Informed consent and patient participation in the medical encounter: a list of questions for an informed choice about the type of anaesthesia

The present study was undertaken to evaluate the impact of a new procedure for eliciting informed consent by patients undergoing minor surgical proced ures, in which the choice between general anaesthesia (GA) and regional ana esthesia (RA) was possible. In this prospective study, two randomly selecte d groups of patients were compared: study group (SG), 52 patients, received from the nurse before the preoperative interview, a list of seven question s, which they were invited to ask the anaesthetist; while the control group (CG), 73 patients, did not receive any suggested questions. There were two end points: the proportion that chose RA and the number of questions actua lly addressed to the doctor at the preanaesthetic interview. Psychological aspects were taken into account by collecting the Hospital Anxiety and Depr ession (HAD) scale before the preanaesthetic interview. Satisfaction with t he interview was recorded using a telephone questionnaire 2 weeks after the operation. The results from the two groups were compared by calculating th e odds ratio according to Mantel-Haenszel and by logistic analysis. Altoget her, 71.2% of the patients chose RA without any difference between the grou ps. The average number of questions asked by each SG patient was higher tha n for the CG (1.67 vs. 0.96). The satisfaction level was similar in the two groups. Our list of questions was designed to facilitate patient autonomy. It offered an aid to those requesting more information and assisted commun ication. The method did not change the proportion who chose a specific kind of anaesthesia, but does seem to improve patient participation in the deci sion-making process.