The role of an information sheet in patient led decision making about sedation and anaesthesia during gastroscopy.
BACKGROUND
The need for patients to be informed about their disease and its management is now widely recognised, as well as their right to make decisions, which might conflict with the views of their clinicians. There remains a need for the clinician to ensure that patients are provided with accurate evidence-based information. This should be in a form which can be readily understood, retained and acted upon. In order to identify patients' views and to establish evidence of this process there is a need to develop decision trees, which demonstrate their active involvement.


OBJECTIVE
A short text was designed to outline choices available to patients who were to undergo a gastroscopy. Its purpose was to describe the forms of sedation available and provide information which would allow patients to make an informed choice. The design was such that choices were to be made by patients in an active way and recorded on a document signed by the patient.


RESULTS
97 successive patients completed the choices on an information sheet allowing them to select the nature of their sedation and oral preparation for the procedure. Of these 13 were of South Asian origin and 44 women. 91% of patients wanted some form of sedation or oral anaesthesia. Most (45%) chose lidocaine spray alone, although 5% wished the procedure to be done under a general anaesthetic. 26% of patients wanted the endoscopist to make choices.


CONCLUSIONS
In summary, patient choice should include the form of sedation or topical anaesthesia in endoscopic practice. The development of a decision tree is an effective way of providing information and recording a patient's choice.
Mayberry
H
H
Department of Digestive Diseases & Sciences, University Hospitals of Leicester, Leicester, UK.
Mayberry
J F
JF
D000758:Anesthesia / Q000379:methods* / Q000523:psychology; D002755:Choice Behavior; D016292:Procedural Sedation / Q000379:methods* / Q000523:psychology; D003657:Decision Making; D003663:Decision Trees; D005260:Female; D005773:Gastroscopy / Q000379:methods* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation