GAPS IN INFORMED CONSENT PROCESS AMONG WOMEN WHO HAVE UNDERGONE ELECTIVE CAESAREAN SECTION AT AIC KIJABE HOSPITAL, KIAMBU COUNTY KENYA

Abstract

Informed consent is a legal and ethical requirement that allows respectful and dignified care. Informed consent process includes decision-making capacity, provision of adequate information, and voluntary consenting without coercion. The aim of this study was to examine the informed consent process for elective C sections at Kijabe Hospital with a focus on identifying gaps. This was a cross sectional study. A structured questionnaire assessing 15 elements of informed consent process was administered to 137 women who were consecutively sampled. Descriptive statistics were used for socio-demographic data. The 15 elements were aggregated. T-tests were used to evaluate the associations between aggregate score and chance to address patients‘ questions and concerns and time taken to obtain consent. P-value of less than 0.05 was considered statistically significant. Data were analyzed using STATA. Most participants (70.8%) were between 26-35 years of age, 75% had tertiary education, 94.7% were married, and 89.1% had more than two previous deliveries. There was no statistically significant association between each socio-demographic characteristic and the aggregate score on informed consent process. Of the 15 elements of informed consent, only benefits, implications on future pregnancy and postoperative briefing were infrequently addressed at 59.1%, 57.7% and 67.9% respectively. Documentation of informed consent process was not done at all, although consent forms were signed invariably. 97.1% of the participants had a chance to ask questions and have their concerns addressed. Averagely 10 minutes were spent on obtaining consent. Allowing a chance to address patients‘ questions and concerns and taking more time to obtain consent was associated with a higher aggregate score, a p-value of 0.01. Overall, the consenting process was working well. Allowing chance to address patients‘ questions and concerns and spending more time to obtain consent were associated with an in-depth informed consent process.