A parental educational intervention to facilitate informed consent for emergency operations in children

Abstract

Background: In contrast to elective surgery, there are little data available on how to facilitate informed consent for emergency surgery. We hypothesized that in parents of children undergoing an emergency operation, portable computer technology would improve their perception of the adequacy of informed consent in the four domains of autonomy, beneficence, content, and assent.

Materials and methods: This study is a quasi-experimental time series in which we prospectively compared two methods of preoperative education for parents of children undergoing appendectomy. The control group (N = 45) received standard preoperative discussion, whereas in the intervention group (N = 36) the preoperative education was facilitated by a portable computer presentation. Subjects completed a questionnaire following preoperative education to assess the extent to which informed consent was achieved immediately and at 3-4 weeks.

Results: Compared to control, initial ratings for the domains of informed consent tested were significantly higher in the intervention group: autonomy (N = 0.025), beneficence (N = 0.047), assent (N = 0.005), and content (N = 0.003). After 3 weeks, however, the advantage of the intervention group was preserved for the "content" domain, while ratings for "autonomy" significantly declined for both groups.

Conclusion: A standardized portable computer presentation is an effective means of facilitating preoperative parental education for informed consent prior to emergency surgery in children. However, there is a decline in parental recall and perception of autonomy that is not affected by the strategy chosen for preoperative education.