The process of informed consent for obstetric anaesthesia in the Department of Anaesthesia at the University of Witwatersrand, a descriptive cross- sectional study

Abstract

Background Informed consent (IC) constitutes an important part of obstetric anaesthesia services, but the process of informed is not well described. The obstetric patient is deemed competent to make an informed consent despite unique challenges such as time limitations, pain and the effects of narcotic analgesia. Aim This study aims to describe the process of obtaining IC for obstetric anaesthesia as reported by anaesthetists at hospitals associated with the University of the Witwatersrand Department of Anaesthesia. Methods A descriptive cross-sectional study was conducted, and data was collected using an online self-administered questionnaire using the Redcap® platform. The study collected data from medical offers and registrars in the Department of Anaesthesia at the University of the Witwatersrand between June and July 2023. Data was analysed using SPSS statistical software. Results Of the 139 questionnaires sent out, 80 responses were registered, representing a 58% response rate. The majority (52.8%) are confident in their ability to get adequate IC. Eighty- five point one percent (85.1%) most commonly obtain verbal consent. Implied consent is used by 6.8% of the respondents. Only 8.1% use written consent. There is a variation in the risks disclosed to patients with common complications more frequently disclosed than those associated with more severe consequences. The respondents frequently encounter language barriers during the IC process and utilise other patients as translators, use mobile phone translation applications or simplify the English used. Most respondents do not modify their IC process based on whether the surgery is an elective or an emergency. Conclusion vii The process of obtaining IC for obstetric anaesthesia at hospitals associated with the University of the Witwatersrand Department of Anaesthesia varies among anaesthetists with a propensity for verbal consent.