Title

Analyzing Informed Consent in Diabetic Patients Undergoing Cataract Surgery at Teaching Centers

Document Type

Presentation

Publication Date

6-24-2015

Comments

Advisor:

R McIntire, Jefferson School of Population Health, Thomas Jefferson University, Philadelphia, PA.

Abstract

Cataract surgery is one of the most commonly performed surgeries in the United States. With the aging population, the number of cataract surgeries performed on a yearly basis will increase significantly: 30 million Americans are estimated to develop cataracts by 2020.1 Surgical training, especially cataract surgery, is a necessary facet of ophthalmology residency training programs but resident involvement in cataract surgery remains a significant problem in terms of full disclosure and patient agreement. The purpose of this project was to identify factors associated with agreement/disagreement to resident involvement for diabetic and non-diabetic patients and to recommend interventions to reduce patients’ fear of resident training. Data from a semi-structured interview were analyzed to compare non-diabetic and diabetic participants. The independent samples t test was used to assess differences in the mean values for age between diabetic and non-diabetic patients and the mean values for length of doctor-patient relationship between diabetic and non-diabetic patients. The nonparametric test for proportions was used to refute or confirm any differences in proportions (e.g., demographics, length of doctor patient relationship and visual acuity) between diabetic and non-diabetic patients. Χ2 test with odds ratios were used to determine the association between diabetes status and agreement to resident involvement and between diabetes and factors associated with resident involvement. Diabetics comprised 24.74% of the 97 respondents. The primary factor associated with agreeing to resident involvement for diabetic respondents included having a positive doctor-patient relationship with the attending while the primary factor for non-diabetic respondents was the belief that hands-on experience is a requirement for learning. In terms of disagreeing to resident involvement, diabetic patients cited having a positive doctor-patient with the attending and for non-diabetic respondents, perceived risk of resident involvement. Independent of diabetes status, both groups acknowledged a need for residency training (98%) but personal responsibility in training residents varied. Study findings support that full disclosure can be benefit residency training. Further research is needed to determine best practices for patient education on residency training and health professional communication skills.

Presentation: 21 minutes