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Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka
OBJECTIVE: To identify the different perceptions on informed surgical consent in a group of Sri Lankan patients. METHODS: A qualitative study was conducted in a single surgical unit at a tertiary care hospital from January to May 2018. The protocol conformed to the Declaration of Helsinki. Patients...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347869/ https://www.ncbi.nlm.nih.gov/pubmed/30813111 http://dx.doi.org/10.1136/bmjopen-2018-025299 |
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author | Samaranayake, Udagedara Mudiyanselage Jayami Eshana Mathangasinghe, Yasith Banagala, Anura Sarath Kumara |
author_facet | Samaranayake, Udagedara Mudiyanselage Jayami Eshana Mathangasinghe, Yasith Banagala, Anura Sarath Kumara |
author_sort | Samaranayake, Udagedara Mudiyanselage Jayami Eshana |
collection | PubMed |
description | OBJECTIVE: To identify the different perceptions on informed surgical consent in a group of Sri Lankan patients. METHODS: A qualitative study was conducted in a single surgical unit at a tertiary care hospital from January to May 2018. The protocol conformed to the Declaration of Helsinki. Patients undergoing elective major surgeries were recruited using initial purposive and later theoretical sampling. In-depth interviews were conducted in their native language based on the grounded theory. Initial codes were generated after analysing the transcripts. Constant comparative method was employed during intermediate and advanced coding. Data collection and analyses were conducted simultaneously, until the saturation of the themes. Finally, advanced coding was used for theoretical integrations. RESULTS: Thirty patients (male:female=12:18) were assessed. The mean age was 41±9 years. Sinhalese predominated (50.0%, n=15). Majority underwent thyroidectomy (36.7%, n=11). The generated theory categorises the process of obtaining informed consent in four phases: initial interaction phase, reasoning phase, convincing phase and decision-making phase. Giving consent for surgery was a dependent role between patient, family members and the surgeon, as opposed to an individual decision by the patient. Some patients abstained from asking questions from doctors since doctors were ‘busy’, ‘short-tempered’ or ‘stressed out’. Some found nurses to be more approachable than doctors. Patients admitted that having a bystander while obtaining consent would relieve their stress. They needed doctors to emphasise more on postoperative lifestyle changes and preprocedure counselling at the clinic level. To educate patients about their procedure, some suggested leaflets or booklets to be distributed at the clinic before ward admission. The majority disliked watching educational videos because they were ‘scared’ to look at surgical dissections and blood. CONCLUSION: The informed consent process should include key elements that are non-culture specific along with elements or practices that consider the cultural norms of the society. |
format | Online Article Text |
id | pubmed-6347869 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-63478692019-02-08 Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka Samaranayake, Udagedara Mudiyanselage Jayami Eshana Mathangasinghe, Yasith Banagala, Anura Sarath Kumara BMJ Open Surgery OBJECTIVE: To identify the different perceptions on informed surgical consent in a group of Sri Lankan patients. METHODS: A qualitative study was conducted in a single surgical unit at a tertiary care hospital from January to May 2018. The protocol conformed to the Declaration of Helsinki. Patients undergoing elective major surgeries were recruited using initial purposive and later theoretical sampling. In-depth interviews were conducted in their native language based on the grounded theory. Initial codes were generated after analysing the transcripts. Constant comparative method was employed during intermediate and advanced coding. Data collection and analyses were conducted simultaneously, until the saturation of the themes. Finally, advanced coding was used for theoretical integrations. RESULTS: Thirty patients (male:female=12:18) were assessed. The mean age was 41±9 years. Sinhalese predominated (50.0%, n=15). Majority underwent thyroidectomy (36.7%, n=11). The generated theory categorises the process of obtaining informed consent in four phases: initial interaction phase, reasoning phase, convincing phase and decision-making phase. Giving consent for surgery was a dependent role between patient, family members and the surgeon, as opposed to an individual decision by the patient. Some patients abstained from asking questions from doctors since doctors were ‘busy’, ‘short-tempered’ or ‘stressed out’. Some found nurses to be more approachable than doctors. Patients admitted that having a bystander while obtaining consent would relieve their stress. They needed doctors to emphasise more on postoperative lifestyle changes and preprocedure counselling at the clinic level. To educate patients about their procedure, some suggested leaflets or booklets to be distributed at the clinic before ward admission. The majority disliked watching educational videos because they were ‘scared’ to look at surgical dissections and blood. CONCLUSION: The informed consent process should include key elements that are non-culture specific along with elements or practices that consider the cultural norms of the society. BMJ Publishing Group 2019-01-25 /pmc/articles/PMC6347869/ /pubmed/30813111 http://dx.doi.org/10.1136/bmjopen-2018-025299 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Surgery Samaranayake, Udagedara Mudiyanselage Jayami Eshana Mathangasinghe, Yasith Banagala, Anura Sarath Kumara Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka |
title | Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka |
title_full | Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka |
title_fullStr | Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka |
title_full_unstemmed | Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka |
title_short | Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka |
title_sort | are predominantly western standards and expectations of informed consent in surgery applicable to all? a qualitative study in a tertiary care hospital in sri lanka |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6347869/ https://www.ncbi.nlm.nih.gov/pubmed/30813111 http://dx.doi.org/10.1136/bmjopen-2018-025299 |
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