Facial Plast Surg 2021; 37(05): 585-589
DOI: 10.1055/s-0041-1722912
Original Research

Development and Assessment of a Video-Based Intervention to Improve Rhinoplasty Informed Consent

1   Department of Otolaryngology—Head and Neck Surgery, Beckman Laser Institute and Medical Clinic, Irvine, California
,
Lauren Standiford
1   Department of Otolaryngology—Head and Neck Surgery, Beckman Laser Institute and Medical Clinic, Irvine, California
,
Edward Chang
1   Department of Otolaryngology—Head and Neck Surgery, Beckman Laser Institute and Medical Clinic, Irvine, California
,
Brian Jet-Fei Wong
1   Department of Otolaryngology—Head and Neck Surgery, Beckman Laser Institute and Medical Clinic, Irvine, California
2   Department of Otolaryngology—Head and Neck Surgery, University of California Irvine Medical Center, Irvine, California
3   Department of Bioengineering, University of California Irvine Henry Samueli School of Engineering, Irvine, California
› Author Affiliations

Abstract

There has been a growing interest in improving the informed consent process to ensure patients truly understand the benefits, risks, and alternatives of their procedures. Herein, we sought to describe the production of an educational video to supplement the traditional rhinoplasty informed consent process. Additionally, we evaluate satisfaction and risk recall among prospective rhinoplasty patients who participated in the video-assisted informed consent process. One author attended 30 rhinoplasty consultations where informed consent was performed and generated 65 questions related to the benefits, risks, alternatives, and general knowledge of rhinoplasty operations. A video of the senior author answering these questions was filmed and edited to 25 minutes. Prospective rhinoplasty patients watched the video before their initial consultation and were asked to complete two surveys assessing their satisfaction with the video-assisted process as well as their ability to recall risks discussed in the video. Understandability and actionability of the video was assessed by three independent reviewers using the Patient Education Materials Assessment Tool. Postvideo surveys were completed by 40 patients. Patients strongly agreed that the video informed them about rhinoplasty risks and benefits (4.90/5.00), effectively answered their questions and/or concerns (4.78/5.00), and provided adequate information before surgery (4.85/5.00). Participants strongly recommended that all prospective patients watch the video prior to surgery (4.97/5.00). Participants on average correctly answered 4.00 ± 0.877 out of five risk recall questions. There was no statistically significant difference in risk recall performance between college graduates (4.19 ± 0.602) and those who did not graduate college (3.79 ± 1.08), p = 0.076. No significant correlation was found between patient age and recall performance (r = –0.011), p = 0.943. The overall mean understandability and actionability scores for the video were 100%. Video-assisted informed consent for rhinoplasty may enhance and overcome limitations to the traditional verbal consent process by ensuring comprehensive, standardized, and readily understandable information.



Publication History

Article published online:
25 February 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 The Joint Commission, Division of Health Care Improvement. Informed consent: more than getting a signature. Quick Saf. 2016: 21
  • 2 Sherlock A, Brownie S. Patients' recollection and understanding of informed consent: a literature review. ANZ J Surg 2014; 84 (04) 207-210
  • 3 Brezis M, Israel S, Weinstein-Birenshtock A, Pogoda P, Sharon A, Tauber R. Quality of informed consent for invasive procedures. Int J Qual Health Care 2008; 20 (05) 352-357
  • 4 Hadden KB, Prince LY, Moore TD, James LP, Holland JR, Trudeau CR. Improving readability of informed consents for research at an academic medical institution. J Clin Transl Sci 2017; 1 (06) 361-365
  • 5 Larson E, Foe G, Lally R. Reading level and length of written research consent forms. Clin Transl Sci 2015; 8 (04) 355-356
  • 6 Kadam RA. Informed consent process: a step further towards making it meaningful!. Perspect Clin Res 2017; 8 (03) 107-112
  • 7 Glaser J, Nouri S, Fernandez A. et al. Interventions to improve patient comprehension in informed consent for medical and surgical procedures: an updated systematic review. Med Decis Making 2020; 40 (02) 119-143
  • 8 Gargoum FS, O'Keeffe ST. Readability and content of patient information leaflets for endoscopic procedures. Ir J Med Sci 2014; 183 (03) 429-432
  • 9 Simonds VW, Garroutte EM, Buchwald D. Health literacy and informed consent materials: designed for documentation, not comprehension of health research. J Health Commun 2017; 22 (08) 682-691
  • 10 Snyder-Ramos SA, Seintsch H, Böttiger BW, Motsch J, Martin E, Bauer M. Patient satisfaction and information gain after the preanesthetic visit: a comparison of face-to-face interview, brochure, and video. Anesth Analg 2005; 100 (06) 1753-1758
  • 11 Murphy PW, Chesson AL, Walker L, Arnold CL, Chesson LM. Comparing the effectiveness of video and written material for improving knowledge among sleep disorders clinic patients with limited literacy skills. South Med J 2000; 93 (03) 297-304
  • 12 Wilson ME, Krupa A, Hinds RF. et al. A video to improve patient and surrogate understanding of cardiopulmonary resuscitation choices in the ICU: a randomized controlled trial. Crit Care Med 2015; 43 (03) 621-629
  • 13 Sarmiento S, Wen C, Cheah MA, Lee S, Rosson GD. Malpractice litigation in plastic surgery: can we identify patterns?. Aesthet Surg J 2020; 40 (06) NP394-NP401
  • 14 Heilbronn C, Cragun D, Wong BJF. Complications in rhinoplasty: a literature review and comparison with a survey of consent forms. Facial Plast Surg Aesthet Med 2020; 22 (01) 50-56
  • 15 Neaman KC, Boettcher AK, Do VH. et al. Cosmetic rhinoplasty: revision rates revisited. Aesthet Surg J 2013; 33 (01) 31-37
  • 16 Rodman R, Kridel R. A staging system for revision rhinoplasty: a review. JAMA Facial Plast Surg 2016; 18 (04) 305-311
  • 17 Park BY, Kwon J, Kang SR, Hong SE. Informed consent as a litigation strategy in the field of aesthetic surgery: an analysis based on court precedents. Arch Plast Surg 2016; 43 (05) 402-410
  • 18 Rubel KE, Alwani MM, Nwosu OI. et al. Understandability and actionability of audiovisual patient education materials on sinusitis. Int Forum Allergy Rhinol 2020; 10 (04) 564-571
  • 19 Shoemaker SJ, Wolf MS, Brach C. Development of the Patient Education Materials Assessment Tool (PEMAT): a new measure of understandability and actionability for print and audiovisual patient information. Patient Educ Couns 2014; 96 (03) 395-403
  • 20 Migden M, Chavez-Frazier A, Nguyen T. The use of high definition video modules for delivery of informed consent and wound care education in the Mohs Surgery Unit. Semin Cutan Med Surg 2008; 27 (01) 89-93
  • 21 Eggers C, Obliers R, Koerfer A. et al. A multimedia tool for the informed consent of patients prior to gastric banding. Obesity (Silver Spring) 2007; 15 (11) 2866-2873
  • 22 Vo TA, Ngai P, Tao JP. A randomized trial of multimedia-facilitated informed consent for cataract surgery. Clin Ophthalmol 2018; 12: 1427-1432
  • 23 Fleischman M, Garcia C. Informed consent in dermatologic surgery. Dermatol Surg 2003; 29 (09) 952-955 , discussion 955
  • 24 Saigal R, Clark AJ, Scheer JK. et al. Adult spinal deformity patients recall fewer than 50% of the risks discussed in the informed consent process preoperatively and the recall rate worsens significantly in the postoperative period. Spine 2015; 40 (14) 1079-1085
  • 25 Perrenoud B, Velonaki VS, Bodenmann P, Ramelet AS. The effectiveness of health literacy interventions on the informed consent process of health care users: a systematic review protocol. JBI Database Syst Rev Implement Reports 2015; 13 (10) 82-94
  • 26 Makdessian AS, Ellis DAF, Irish JC. Informed consent in facial plastic surgery: effectiveness of a simple educational intervention. Arch Facial Plast Surg 2004; 6 (01) 26-30
  • 27 Chesser AK, Keene Woods N, Smothers K, Rogers N. Health literacy and older adults: a systematic review. Gerontol Geriatr Med 2016; 2: 2333721416630492 DOI: 10.1177/2333721416630492.
  • 28 Abbas OL. Revision rhinoplasty: measurement of patient-reported outcomes and analysis of predictive factors. Springerplus 2016; 5 (01) 1472