Development and pilot testing of an informed consent video for patients with limb trauma prior to debridement surgery using a modified Delphi technique

BMC Medical Ethics

Research Article

Chia-Ju Lin¹  Leiyu Shi²  Yin-Chun Tien³  Yuan-Chia Cheng⁴  Tsung-Ying Lin⁴  Liang-Chi Kuo⁴  Wei-Che Lee⁵  Chao-Wen Chen⁵  Yen-Ko Lin⁶ 

[1] College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 21205, Baltimore, Maryland, USA;Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Emergency Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;Division of Trauma and Surgical Critical Care, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Medical Humanities and Education, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;Department of Emergency Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan;

关键词: Informed consent;    Educational video;    Trauma;    Emergency department;    Delphi technique;   

DOI  :  10.1186/s12910-017-0228-3

 received in 2016-11-06, accepted in 2017-11-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundEnsuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process.MethodsA modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery.ResultsThe modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department (ED) were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video.ConclusionsOur process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care.Trial registrationThe ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011 (retrospectively registered).

【 授权许可】

CC BY   
© The Author(s). 2017