Adequacy of consenting patients for computed tomography (CT) scans in a developing country: a survey of two academic hospitals in Johannesburg, South Africa
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Date
2015-03-27
Authors
Shayingca, Thandaza Mitchel
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
INTRODUCTION
South
Africa
presents
a
complex
scenario
with
regard
to
patients
consenting
for
medical
procedures,
because
of
the
differing
profiles
of
the
population
and
the
health
care
workers
who
perform
the
consenting
procedures.
AIM
To
evaluate
consenting
practice
for
CT
scanning,
within
the
South
African
tertiary
referral
setting
and
to
determine
if
there
are
any
associations
between
patient
demographic
profile
and
the
level
of
understanding
with
the
adequacy
of
consent.
METHOD
A
prospective
survey
regarding
consenting
practices
for
CT
scanning
was
performed
in
a
form
of
an
interview
questionnaire
in
patients
presenting
to
Chris
Hani
Baragwanath
Academic
and
Charlotte
Maxeke
Johannesburg
Academic
hospitals.
Determination
of
any
associations
between
patient
age,
racial
group,
language
and
education
was
made
with
the
level
of
understanding
and
adequacy
of
consent.
RESULTS
The
survey
was
conducted
on
117
patients;
86
from
Charlotte
Maxeke
Johannesburg
Academic
Hospital
and
31
from
Chris
Hani
Baragwanath
Academic
Hospital.
We
found
no
significant
association
between
gender
and
age
category
(p=0.11),
racial
group
(p=0.17),
education
(p=0.26),
home
language
(p=0.21)
or
residential
area
type
(p=0.70).
vi
There
was
a
significant,
weak,
association
between
age
category
and
education
(p=0.043;
Cramer’s
V=0.29).
There
was
a
significant,
moderate
association
between
the
understanding
of
the
language
of
consent
and
the
home
language
of
the
patients
(p=0.0013;
phi
coefficient=0.43).
There
was
also
some
association
between
education
and
age.
Just
over
50%
of
patients
felt
that
they
had
been
given
enough
information
and
had
had
an
opportunity
to
ask
questions
and
only
33%
had
been
offered
an
alternative
to
the
CT
scan.
There
was
a
significant
difference
in
the
mean
adequacy
of
consent
score
with
regards
to
racial
group
(p<0.0001),
home
language
(p=0.0073),
residential
area
type
(p<0.0001)
and
level
of
education
(p<0.0001).
CONCLUSION
Language
differences
between
patients
and
personnel
performing
the
consent
procedure
proved
to
be
a
major
barrier
in
offering
adequate
consenting
for
CT
Scans.
Description
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
Diagnostic
Radiology
Johannesburg,
2014