Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka

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dc.contributor.author Mathangasinghe, Yasith
dc.contributor.author Samaranayak, Jayami Eshana
dc.contributor.author Banagala, Anura Sarath Kumara
dc.date.accessioned 2021-07-30T14:30:04Z
dc.date.available 2021-07-30T14:30:04Z
dc.date.issued 2018
dc.identifier.citation Samaranayake, U. M. J. E., Mathangasinghe, Y., & Banagala, A. S. K. (2019). Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka. BMJ open, 9(1), e025299. en_US
dc.identifier.uri http://archive.cmb.ac.lk:8080/xmlui/handle/70130/5616
dc.description.abstract Objective To identify the different perceptions on informed surgical consent in a group of Sri Lankan patients. Methods A qualitative study was conducted in a single surgical unit at a tertiary care hospital from January to May 2018. The protocol conformed to the Declaration of Helsinki. Patients undergoing elective major surgeries were recruited using initial purposive and later theoretical sampling. In-depth interviews were conducted in their native language based on the grounded theory. Initial codes were generated after analysing the transcripts. Constant comparative method was employed during intermediate and advanced coding. Data collection and analyses were conducted simultaneously, until the saturation of the themes. Finally, advanced coding was used for theoretical integrations. results Thirty patients (male:female=12:18) were assessed. The mean age was 41±9 years. Sinhalese predominated (50.0%, n=15). Majority underwent thyroidectomy (36.7%, n=11). The generated theory categorises the process of obtaining informed consent in four phases: initial interaction phase, reasoning phase, convincing phase and decision-making phase. Giving consent for surgery was a dependent role between patient, family members and the surgeon, as opposed to an individual decision by the patient. Some patients abstained from asking questions from doctors since doctors were ‘busy’, ‘short-tempered’ or ‘stressed out’. Some found nurses to be more approachable than doctors. Patients admitted that having a bystander while obtaining consent would relieve their stress. They needed doctors to emphasise more on postoperative lifestyle changes and preprocedure counselling at the clinic level. To educate patients about their procedure, some suggested leaflets or booklets to be distributed at the clinic before ward admission. The majority disliked watching educational videos because they were ‘scared’ to look at surgical dissections and blood. Conclusion The informed consent process should include key elements that are non-culture specific along with elements or practices that consider the cultural norms of the society. en_US
dc.language.iso en en_US
dc.publisher The British Medical Association en_US
dc.title Are predominantly western standards and expectations of informed consent in surgery applicable to all? A qualitative study in a tertiary care hospital in Sri Lanka en_US
dc.type Article en_US


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