Attitudes and Experiences With Informed Consent for Percutaneous Coronary Intervention in Korea: A Mixed-Methods Study

Abstract

Background: Percutaneous coronary intervention (PCI) is one of the most popular invasive cardiovascular procedures performed worldwide. However, patients often overestimate its benefits or underestimate potential risks, which should be addressed during informed consent (IC). In light of this, our study aimed to explore in greater depth the attitudes and experiences with IC regarding PCI in South Korea.

Methods: This mixed-methods study employed a sequential design following the guidelines of the Mixed Methods Reporting in Rehabilitation and Health Sciences. Between December 2022 and January 2023, a cross-sectional survey was completed by 255 patients and 136 physicians. From February to April 2023, in-depth interviews were conducted with 13 physicians were conducted and analyzed using conventional content analysis.

Results: Patients and physicians showed a significant difference in agreement with the purpose of IC with respect to the right to self-determination (P < 0.001; mean patient rank 178.1, mean physician rank 228.0). There were gaps between patients and physicians in the degrees of agreement regarding understanding (P < 0.001; mean patient rank 182.2, mean physician rank 220.4) and remembering (P = 0.014; mean patient rank 185.5, mean physician rank 214.3) information during the IC process. Physicians experienced difficulties due to patients' low comprehension of the information provided during the IC process.

Conclusion: Patients should first be educated on the purpose of IC to prepare them for receiving detailed information about PCI. When they are ready to accept information, strategies suggested by several studies may be applied to improve their understanding. This step-by-step provision of information will elevate patient compliance with IC.