Quality of Receiving Patient's Informed Consent in the Surgical Wards of a Military Hospital in Tehran at 2016 and its Improvement Solutions

Getting an informed consent as one of the principles of patients’ rights, is a process that he (she) decides on therapeutic intervention after receiving adequate information from the therapist team. The aim of this study was to explain the quality of the informed consent process of patients in surgical wards of a military hospital in Tehran and to present some solutions to improve it at 2016.
The combined study was conducted in two phases. The quantitative phase was a cross-sectional descriptive study using the quality of an informed consent questionnaire that evaluated the six dimensions of informed consent with 19 questions. We evaluated the questionnaire’s content validity and its internal consistency. The Cronbach’s Alpha value of the whole questionnaire was 0.85. A stratified random sampling of 120 subjects was performed and the results were analyzed by SPSS 17 software. In the qualitative phase, which was based on the framework content analysis resulting from the results of quantitative phase, 7 experts were selected in a targeted manner and group interviews were conducted with the expert panel method. The results of the interviews were presented in two steps as: after a framework content analysis and re-approval of experts and were presented as improved suggestions.
In accessing the quality of the informed consent, the average score in the dimension of "providing information" with 18.93, "compliance with patient's decision-making competence" with 7.48, and "how to get written consent" with 5.47, were lower than the expected average, and the average score of "patient comprehension" with 9.77, "Volunteerism" with 8.16 and "Interaction between physician and patient" with 16.02, were in an acceptable level. The experts provided 15 improvement suggestions. The most important were "providing information to patients in the preparation clinic” and giving patients enough time to choose a therapeutic approach”."
The quality of providing information and how to get a written consent was less than expected. Therefore, paying attention to patients’ role in the informed consent process, providing sufficient information to patients by a counseling physician in preparation clinic, training physicians and providing adequate opportunities to patients for choosing a therapeutic approach can be effective in improving the quality of informed consents.