TITLE:
Informed Consent Prior to Elective Gynaecological Surgery in Two Reference Hospitals in Yaoundé, Cameroon: A Mixed Methods Study
AUTHORS:
Christiane Nsahlai, Ojong Samuel, Luchuo Engelbert, Nseme Eric, Tarkang Elvis, Gouané Mathias, Ombaku Kingsley, Foumane Pascal
KEYWORDS:
Informed Consent, Elective Gynaecological Surgery, Yaounde
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.9,
September
16,
2022
ABSTRACT: Introduction: Informed consent is a
process that enshrines respect for patients’ autonomy, their dignity, and their
rights to determine what happens to their own bodies. We set out to describe
the surgical informed consent process and evaluate its quality in patients undergoing
elective gynaecological surgeries in two University Teaching Hospitals in
Yaounde, Cameroon. Methods: This was a cross-sectional, prospective
study over 9 month period, from October 1st, 2018, to June 30th,
2019 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the
Yaounde Central Hospital (YCH). By administering a modified Brezis
questionnaire 48 hours after surgery, we obtained data which enabled us to
evaluate and score the informed consent process and obtained written reports of
patients’ appreciation of key aspects of the informed consent process prior to
surgery. We then called each participant 6 months after their surgery date to
obtain information on the occurrence or not of post-operative complications. Results: We recruited 72 patients aged 24 to 68 years old (61 at YGOPH, 11 at YCH).
The operating gynaecologist sought patient consent in 65.3% (49/72) of cases,
while 61.1% (44/72) of the subjects would have loved to have more information
on surgical risks; 69.4% (50/72) were satisfied with the consent process; and
56.9% (41/72) could recall and repeat the information they received prior to
surgery. While 37.5% (27/72) had poor quality (non-valid consent), 40.3% had
good quality consent (valid). Consent administered by the gynaecologist (OR =
0.172; 95% CI = 0.060 - 0.049) was a strong determinant of valid consent. Also,
patients with non-valid consent significantly reported more complications (OR =
4.469; 95% CI = 1.412 - 14.147) than those with valid consent. Conclusion: Informed
consent prior to elective gynaecological surgeries in our study was poor. The
timing of the consent process, as well as the person involved in the process
affect the validity of the consent.