Barriers during Preoperative Informed Consent Process from Patients’ and Health Professionals’ Perspective: A Qualitative Study

Background: Informed consent involves information disclosure, recommendation of a plan of care, patient understanding, informed decision making, and authorization to proceed with the plan of care. Informed consent discussions are individualized not only with regard to the patients’ surgical condition and goals but also their varying information needs, health literacy, and anxiety. Therefore, we try to figured out barriers in the informed consent process from both patient and health proffetionals perspective. Objective: The main objective of this study is to explore patients’ and health professionals’ perceived barriers during informed consent process and identify suggested solutions for improvement Methods: : A qualitative research using focused group discussions and in-depth interviews was employed on patients who underwent elective surgery, anesthetists and surgeons at a comprehensive specialized hospital in Ethiopia. Purposive sampling was used to select the study participants. The sample size was determined depending on the theoretical saturation of idea during data collection. Focused group discussions (FGDs) and key informant interviews data were thematically analyzed using Open Code Version 4.2 software and presented with narrations and quotations. Results: 12 patients were participated for the in-depth interview and 2 FGDs were conducted with surgeons and anesthetists. The main barriers identified by the patients include: inadequate explanation about the intended procedure, family’s influence in the decision making, fear of surgery, fear of light/power interruption, inadequate time for discussion and not letting the family members to attend the discussion. On the other hand, healthcare professionals also identified various barriers during informed consent process. These include: inability of patients to understand the information, limited time to discuss with patients in detail, poorly designed informed consent form, poor awareness of patients/community, fear of patient refusal for surgery if the risks and associated health problems are explained, lack of adequate investigation to confidently explain about the disease, use of medical jargons, poor documentation habit of professionals and lack of legal system regarding ethical dilemmas. Conclusion: Patients and health professionals have identified an avoidable barriers that needs the attention of concerned health professionals, educators and the healthcare delivery system.