Use of a Standardized Video to Supplement Informed Consent for Hysterectomy

INTRODUCTION: Video aids can enhance patient comprehension, bridging the gap for some deficiencies in the consent process compared to those relying solely on traditional consultations. They provide a standard consultation that has been curated with the most relevant, simple, and least biased language that can be repeated by the patient multiple times. The primary hypothesis was that women who watched the video would have significantly higher patient satisfaction and knowledge about the surgery than women who did not. OBJECTIVE: The primary aim was to assess the efficacy of the standardized video on patients’ satisfaction with the informed consent process. Secondary outcomes were to evaluate the video's uptake and impact on the patient’s understanding and knowledge. METHODS: Nested subgroup analysis of a larger quality improvement study. The study invited patients who planned to undergo hysterectomy between June 2023 and April 2024 for benign reasons, who verbally agreed to participate. The standardized video was previously created by consultation of stakeholder physicians and nurses. The video content was adjusted based on questionnaire results from prior assessments, stakeholder input, the ACOG patient FAQ handout, and SGS hysterectomy recommendations. When patients confirmed the date for their surgery, they received a text message link containing the video. At the time of the patient’s preoperative education appointment, they were given a questionnaire addressing demographics, knowledge questions, consent process, and satisfaction with the consent process. The primary outcome was a composite scale of the 6 different satisfaction questions adapted from Hallock et al. To detect a difference of 1.7, with 80% power and α= 0.05, the target enrollment was 43 patients each in the video and control groups. RESULTS: 49 respondents watched the video, and 47 patients did not. Demographics were similar between groups. Satisfaction scores were high, with a median composite score of 30/30 in both groups (IQR 26–30). 92.7% of respondents were strongly satisfied or satisfied with the information provided, with no significant difference between groups and similar distributions in the 6 satisfaction questions. When asked about risks and benefits of the procedure, only 71% reported they had been informed about the rare possibility of a life-threatening complication; this was not different between groups. Most respondents answered correctly the knowledge questions about not having periods after hysterectomy. However, 34% of respondents expressed that periods continue after hysterectomy or were unsure. About 13% of both groups expressed they were unsure or thought they could still get pregnant and only 59% were sure they would still be able to have intercourse. When asked about menopause symptoms, both groups expressed uncertainty regarding whether someone who has had a hysterectomy will have symptoms of menopause. There was no significant difference in the knowledge questions between groups. CONCLUSIONS: Patients were satisfied with the consent process and reported being provided enough information to understand the surgery. Texting a video link resulted in approximately 50% of patients accessing an informative video about hysterectomy, which improved patient experience with the risks and benefits of the procedure but did not impact satisfaction or knowledge scores (Tables 1–3).