Discussing surgical innovation with patients: a qualitative study of surgeons’ and governance representatives’ views
Objectives Little is known about how innovative surgical procedures are introduced and discussed with patients. This qualitative study aimed to explore perspectives on information provision and consent prior to innovative surgical procedures.Design Qualitative study involving semi-structured intervi...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e035251.full |
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| author | Jane M Blazeby Angus G K McNair Natalie S Blencowe Kerry Avery Sian Cousins Daisy Elliott Jesmond Zahra Sangeetha Paramasivan Johnny Mathews Barry G Main Robert Hinchliffe |
| author_facet | Jane M Blazeby Angus G K McNair Natalie S Blencowe Kerry Avery Sian Cousins Daisy Elliott Jesmond Zahra Sangeetha Paramasivan Johnny Mathews Barry G Main Robert Hinchliffe |
| author_sort | Jane M Blazeby |
| collection | DOAJ |
| description | Objectives Little is known about how innovative surgical procedures are introduced and discussed with patients. This qualitative study aimed to explore perspectives on information provision and consent prior to innovative surgical procedures.Design Qualitative study involving semi-structured interviews. Interviews were audio recorded, transcribed and analysed thematically.Participants 42 interviews were conducted (26 surgeons and 16 governance representatives).Setting Surgeons and governance representatives recruited from various surgical specialties and National Health Service (NHS) Trusts across England, UK.Results Participants stated that if a procedure was innovative, patients should be provided with additional information extending beyond that given during routine surgical consultations. However, difficulty defining innovation had implications for whether patients were informed about novel components of surgery and how the procedure was introduced (ie, as part of a research study, trust approval or in routine clinical practice). Furthermore, data suggest surgeons found it difficult to establish what information is essential and how much detail is sufficient, and governance surrounding written and verbal information provision differed between NHS Trusts. Generally, surgeons believed patients held a view that ‘new’ was best and reported that managing these expectations could be difficult, particularly if patient views aligned with their own.Conclusions This study highlights the challenges of information provision and obtaining informed consent in the context of innovative surgery, including establishing if and how a procedure is truly innovative, determining the key information to discuss with patients, ensuring information provision is objective and balanced, and managing patient expectations and preferences. This suggests that surgeons may require support and training to discuss novel procedures with patients. Further work should capture consultations where new procedures are discussed with patients and patients’ views of these information exchanges. |
| format | Article |
| id | doaj-art-51ee89b3ce854f2db568e4ae227f7362 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-51ee89b3ce854f2db568e4ae227f73622024-11-25T06:40:09ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2019-035251Discussing surgical innovation with patients: a qualitative study of surgeons’ and governance representatives’ viewsJane M Blazeby0Angus G K McNair1Natalie S Blencowe2Kerry Avery3Sian Cousins4Daisy Elliott5Jesmond Zahra6Sangeetha Paramasivan7Johnny Mathews8Barry G Main9Robert Hinchliffe10National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UKNational Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UKNational Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UKNational Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UKNational Institute for Health Research Bristol Biomedical Research Centre Surgical and Orthopaedic Innovation Theme, Bristol Centre for Surgical Research, Bristol Medical School, University of Bristol Medical School, Bristol, UKNational Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UKPopulation Health Sciences, University of Bristol, Bristol, UKPopulation Health Sciences, University of Bristol, Bristol, UKPopulation Health Sciences, University of Bristol, Bristol, UKPopulation Health Sciences, University of Bristol, Bristol, UKDepartment of Vascular Surgery, North Bristol NHS Trust, Westbury on Trym, UKObjectives Little is known about how innovative surgical procedures are introduced and discussed with patients. This qualitative study aimed to explore perspectives on information provision and consent prior to innovative surgical procedures.Design Qualitative study involving semi-structured interviews. Interviews were audio recorded, transcribed and analysed thematically.Participants 42 interviews were conducted (26 surgeons and 16 governance representatives).Setting Surgeons and governance representatives recruited from various surgical specialties and National Health Service (NHS) Trusts across England, UK.Results Participants stated that if a procedure was innovative, patients should be provided with additional information extending beyond that given during routine surgical consultations. However, difficulty defining innovation had implications for whether patients were informed about novel components of surgery and how the procedure was introduced (ie, as part of a research study, trust approval or in routine clinical practice). Furthermore, data suggest surgeons found it difficult to establish what information is essential and how much detail is sufficient, and governance surrounding written and verbal information provision differed between NHS Trusts. Generally, surgeons believed patients held a view that ‘new’ was best and reported that managing these expectations could be difficult, particularly if patient views aligned with their own.Conclusions This study highlights the challenges of information provision and obtaining informed consent in the context of innovative surgery, including establishing if and how a procedure is truly innovative, determining the key information to discuss with patients, ensuring information provision is objective and balanced, and managing patient expectations and preferences. This suggests that surgeons may require support and training to discuss novel procedures with patients. Further work should capture consultations where new procedures are discussed with patients and patients’ views of these information exchanges.https://bmjopen.bmj.com/content/10/11/e035251.full |
| spellingShingle | Jane M Blazeby Angus G K McNair Natalie S Blencowe Kerry Avery Sian Cousins Daisy Elliott Jesmond Zahra Sangeetha Paramasivan Johnny Mathews Barry G Main Robert Hinchliffe Discussing surgical innovation with patients: a qualitative study of surgeons’ and governance representatives’ views BMJ Open |
| title | Discussing surgical innovation with patients: a qualitative study of surgeons’ and governance representatives’ views |
| title_full | Discussing surgical innovation with patients: a qualitative study of surgeons’ and governance representatives’ views |
| title_fullStr | Discussing surgical innovation with patients: a qualitative study of surgeons’ and governance representatives’ views |
| title_full_unstemmed | Discussing surgical innovation with patients: a qualitative study of surgeons’ and governance representatives’ views |
| title_short | Discussing surgical innovation with patients: a qualitative study of surgeons’ and governance representatives’ views |
| title_sort | discussing surgical innovation with patients a qualitative study of surgeons and governance representatives views |
| url | https://bmjopen.bmj.com/content/10/11/e035251.full |
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