Informed consent in pediatric surgery: Do parents understand the risks?
OBJECTIVE
To investigate parent understanding of the risks of pediatric ear, nose, and throat surgery after counseling with and without the use of informational aids.


METHODS
Prospective, randomized trial.


METHODS
Academic tertiary care center.


METHODS
Parents of children undergoing ear, nose, and throat surgery.


METHODS
Parents were randomized to receive standard informed consent with or without detailed informational aids.


METHODS
Parents completed identical questionnaires testing their general procedure knowledge and their recall of 9 specific surgical risks both immediately after counseling and on the day of surgery.


RESULTS
Thirty-four parents enrolled in and completed the study (18 in the control group and 16 in the test group). The mean time from informed consent to surgery was 6.3 days (range, 1-22 days). Parents in the test group scored significantly higher on identifying the 9 risks on both the preoperative questionnaire (mean score, 6.00 vs 4.44; P = .007, 2-tailed t test) and the postoperative questionnaire (6.25 vs 4.17; P < .001). There was a negative correlation (inverse relationship) between parent education score and risk recall, with parents with lower education levels scoring higher on both the preoperative (Pearson r = -0.36; P = .04) and the postoperative (r = -0.35; P = .04) surveys. The maternal parent recalled risks significantly better than the paternal parent, with surgical risk recall scores of 5.46 out of 9 vs 3.67 out of 9 (P = .02, 2-tailed t test).


CONCLUSIONS
Parents of children undergoing ear, nose, and throat surgery recall far less than 100% of counseled risks. The use of detailed surgical risk counseling improves measured parental understanding of surgical risk. Parental educational level and maternal vs paternal parent may affect risk counseling recall.
Nadeau
Daniel P
DP
Department of Otolaryngology-Head and Neck Surgery, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.
Rich
Jeremy N
JN
Brietzke
Scott E
SE
D000328:Adult; D057189:Checklist; D002648:Child; D002675:Child, Preschool; D003376:Counseling; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D007258:Informed Consent; D008297:Male; D011939:Mental Recall; D013517:Otorhinolaryngologic Surgical Procedures; D010290:Parents; D010353:Patient Education as Topic; D011446:Prospective Studies; D012306:Risk; D011795:Surveys and Questionnaires