Patients' views of the consent process for adult cardiac surgery: questionnaire survey.
OBJECTIVE
Consent for surgical procedures has assumed increasing importance in surgical practice in recent days especially following the public inquiry into paediatric cardiac surgery deaths at Bristol in the UK. This study examines patient perceptions and recollections following surgical consent as currently practised in a UK cardiac unit.


METHODS
One hundred consecutive patients who underwent cardiac surgery in a London teaching hospital from January to February 2003 were studied. Patients completed questionnaires a day before their discharge from the hospital.


RESULTS
The majority of patients (89/100) responded that the information given at consent had been adequate or more than adequate. The time spent on the consent process was thought to be adequate by 91 patients. Eleven patients felt the consent had been insensitive. Several patients (38/100) felt use of booklets in preference to verbal explanations would be less intimidating. For most patients (94/100) the operation and postoperative course met their expectations; although 12 patients experienced untold complications, only five felt that they should have been informed of the possibility of the complication. Although most patients were informed of the risk of death during consent, at time of discharge 43 had forgotten the figure that had been quoted. Regarding the influence of media and publicity, 19 patients said that media had influenced their expectations of the consent process, 59 would have liked to see hospital league tables while 26 would have liked to know the mortality figures for their surgeon prior to giving consent.


CONCLUSIONS
Our study shows that patients undergoing cardiac surgery are largely satisfied with our improved consent procedures in the post-Bristol era. Use of booklets may be a useful adjunct to verbal consent as currently practised.
Howlader
Mohammad H
MH
Department of Cardiothoracic Surgery, St Bartholomew's Hospital, Bart's and The London NHS Trust, Bartholomew Close, London EC1A 7BE, UK. m.howlader@ucl.ac.uk
Dhanji
Al-Rehan
AR
Uppal
Rakesh
R
Magee
Patrick
P
Wood
Alan J
AJ
Anyanwu
Ani C
AC
D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D003142:Communication; D005260:Female; D019538:Health Care Surveys; D015285:Hospital-Patient Relations; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D007258:Informed Consent / Q000592:standards*; D008131:London; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards; D011939:Mental Recall; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013664:Teaching Materials; D013903:Thoracic Surgery / Q000592:standards