having a visual aid in addition to text- based descriptions is very helpful, said Ms. Rockwell. When translated into a different language, they undergo review again by representative focus groups.
These PDAs are also accompanied by a postprocedure handout, which includes information about what to expect following a procedure.
“It has common things to look out for, like the potential for some soreness, or that you’ll have some redness, but if ‘this’ happens you should call your clinician or go seek emergency medical care,” Ms. Rockwell said. “It’s also nice to have this physical sheet of paper to share with family members and caregivers.”
These PDAs can be given to patients while in the waiting room, allowing the patient to learn and think about their options while waiting to be seen. This often leads to more informed conversations and questions during the visit, Dr. Newton and Ms. Rockwell say.
When tested at two academic medical centers, patients who were given a PDA while in the IR waiting room reported greater understanding of the procedure and satisfaction with the consent conversation, compared to those who did not receive a PDA. This effect occurred without any change to the consent conversation itself, as the clinicians were blinded.7
The impact of consent and literacy While obtaining informed consent is necessary from an ethical and legal standpoint, it’s also a chance for clinicians to engage with their patients and build a connection, Ms. Rockwell says.
“It represents an important opportunity for us to connect with our patients and empower them in their rightful ability to make an informed choice regarding their healthcare—whether that is to do an intervention, to not do an intervention or to explore alternatives,” said Ms. Rockwell. “It’s a fundamental component of a meaningful provider and patient partnership.”
Providing patient education material and being willing to educate yourself are key to the patient interaction, says Dr. Newton, who is working on a curriculum
This disconnect is particularly challenging when it comes to IR treatments since the public has less of a baseline familiarity with IR and image-guided therapies.
for clinicians on how to engage in compassionate consent communication with patients.
“I learned about how to speak in not just a more compassionate way, but in way that will respect where patients are when they come to that communication, how to work with patients who are facing barriers or having difficulties and how to be a more holistic and better physician all around,” Dr. Newton said. “I’m excited to teach that to my colleagues.”
Investing time to implement good consenting practices is well worth it, she says.
“Data has shown over and over again that you need to slow down to speed up,” Dr. Newton said. “If you invest just a little bit of time at the front end, patients will have a deeper sense of trust in the relationship, a better sense of understanding and better adherence to the plan later on. And then you and your patient will be partners in their wellness.”
And patient education materials can be a vital tool in expanding access to care, specifically interventional radiology, Ms. Rockwell adds.
“There are a lot of patients from historically marginalized populations who have more difficulty receiving healthcare,” Ms. Rockwell said. “There is definitely a void there that IR could help fill because our procedures are minimally invasive, so there is often less downtime than after open surgery. For a patient, if their work is sustaining them and their family and they can’t afford to miss a week of time to have a more invasive intervention, often there’s an IR procedure that might also be able to provide them some benefit.”
irq.sirweb.org | 35
Education material can be helpful when comparing options like medical management, surgery, and IR procedures to help patients make the best decision for their health and lifestyle.
Ms. Rockwell also believes that the impact can be felt on a global scale as well.
“As we branch out into global health, we can translate this information into the primary language of wherever we’re going,” she said. “It can be a great way of conveying what we as IRs do and connecting with patients and healthcare institutions globally.”
References
1. Nutbeam D. The evolving concept of health literacy. Soc Sci Med. 2008;67(12):2072–8.
2. Baker DW, Gazmararian JA, Williams MV, Scott T, Parker RM, Green D, Ren J, Peel J. Functional Health Literacy and the Risk of Hospital Admission Among Medicare Managed Care Enrollees. Am J Public Health. 2002;92(8):1278–83.
3. Institute of Medicine (US) Committee on Health Literacy. Health Literacy: A Prescription to End Confusion. Executive Summary. 2004.
ncbi.nlm.
nih.gov/books/NBK216029
4. Ayotte BJ, Allaire JC, Bosworth H. The Associations of Patient Demographic Characteristics and Health Information Recall: The Mediating Role of Health Literacy. Aging Neuropsychol Cogn. 2009;16(4):419–32.
5. Liu C, Wang D, Liu C, et al. What is the meaning of health literacy? A systematic review and qualitative synthesis. Fam Med Community Health 2020;8:e000351.
6. Centers for Disease Control. Understanding literacy and numeracy. 2022.
cdc.gov/ healthliteracy/learn/
UnderstandingLiteracy.html
7. Srinivas S, Newton IG, Waradzyn M, Kothary N, Keller EJ. Patient decision aids before informed consent conversations for image-guided procedures: controlled trials at two institutions. AJR. 10.2214/AJR.22.28165.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40
