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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Information needs of patients in spinal neurosurgery: Validation of a question prompt list for informed consent in a prospective setting

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  • Julian Haaf - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland; Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Psychosomatische Klinik und Poliklinik, Abteilung für Medizinische Psychologie und Soziologie, Mainz, Deutschland
  • Mirjam Renovanz - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
  • Mirjam Renovanz - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
  • Rebecca Nesbigall - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland; Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Psychosomatische Klinik und Poliklinik, Abteilung für Medizinische Psychologie und Soziologie, Mainz, Deutschland
  • Wilfried Laubach - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Psychosomatische Klinik und Poliklinik, Abteilung für Medizinische Psychologie und Soziologie, Mainz, Deutschland
  • Florian Ringel - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
  • Sabine Fischbeck - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Psychosomatische Klinik und Poliklinik, Abteilung für Medizinische Psychologie und Soziologie, Mainz, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV299

doi: 10.3205/18dgnc319, urn:nbn:de:0183-18dgnc3191

Published: June 18, 2018

© 2018 Haaf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Informed consent is mandatory before surgery and a fundamental doctor-patient interaction. A question prompt list (QPL) is a structured list of questions designed to encourage patients to acquire important information during a medical consultation. The objective of this interdisciplinary approach was to validate a 37-item spinal neurosurgical QPL (sNEURO-QPL) which was developed by the research group for patients undergoing spine surgery.

Methods: The sNEURO-QPL was validated in patients with planned spine surgeries prior (t1) and after (t2) informed consent discussion as well as before discharge (t3). Patients rated the importance of the items on a Likert scale (1=not important – 5=very important) at t1 and how intensivelyevery item was discussed during the informed consent discussion (t2). The difference of item-means t2- t1 indicates if information needs are met or not. We assessed sociodemographic and clinical data at t1, t2, t3. Subscales were constructed and their internal consistency was analyzed (Cronbach’s α). Finally,we performed aprincipal component analysis in order to condense the list to fewer items to the final sNEURO-QPL.

Results: 118 patients participated in this evaluation. At t1, the mean level of importance for all questions was regarded 4.32 (4 = "rather important", SD=0.55, range=1.44–5, p= .001). The sNEURO-QPL revealed patients’ needs for information regarding the subscales

1.
"complications and possible postoperative deficits" (n=8 items, Cronbach’s α =0.88)
2.
"prognosis and follow-up" (n=8 items, Cronbach’s α =0.86)
3.
"preoperative inpatient stay and organizational issues" (n=5 items, Cronbach’s α =0.75) and
4.
"safety of the surgical procedure" (n=6 items, Cronbach’s α =0.84).

The highest unmet information needs were found in the area "prognosis and follow-up" (scale difference mean= -1.74, SD= 1.14), the lowest in "preoperative inpatient stay" (mean= -0.73, SD 1.30). The item with the highest unmet information needs was "how much professional experience has my surgeon?" (mean -2.6, SD = 1.63). A four component solution revealed the most stable results and best internal consistencies; the final sNEURO-QPL comprises 27 items.

Conclusion: Our sNeuro-QPL not only seems to be helpful but also valid and could be condensed to a 27-item list which has to be evaluated with regard to the optimal appliocation mode.The sNEURO-QPLcould help to optimize the pre- and postoperative satisfaction and physician related trust of patients facing spinal surgery.