Informed-Consent Taking Procedure for Elective Surgery in Gaza strip: Patient's Satisfaction with Doctor's Communication

BACKGROUND : Widespread dissatisfaction and mistrust exists among patients in the Gaza Strip towards doctors. A sense of a lack of sufficient information regarding diagnosis, risks and benefits of interventions and subsequent management plans is present among patients. All of these areas are considered essential components in the surgical consent process. A gap between patients’ actual understanding and that perceived by doctors has been shown to exist in different settings.1 Unfortunately, no former study has been done on this topic in the Gaza-Strip.   OBECTIVES : This study aims to assess the satisfaction of patients in Gaza with the information provided to them during the consent process prior to an invasive procedure and compare this to the current practice and attitudes of surgeons.   METHODS : A five-section self-designed questionnaire was administered using convenience sampling to the first 60 patients and first 60 surgeons who met the selection criteria in the two hospitals in the Gaza Strip: Al-Shifa Hospital and the European Gaza Hospital.   FINDINGS : Among the surgeons surveyed, 55% answered that informed consent should be obtained by doctors only, 3% thought that it can be obtained by nurses only, while 45% stipulated either doctors or nurses can obtain it. In total only 38% of those healthcare professionals taking the consent from the patient, actually performed the procedure. During consent procedures, 73% of surgeons reported providing written documents 30% drawings explaining the procedure, 3% giving videos or animations and 8% suggesting website links for more information. The survey of patients revealed that only 25% of surveyed surgeons identified themselves to their patients, and 12% asked for the patients’ signature without a complete discussion of the intervention. Around 35% of surgeons depended on verbal communication only. Surgeons identified barriers for best practice as time constraints, as well as lack of hospital policies and informational resources. However, 87% of surgeons believed that informed consent has an impact on patient wellbeing. A total of 90% of surveyed patients thought they received the right treatment and were satisfied. While 43% of patients prefer to travel overseas to get treatment, 77% of these because of a perceived lack of medical equipment and facilities