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Mapping the Quality of Informed Consent for Major Surgical Procedures in Public Dental Hospitals in Khartoum State, Sudan, 2017: A Cross Sectional Study

Rawan A Akasha, Lamis Beshir and Maisa El-Fadul

Background: Informed Consent (IC) is a valuable document that remains central to medical ethics because it supports patient autonomy. Even after signing an IC document, many patients in developing countries are still illinformed. Little is known about the quality of the IC document and the process related to surgical dental procedures in Sudan.
Objectives: This study was conducted to determine the availability of consent form and to assess the quality of IC form and its processing in Khartoum governmental dental hospitals by comparing them to international standards and between each other with regard to comprehensiveness and simplicity of the form.
Methodology: A cross-sectional study was carried out in three public dental hospitals- 1) United Police Force Hospital (UPFH), 2) Khartoum Dental Teaching Hospital (KDTH) and 3) Military Hospital-Omdurman (MH-O) in which 12 consent forms were reviewed during the period from January to March 2017 and a total of 50 patients were recruited. The study sample was taken from patients who underwent major oral and maxillofacial surgical procedures in these hospitals. International standards on availability and quality of IC document were used to elaborate checklists to collect appropriate data. Patients were also interviewed to assess their comprehension of IC. Descriptive and inferential statistics have been done to analyze the quality of IC and patients comprehension.
Results: A generic type of IC was available in all governmental dental hospitals but was not modified according to the type of major surgical procedure. The available IC elements in the MH-O found in comparison to international standards was (61.5%), (53.8%) in KDTH and (46.2%) in UPFH. In regards to the comprehensiveness of each IC element and the use of local understandable language, it was found to be average in MH-O and KDTH and low in UPFH. Patient’s comprehension of IC was poor with a total of 54% of all patients that did not understand the IC at all, 42.3% of those being illiterate. Age and level of education was significantly associated with an understanding of IC elements.
Conclusion: The Governmental dental hospitals in Sudan do not have tailored IC. The IC was neither comprehensive nor understandable to the patients.