Informed Consent in Plastic Surgery, Evaluation of its Effectiveness for Mutual Satisfaction of Patient and Doctor: Comparison of Methods

Informed Consent in Plastic Surgery, Evaluation of its Effectiveness for Mutual Satisfaction of Patient and Doctor: Comparison of Methods
Paolo G. Morselli, Andrea Lippi, Federico A. Giorgini, Erich Fabbri, Valentina Pinto
Journal of Plastic, Reconstructive & Aesthetic Surgery, 5 June 2019
Abstract
Background
The acquisition of signed informed consent is not always enough to ensure adequate medical protection. Particularly in plastic surgery improving the doctor-patient relationship by understanding the patient’s emotions and expectations becomes a determining factor when choosing the best therapeutic strategy for the subject in question, which may also include non-surgical eligibility.
Methods
90 patients, with various plastic surgery disabilities, were recruited and randomly divided into three groups: the 1st group underwent the “traditional” clinical interview, the 2nd to the clinical approach called Shared Decision Making (SDM), the third group received both the SDM and a questionnaire evaluating patient expectations (Expectation Questionnaire-Pgm). At the end of each interview, a specialist physician in Plastic, Reconstructive and Aesthetic Surgery was asked to fill in a questionnaire regarding his/her satisfaction with the method used. Likewise, the patient filled in a questionnaire on his/her satisfaction with the interview.
Results
For the doctors, the third method was superior in investigating patient expectations, emotions and personal preferences. For the patients, the third method score significantly higher than the first one for overall satisfaction, ability to evaluate personal preferences and needs; and higher than the first and second in assessing expectations.
Conclusions
For doctors, the SDM coupled with the Expectation Questionnaire-Pgm proved to be the most useful tool to understand patient expectations and emotions and thus improve the medical-patient relationship through shared decision-taking. The third method therefore makes for better patient coverage and improved informed consent, reducing the likelihood of litigation and better assessing non-fitness for operation.

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