An investigation into the knowledge and practice of securing informed consent for surgery by health care workers in a selected institution in KwaZulu-Natal.
Ngwenya, Jabulani Goodman.
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Background: Patients undergoing elective surgery experience fear and anxiety because they do not know what to expect and most of them lack knowledge about their legal rights as far as surgery is concerned. Pre-operative information should be provided by members of the multidisciplinary health team, for example the surgeon, anaesthetist, nurse and physiotherapist (Chetty and Ehlers, 2009) so that the patient can foster realistic post-operative expectations and co-operate in his/her wellness. Problem statement: Illiteracy is found to be one of the problems faced by the patients globally, nationally and provincially. In developing African countries religious and cultural issues, uneducated and unsophisticated patient population, as well as pressure of work for health care workers, also pose serious challenges in conveying adequate information to the patient (Ezeome et al., 2011). The purpose: The purpose of the study was an investigation into the knowledge and practice of securing informed consent for surgery by health care workers in a selected institution. Methods: A quantitative approach was taken, whereby orderly, disciplined procedures were used to acquire information. The researcher adopted census and convenient sampling. This study included 61 HCWs in the selected units or wards,15 HCWs observed securing informed consent from the patients, and 31 signed consent forms covering a period of one month were reviewed retrospectively for completeness. A questionnaire with close ended questions for knowledge, and observation and record review checklists for practice were utilised for data collection. Results: The return rate of 76.25 per cent (n=61) was achieved after three reminders through phone calls and visits. The study indicated that there was a discrepancy in the knowledge and practice of informed consent by surgeons. Though efforts were made to ensure understanding in terms of the use of layman‘s language, some important aspects of the information were not shared, for example, risks related to anaesthesia and surgery, adverse effects of blood transfusion, potential undesirable effects of surgery, ventilation (for patients who need ventilation after surgery), length of hospital stay for surgery, and other treatment options, for example, asking for a second opinion. In addition, health care workers sometimes displayed paternalistic attitudes towards patients, possibly relating to the patients‘ illiteracy and language barriers.