The effect of a visual aid on the comprehension of cataract surgery in a rural, indigent South Indian population
Article Sidebar
Main Article Content
Abstract
Purpose
To determine whether a visual aid improves the understanding and retention of information presented during informed consent for rural, indigent patients presenting for cataract surgery.
Subjects and Methods
This was a randomized, unmasked, interventional study. We recruited patients who presented to the Hande Surgical Hospital in Chennai, India, for cataract surgery. Patients were randomized into two groups: verbal consent alone (group A) and verbal consent plus a poster (group B). Both groups completed an 11-question true/false quiz immediately before and after informed consent and one day after surgery.
Results
A total of 60 patients were recruited for the study, with 30 randomly assigned to each group; 23 patients from group A and 17 from group B completed the study. Informed consent improved patient scores in both groups; however, group B had significantly higher mean scores on postoperative day 1 (7.4 vs 8.7, P = 0.005) and significantly greater improvement in mean scores from pre-informed consent to postoperative day 1 (1.3 vs 3.6, P = 0.002).
Conclusion
Informed consent improves patient understanding of cataract surgery. Using a visual aid during informed consent for cataract surgery improves understanding and retention of information more than verbal consent alone in a rural South Indian population.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Satyanarayana K, Srivastava S. Poverty, health & intellectual property rights with special reference to India. Indian J Med Res 2007;126:390-406.
O'Donnell O. Access to health care in developing countries: breaking down demand side barriers. Cad Saude Publica 2007;23:2820-34.
Finger RP. Cataracts in India: current situation, access, and barriers to services over time. Ophthalmic Epidemiol 2007;14:112-8.
Strasser R. Rural health around the world: challenges and solutions. Fam Pract 2003;20:457-63.
Chang MA, Congdon NG, Baker SK, Bloem MW, Savage H, Sommer A. The surgical management of cataract: barriers, best practices and outcomes. Int Ophthalmol 2008;28:247-60.
Mahendradhata Y, Ahmad RA, Lefèvre P, Boelaert M, Van der Stuyft P. Barriers for introducing HIV testing among tuberculosis patients in Jogjakarta, Indonesia: a qualitative study. BMC Public Health 2008;8:385.
Manafa O, Lindegger G, Ijsselmuiden C. Informed consent in an antiretroviral trial in Nigeria. Indian J Med Ethics 2007;4:26-30.
Bernat JL, Peterson LM. Patient-centered informed consent in surgical practice. Arch Surg 2006;141:86-92.
Moseley TH, Wiggins MN, O'Sullivan P. Effects of presentation method on the understanding of informed consent. Br J Ophthalmol 2006;90:990-3.
Scanlan D, Siddiqui F, Perry G, Hutnik CM. Informed consent for cataract surgery: what patients do and do not understand. J Cataract Refract Surg 2003;29:1904-12.
Panton RL, Downie R, Truong T, Mackeen L, Kabene S, Yi QL, et al. A visual approach to providing prognostic information to parents of children with retinoblastoma. Psychooncology 2009;18:300-4.
Bollschweiler E, Apitzsch J, Obliers R, Koerfer A, Mönig SP, Metzger R, Hölscher AH. Improving informed consent of surgical patients using a multimedia-based program: results of a prospective randomized multicenter study of patients before cholecystectomy. Ann Surg 2008;248:205-11.
Humayun A, Fatima N, Naqqash S, Hussain S, Rasheed A, Imtiaz H, et al. Patients' perception and actual practice of informed consent, privacy and confidentiality in general medical outpatient departments of two tertiary care hospitals of Lahore. BMC Med Ethics 2008;9:14.
Yousuf RM, Fauzi AR, How SH, Rasool AG, Rehana K. Awareness, knowledge and attitude toward informed consent among doctors in two different cultures in Asia: a cross-sectional comparative study in Malaysia and Kashmir, India. Singapore Med J 2007;48:559-65.
Luna F. Paternalism and the argument from illiteracy. Bioethics 1995; 9:283-90.
Bastia BK. Consent to treatment: practice vis-à-vis principle. Indian J Med Ethics 2008;5:113-4.