THE IMPACT OF A TABLET-BASED GRAPHICS APPLICATION ON PATIENTS' EXPERIENCES AND ENGAGEMENT DURING THE CONSENT PROCESS FOR INPATIENT CARDIAC CATHETERIZATION Open Access

Abstract

Abstract

THE IMPACT OF A TABLET-BASED GRAPHICS APPLICATION

ON PATIENTS' EXPERIENCES AND ENGAGEMENT

DURING THE CONSENT PROCESS

FOR INPATIENT CARDIAC CATHETERIZATION

BY

Janci A. Demyun

Objective: The objective of this exploratory study was to assess the impact of an interactive, tablet-based graphics application on patients' experiences with the consent process and decision-making for inpatient cardiac catheterization.

Methods: We employed a modified pre-post design. Eighteen patients underwent a consent process incorporating the tablet-based graphics application; 22 patients underwent a standard consent process. Outcomes were assessed via structured interview and included procedural knowledge, satisfaction with the consent process, and perceptions of the intervention.

Results: Patients from both groups reported high satisfaction with the consent process. No significant differences were appreciated between groups regarding procedural understanding or treatment decisions. Many intervention patients valued seeing the procedure beforehand. In particular, patients reported that pictorial representations created a sense of reassurance and comfort.

Conclusion: Significant differential impact on objective outcome measures was not appreciated but was difficult to assess given high background satisfaction. However, patients' responses were very positive toward the intervention. Applications like this may enhance patients' experiences of consent and reduce procedural anxiety. These goals have practical and ethical importance independent of procedural knowledge or decisions.

Table of Contents

Table of Contents

Chapter One: Introduction 1

Overview of Problem 1

Background 1

Primary Research Questions 3

Purpose of study 4

Chapter Two: Literature Review 5

Patient-centered medical care 5

Five dimensions of PCC 5

Shared decision-making and relationship-centered care 6

Barriers 7

IT and Informed Consent 8

Knowledge 9

Communication 10

Summary of Findings 12

Chapter Three: Methods 13

Purpose of study 13

Study Design 14

Study Population 15

Recruitment 15

Sampling 15

Questionnaire/Interview guide 16

Physician Focus Groups 17

Data Collection and management 17

Data analysis 18

Results 18

Chapter Four: Discussion and conclusion 22

Discussion 22

Conclusion 24

Chapter Five: Journal article 25

Appendix A: IRB Approval 37

Appendix B: Patient Interview Guide 38

Bibliography 46

List of Tables

Table 1. Demographic information 19, 30

Table 2. Relevant themes 20, 31

List of Figures

Figure 1. Sample graphics from the intervention 3, 14, 28

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery
Keyword	second-order goals cardiac catheterization informed consent reassurance shared decision-making comfort
Committee Chair / Thesis Advisor	Smith, Iris E, Emory University
Committee Members	Dickert Jr, Neal, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs Industrial or Commercial (for-profit) organization Hospital or other health care provider

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	IRB_Approval_05_29_2013.pdf ()	2018-08-28 14:31:54 -0400	Press to Select an action Download