Multimedia in improving informed consent for caesarean section: A randomised controlled trial.

Abstract

Multimedia modules have been used as an adjunct to improve patient knowledge and recall for various elective surgical procedures, but have been incompletely evaluated in patients undergoing caesarean section. To compare the use of a supplementary multimedia module with written information in improving the informed consent process prior to elective caesarean section. This was a prospective randomised controlled trial (ACTRN12616000430437). Primary outcomes were knowledge and anxiety scores immediately following the intervention and on the day of surgery. Secondary outcomes were patient satisfaction, length of stay, time to cessation of analgesia, and patient assessment of the consent types. Seventy-five patients completed the study. Both multimedia module and written information groups demonstrated a significant increase in knowledge scores with no difference between the groups. In the multimedia-assisted consent group, scores improved from baseline by +2.31 (P<0.001) immediately after watching the multimedia module and by +2.41 (P<0.001) on the day of surgery. In the written information group, scores improved by +1.76 (P<<0.001), and +2.31 (P<0.001) respectively. There was no adverse impact on anxiety in either group. Patient-reported understanding (92.4% vs 78.5%, P=0.001), and helpfulness (90.1% vs 73.3%, P=0.001) was significantly higher in the multimedia module group than in the written information group. The multimedia module was assessed as 'slightly too long' and provided 'slightly too much information'. Multimedia modules are a valuable adjunct to traditional processes of obtaining informed consent for elective caesarean section and should be offered and made available to patients prior to surgery.