Informed Consent in Surgical Practice in Port Harcourt: How Informed are the Patients?

Aim: The aim of this study was to ascertain the opinion of patients on counselling of the surgical patient in tertiary healthcare facilities in Port Harcourt in the months of May and June 2020. Background: Counseling of the surgical patient is a dynamic process and its scope which is individualized should arm the patient with information on the purpose and nature of the disease and treatment, etc. Materials and Methods: Four hundred and twenty respondents were recruited for this cross-sectional descriptive study carried out in the wards and specialist surgical out-patient clinics of Teaching Hospitals in Port Harcourt, Nigeria between the months of May and June 2020 using semi-structured questionnaires. Data obtained was analysed using the Statistical Package for the Social Sciences (SPSS) version 20.0. Results: Two hundred and twenty-five (53.6%) respondents asserted that they had counselling sessions for the surgical operation, 108 (25.7%) respondents opined that they did not have counselling session, while 87 (20.7%) were not sure if they had or not. Forty-five (10.7%) respondents asserted that the surgeons carried out the counselling. Only, 227 (54.0%) of the respondents affirmed that they were satisfied with the counselling sessions, while 104 (24.8%) respondents asserted that there was no counselling session at all. Conclusion: The opinion of patients on the counselling service experience is not entirely satisfactory. There is need for closer attention to be paid to issues of counselling of the surgical patient in order to ensure the full benefits of the services rendered.

Effect of the REDI Counselling Approach on the Use of Modern Postpartum Contraceptive Methods among Adolescent Mothers in Iran

Rapid repeat pregnancies expose adolescent mothers and their neonates to a greater risk of adverse outcomes. One way to decrease rapid subsequent pregnancies is to increase the use of postpartum contraceptives. The study aimed to investigate the effect of a counselling method for family planning on the decision-making about the use of postpartum modern contraceptives immediately, 1 week, and 2 months following the counselling session. This quasi-experimental study was carried out on 352 adolescent mothers who visited health centres for baby care at 4 to 6 months following childbirth. The intervention group received one counselling session for family planning based on the model of Rapport-building, Exploring, Decision-making, and Implementing the Decision (REDI). The control group received routine services. The adolescent mothers in the intervention group were more likely to use modern contraceptives 1 week and 2 months following the counselling session. Two months after the counselling session, the demand for family planning with modern methods was calculated at 29 per cent and 78 per cent in the control and intervention groups, respectively. The results showed that the REDI counselling approach was effective as the use of modern contraceptives reported higher in the intervention group than the control group. Given the demonstrated link between the REDI framework for family planning counselling and the use of modern contraceptives, healthcare providers should be trained in counselling skills based on the REDI framework to strengthen counselling on contraception.

Interest in telephone nightmare counselling in patients with sleep-related breathing disorders

Background and objective Nightmares are typically underdiagnosed and undertreated, even though frequent nightmares are quite common in patients with sleep-related breathing disorders. Based on a previous study, we investigated whether patients would respond if they were specifically asked whether they would be interested in telephone counselling about nightmares and nightmare treatment. Materials and methods The present study included 537 patients with sleep-related breathing disorders who completed a nightmare questionnaire and—if interested—provided their contact data for a telephone counselling session. Results Of the total patients, 5.40% were interested in the telephone counselling. Most of these patients had never sought help for their nightmare condition before. This percentage is much lower than in a previous study, possibly due to the higher time expenditure related to the new consent procedure. Conclusion The findings indicate that patients with nightmare problems can be reached with this approach even though they have never sought professional help before. In order to minimize the threshold, it would be desirable to have clinical in-house nightmare counselling, which would not require a detailed study information brochure and informed consent.

Logistics and Uptake of Genetic Testing for Patients Referred for Telegenetic Counselling for Cancer

Purpose: There is a dearth of information about the uptake of genetic testing after telegenetic (videoconference) counselling for hereditary cancer, which has been previously reported as a limitation of this service delivery model. Methods: We performed a review of the triage list for patients referred to The Ohio State University (OSU) from two community cancer centres for telegenetic counselling appointments from April 1, 2014 to May 31, 2016. Results: A total of 179 patients were referred for telegenetic counselling, and of these 62.6% (112/179) completed a 30-60 minute telegenetic counselling appointment. Of those counselled, 82.1% (92/112) completed genetic testing, 12.0% (11/92) of whom were found to have a pathogenic mutation. Of those with mutations, 45.5% (5/11) returned for a follow-up telegenetic counselling session to review results in more detail. In addition, 18.5% (17/92) of patients tested had at least one variant of uncertain significance (VUS). Conclusions: The presence of a nurse/nurse practitioner with the patient at the remote site during the telegenetic counselling session may have facilitated higher completion rates for genetic testing compared to previous reports in the literature, and appropriateness of genetic testing in this method of providing genetic counselling is reflected in the rates of results identifying deleterious mutations and variants of uncertain significance.

How and why Muslim counsellors integrate spiritual and religious elements implicitly into counselling practices in Malaysia: A qualitative exploration

Implicit incorporation of spiritual and religious elements in counselling has turned into a practice among several counsellors, but issues may arise when clients demand it in an explicit manner. As such, this study investigated how and why counsellors integrate spiritual and religious elements implicitly into counselling practices. With that, 13 registered counsellors were selected as participants for this study. They were interviewed and the data gathered were analyzed by using the constant comparative analysis. The results revealed that counsellors avoided highlighting the aspects of spiritual and religion at the initial part of their counselling session, but embedded them slowly and obscurely so as to prevent unprepared clients from being resistant, feeling uncomfortable, getting confused, as well as to hinder any sensitive issue related to spiritual and religious elements. Furthermore, the study points out that the central implications are the need to create a culture of openness and to boost confidence among counsellors to integrate the spiritual and religious aspects in an explicit manner. On top of that, competence among counsellors can be further enhanced with appropriate theoretical considerations and personal challenges. This does not only improve the effectiveness of treatment, but also protects the clients and enables consistency in work. Keywords: spiritual and religion, integration, counselling, implicit