title: Informed consent in trauma: does written information improve patient recall of risks? A prospective randomised study.
abstract: Informed consent is vital to good surgical practice. Pain, sedative medication and psychological distress resulting from trauma are likely to adversely affect a patient's ability to understand and retain information thus impairing the quality of the consent process. This study aims to assess whether provision of written information improves trauma patient's recall of the risks associated with their surgery. 121 consecutive trauma patients were randomised to receive structured verbal information or structured verbal information with the addition of supplementary written information at the time of obtaining consent for their surgery. Patients were followed up post-operatively (mean 3.2 days) with a questionnaire to assess recall of risks discussed during the consent interview and satisfaction with the consent process. Recall of risks discussed in the consent interview was found to be significantly improved in the group receiving written and verbal information compared to verbal information alone (mean questionnaire score 41% vs. 64%), p=0.0014 using the Mann-Whitney U test. Patient satisfaction with the consent process was improved in the group receiving written and verbal information and 90% of patients in both groups expressed a preference for both written and verbal information compared to verbal information alone. Patients awaiting surgery following trauma can pose a challenge to adequately inform about benefits conferred, the likely post operative course and potential risks. Written information is a simple and cost-effective means to improve the consent process and was popular with patients.
authors.affiliation: Department of Trauma & Orthopaedics Bristol Royal Infirmary Upper Maudlin Street Bristol BS2 8HW United Kingdom. hsmith22@doctors.org.uk
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Smith
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Manjaly
authors.forename: Taher
authors.initials: T
authors.lastname: Yousri
authors.forename: Neil
authors.initials: N
authors.lastname: Upadhyay
authors.forename: Hazel
authors.initials: H
authors.lastname: Taylor
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Nicol
authors.forename: James A
authors.initials: JA
authors.lastname: Livingstone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D032882:Comprehension; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007258:Informed Consent; D007603:Jurisprudence; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000601:surgery*; D055815:Young Adult