Skip to main content
Top
Published in: BMC Emergency Medicine 1/2023

Open Access 01-12-2023 | Research

Experiences of patients and next of kin on informed consent process for emergency surgery in two Urban university teaching hospitals in Uganda: a comparative cross sectional study

Authors: Olivia Kituuka, Erisa Mwaka, Ian Munabi, Moses Galukande

Published in: BMC Emergency Medicine | Issue 1/2023

Login to get access

Abstract

Informed consent for emergency surgery is a process in which a patient or their next of kin must make quick decisions required for surgery in a life-threatening situation or surgery that may have life-altering outcomes. The objective of the study was to describe patients and their next of kin experiences and factors influencing the informed consent process in two urban university teaching hospitals in Uganda. Methods: A cross-sectional survey involving patients who underwent emergency surgery and their next of kin was conducted in two tertiary care hospitals; one public and one private-not-for profit institution. A questionnaire was administered to collect sociodemographic information, type of Surgery that was done, how informed consent was obtained and experiences and expectations from the informed consent process. Univariate and multivariate analyses of the variables was done. Results: We collected data from 210 patients from a public hospital and 170 from a private-not-for profit hospital. Overall, most patients did not have the risks of the surgery communicated to them (79.7%), were not given alternative options (87.6%) and had no opportunity to ask questions (57.4%). Patients at the private institution had 3.35 times the odds of expecting the consent form to be explained to them than those at the public institution. Patients at the public hospital had 0.12 times the odds of preferring to have consent administered by a nurse than patients at the private institution OR 0.12 (0.05–0.29, p < 0.001). Patients in the public institution had 0.18 times the odds of preferring to have consent administered by a doctor than patients in the private institution OR 0.18 (0.08–0.45, p < 0.001). Conclusion: Patients in both public and private institutions are not informed about the risks of surgery, alternative options and are not given the opportunity to ask questions. Interpretation of the findings of this study on patient preferences on who administered consent though statistically significant were inconclusive due to the responses not being mutually exclusive.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hall DE, Prochazka AV, Fink AS. Informed consent for clinical treatment. Volume 184. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne; 2012. pp. 533–40. 5. Hall DE, Prochazka AV, Fink AS. Informed consent for clinical treatment. Volume 184. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne; 2012. pp. 533–40. 5.
2.
go back to reference Abaunza H. R.K., Elements for adequate informed consent in the surgical context. World J Surg, 2014. 38. Abaunza H. R.K., Elements for adequate informed consent in the surgical context. World J Surg, 2014. 38.
3.
go back to reference Cocanour CS. Informed consent—It’s more than a signature on a piece of paper. Am J Surg. 2017;214(6):993–7.CrossRefPubMed Cocanour CS. Informed consent—It’s more than a signature on a piece of paper. Am J Surg. 2017;214(6):993–7.CrossRefPubMed
4.
go back to reference Akkad A, et al. Informed consent for elective and emergency surgery: questionnaire study. BJOG: An International Journal of Obstetrics & Gynaecology. 2004;111(10):1133–8.CrossRef Akkad A, et al. Informed consent for elective and emergency surgery: questionnaire study. BJOG: An International Journal of Obstetrics & Gynaecology. 2004;111(10):1133–8.CrossRef
5.
go back to reference Jones JW, McCullough LB, Richman BW. A comprehensive primer of Surgical Informed Consent. Surg Clin North Am. 2007;87(4):903–18.CrossRefPubMed Jones JW, McCullough LB, Richman BW. A comprehensive primer of Surgical Informed Consent. Surg Clin North Am. 2007;87(4):903–18.CrossRefPubMed
6.
go back to reference Aacharya RP, Gastmans C, Denier Y. Emergency department triage: an ethical analysis. BMC Emerg Med. 2011;11(1):1–13.CrossRef Aacharya RP, Gastmans C, Denier Y. Emergency department triage: an ethical analysis. BMC Emerg Med. 2011;11(1):1–13.CrossRef
7.
go back to reference Barish RA, Mcgauly PL, Arnold TC. Emergency room crowding: a marker of hospital health. Trans Am Clin Climatol Assoc. 2012;123:304.PubMedPubMedCentral Barish RA, Mcgauly PL, Arnold TC. Emergency room crowding: a marker of hospital health. Trans Am Clin Climatol Assoc. 2012;123:304.PubMedPubMedCentral
8.
go back to reference Shannon H, Scott T. Patients’ perceptions of informed consent for surgical procedures in Northern Ireland: a retrospective survey. Br J Anaesthetic Recovery Nurs. 2008;9(3):55–65.CrossRef Shannon H, Scott T. Patients’ perceptions of informed consent for surgical procedures in Northern Ireland: a retrospective survey. Br J Anaesthetic Recovery Nurs. 2008;9(3):55–65.CrossRef
9.
go back to reference Kituuka O. Patient and next of kin questionnaire for emergency surgery. Editor: I.M. Erisa Mwaka; 2021. Kituuka O. Patient and next of kin questionnaire for emergency surgery. Editor: I.M. Erisa Mwaka; 2021.
10.
go back to reference Kigera J, Nguku L, Naddumba E. The impact of Bodaboda Motor Crashes on the Budget for Clinical Services at Mulago Hospital, Kampala. East and Central African Journal of Surgery. 2010;15(1):57–61. Kigera J, Nguku L, Naddumba E. The impact of Bodaboda Motor Crashes on the Budget for Clinical Services at Mulago Hospital, Kampala. East and Central African Journal of Surgery. 2010;15(1):57–61.
11.
go back to reference Ochieng J, et al. Informed consent practices for surgical care at university teaching hospitals: a case in a low resource setting. BMC Med Ethics. 2014;15(1):1–5.CrossRef Ochieng J, et al. Informed consent practices for surgical care at university teaching hospitals: a case in a low resource setting. BMC Med Ethics. 2014;15(1):1–5.CrossRef
12.
go back to reference Susilo AP, et al. Nurses’ roles in informed consent in a hierarchical and communal context. Nurs Ethics. 2013;20(4):413–25.CrossRefPubMed Susilo AP, et al. Nurses’ roles in informed consent in a hierarchical and communal context. Nurs Ethics. 2013;20(4):413–25.CrossRefPubMed
13.
go back to reference Perić O, Tirić D, Penava N. Patients’ experience regarding informed consent in elective and emergency surgeries. Medicinski Glasnik, 2018. 15(2). Perić O, Tirić D, Penava N. Patients’ experience regarding informed consent in elective and emergency surgeries. Medicinski Glasnik, 2018. 15(2).
14.
go back to reference Wismayer R. Study about Informed Consent for Surgical Care in East Africa. New Horizons in Medicine and Medical Research Vol. 2022;3:210–5.CrossRef Wismayer R. Study about Informed Consent for Surgical Care in East Africa. New Horizons in Medicine and Medical Research Vol. 2022;3:210–5.CrossRef
15.
go back to reference Chima S. Evaluating knowledge, practice, and barriers to informed consent among Professional and Staff Nurses in South Africa: an empirical study. Can J Bioethics/Revue canadienne de bioéthique. 2022;5(2):44–70. Chima S. Evaluating knowledge, practice, and barriers to informed consent among Professional and Staff Nurses in South Africa: an empirical study. Can J Bioethics/Revue canadienne de bioéthique. 2022;5(2):44–70.
16.
go back to reference Lee S, et al. Nurses’ perceptions of informed consent and their related roles in Korea: an exploratory study. Int J Nurs Stud. 2009;46(12):1580–4.CrossRefPubMed Lee S, et al. Nurses’ perceptions of informed consent and their related roles in Korea: an exploratory study. Int J Nurs Stud. 2009;46(12):1580–4.CrossRefPubMed
17.
go back to reference Dairo M, Oyetunde M, Olaitan P. Informed consent in a tertiary hospital in Nigeria: how involved is the nurse. Niger Postgrad Med J. 2007;14:209–12.CrossRefPubMed Dairo M, Oyetunde M, Olaitan P. Informed consent in a tertiary hospital in Nigeria: how involved is the nurse. Niger Postgrad Med J. 2007;14:209–12.CrossRefPubMed
18.
go back to reference Ochieng J, et al. Informed consent in clinical practice: patients’ experiences and perspectives following surgery. BMC Res Notes. 2015;8(1):1–6.CrossRef Ochieng J, et al. Informed consent in clinical practice: patients’ experiences and perspectives following surgery. BMC Res Notes. 2015;8(1):1–6.CrossRef
19.
go back to reference Chima SC. Evaluating the quality of informed consent and contemporary clinical practices by medical doctors in South Africa: an empirical study. BMC Med Ethics. 2013;14(1):S3.CrossRefPubMedPubMedCentral Chima SC. Evaluating the quality of informed consent and contemporary clinical practices by medical doctors in South Africa: an empirical study. BMC Med Ethics. 2013;14(1):S3.CrossRefPubMedPubMedCentral
22.
go back to reference Davoudi N, et al. Challenges of obtaining informed consent in Emergency Ward: a qualitative study in one iranian hospital. open Nurs J. 2017;11:263–76.CrossRefPubMedPubMedCentral Davoudi N, et al. Challenges of obtaining informed consent in Emergency Ward: a qualitative study in one iranian hospital. open Nurs J. 2017;11:263–76.CrossRefPubMedPubMedCentral
23.
go back to reference Muskens IS, et al. When Time is critical, is informed Consent Less so? A discussion of patient autonomy in Emergency Neurosurgery. World Neurosurg. 2019;125:e336–40.CrossRefPubMed Muskens IS, et al. When Time is critical, is informed Consent Less so? A discussion of patient autonomy in Emergency Neurosurgery. World Neurosurg. 2019;125:e336–40.CrossRefPubMed
24.
go back to reference Degerliyurt K, Gunsolley JC, Laskin DM. Informed consent: what do patients really want to know? J Oral Maxillofac Surg. 2010;68(8):1849–52.CrossRefPubMed Degerliyurt K, Gunsolley JC, Laskin DM. Informed consent: what do patients really want to know? J Oral Maxillofac Surg. 2010;68(8):1849–52.CrossRefPubMed
25.
go back to reference Falagas ME, et al. Informed consent: how much and what do patients understand? Am J Surg. 2009;198(3):420–35.CrossRefPubMed Falagas ME, et al. Informed consent: how much and what do patients understand? Am J Surg. 2009;198(3):420–35.CrossRefPubMed
Metadata
Title
Experiences of patients and next of kin on informed consent process for emergency surgery in two Urban university teaching hospitals in Uganda: a comparative cross sectional study
Authors
Olivia Kituuka
Erisa Mwaka
Ian Munabi
Moses Galukande
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2023
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-023-00856-0

Other articles of this Issue 1/2023

BMC Emergency Medicine 1/2023 Go to the issue