups using an unpaired t-test and Mann–Whitney U-test. Result: Data collection was done from 39 patients for emergency operative procedures and 52 for elective surgical procedures. A composite comprehension score was calculated after adjusting for questions not asked while taking IC. The mean comprehension score for emergency procedures was 18.86 and for planned surgery, it was 20.14. Unpaired t-test showed significantly high mean comprehension for planned procedures than the emergency procedures (P = 0.007). Comprehension is significantly poorer in emergency conditions even after controlling for age and literacy denoting difficulty in decision-making in emergency scenarios. Conclusion: It is suggested that the procedure of consent taking should be more structured and interactive so that even in stressful conditions participant understand better about the procedures and take their own decision instead of relying blindly on doctors.