A TRIAL OF METHODS OF INSTRUCTING PATIENTS TO MEET INFORMED CONSENT GUIDELINES FOR COLONOSCOPY (PATIENT EDUCATION, VIDEOTAPE).

Description

Informed consent has been a legal, medical, and ethical issue for most of the twentieth century. While written consent is almost universally obtained, it is frequently acquired without the patient's real understanding of the reasons for the procedure, the risks, benefits, and alternatives. This study, designed to see if knowledge could be improved, was comprised of two parts. The first was the development of a videotape on the information necessary for informed consent for colonoscopy. The second was to use the videotape in a three-group posttest-only design to test differences in knowledge of material for that informed consent. Two hundred twenty-four consecutive colonoscopy patients for one gastroenterologist were approached; 201 were enrolled and randomly assigned to one of three groups. Group 1 saw a videotape of the physician explaining all pertinent information required in a "reasonable person" standard of informed consent followed by a meeting with him where he used a checklist to review the information and then answered questions; Group 2 saw the same videotape of the physician followed by a meeting with him where he only answered questions; and Group 3 had a traditional consultation with the physician during which he used the checklist to cover the information contained in the videotape and answered questions. Approximately 10 minutes after consent to have colonoscopy was obtained, all patients took a 13-item multiple choice knowledge questionnaire and the State-Trait Anxiety Inventory. Separate analyses of variance with planned orthogonal comparisons were performed to determine differences between groups on knowledge and anxiety respectively. Patients in the two video groups scored significantly better on the knowledge questionnaire than patients in the physician alone group (p $<$.001). There was no significant difference in knowledge between the two video groups. There were no significant differences in anxiety among the three groups.

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