2017 HSC Section 2 - Practice Management
Otolaryngology–Head and Neck Surgery 155(2)
surgeons may provide more generalizable results. Despite these limitations, the current study was the first to assess recall rates through objective assessments (video recordings) of what was actually discussed during the consultation. Conclusion Parents of children considering elective pediatric otolaryn- gology operations recalled less than half of the surgical risks and benefits mentioned during the informed consent discussion. The decision to proceed with surgery as com- pared with watchful waiting was associated with a poorer recall of surgical risks. Parents were likely seeking informa- tion from other sources about the surgical procedure. This information is significant because a low rate of recall may influence parents’ perspectives of the procedure and could alter their decision-making processes or expectations. Future studies should assess methods to increase recall and under- standing of the information shared during the informed con- sent process. Acknowledgments We thank the nurses for their support and time and the families who participated in the study. Author Contributions Kiersten Pianosi , collected and analyzed data, wrote article, revised article; Ayala Y. Gorodzinsky , designed study, analyzed data, revised article; Jill MacLaren Chorney , designed study, col- lected and analyzed data, revised article; Gerard Corsten , designed study, collected data, revised article; Liane B. Johnson , designed study, collected data, revised article; Paul Hong , designed study, collected and analyzed data, revised article. Funding source: Canadian Institutes of Health Research, Nova Scotia Health Research Foundation, and Dalhousie Department of Surgery. No role in study. Supplemental Material Additional supporting information may be found at http://otojour- nal.org/supplemental. 1. Section on Pediatric Pulmonology, Subcommittee on Obstructive Sleep Apnea Syndrome, American Academy of Pediatrics. Clinical practice guideline: diagnosis and man- agement of childhood obstructive sleep apnea syndrome. Pediatrics . 2011;209:704-712. 2. Daniel M, Kamani T, El-Shunnar S, et al. National institute for clinical excellence guidelines on the surgical management of otitis media with effusion: are they being followed and have they changed practice? Int J Pediatr Otorhinolaryngol . 2013; 77:54-58. 3. Burton MJ, Glasziou PP, Chong LY, Venekamp RP. Tonsillectomy or adenotonsillectomy versus non-surgical References Disclosures Competing interests: None. Sponsorships: None.
treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev . 2014;11:CD001802. 4. Engel KG, Heisler M, Smith DM, Robinson CH, Forman JH, Ubel PA. Patient comprehension of emergency department care and instructions: are patients aware of when they do not understand? Ann Emerg Med . 2009;53:454-461. 5. Hawley ST, Lantz PM, Janz NK, et al. Factors associated with patient involvement in surgical treatment decision making for breast cancer. Patient Educ Couns . 2007;65:387-395. 6. Gorodzinsky AY, Hong P, Chorney JM. Parental knowledge in pediatric otolaryngology surgical consultations: a qualitative content analysis. Int J Pediatr Otorhinolaryngol . 2015;79: 1135-1139. 7. Goldfarb J, Gupta V, Sampson H, Chiodo A. Resource devel- opment in otolaryngology-head and neck surgery: an analysis on patient education resource development. J Otolaryngol Head Neck Surg . 2014;43:27. 8. McAllister KA, Clement WA. Readability and content of postoperative tonsillectomy instructions given to patients in Scotland, a completed audit cycle. Scot Med J . 2012;57:4-7. 9. Tait AR, Voepel-Lewis T, Gauger V. Parental recall of anesthesia information: informing the practice of informed consent. Anesth Analg . 2011;112:918-923. 10. Papsin E, Haworth R, Chorney JM, Bezuhly M, Hong P. Pediatric otoplasty and informed consent: do information handouts improve parental risk recall? Int J Pediatr Otorhinolaryngol . 2014;78:2258-2261. 11. Nadeau DP, Rich JN, Brietzke SE. Informed consent in pedia- tric surgery: do parents understand the risks? Arch Otolaryngol Head Neck Surg . 2010;136:265-269. 12. Rosique I, Pe´rez-Ca´rceles MD, Romero-Martı´n M, Osuna E, Luna A. The use and usefulness of information for patients undergoing anaesthesia. Med Law . 2006;25:715-727. 13. Steven M, Broadis E, Carachi R, Brindley N. Sign on the dotted line: parental consent. Ped Surg Int . 2008;24:847-849. 14. Aremu SK, Alabi BS, Segun-Busari S. The role of informed consent in risks recall in otorhinolaryngology surgeries: verbal (nonintervention) vs written (intervention) summaries of risks. Am J Otolaryngol . 2011;32:485-489. 15. Kieran S, Gorman C, Kirby A, et al. Risk factors for desatura- tion after tonsillectomy: analysis of 4,092 consecutive pedia- tric cases. Laryngoscope . 2013;123:2554-2559. 16. Wei JL, Mayo MS, Smith HJ, Reese M, Weatherly RA. Improved behavior and sleep after adenotonsillectomy in chil- dren with sleep-disordered breathing. Arch Otolaryngol Head Neck Surg . 2007;133:974-979. 17. Isaacson G. Avoiding airway obstruction after pediatric adeno- tonsillectomy. Int J Ped Otorhinolaryngol . 2009;73:803-806. 18. Anderson OA, Wearne IMJ. Informed consent for elective sur- gery: what is best practice? J R Soc Med . 2007;100:97-100. 19. Truog RD, Brown SD, Browning D, et al. Microethics: the ethics of everyday clinical practice. Hastings Cent Rep . 2015; 45:11-17. 20. Crepeau AE, McKinney BI, Fox-Ryvicker M, Castelli J, Penna J, Wang ED. Prospective evaluation of patient comprehension of informed consent. J Bone Joint Surg Am . 2011;93:e114.
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