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Author: Caroline Elizabeth Pawlak
Publisher:
ISBN:
Category :
Languages : en
Pages : 120
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Book Description
Introduction: Previous research has demonstrated that current methods of informed consent are relatively ineffective as shown by poor recall and comprehension by adolescent patients and their parents. The purpose of this study was to determine if adding a short video reiterating the issues related to informed consent to a modified informed consent document that places emphasis on a limited number of core and patient specific custom "chunks" located at the beginning of an informed consent presentation improved the recall and comprehension of the risks, benefits and alternatives related to orthodontic treatment. Methods: 70 patient/parent pairs were randomly divided into two groups. The intervention group (Group A) patients and parents reviewed a customized slideshow and a short video describing the key risks of orthodontic treatment together. Group B followed the same protocol without viewing the video. All patients and parents were interviewed independently by research assistants using an established measurement tool with open-ended questions. Interviews were transcribed and scored for appropriateness of response using a previously established codebook. Lastly, the patients and parents were administered the REALM and WRAT questionnaires to establish health literacy and literacy in general, respectively, and completed the self-administered demographic and psychological state questionnaires. Results: No significant differences existed between the groups for socio-demographic variables. There were no significant differences between the groups for overall recall and comprehension; recall and comprehension for the domains of treatment, risk and responsibility; and recall and comprehension for core, general and custom items. Conclusions: There was no benefit to adding a short video to the previously established improved readability and audiovisual supplementation. When compared to previous studies, these data further demonstrate the benefit of improved readability and audiovisual supplementation with the addition of chunking. Positional effects indicate the most important informed consent information should be presented last.
Author: Caroline Elizabeth Pawlak
Publisher:
ISBN:
Category :
Languages : en
Pages : 120
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Book Description
Introduction: Previous research has demonstrated that current methods of informed consent are relatively ineffective as shown by poor recall and comprehension by adolescent patients and their parents. The purpose of this study was to determine if adding a short video reiterating the issues related to informed consent to a modified informed consent document that places emphasis on a limited number of core and patient specific custom "chunks" located at the beginning of an informed consent presentation improved the recall and comprehension of the risks, benefits and alternatives related to orthodontic treatment. Methods: 70 patient/parent pairs were randomly divided into two groups. The intervention group (Group A) patients and parents reviewed a customized slideshow and a short video describing the key risks of orthodontic treatment together. Group B followed the same protocol without viewing the video. All patients and parents were interviewed independently by research assistants using an established measurement tool with open-ended questions. Interviews were transcribed and scored for appropriateness of response using a previously established codebook. Lastly, the patients and parents were administered the REALM and WRAT questionnaires to establish health literacy and literacy in general, respectively, and completed the self-administered demographic and psychological state questionnaires. Results: No significant differences existed between the groups for socio-demographic variables. There were no significant differences between the groups for overall recall and comprehension; recall and comprehension for the domains of treatment, risk and responsibility; and recall and comprehension for core, general and custom items. Conclusions: There was no benefit to adding a short video to the previously established improved readability and audiovisual supplementation. When compared to previous studies, these data further demonstrate the benefit of improved readability and audiovisual supplementation with the addition of chunking. Positional effects indicate the most important informed consent information should be presented last.
Author: Brennan Skulski
Publisher:
ISBN:
Category : Orthodontics
Languages : en
Pages : 77
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Book Description
Introduction: Proper informed consent allows patients to take an active role in their own treatment decisions and may improve treatment outcomes due to enhanced compliance. The objective was to determine if hand-written rehearsal of core and custom consent items would increase short-term recall and comprehension. Methods: Ninety patient-parent pairs were randomly assigned to two groups. After case presentation, each subject was provided 10 minutes to read a modified informed consent document. Group A received visual printouts containing the four core elements (root resorption, decalcification, pain, and relapse/retention) likely to be encountered by all patients and up to four custom elements (e.g. impacted teeth, orthognathic surgery or other case specific treatment issues). Subjects identified and wrote what the image depicted and how it could affect treatment. Group B viewed a slideshow presentation on all 18 consent elements arranged from general to specific. All participants were interviewed, and each provided their socio-demographic data, as well as completed literacy, health literacy, and state anxiety questionnaires. The groups were compared for recall and comprehension through an ANCOVA. Results: The rehearsal intervention significantly improved recall and comprehension of the core elements (p=0.001). Rehearsal also improved custom recall and comprehension, but not significantly. Group B performed significantly better on treatment questions (p=0.001). Overall, as anxiety increased, correct responses decreased. Conclusions: The rehearsal group improved recall and comprehension of the core and custom elements of informed consent and proved a more efficient method than an audiovisual presentation to provide informed consent.
Author: Alexander Robert Desman
Publisher:
ISBN:
Category : Informed consent (Medical law)
Languages : en
Pages : 90
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Book Description
Introduction: The purpose of this study was to determine if written rehearsal of informed consent improved six-months recall and comprehension compared to the current best practices. Methods: A consultation was provided and subjects read the modified informed consent. They were randomized to Group A (received the core and up to four custom elements of treatment, wrote what each image displayed) or Group B (presentation of the 18 elements with core elements chunked at the end followed by up to four custom elements). Interviews recording recall/comprehension occurred immediately and six months later. Results: Overall, no significant differences in baseline or 6-month follow-up scores were found between groups. Initially, Group A outperformed Group B in some core domains. There were no significant differences between groups in the change of scores from initial to recall. Follow-up scores were significantly lower than baseline scores (p0.05). Higher initial scores were associated with larger drops at follow-up. A decrease in knowledge 20% was common. Conclusions: Overall the methods are comparable at baseline and 6-months. Initial content retention was roughly 2/3, with 6-9% deterioration. For areas of treatment methods, risk, discomfort, and resorption at 6-months, the current processes fail the patient and leave the practitioner vulnerable to risk management issues. Results support the rehearsal method with immediate feedback for misunderstandings as the preferred method for informed consent.
Author: Edith Young Kang
Publisher:
ISBN:
Category : Informed consent (Medical law)
Languages : en
Pages : 290
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Book Description
Abstract: Introduction: A few studies have shown minimal recall of risks after an orthodontic case presentation/consultation appointment, where obtaining informed consent is usually part of this process. Reducing the reading grade level and altering the format for improved processability may improve recall and comprehension of this information. This study developed a measuring tool for recall and comprehension and investigated differences in these variables among different methods of communicating orthodontic informed consent information. Methods: The American Association of Orthodontists' (AAO®) informed consent document was used as the gold standard; a modified informed consent document (MIC) represented improved readability; and an automated PowerPoint® slide show with visual and audio cues for elements of informed consent had improved processability. A questionnaire that probed 18 elements of an orthodontic informed consent was created. A pilot study consisting of 20 orthodontists validated this measurement tool for face and content validity. The slideshow was also validated for face and content validity. Twenty graduate orthodontic clinic patients and their parents were recruited for a second pilot study to establish face validity of the measurement tool and the slideshow. A convenience sample of 90 patient/parent pairs (n=180) from a university-based graduate orthodontic clinic were recruited at their initial orthodontic consultationltreatment presentation appointment. Patients were 12-18 years of age, with no previous history of orthodontic treatment, no family members had treatment or were currently in treatment at the clinic, and spoke English (as did their parents). The subject pairs were stratified into three treatment groups matched by age of the patient. Group A received only the AAO® document (grade level 14) during their consultation -- gold standard informed consent. Group B received the MIC document (grade level 7) -- improved readability. Group C received the MIC document and the PowerPoint® slide show -- improved readability and processability. Reading level, health literacy, and anxiety were evaluated using three standard measurement tools - the Wide Range Achievement Test 3 (WRAT 3)̧, Rapid Estimate of Adult Literacy in Medicine (REALM)̧, and the 6 item State Trait Anxiety Inventory (STAI-6), respectively. The validated measurement tool was administered to subjects in an interview format to determine comprehension and recall of orthodontic treatment risks and benefits. All interviews were digitally recorded and later transcribed. Each response in the interview was scored for the desired response on a 4 point scale: inappropriate response; on target; don't know/don't remember; no answer given/skipped. Demographic information was collected to determine if various socioeconomic factors have an impact on comprehension. Fisher's exact test, X2 test and multivariate regression analysis were used for data analysis. Results: The orthodontist pilot study showed no significant difference (p>0.05) between the pre and post refinements and a greater than 96% rating of approval for the measurement tool. There was no significant difference (p>0.05) in the pre and post refinements regarding the content validity of each of the questions in the measurement tool. The clinic pilot study showed the level of recall and comprehension to be 73.2% and 78% acceptable for pre and post refinements, respectively, with no significant difference (p>0.05) between pre and post refinements for the questionnaire. There was no statistically significant difference (p>0.05) in the level of recall and comprehension between treatment group A and treatment group B. Internal reliability was low for both patient and parent. Conclusions: The patient and parent subjects and orthodontists appear to have established face validity for the measurement tool and the slideshow. The orthodontist established content validity for the measurement tool. The clinical pilot study also established face validity. The level of recall and comprehension is moderate at best and does not appear to improve with an improved readability form.
Author: Kelly Marie Carr
Publisher:
ISBN:
Category :
Languages : en
Pages : 76
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Book Description
Abstract: Introduction: Previous orthodontic informed consent research shows low patient/parent recall and comprehension of treatment risks and limitations. The purpose of this study was to: 1) evaluate the effectiveness of a shortened oral presentation of an established informed consent method and 2) determine if customized computer-based presentations (PPTs) improve the recall and comprehension of the risks and limitations of orthodontic treatment.
Author:
Publisher:
ISBN: 9781683086857
Category :
Languages : en
Pages : 546
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Book Description
In addition to reprinting the PDF of the CMS CoPs and Interpretive Guidelines, we include key Survey and Certification memos that CMS has issued to announced changes to the emergency preparedness final rule, fire and smoke door annual testing requirements, survey team composition and investigation of complaints, infection control screenings, and legionella risk reduction.
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Author: John Reynold Williams
Publisher:
ISBN: 9780953926152
Category : Dental ethics
Languages : en
Pages : 135
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Author:
Publisher:
ISBN: 9781622701070
Category :
Languages : en
Pages :
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The Cal/OSHA Pocket Guide for the Construction Industry is a handy guide for workers, employers, supervisors, and safety personnel. This latest 2011 edition is a quick field reference that summarizes selected safety standards from the California Code of Regulations. The major subject headings are alphabetized and cross-referenced within the text, and it has a detailed index. Spiral bound, 8.5 x 5.5"
Author: Nathan I. Cherny
Publisher: Oxford University Press, USA
ISBN: 0199656096
Category : Medical
Languages : en
Pages : 1281
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Book Description
Emphasising the multi-disciplinary nature of palliative care the fourth edition of this text also looks at the individual professional roles that contribute to the best-quality palliative care.
Author: John P. Bilezikian
Publisher: Wiley-Blackwell
ISBN:
Category : Medical
Languages : en
Pages : 100
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Book Description
"This volume presents manuscripts stemming from the conference entitled 'Bisphosphonates & Osteonecrosis of the Jaw,' held May 19, 2007 at the New York Academy of Sciences
