The researchers examined guardians and children undergoing spinal fusion for adolescent idiopathic scoliosis at four institutions. The guardians completed a questionnaire on risks, benefits and expected results of operative treatment and comprehension. There were 176 patients enrolled, but 57 patient/guardian questionnaires were incomplete.
The researchers found:
1. A greater percentage of guardians had good overall surgical consent comprehension compared to patients. Among patients, 59.7 percent had good overall comprehension compared with 71.4 percent of guardians.
2. The postoperative mobility was poorly understood—31 percent of patients and 42 percent of guardians understood the postoperative mobility.
3. The surgical risks, including neurologic injury, infection, hardware failure and future sequela, were modestly understood by both groups with 40 percent to 70 percent of the questions correct.
4. The factors associated with better understanding were:
• Older patients over the age of 12
• Guardians with a college degree
• Attending surgeons obtaining consent
• Consent obtained at a preoperative visit instead of at the time of teaching
• Using visual aids
• Participation in a “peer-support group” preoperatively
5. There was a trend of the guardians’ and patients’ self-assessment of understanding mirrored their respective objective performance.
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