Highlights
- •There is a need for better consent conversations in pediatric surgery informed by parents and healthcare providers.
- •Patients and families appreciate surgeon empathy, good surgeon communication, patient engagement, and adequate time for discussion and questions in a consent conversation.
Summary
Background
Consent conversations in pediatric surgery are essential components of pre-operative
care which, when inadequate, can lead to significant adverse consequences for the
child, parents, surgeon, and others in the healthcare system. The aim of this study
is to explore expert consenting practice from the key stakeholders’ perspective.
Methods
Four senior attending pediatric surgeons obtained consent from a standardized mother
of a child requiring surgery in two scenarios: a low-risk elective surgery (inguinal
hernia repair - Video 1), and a high-risk emergency surgery (intestinal atresia -
Video 2). All sessions were recorded. Families of children who had undergone minor
or major surgery, families without medical or surgical background, and healthcare
professionals were invited to view and evaluate the videos using a semi-structured
questionnaire.
Results
Out of 251 distributed surveys, 56 complete responses were received. Thirty two participants
(57.1%) evaluated video 1 and 24 (42.9%) evaluated. Overall, 22 (69%) respondents
to video 1 and 20 (84%) respondents to video 2 were “very satisfied” with the recorded
consent conversation. Qualitative responses shared common themes of valuing surgeon
empathy, good surgeon communication, patient engagement, and adequate time and information.
Suggestions for improvement included additional resources and visual aids, improved
patient engagement, and discussion of post-operative expectations.
Conclusion
Our data identifies strengths and gaps in the current consent process from the perspective
of patient families and providers. Identified areas for improvement in the informed
consent process based on multi-stakeholder input will guide the planned development
of a consenting educational video resource.
Level of Evidence
IV.
Keywords
Abbreviations:
REB (Research Ethics Board), MCH (The Montreal Children’s Hospital), SDM (Shared Decision Making), NICU (Neonatal Intensive Care Unit)To read this article in full you will need to make a payment
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Article info
Publication history
Accepted:
January 3,
2023
Received:
January 2,
2023
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
