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. 2024 Jan 13;18(1):2.
doi: 10.1186/s13037-023-00386-5.

Patient knowledge of surgical informed consent and shared decision-making process among surgical patients in Ethiopia: a systematic review and meta-analysis

Mengistu Mera Mihiretu  1 , Ermias Bekele  2 , Kokeb Ayele  3 , Lakew Asmare  4 , Fekade Demeke Bayou  4 , Mastewal Arefaynie  5 , Yawkal Tsega  6 , Abel Endawkie  4 , Shimels Derso Kebede  2 , Natnael Kebede  3
Affiliations

Patient knowledge of surgical informed consent and shared decision-making process among surgical patients in Ethiopia: a systematic review and meta-analysis

Mengistu Mera Mihiretu et al. Patient Saf Surg. .

Abstract

Background: Informed consent is one of the safeguarding of the patient in medical practice at different standards such as ethical, legal, and administrative purposes. Patient knowledge and perception of informed consent are one of the priority concerns in surgical procedures. Patient knowledge and perception towards informed consent increased patient satisfaction, feeling high power on their determination, and accountability for the management, and facilitated positive treatment outcomes. Despite this, in Ethiopia, there are small-scale primary studies with inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis study estimated the pooled prevalence of patient knowledge and perception of informed consent and its determinants in Ethiopia.

Methods: We searched major databases such as PubMed, Hinary, MEDLINE, Cochrane Library, EMBASE, Scopus, African Journal Online (AJO), Semantic Scholar, Google Scholar, google, and reference lists. Besides this, University databases in the country were also searched from August 20, 2023, until September 30, 2023,. All published and unpublished studies that report the prevalence of patient knowledge and perception toward informed consent and its associated factors were included. All studies reported in English were included. Studies conducted between January 01, 2015 to September 30, 2023 were included. There are three outcome measurements pooled level of patient knowledge towards informed consent, pooled level of patient perception towards informed consent, and pooled effect that affects patient knowledge of informed consent. Three reviewers (MMM, NK, and YT) independently screened the articles that fulfilled the inclusion criteria to avoid the risk of bias. The studies' quality was appraised using a modified Newcastle-Ottawa Scale (NOS) version.

Results: The pooled prevalence of appropriate patient knowledge and perception towards informed consent was 32% (95% CI: 21, 43) and 40% (95% CI: 16, 65) respectively. Having formal education 2.69 (95% CI: 1.18, 6.15) and having a history of signed informed consent before 3.65 (95% CI:1.02,13.11) had a statistically significant association with good patient knowledge towards informed consent.

Conclusion: The appropriate patient knowledge and perception of informed consent in Ethiopia is low. Formal education and history of signed informed consent were positive factors for appropriate patient knowledge of informed consent in Ethiopia. Physicians, policymakers, and health facility managers should focus on patients without prior experience with signed informed consent and not have formal education to improve patient knowledge towards informed consent. The protocol was registered at Prospero with number CRD42023445409 and is available from: https://www.crd.york.ac.uk/PROSPERO/#myprospero .

Keywords: Ethiopia; Factors; Informed consent; Knowledge; Perception; Surgical patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram
Fig. 2
Fig. 2
Forest plot pooled prevalence of patient knowledge towards informed consent among surgical patients in Ethiopia 2023
Fig. 3
Fig. 3
Forest plot pooled prevalence of patient perception towards informed consent among surgical patients in Ethiopia 2023
Fig. 4
Fig. 4
Forest plot for patient knowledge towards informed consent among surgical patients in Ethiopia, sensitivity analysis, 2023
Fig. 5
Fig. 5
Forest plot pooled prevalence of patient knowledge towards informed consent among surgical patients after omitting a single outlier study in Ethiopia 2023
See this image and copyright information in PMC

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