Informed consent in patients undergoing eye surgery: A qualitative study assessing their attitude, knowledge and anxiety level in a community based hospital of Nepal

Introduction and purpose: Informed consent means the process whereby patients are informed of all the necessary information about health care and subsequent treatment plans. In socioeconomically developing semi-urban setting, where most of the patients are illiterate, we wanted to assess knowledge, attitude and anxiety of patients towards informed consent. Methods: Patients were recruited from the waiting list for ophthalmic surgery at the department of Ophthalmology, Dhulikhel Hospital. A detail optometric and ophthalmologic evaluation was carried out. Data were collected through a 12-item questionnaire and an 8-item Likert scale. Statistics included regression analysis, chi-square test as well as frequency and percentages. Results: Of 42 questionnaire responders, female participation was high (64.3%). Sixty two percent of patients wanted the physician to decide for or against the surgery. Most of (69%) patients thought that by signing the consent they were agreeing for surgery and few (16.7%) thought that the consent was a legal document. Twenty two patients (52.4%) gave importance to the surgical intervention even though there were chances of serious complications. The preoperative anxiety was affected by surgical outcome (81%), complication (40.5%) and anaesthesia (9.5%). The patients prioritized the preoperative information on nature of illness, need for operation and the chances of vision improvement after surgery. Conclusion: Most of patients wanted the doctor to decide their treatment. Many patients wanted to know about the disease, treatment and the success rate of surgery. The success of the operation, the anaesthesia and the long list of complications tended to provoke anxiety.