Knowledge, Attitude and Practices Among Surgical Patients on the Informed Consent Process in Mulago National Referral Hospital.

Abstract

Introduction: Obtaining an Informed consent is considered an integral part of modern clinical practice more especially in surgical procedures which deals with diagnosis and treatment of diseases by manual and instrumental means. This helps to protect the patients' rights as well as minimizes the chances of legal actions against the medical team involved in the surgery. Objective: The study was mainly to explore the knowledge levels, attitude and practice of informed consent process among the patients in the surgical wards in Mulago hospital. Methodology: A descriptive cross-sectional study was conducted among patients admitted for elective surgery and those who had undergone surgery in surgical wards within the study period. 102 participants aged 18 years above were interviewed by use of questionnaires assessing their knowledge levels on informed consent, attitudes towards informed consent and practices on informed consent. Results: The findings of the research identified big gaps in the knowledge levels of the patients in that (34.3%) of the patients clearly understood what informed consent is about. Minimum information was availed to the patients and 64.7% of the patients were not given opportunity to ask questions. The majority (63.7%) agreed that the decision to undergo operation was solemnly theirs and reported it was important to make consent. Most of the patients (85%) expressed anxiety of various origins before surgery which could have also affected the consent process,Ninety seven percent of the patients consent forms were signed with exception of a few who were operated without consent. It was found that most surgeons don't consent patients which lead to patients receiving inadequate information about the operation they underwent. Summary: The research concluded that, the quality of the existing informed consent process in Mulago national referral hospital is less than ideal, therefore there is great need to make the patients and the doctors understand their responsibility during the consent process so that patients autonomy is not compromised and the patients access adequate information about their disease and proposed surgery to ensure participatory decision making is observed. Therefore the Government of Uganda needs to work together with M.O.H so that Mulago hospital is well supported with enough staff so that patients who undergo surgery are well prepared before signing consent forms. MulagoNational Referral Hospital should ensure that quality consent process is observed before surgery and discipline staffs who take patients for granted especially during consent process so that other hospitals may borrow a leaf from them.