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Multimedia intervention (MMI). The MMI used in this study was a PowerPoint® presentation that was displayed while a surgical provider obtained informed consent from the parent. The MMI consisted of 20 slides and explained the diagnosis, initial treatment (fluid and electrolyte resuscitation), surgical procedure including risks, benefits, alternatives, and after care including the immediate post-operative period, typical hospital length of stay, criteria for being discharged home, and care once arriving home
Source publication
Purpose
Before performing a surgical procedure, informed consent (IC) is obtained. Parents may exhibit anxiety and/or a desire for more knowledge during the IC process for their child. The purpose of this study was to measure the impact of a multimedia intervention (MMI) versus conventional discussion on parental understanding and anxiety during th...
Citations
... Pre-procedural anxiety is common and important issue in pre operative setting. A study conducted by Paton et al. [6] demonstrated that the use of multimedia teaching tools significantly decreases anxiety levels [6]. Limitation of the study by Paton et al. [6] is small sample size, lack of control group and use of a single surgical procedure. ...
... Pre-procedural anxiety is common and important issue in pre operative setting. A study conducted by Paton et al. [6] demonstrated that the use of multimedia teaching tools significantly decreases anxiety levels [6]. Limitation of the study by Paton et al. [6] is small sample size, lack of control group and use of a single surgical procedure. ...
... A study conducted by Paton et al. [6] demonstrated that the use of multimedia teaching tools significantly decreases anxiety levels [6]. Limitation of the study by Paton et al. [6] is small sample size, lack of control group and use of a single surgical procedure. Moerman et al. developed the Amsterdam Preoperative Anxiety and Information Scale (APAIS) in 1996, which comprises selfreport questionnaires [7]. ...
Aims: Traditionally, informed consent involves verbal and/or written material provided to the patient by a treating clinician. Multimedia interventions improve patients' knowledge and understanding during the informed consent process. This study aimed to compare pre-procedural anxiety levels 2 and pain scores between educational video-assisted informed consent and traditional informed consent for extracorporeal shockwave lithotripsy (ESWL) at our centre. Methodology: The study group consisted of all adult patients undergoing ESWL in. both centres. A video presentation explaining the ESWL procedure was developed in two languages, and group allocation was randomised using a computer-based random number generator. Anxiety levels were assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire, visual analogue scale, and numerical rating scale used to collect data on pain scores. Results: A total of 54 respondents, with a predominance of male patients (57.4%) and the majority of patients having completed secondary school education (53.7%). In comparing the two groups, the video-assisted respondents exhibited significantly lower anxiety scores regarding the procedure than those in the traditional group (p< 0.05). However, there were no statistically significant differences between the groups in terms of pain scores, both pre-and post-procedural. Conclusion: Video-assisted informed consent can reduce procedure-related patient anxiety levels before ESWL; however, there was no difference in pain scores between the two consent methods. patients.
... The informed consent process in healthcare has traditionally been opaque due to the lack of medical knowledge the average patient has, but recent advancements to improve this process have included multimedia interventions such as videos and interactive computer software or written information like informational leaflets or pamphlets [92]. More novel approaches, such as eConsenting (the practice of using digital devices such as mobile phones or computers in the informed consent process), have come into prominence across multiple areas of healthcare, but standards of this ...
In healthcare, the role of AI is continually evolving, and understanding the challenges its introduction poses on relationships between healthcare providers and patients will require a regulatory and behavioral approach that can provide a guiding base for all users involved. In this paper, we present IAC (Informing, Assessment, and Consent), a framework for evaluating patient response to the introduction of AI-enabled digital technologies in healthcare settings. We justify the need for IAC with a general introduction of the challenges with and perceived relevance of AI in human-welfare-centered fields, with an emphasis on the provision of healthcare. The framework is composed of three core principles that guide how healthcare practitioners can inform patients about the use of AI in their healthcare, how practitioners can assess patients' acceptability and comfortability with the use of AI, and how patient consent can be gained after this process. We propose that the principles composing this framework can be translated into guidelines that improve patient agency regarding the use of AI in healthcare while broadening the discourse on this topic.
... 10 Anxiety levels of parents decrease when they have sufficient information about their children's medical condition, anesthesia and surgery plan, possible anesthesia and surgical complications. [11][12][13][14] In addition to these, they should be able to evaluate and correctly interpret the health information given about these issues. Health literacy is defined as the cognitive and social skills related to the ability and desire of individuals to access, understand and use information about health in order to maintain and improve well-being in health. ...
Aims: In this study, it was aimed to determine preoperative anxiety levels, related factors, the relationship between health literacy and anxiety in parents of pediatric patients. Methods: This descriptive cross-sectional study was conducted on the parents of children who will be operated in a tertiary hospital between 15 June and 15 September 2022. The number of 82 people were included in the study. Information form introducing children and families, Health Literacy Scale(HLS), State Trait Anxiety Inventory(STAI) questionnaires were applied to parents. p<0.05 was considered significant in statistical analysis. Results: The state anxiety score of the parents participating in the study was 37.51±9.50, trait anxiety score was 42.55±8.83, HLS 45.46±14.34. Preoperative state anxiety level of mothers(39.63±9.97) was higher than that of fathers(34.36±8.71)(p=0.040), trait anxiety level was similar(p=0.189), mothers' health literacy(40.36±11.11) was found to be lower (48.11±15.19) than fathers(p=0.019). The state anxiety level of parents whose income is equal to expenditure was found to be the lowest(33.43±7.33)(p<0.001). While the state anxiety score was found to be significantly lower(p=0.024), the trait anxiety score was similar(p=0.560) and the health literacy score was higher(p=0.042), among the parents who had knowledge about anesthesia. The relationship between state anxiety score and health literacy score was negative and significant(p<0.001). Conclusion: It is seen that the anxiety levels of parents with low health literacy increase before the surgery. It is important to know the factors related to the anxiety levels of the parents before the surgery.
... presentations during the informed consent process has been shown to increase caregiver knowledge and satisfaction and reduce anxiety. 15,16 With communication and consent interactions playing crucial roles in patient-centered healthcare, there is opportunity for amelioration of the informed consent process. This is of particular importance in more stressful clinical situations, such as pediatric surgery, offering potential for high-yield clinical benefit. ...
Background:
Surgery generates anxiety and stress, which can negatively impact informed consent and postoperative outcomes. This study assessed whether educational, illustrated children's books improve comprehension, satisfaction, and anxiety of caregivers in pediatric surgical populations.
Methods:
A prospective randomized trial was initiated at a tertiary care children's hospital. All patients ≤ 18 years old with caregiver and diagnosis of 1) uncomplicated appendicitis (English or Spanish speaking); 2) ruptured appendicitis; 3) pyloric stenosis; 4) need for gastrostomy tube; or 5) umbilical hernia were eligible. Conventional consent was obtained followed by completion of 17 validated survey questions addressing apprehension, satisfaction, and comprehension. Randomization (2:1) occurred after consent and before operative intervention with the experimental group (EG) receiving an illustrated comprehensive children's book outlining anatomy, pathophysiology, hospital course, and postoperative care. A second identical survey was completed before discharge. Primary outcomes were caregiver apprehension, satisfaction, and comprehension.
Results:
Eighty caregivers were included (55: EG, 25: control group [CG]). There were no significant differences in patient or caregiver demographics between groups. The baseline survey demonstrated no difference in comprehension, satisfaction, or apprehension between groups (all p values NS). After intervention, EG had significant improvement in 14 of 17 questions compared with CG (all p < 0.05). When tabulated by content, there was significant improvement in comprehension (p = 0.0009), satisfaction (p < 0.0001), and apprehension (p < 0.0001).
Conclusion:
The use of illustrated educational children's books to explain pathophysiology and surgical care is a novel method to improve comprehension, satisfaction, and anxiety of caregivers. This could benefit informed consent, understanding, and postoperative outcomes.
... The informed consent process in healthcare has traditionally been opaque due to the lack of medical knowledge the average person has, but recent advancements to improve this process have included multimedia interventions such as videos and interactive computer software or written information like informational leaflets or pamphlets (Paton et al. 2018). ...
In healthcare, the role of AI is continually evolving and understanding the challenges its introduction poses on relationships between healthcare providers and patients will require a regulatory and behavioural approach that can provide a guiding base for all users involved. In this paper, we present ACIPS (Acceptability, Comfortability, Informed Consent, Privacy, and Security), a framework for evaluating patient response to the introduction of AI-enabled digital technologies in healthcare settings. We justify the need for ACIPS with a general introduction of the challenges with and perceived relevance of AI in human-welfare centered fields, with an emphasis on the provision of healthcare. The framework is composed of five principles that measure the perceptions of acceptability, comfortability, informed consent, privacy, and security patients hold when learning how AI is used in their healthcare. We propose that the tenets composing this framework can be translated into guidelines outlining the proper use of AI in healthcare while broadening the limited understanding of this topic.
... Visual consent had the strongest influence on parents' comprehension [43] and could hence be used to enhance the process of informed consent. Using multimedia tools help in lowering patient anxiety during the informed consent process [44]. Meanwhile, the majority of participants reported that they receive enough information during the consent process. ...
Background
Informed consent (IC) is a healthcare standard emphasizing the meaning of human dignity as clarified in the Universal Declaration of Human Rights. Data about IC practices in Egypt is insufficient. This study aimed to assess the Egyptian patients'/guardians' experiences about IC and their expectations about its practices' purposes in general and according to the type of the healthcare facility.Methods
Self-administered questionnaire was carried out for 1092 participants who had undergone or were scheduled to a procedure requiring an IC at three studied types for Egyptian health care facilities. Ten statements were ranked twice by the participants to reflect their perception of IC purpose as per what is currently practiced and what they believe should be practiced.ResultsIC implementation varies significantly (p
... A previous study reported that a multimedia intervention significantly reduced anxiety and increased knowledge in parents. [63] Further studies are needed to confirm these findings in the ED. ...
Background
Obtaining valid parental informed consent for pediatric procedures in the emergency department (ED) is challenging. This study compared a video-assisted informed consent intervention with conventional consent discussion to inform parents about pediatric procedural sedation in the ED.
Methods
A video-assisted informed consent intervention was developed to explain the process, benefits, risks, and alternatives of pediatric procedural sedation. A prospective randomized controlled trial was conducted with a convenience sample of parents of children recommended for procedural sedation for facial laceration in the ED. Intervention group participants watched the video. Control group participants received information from physicians during conventional discussion. Participants completed pre- and post-education knowledge tests and rated their satisfaction with the informed consent process. The primary outcome was efficacy of the video intervention compared with conventional discussion. Secondary outcomes were parental satisfaction and consent refusal. A covariate-controlled multivariable regression model was used to analyze between-group differences in knowledge and satisfaction.
Results
There were 32 participants in the intervention group and 30 in the control group. Mean knowledge scores were higher in the intervention group (91.67 ± [standard deviation] 12.70) than in the control group (73.33 ± 19.86). The intervention group showed significantly greater knowledge score differences (coefficient: 18.931, 95% confidence interval: 11.146–26.716). Intervention group participants showed greater satisfaction than control group participants.
Conclusions
Video-assisted informed consent was superior to conventional discussion for informing parents during an ED informed consent process. Video-assisted informed consent may improve parents’ understanding of pediatric procedural sedation and satisfaction with the informed consent process in the ED. Institutions should develop structured methods and strategies to better inform parents, facilitate treatment decisions, and improve parent satisfaction in the ED.
Trial registration
The ClinicalTrials.gov Identifier is NCT01850329. Registered 9 May, 2013 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT01850329
... presentation can improve the informed consent process for appendectomy in an emergency department [6]. Recently, Paten et al. showed that a multimedia teaching tool can decrease parental anxiety for infants undergoing pyloromyotomy [7]. Yet, in general, there are very few studies about the informed consent process in the field of pediatrics and pediatric surgery. ...
Background:
There is limited time within the clinical workflow of most pediatric surgeons to obtain a comprehensive, well informed consent. This study evaluates whether ad-lib access to an online video on the consent dialogue enhances the consent process for inguinal hernia repair (IHR) in children.
Methods:
The study was approved by the state ethics board. A 6-min video of a consent speech on IHR was produced and uploaded to a nonpublic online channel, explaining the condition, procedure, complications, and postoperative expectations. A total of 50 families were randomized to conventional, face-to-face consenting in clinic either with (intervention) or without (control) access to the online video. During their child's IHR, the parents were asked to complete the State-Trait-Anxiety Inventory (STAI), a modified Friedlander questionnaire on assessing knowledge sufficient to provide informed consent, and a validated satisfaction survey. Scores of the intervention and control group were statistically compared.
Results:
The intervention group demonstrated significantly decreased anxiety measured with the STAI (p = 0,026) and increased knowledge (p = 0,016) compared to controls. There was no difference in satisfaction (p = 0,557).
Conclusion:
Preoperatively providing access to an online consent video regarding IHR reduces anxiety and enhances knowledge without altering satisfaction level. Adjunct online videos are a useful tool to enhance the consent process.
Type of study:
Prospective randomized controlled trial.
Level of evidence:
Level I.
Objectives:
Although radiotherapy is an essential component of pediatric cancer treatment, inadequate radiotherapy information for childhood cancer and unusual treatment situations can negatively affect parental perceptions and emotions. This study aims to investigate the effect of two-step audio-visual instruction system effects introduced by our institution on parent satisfaction and anxiety when initiating radiotherapy.
Methods:
The two-step audio-visual instruction system comprised instructive animation using patient avatars and a live video system. The live video system has a 55-inch-wide monitor, and a no-latency sound module. Parents in the radiotherapy division can view the patient in the treatment room through the live video system. This prospective study compared satisfaction and anxiety about radiotherapy introduction before and after two-step audio-visual instruction. We enrolled 20 parents whose child underwent radiotherapy, and they completed a set of questionnaires-Client Satisfaction Questionnaire, State-Trait Anxiety Inventory, and original questionnaires about radiotherapy.
Results:
Satisfaction scores improved significantly after two-step audio visual instruction (25.5 ± 3.4) compared with those before the instruction (27.7 ± 3.1) (p = <0.01). Anxiety scores also decreased significantly after the instruction (50 ± 9) compared with those before the instruction (54 ± 11) (p = 0.004). However, anxiety-related personality trait scores did not change drastically before and after viewing (48 ± 8.5 vs. 49 ± 7.5) (p = 0.419).
Conclusion:
This single-arm prospective study indicates that two-step audio-visual instruction for radiotherapy is effective in improving parents' anxiety about radiotherapy introductions. However, large-scale and comparative studies are warranted to generalize the benefit of two-step audio visual instruction.
Introduction:
Informed consent is an essential component of medical ethics. In children, the parent or legally authorized guardian must consent to any medical or surgical intervention. A number of adjuncts have been developed to supplement the consent process including multimedia tools. Unfortunately, there is little information regarding the use of Multimedia teaching tools (MMT) in pediatric settings in developing countries with diversities in language, socioeconomic and educational status.
Objectives:
The objectives of the study were to compare the parental comprehension of the surgery through the informed consent obtained either by conventional method or by multimedia tool and the effect of MMT in alleviating parental anxiety against the conventional method and to assess their overall satisfaction.
Methods:
A randomized control trial was conducted between 2018 and 2020, including MMT and conventional groups. A novel Multimedia tool with a Microsoft PowerPoint presentation was created. A 5-Question knowledge-based test, State-Trait Anxiety Inventory (STAI) tool, and a Likert-based questionnaire were used to assess the comprehension, anxiety, and satisfaction of parents.
Results:
Among 122 randomized cohorts, the mean value of percentage fall in anxiety STAI score in the MMT group was 44.64 ± 10.14 whereas in the Conventional group it was 26.6 ± 11.91 (p < 0.05). MMT cohort scored higher in the knowledge-based test (p < 0.05) and recorded higher parental satisfaction.
Conclusion:
The Multimedia tool aided consent procedure is effective in reducing parental anxiety and improving their comprehension and overall satisfaction. Thus, they can be used as an effective supplement in preoperative surgical education and consent procedure.
Level of evidence:
Level I.
