Patient Recall Of Information Research Articles

E-Consent: approaching surgical consent with mobile technology

Patient recall of information about procedures, including risks and benefits and potential outcomes, is often insufficient. We sought to determine whether a multimedia educational tool enhances the informed consent discussion for elective neurosurgical procedures by increasing patient knowledge of the procedure. Adult patients from a single neurosurgical site eligible for 4 neurosurgical procedures (lumbar spine or cervical spine decompression for degenerative disease, craniotomy for brain tumour or trigeminal neuralgia treatment) were offered enrolment. Patients were randomly assigned to either the control arm (standard consent discussion) or the intervention arm (review of an e-book containing information tailored to their disease/injury plus standard consent discussion). Participants completed a 14-item questionnaire before and after the consent discussion. Questionnaires were completed by 38 participants, 18 in the control group and 20 in the intervention group. The mean age was 62.2 (standard deviation [SD] 13.6) years and did not differ significantly between the 2 groups. The mean baseline questionnaire scores were similar for the control and intervention groups (20.4 [SD 7.3] v. 20.6 [SD 6.7]). However, the mean scores on the follow-up questionnaire were significantly different between the 2 groups (20.2 [SD 4.0] v. 23.2 [SD 4.9], p = 0.02). There was no change in the scores on the 2 questionnaires in the control group, whereas, in the intervention group, the mean score was significantly higher after the intervention (p = 0.03). The use of an electronic booklet appears to improve patients’ knowledge of their surgical procedure. The use of multimedia booklets in clinical practice could help standardize and optimize the consent process, ensuring that patients receive the relevant information to make a truly informed decision.

Factors associated with patient recall of key information in ambulatory specialty care visits: Results of an innovative methodology.

While some studies have assessed patient recall of important information from ambulatory care visits, none has done so recently. Furthermore, little is known about features of clinical interactions which are associated with patient understanding and recall, without which shared decision making, a widely shared ideal for patient care, cannot occur. Our objective was to evaluate characteristics of patients and outpatient encounters associated with patient recall of information after one week, along with observation of elements of shared decision making. This was an observational study based on coded transcripts of 189 outpatient encounters, and post-visit interviews with patients 1 week later. Coding used three previously validated systems, adopted for this study. Forty-nine percent of decisions and recommendations were recalled accurately without prompting; 36% recalled with a prompt; 15% recalled erroneously or not at all. Provider behaviors hypothesized to be associated with patient recall, such as open-questioning and “teach back,” were rare. Patients with less than high school education recalled 38% of items freely and accurately, while patients with a college degree recalled 65% (p < .0001). In a multivariate model, the total number of items to be recalled per visit, and percentage of utterances in decision-making processes by the provider (“verbal dominance”), were significant predictors of poorer recall. The item count was associated with poorer recall for lower, but not higher, educated patients.

Patient Recall of Information on a Third Molar Informed Consent Video

Experience has shown that in malpractice cases patients often claim certain information was not provided during the informed consent process. The purposes of this study were to determine how much of an informed consent video patients initially remember and how much is recalled when there is a hiatus from viewing the video to the surgery. In this prospective cohort study, patients presenting for impacted third molar removal in an academic setting (n=50) or a private office (n=50) viewed an informed consent video and then met with the treating doctor for further discussion and signing of an informed consent form. Then, they were given a 10-item test containing questions relating to the information provided on the video. At the subsequent time of surgery, they were again given the same test. The number of correct answers at the 2 points was compared. There was a significant difference in the number of correct responses between the 2 time points (P=.0212) and between patients from the 2 practice settings (P=.0076). However, these differences were less than 0.5 of a possible 10. The number of correct responses was not associated with age (P=.1203), gender (P=.6647), or number of days between testing (P=.7272). Patients have good recall of the information provided by the informed consent video. However, because some information was forgotten, a presurgical review of the information is advisable.

Efficacy of patient information concerning casts applied post-fracture

Serious complications can result when casts are used for bone immobilization following fracture. Adequate patient information regarding cast care and possible complications is vital for prevention. This study examines the effectiveness of verbal and written patient information regarding cast safety. Patients (n= 109; age ≥18 years) from three Western Australian teaching hospitals were interviewed using a custom-designed questionnaire. Patients' understanding of cast care and possible complications were tested by recall of seven categories of information, notably: pain, swelling, cast care, itching, neural signs, vascular signs/symptoms, exercise/rest. A follow-up phone call (3-8 weeks after initial interview) was conducted to elicit complications and determine information recall. Written information was received by 62% of patients; however, overall, only 35% claimed to have read the information provided. Of these, the highest recall was in four of seven information categories. A high proportion of those given only verbal information had poor recall (≤2 categories, defined a priori). In contrast, patients who also received written information had better recall (three or more categories, defined a priori, P= 0.031). Four of the 109 patients developed complications attributable to the cast (three had pressure ulcers and one had a deep vein thrombosis). Patient recall of information concerning cast care and possible complications was no more than 60%. The provision of written information was associated with a significantly higher awareness of possible complications. The results indicate that for fracture care, the delivery and use of information protocols can be greatly improved.

The reliability of patient recall of hospital readmission following orthopaedic trauma

Accuracy of patient recall of information is integral to the success of clinical registries, trials and doctor-patient interaction. Inaccurate or unreliable patient reporting of information has the potential to impact on the validity of research and clinical findings. The objective was to determine the level of agreement between patient recall of readmission to hospital in a population of orthopaedic trauma patients. Language: en

Receiving the Diagnosis of Lung Cancer: Patient Recall of Information and Satisfaction With Physician Communication

Little is known about the information newly diagnosed patients with lung cancer recall and how satisfied they are with physicians' communication. Seventy-one consecutive patients with newly diagnosed lung cancer were surveyed 1 to 3 days after the disclosure of diagnosis. Patients' recall of the given information was assessed, as well as their satisfaction with physicians' communication of diagnosis, treatment procedure, and goal of treatment as curative or palliative. Physicians who provided diagnosis were asked to complete a questionnaire concerning what information they had given to the patient. Congruence between physician information and patient recall of that information was then evaluated. Ninety percent (62 of 69 patients) correctly recalled their physician's information about the diagnosis, 83% (55 of 66 patients) knew what treatment procedure their physicians proposed, and 49% (32 of 65 patients) accurately recalled information about the goal of treatment. Seventy-six and 73% of patients were highly satisfied with their physician's communication of diagnosis and treatment procedure, respectively. Only 39% were highly satisfied with communication of the treatment goal. Patients who correctly recalled information regarding the treatment procedure were significantly more satisfied with its communication. Recall of information about the intent of treatment is poor, and satisfaction with communication of the intent of treatment is lacking among newly diagnosed patients with lung cancer. Future studies should address whether specific interventions can improve these deficiencies.

Using written material to support recall of orthodontic information: a comparison of three methods.

The objective was to determine the effect of three different methods of presenting information on the recall of information in orthodontic patients in the short and long term. Thirty orthodontic patients at the commencement of their treatment were allocated randomly to groups receiving supporting written information in one of the three formats: mind map, acronym, and information leaflet. Short-term retention was assessed by administration of a nine-item questionnaire 10 to 15 minutes after receiving the information, and long-term retention was assessed after six weeks by repeating the same questionnaire without repetition of the information. Correct answers to the questions were compared across the three groups at short-term recall and long-term recall. A total knowledge score was determined by summing the number of correct answers across all nine items, and an analysis of covariance (ANCOVA) was conducted to determine the effect of the method of information on long-term retention of the information. There were significant differences in recall between the three methods of presentation at both time 1 and time 2 (Fshort-term = 5.97, P < .01; Flong-term = 3.19, P < .05). Participants who were given a written information leaflet recalled less information on both occasions of testing. ANCOVA revealed that the three methods did not differ in the rate of forgetting of the material (F = 1.96, nonsignificant). Mind maps and acronyms convey a small but significant advantage in patient recall of information over written information leaflets.

How should doctors communicate the diagnosis of cancer to patients?

The majority of doctors in North America, Australia and much of Europe now inform patients about a cancer diagnosis. However, many doctors report that they have difficulty disclosing a cancer diagnosis. Poor doctor-patient communication skills may lead to psychological distress including increased anxiety and depression and poorer psychological adjustment to cancer. Presenting ‘bad’ news in an unhurried, honest, balanced and empathic fashion has been shown to produce greater satisfaction with communication of the news. Consensus guidelines have been developed to assist doctors to disclose a cancer diagnosis. Important aspects include exploring the patient's expectations, warning him/her that the news is bad, giving the news at the patient's own pace, allowing time for the patient to react and eliciting the patient's concerns. Doctor-patient communication can be improved by including training courses in communication skills for medical students and clinicians and providing audiotapes of bad news consultations to enhance patient recall of information and increase patient satisfaction with communication. Additional research is needed to investigate effects of strategies to implement guidelines for delivering a cancer diagnosis.

Psychological preparation for surgery: Patient recall of information

A study has been undertaken to assess the level of recall of preparatory information supplied by interview in a preoperative setting. A consecutive series of women undergoing minor gynaecological surgery( N = 36) received a preparatory interview on the day prior to surgery, of the form found to improve postoperative patient response. A second interview was conducted after an interval of either 30 min or 3 hr in order to establish the amount of information available for recall. Level of recall compared favourably with those reported in general practice settings, with significantly more information recalled on immediate assessment. A sex difference also emerged, with male interviewers achieving significantly higher levels of patient recall. Patients displayed uniformly positive attitudes towards receiving this kind of interview. The implications of these results are discussed in terms of the explanations put forward to account for the benefits of psychologically preparing patients for surgery.