scholarly journals Public understanding of female genital anatomy and pelvic organ prolapse (POP); a questionnaire-based pilot study

2021 ◽  
Author(s):  
Dina El-Hamamsy ◽  
Chanel Parmar ◽  
Stephanie Shoop-Worrall ◽  
Fiona M. Reid
Keyword(s):  
Decision Making ◽  
Pelvic Organ Prolapse ◽  
Informed Consent ◽  
Shared Decision Making ◽  
Pelvic Organ ◽  
Public Understanding ◽  
Free Text ◽  
Shared Decision ◽  
White Ethnicity ◽  
Female Genital

Abstract Introduction and hypothesis Health literacy underpins informed consent and shared decision-making. In gynaecology, this includes understanding of normal anatomy and urogenital disease. This study evaluated public knowledge of external female genital anatomy and pelvic organ prolapse (POP). Methods A questionnaire study asked participants for their demographics and to label a female external genitalia diagram and included free-text questions on POP, its symptoms and treatment. Questionnaires were distributed at general outpatient (OPD) and urogynaecology (UG) departments at a UK teaching hospital. Differences in the number of correct anatomy labels between participant genders were assessed via chi-squared tests and, within female participants, multivariable linear and logistic regressions assessed associations with increasing correct anatomical labels and an understanding (versus no understanding) of POP, respectively. Results Within 191 (n = 160 OPD, n = 31 UG), 9/103 (9%) labelled all anatomical structures correctly. Females had more correct labels (median 1, IQR 0,3) versus males (median 0, IQR 0,1), P = 0.022). Higher education (vs. < secondary) and white ethnicity were associated with greater numbers of correct labels [coefficient (95% CI): 1.05 (0.14, 1.96), P = 0.024, 1.45 (0.58, 2.33), P = 0.001 respectively]. Fifty-three per cent understood POP. POP understanding increased with increasing age, white ethnicity (OR: 4.38, 95% CI: 1.36, 14.08, P = 0.013) and more correct anatomy labels (OR: 1.43, 95% CI 1.14, 1.79, P = 0.002). Of those who understood POP, only 35% identified “bulge” as a symptom and 7% physiotherapy as a treatment option. Conclusion There was poor public understanding of external female genital anatomy and POP, which may have significant implications for health-seeking, shared decision-making and informed consent.

Attitudes, Beliefs, and Practices of Aesthetic Plastic Surgeons Regarding Informed Consent

2019 ◽  
Author(s):  
Chelsea O Hagopian ◽  
Teresa B Ades ◽  
Thomas M Hagopian ◽  
Erik M Wolfswinkel ◽  
W Grant Stevens
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Plastic Surgery ◽  
Shared Decision Making ◽  
Online Survey ◽  
Free Text ◽  
Shared Decision ◽  
Essential Information ◽  
Beliefs And Practices ◽  
Aesthetic Plastic Surgery

Abstract Background Best practice for informed consent in aesthetic plastic surgery is a process of shared decision-making, yet evidence strongly suggests this is not commonly reflected in practice nor is it supported by traditional informed consent documents (ICD). Falsely held beliefs by clinicians about shared decision-making may contribute to its lack of adoption. Objective The authors sought to understand the baseline attitudes, beliefs, and practices of informed consent among board-certified plastic surgeons with a primarily aesthetics practice. Methods A 15-question online survey was emailed to active members of the American Society for Aesthetic Plastic Surgery. Items included demographics, Likert scales, free-text, acceptability, and 1 question seeking consensus on general information all patients must understand before any surgery. Results This survey yielded a 13% response rate with a 52% completion rate across 10 countries and 31 US states. A total of 69% were very or extremely confident that ICD contain evidence-based information, but 63% were not at all or not so confident in ICD effectiveness of prompting patients to teach-back essential information. A total of 50% believed surgical ICD should be reviewed annually. Eighty-six percent reported assistance with patient education during informed consent. Members of professional plastic surgery societies should be a source of evidence for content (free-text). A total of 64% were somewhat to very satisfied with the survey and 84% will probably to definitely participate in future related surveys. Conclusions The findings echo concerns in the literature that ICD are focused on disclosure instead of patient understanding. There is notable concern regarding information overload and retention but less regarding the quality and completeness of information. Current culture suggests key clinician stakeholders are amenable to change.

Certified Patient Decision Aids: Solving Persistent Problems with Informed Consent Law

2017 ◽  
Vol 45 (1) ◽  
pp. 12-40 ◽  
Author(s):  
Thaddeus Mason Pope
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Medical Treatment ◽  
Shared Decision Making ◽  
Decision Aids ◽  
Shared Decision ◽  
Legal Doctrine ◽  
Patient Decision Aids ◽  
Patient Decision ◽  
Decision Making Processes

The legal doctrine of informed consent has overwhelmingly failed to assure that the medical treatment patients get is the treatment patients want. This Article describes and defends an ongoing shift toward shared decision making processes incorporating the use of certified patient decision aids.

Holistic Nurse Practitioner Care Including Promotion of Shared Decision-Making

2021 ◽  
pp. 089801012110627
Author(s):  
Elizabeth Kinchen
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Condition ◽  
Holistic Care ◽  
Special Focus ◽  
Free Text ◽  
Shared Decision ◽  
Convenience Sample

The purpose of this quantitative, descriptive, exploratory study was to gauge the degree to which nurse practitioners (NPs) incorporate holistic nursing values in their care, with a special focus on shared decision-making (SDM), using the Nurse Practitioner Holistic Caring Instrument (NPHCI), an investigator-developed scale. A single open-ended question inviting free-text comment was also included, soliciting participants’ views on the holistic attributes of their care. A convenience sample of NPs ( n = 573) was recruited from a southeastern U.S. state Board of Nursing's (BON) publicly available list of licensed NPs. Results suggest that NPs do indeed perceive their care to be holistic, and that they routinely incorporate elements of SDM in their care. Highest scores were accorded to listening, taking time to talk to patients, knowledge of physical condition, soliciting patient input in care decisions, considering how other areas of a patient's life may affect their medical condition, and attention to “what matters most” to the patient. Age, gender, level of education, practice specialty, and location were also associated with inclusion of holistic care. Free-text responses revealed that NPs value holistic care and desire to practice holistically, but identify “lack of time” to incorporate or practice holistic care as a barrier.

Das präoperative anästhesiologische Patientengespräch

2009 ◽  
Vol 66 (7) ◽  
pp. 503-508 ◽  
Author(s):  
Christoph Harms ◽  
Christoph H. Kindler
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Shared Decision Making ◽  
Shared Decision

Anästhesisten treffen ihre Patienten häufig in Ausnahmesituationen an, geprägt von Angst und großer Unsicherheit. Selbst zeitlich kurze Kontakte sind daher meist intensiv und bedeutsam. Das persönliche, anästhesiologische Gespräch steht am Beginn der Beziehung von Patient und Anästhesist und soll die geplanten Maßnahmen, welche der Anästhesist durchführen wird, erklären und begleiten. Ein solches Gespräch dauert heute durchschnittlich 20 Minuten. Es beinhaltet die Erhebung der Anamnese, die strukturierte und verständliche Informationsübermittlung zwischen Anästhesist und Patient (inklusive Informationen über die anästhesiologischen Interventionen, Instruktionen zum Verhalten des Patienten und die offene und klare Kommunikation von Vor- und Nachteilen sowie Risiken möglicher Anästhesieverfahren) sowie den professionellen Umgang mit den Emotionen des Patienten, insbesondere seiner präoperativen Angst. Da Patienten heute in der Anästhesiologie vermehrt in den Entscheidungsprozess mit einbezogen werden, entwickelt sich dieses Gespräch zunehmend von einer eher paternalistischen Arzt-Patienten Interaktion zu einer gemeinsamen Entscheidungsfindung, dem so genannten „shared decision making“. Formal sollte das präoperative Gespräch die bekannten Voraussetzungen für eine erfolgreiche Verständigung zwischen Patient und Arzt wie Deutlichkeit, Eindeutigkeit, identische Kodierung, Empathie und Rückmeldung erfüllen und mit dem einholen eines „informed consent“ enden.

scholarly journals Principles for screening: Too few concerns for informed consent and shared decision-making?

2018 ◽  
Vol 190 (37) ◽  
pp. E1115-E1115 ◽  
Author(s):  
Alain Braillon ◽  
Philippe Nicot ◽  
Cécile Bour
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Shared Decision Making ◽  
Shared Decision
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