Amount and quality of information received by patients who agreed to coordinated surgeries

Abstract

Introduction: informed consent implies an interaction and communication process whereby the amount and quality of the information provided is essential for it to be valid. The information received by patients is not always appropriately decoded, understood or remembered.
Objetives: 1. To learn about the information the patient is able to transmit once it has agreed to a coordinated surgery procedure that falls into the category of major or high surgery.
2. To determine whether patients knew the pre-surgical diagnosis, the suggested surgical treatment, the possible complications and diagnosis prior to surgery, and whether they were willing to learn more about their disease or the proposed surgery.
Method: we selected a convenience sample of 60 patients who were admitted for major or high surgery and had received information and accepted the proposed treatment. A five question form was used.
Results: patients selected were 39 women and 21 men. Average age: 59 years and 7 months (19-84 years old). Most patients (n=55) stated they had been informed about their disease. In 11 cases, the disease described verbally did not coincide with the diagnosis. Cases where the disease was ignored and the diagnosis differed from the information corresponded to oncologic patients.
In cases where consent to treatment had already been given, treatment was unknown to 13 patients. Most patients (n=33) were not fully aware of the treatment’s risks. Most patients stated they were not interested in asking more questions or learning more, although ten wished to ask questions.
Discussion: a significant number of patients did not receive or was unable to remember or verbally express information for the making of decisions, what could have resulted from the scarce and/or low quality information or from factors that depend on the patient – such as refusal upon anguish generated by the disease and its prognosis. A patronizing or condescending bias that is accepted in the current Uruguayan reality was recognized. Ignorance of treatment cannot be justified and it implies an ethical problem and a medico-legal risk for surgeons.
Conclusions: a significant percentage of patients lacked appropriate and sufficient information after having given consent to major or higher surgery, in writing and having subscribed the relevant record. We need to deepen the study of the causes of failure in the informed consent process. It is advisable for surgeons to know about these weaknesses and to improve the information processes with the purpose of protecting their patients’ rights and to perform safer surgeries.