| Summary: | A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in the branch of Anaesthesiology
Johannesburg, 2015 === In anaesthetic practice, it is the responsibility of the anaesthetist to obtain fully informed consent from the patient for the proposed procedure. This practice is difficult owing to systemic, anaesthetic and patient-related factors and is increasingly evidenced to be inadequate. The aim of this study was to describe recall of information received relating to labour epidural analgesia in primiparous women within 24 hours of delivery at CHBAH using the standard method and an alternative method of obtaining informed consent. The researcher enrolled 40 primiparous women who received epidurals from 1 December 2014 to 31 December 2014. An epidural analgesia informed consent standard and questionnaire were designed by the researcher in consultation with anaesthetists experienced in the field of obstetric anaesthesia. The women were divided into two groups of 20 and randomly assigned to either the control or intervention group. In the control group women were provided with informed consent in the standard manner, that is verbally only, and in the intervention group, women were provided with informed consent in an alternative manner, that is verbally with demonstration on a doll. The women were presented with a questionnaire within 24 hours of delivery to assess their recall. Recall of information pertaining to that provided by the researcher in the informed consent process was described, with women in the control group obtaining a mean score of 11.85 (SD: 2.32) with a range from 7-16. In the intervention group women obtained a mean score of 13.65 (SD: 2.32) with a range of 10-18. The information and complications recalled were documented. Women were asked whether they had received antenatal information regarding labour epidural analgesia. Only one woman had received information and stated her sources to be books, magazines and her obstetrician. Women indicated their preferred methods by which they wanted to receive information. Twenty-nine (72.5%) women wanted to receive information in early labour. Twenty-five (62.5%) women wanted to receive information verbally with demonstration on a doll and 39 (97.5%) women wanted to receive information in their home language.
The necessity of obtaining adequate informed consent is relevant for its medico-legal, ethical and patient-related implications. The informed consent process can be improved by placing a greater emphasis on antenatal information provision, appropriate timing of imparting information and improvements to the current means of information delivery and transfer. === MT2017
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