BENEFITS OF MEDICAL-MEDIATION IN INFORMED CONSENT: EVALUATING CLINICIANS’ PERSPECTIVES

Volume 6, Issue 6, December 2021     |     PP. 488-499      |     PDF (312 K)    |     Pub. Date: October 24, 2021
DOI: 10.54647/cm32643    85 Downloads     3294 Views  

Author(s)

Toshimi Nakanishi, General Medical Education Center, Faculty of Medicine, Yamagata University, Yamagata, Japan
Miyu Hayasaka, Chiba University Hospital, Chiba, Japan
Eri Endo, Wakayama Rosai Hospital, Japan Organization of Occupational Health and Safety, Wakayama, Japan
Ayumi Tsuchiya, Yamagata University Graduate School of Medicine, Yamagata, Japan

Abstract
Ensuring shared decision-making processes between physicians and patients/families through informed consent (IC) is essential. However, information gaps and time constraints can make it difficult to achieve satisfactory IC. Therefore, medical-mediation by “a mediator” was conceived to address these issues. Medical-mediation solves problems by visualizing reasons for cognitive conflicts during dialogue. We investigated its usefulness in five IC settings conducted by five clinicians in Japan. Semi-structured interviews were conducted using five questionnaires after the same mediator-mediated IC. Data were qualitatively analyzed using KH Coder 3 developed by Koichi Higuchi. Clinicians’ ages ranged from 30 to 65 years, and the time required for IC was 7 to 15 minutes. In all the questions, none of the participants rejected medical-mediation. The co-occurrence network analysis showed a connection between “mediator” and "ease of explanation," "facilitating questions," and "sharing and obtaining information." In terms of IC time, characteristic words were "explanation" and "patient" for less than 10 minutes, and “family” for more than 10 minutes. In terms of clinicians’ years of experience, the characteristic words were "explanation" and "ease" for less than 9 years, and "family," "concrete," and "feelings" for more than 9 years. During medical-mediation, the mediator can be close to both parties, making it easier for both parties to ask questions and disclose more information spontaneously, such as addressing the patient's questions and concerns. The patients expressed their satisfaction with the IC. This study showed that clinicians' assessment by medical mediation is beneficial in the shared decision-making process of IC.

Keywords
clinician; decision-making process; facilitation; informed consent; medical- mediation

Cite this paper
Toshimi Nakanishi, Miyu Hayasaka, Eri Endo, Ayumi Tsuchiya, BENEFITS OF MEDICAL-MEDIATION IN INFORMED CONSENT: EVALUATING CLINICIANS’ PERSPECTIVES , SCIREA Journal of Clinical Medicine. Volume 6, Issue 6, December 2021 | PP. 488-499. 10.54647/cm32643

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