A randomised controlled trial to assess the impact of audiotaped consultations on the quality of informed consent in cardiac surgery

Mishra, P.K., Mathias, H., Millar, K., Nagrajan, K. and Murday, A. (2010) A randomised controlled trial to assess the impact of audiotaped consultations on the quality of informed consent in cardiac surgery. Archives of Surgery, 145(4), pp. 383-388. (doi: 10.1001/archsurg.2010.45)

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<b>Context</b>: Informed Consent has become a contentious issue over the last few decades. It has been discussed and debated in all specialties of medicine. <b>Objective</b>: We have used a previously published and validated questionnaire, which was designed to measure patients’ level of knowledge within the domains described in the General Medical Council’s informed consent guidelines, to evaluate the impact of audiotaping outpatient consultations on informed consent in cardiac surgery. <b>Design</b>: Randomised Controlled Trial <b>Setting</b>: Tertiary health care centre in Scotland <b>Participants</b>: Patients attending outpatient clinic prior to first time coronary artery bypass grafting were recruited. We made audiotape recordings of outpatient consultations conducted by a single consultant surgeon with 84 patients. <b>Intervention</b>: The participants were randomly allocated to three trial arms. The control group (Group A; n = 29) received no tape. The 'generic' group (Group B; n = 25) received a copy of a tape which contained general information about coronary artery surgery which we scripted to include information covering each of the domains described by the General Medical Council. The 'consultation' group (Group C; n = 30) received a tape of their consultation interview. Patients were then interviewed on admission to hospital, shortly after giving consent. As well as the knowledge questionnaire, the Multidimensional Health Locus of Control (MHLC) and Hospital Anxiety and Depression Scale (HADS) were administered. <b>Main outcome measures</b>: Impact of audiotape in improving the informed consent process, as measured by a knowledge questionnaire, in cardiac surgery. Its impact on health locus of control and anxiety and depression was also assessed. <b>Results</b>: The mean knowledge score of patients who received a recording of their consultation was almost two-and-a-half times greater than that of the controls (p<0.001). Patients who received a consultation recording reported a significantly greater sense of control over their own health (p<0.001) and were overall less anxious and depressed. <b>Conclusion</b>: Providing an audiotape of the consultation before cardiac surgery appears to improve patients’ knowledge whilst increasing their perceptions of control of their health status and reducing levels of anxiety and depression.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Millar, Professor Keith
Authors: Mishra, P.K., Mathias, H., Millar, K., Nagrajan, K., and Murday, A.
Subjects:R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine
R Medicine > RD Surgery
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:Archives of Surgery
ISSN (Online):1538-3644

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