Informed consent for elective and emergency surgery: questionnaire study.
OBJECTIVE
To evaluate women's experience of giving consent to obstetric and gynaecological surgery and to examine differences between those undergoing elective and emergency procedures.


METHODS
A prospective questionnaire study.


METHODS
A large teaching hospital.


METHODS
1006 consecutive patients undergoing elective or emergency surgery in obstetrics and gynaecology.


METHODS
Questionnaires were administered to women who had given consent to surgery following the introduction of national guidelines and consent form. Differences in responses between elective and emergency patients were assessed using frequencies, single and multivariable analyses.


METHODS
Patients' experience and recall of the consent process, their overall satisfaction and their views on what is important for adequate consent.


RESULTS
There were significant differences between patients undergoing elective or emergency surgery. Patients undergoing emergency surgery were less likely to have read (OR 0.22) or understood (OR 0.40) the consent form, and were more likely to report feeling frightened by signing it (OR 2.52). They were more likely to report they felt they had no choice about signing the consent form (OR 2.11), and that they would have signed regardless of its content (OR 3.14). Overall, significantly more patients undergoing elective (80%) or emergency (63%) surgery reported satisfaction with the consent process. Patients were more likely to report satisfaction if they read (OR 1.80) and agreed with (OR 3.49) the consent form, and if someone checked that they understood (OR 3.09).


CONCLUSIONS
Patients' needs may not be adequately addressed by current guidelines for consent to treatment, particularly in emergency circumstances. The introduction of more complex forms and procedures appears to conflict with patients' need for personal communication and advocacy. The implications on the ethical and legal standing of consent are considerable.
Akkad
Andrea
A
Division of Obstetrics and Gynaecology, University of Leicester, UK.
Jackson
Clare
C
Kenyon
Sara
S
Dixon-Woods
Mary
M
Taub
Nick
N
Habiba
Marwan
M
D017558:Elective Surgical Procedures; D004630:Emergencies; D004638:Emergency Treatment; D004739:England; D005260:Female; D005831:Genital Diseases, Female / Q000601:surgery*; D006801:Humans; D007258:Informed Consent; D011939:Mental Recall; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011446:Prospective Studies; D011795:Surveys and Questionnaires