Title:
Developing A Multimodal, Patient-focused Consent Taking Protocol for Obstetric Patients Undergoing Caesarean Section under Subarachnoid Block
Wee, Siok Choon1; Tan, Jeremy2; Ngoi, Soo Tein3; Shariffuddin, Ina Ismiarti3; Vallejo, Manuel4; Damanhuri, Mayura3
1Ministry of Health, Malaysia ; 2Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia ; 3Universiti Malaya, Kuala Lumpur, Malaysia ; 4West Virginia University, USA
Objectives:
•To audit current consent-taking practices by assessing obstetric patients’ understanding and recall of subarachnoid block (SAB) risks following standard verbal discussion,
•To identify factors influencing comprehension and retention,
•To develop a bilingual, multimodal consent tool to enhance information delivery,
•To audit the effectiveness of the multimodal consent taking process for quality improvement.
Methods:
•This prospective study was conducted at Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, a tertiary centre.
•Ethics approval was obtained from the UMMC Medical Research Ethics Committee (MREC ID No.: 202331412239)
•The study was conducted in two phases over a period of five months.
•In the first phase, the control group (n=80) received standard verbal discussion on spinal anaesthesia prior to their elective caesarean sections.
•Following the development of a multimodal consent tool, the second phase was carried out with the intervention group (n=80), who received both verbal discussion and a written information pamphlet.
•Within 24 hours post-surgery, all participants completed a questionnaire assessing knowledge, recall of anaesthetic risks, and preference of the consent taking process.
Results:
•The intervention group demonstrated a significant improvement in knowledge retention, with a 24.8% increase in mean knowledge scores compared to the control group (p<0.001).
•Education level, parity, and history of spinal anaesthesia did not significantly influence knowledge scores in either group (p>0.05).
•Most patients (78.1%, n=125) preferred receiving both verbal discussion and written information during consent, 20.0% (n=32) felt verbal discussion alone was sufficient, while three patients (1.9%) were uncertain.
Discussion and Conclusion:
•The introduction of a written information pamphlet significantly enhances patients’ recall of spinal anaesthesia risks, supporting its use as part of a multimodal consent process.
•Routine implementation of this multimodal approach for all elective caesarean sections is recommended to improve the quality of consent-taking and patient satisfaction.
