title: Informed consent for inguinal herniorrhaphy and cholecystectomy: describing how patients make decisions to have surgery.
abstract: BACKGROUND
  We describe how patients perceive the process of informed consent and its influence on decision making for elective surgery.
  
  
  METHODS
  A cohort of 38 patients documented consent for cholecystectomy or inguinal herniorrhaphy using the Veterans Affair's computer-based tool for documenting informed consent for clinical treatment. Participants completed semistructured telephone interviews exploring their attitudes about informed consent, iMed, and the decision-making process. We used qualitative methods to code and analyze the data.
  
  
  RESULTS
  Sixty-nine percent of patients decided to have surgery before meeting their surgeon, and 47% stated that the surgeon did not influence their decision. Although the surgeon was an important source of information for most patients (81%), patients frequently described using information gathered before meeting the surgeon, such as other health care providers (81%) or family members (58%). Most (68%) patients perceived iMed as a legal formality with little influence on decision making.
  
  
  CONCLUSIONS
  Future research should examine whether patient decision making regarding elective surgery becomes better informed if nonsurgeon clinicians connect patients to educational resources such as iMed closer to the time of initial diagnosis and before meeting the surgeon.
authors.affiliation: Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA 15206, USA. hallde@upmc.edu
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Hall
authors.forename: Penelope
authors.initials: P
authors.lastname: Morrison
authors.forename: Cara
authors.initials: C
authors.lastname: Nikolajski
authors.forename: Michael
authors.initials: M
authors.lastname: Fine
authors.forename: Robert
authors.initials: R
authors.lastname: Arnold
authors.forename: Susan L
authors.initials: SL
authors.lastname: Zickmund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002763:Cholecystectomy / Q000523:psychology*; D054626:Consumer Health Information; D003657:Decision Making; D017558:Elective Surgical Procedures / Q000523:psychology*; D057286:Electronic Health Records; D006552:Hernia, Inguinal / Q000523:psychology / Q000601:surgery*; D059685:Herniorrhaphy / Q000523:psychology*; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D007407:Interviews as Topic; D008875:Middle Aged; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology