Administration of Informed Consent for Medical Imaging Services among Patients in Government Hospitals in Nairobi City County, Kenya
Koi, Victoria Otysula
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Informed consent is a requirement by law to allow patients to make decisions with respect to their health and well-being. It is an ethical and legal requirement that patients seeking medical imaging services should give an informed consent prior to seeking treatment with respect from healthcare providers. However, the extent of usage of the informed consent process varies across medical procedures. The study therefore sought to assess informed consent process in medical imaging procedures for patients in government hospitals in Nairobi City County, Kenya. The study adopted a descriptive cross-sectional study design. The study specifically focused on administration of informed consent, contents of the patients Informed Consent Forms and modes of informed consent used among patients for medical imaging services. Imaging departments in Kenyatta National hospital, Mbagathi, Mama Lucy, National spinal injury and National Mathare Hospitals in Nairobi City County were chosen as the area of study. The patients in the imaging departments of the selected hospitals were recruited for the study. The sample size selected was 307 respondents. The respondents were selected using systematic random sampling at a predetermined interval of 3. Collected data was coded for analysis by use of Statistical Package for Social Sciences. Analysis was conducted on descriptive and inferential statistics. Frequency tables, pie-charts and graphs were used to present the quantitative data. Inferential statistics were done using Chi Square tests to determine the association between study variables at 95% confidence interval (p<0.05). The ethical considerations were strictly followed during data collection. The study results revealed that majority 222(75.0%) of respondents were administered with informed consent with 79(75.2%) of respondents in Kenyatta National Hospital reporting to have adequately administered with informed consent before a medical imaging procedure. It was established that most 181(61.1%) patients sought for X-ray services compared to other imaging procedures for treatment. Verbal informed consent was the most used mode of informed consent with 123(55.0%) respondents having administered to it. It was further revealed that age (χ2=3.782; df= 4; p=0.016;), level of education (χ2=3.89; df= 4; p=0.030), revelation of reason for referral (χ2=26.081; df=1; p=0.001), provision of right to refuse or defer imaging (χ2=33.468; df= 1; p=0.001), giving consent for treatment (χ2=70.733; df=1; p=0.001), decision making for wellbeing (χ2=12.056; df=1; p=0.001), pre-operative counseling (χ2=9.533; df=1; p=0.002), cases of negligence from clinicians (χ2=22.414; df=1; p=0.001), understanding information provided by clinicians (χ2=4.394; df=1; p=0.036), adaptation of informed consent doctrine meeting physicians and patients (χ2=7.648; df=1; p=0.006), performance of diagnosis from patients’ past medical history (χ2=9.788; df=1; p=0.002), advice on alternative treatment options available (χ2=8.065; df=1; p=0.005), disclosure of information by practitioners (χ2=19.406; df=1; p=0.001) and physical examination done before medication (χ2=9.006; df=1; p=0.003) were significantly associated with informed consent administration among respondents. The study concludes that informed consent was administered to majority of respondents in Public Hospitals in Nairobi City County. Most of the domains of the contents of informed consent were adhered to. The study further concludes that verbal informed consent was the most prevalent mode administered with most of the respondents utilizing X-ray medical imaging services. These research findings provide a great insights and information to leaders, managers, law makers, governing and oversight authorities in decision making, policy formulation, strategic planning and regulation in a context specific to provide a conducive environment for practicing medical imaging procedures in an ethical and legal manner.