Document Detail

Improving informed consent for patients undergoing radical prostatectomy using multimedia techniques: a prospective randomized crossover study.
MedLine Citation:
PMID:  20346048     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: to compare the comprehension gained by standard consent (SC) vs a unique interactive multimedia presentation (IMP), for radical prostatectomy (RP), as informed consent for RP requires that the patient understands the procedure and potential complications.
PATIENTS AND METHODS: forty patients undergoing RP were prospectively randomized to SC or IMP, followed by a 26-question test on critical aspects of the surgery and its implications. The groups were crossed over and re-tested, with a subsequent statistical analysis. SC involved typical verbal interaction and consultation with physicians and nurses, whilst the IMP provided consistent and animated information on these topics, and included multiple-choice questions probing understanding of key points. Progression through the IMP only occurred with correct responses; incorrect responses prompted a review of the information before repeating the question. Telephone interviews assessed usability, overall understanding, educational level and primary language.
RESULTS: the patient groups had similar demographics. The IMP group (78%) had significantly higher knowledge test scores (P < 0.001) than the SC group (57%), suggesting a better understanding of the implications of surgery. This was maintained on crossover, with the SC group scores improving by 11% compared to testing before IMP (P < 0.001). The initial IMP group scores were unchanged on crossover and repeat testing (P < 0.05).
CONCLUSION: IMP provides better patient understanding than SC for RP, by ensuring that the procedure and risks have been explained consistently, and by actively testing the patient. Such tools assist in obtaining ethical and legally informed consent, thus increasing patient knowledge whilst reducing patient anxiety and potential dissatisfaction or medico-legal consequences when less than ideal outcomes occur.
Dennis Gyomber; Nathan Lawrentschuk; Peter Wong; Frank Parker; Damien M Bolton
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  BJU international     Volume:  106     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-12-07     Completed Date:  2011-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1152-6     Citation Subset:  IM    
University of Melbourne, Department of Urology, Austin Health, Heidelberg, Australia.
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MeSH Terms
Decision Making, Computer-Assisted
Epidemiologic Methods
Informed Consent / psychology*
Middle Aged
Patient Education as Topic / methods*
Prostatectomy / psychology*
Prostatic Neoplasms / psychology*,  surgery

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