Impact of Informative Videos on Proxy Consent by Parents for Pediatric Surgery: A Randomized Controlled Trial

Abstract

Background: Consent is never truly exercised in children as parents act as their proxy and often do not understand the advantages, disadvantages, risks, and benefits of the procedure. Their high anxiety state is mirrored in the child, leading to slower recovery. Hence, this study was designed to understand if an intervention can impact the effect of consent on parents' anxiety, satisfaction, and knowledge.

Methodology: A two-arm, parallel design, randomized controlled trial was conducted from March 2020 to March 2022 to analyze the effect of an educational video in comparison to an informational leaflet in parents giving proxy consents for various listed pediatric surgical procedures.

Results: Parents in the video group had a higher mean knowledge score (6.97 vs. 6.77, P = 0.40), comparable satisfaction scores (27.45 vs. 27.58, P = 0.88), and statistically insignificant difference between anxiety scores. We noted highest score of satisfaction (28.5/40) in the parents educated up to High School level or less. Knowledge scores were lowest in pelvic-ureteric junction obstruction (5.1/10) patients.

Conclusions: Our study done over a period of 2 years included a variety of diagnoses, and the videos and information leaflets were self-designed. It showed comparable anxiety, knowledge, or satisfaction in parents. Studies with more participants would be needed to take this research forward.

Keywords: Anxiety; educational video; information leaflet; knowledge; satisfaction.

Figure 1

CONSORT 2010 flow diagram – Methodology of the trial as conducted in accordance with consolidated standards of reporting trials

Figure 2

Anxiety scores – Box and Whisker plot with intervention group showing a lower mean anxiety score (P = 0.86)

Figure 3

Knowledge scores – Box and Whisker plot with video information group showing a higher mean knowledge score (P = 0.40)

Figure 4

Satisfaction scores – Box and Whisker plot showing very similar average satisfaction scores for the two groups (P = 0.88)