5.1 Socio-demographic characteristics
From total 380 samples, 372 study participants were involved directly in this study giving a response rate of 97.8%. The majority study respondents were married 310 (83.3%) and 167 (44.9%) were between 28-37 years with mean age of 29.5. Majority 182 (48.9%) were Muslim, 267 (70.1%) study participants were Oromo. The majority 242 (65.1%) participants were living in Urban, 168 (45%) were housewife, 291 (78.2%) were literate and nearly half 47.1% had less than 1500EB monthly income (Table 1).
5.2 Patient related factors
Among study participants half (52.2%) of them were multipara. Around three fourth of study participants (74.5%) had undergone emergency surgical procedure. Majority study participants 319 (86%) underwent operation with reason of pregnancy related case followed by 20 (5.4%) gynecological cancer, 12(3.2%) gynecological benign tumor and 11 (3%) pelvic organ disorder. One hundred three (27%) respondents had previous history of surgery, among those 60 (58.3%) of them had once time surgical history while the rest 43 (41.7%) patients had more than one time surgical history (Table 2)
Respondents’ knowledge on surgical informed consent
Figure 1: Women knowledge on surgical informed consent at Jimma Medical Center, Jimma, Oromia Region, Ethiopia 2020.
Women were asked to assess their knowledge towards surgical informed consent. Majority (77.1%) of women had poor knowledge; and the rest around one quarter (22.9%) of them had good knowledge to wards surgical informed consent (Figure 1).
5.3 Service related factors
Two hundred fifty eight (69.4%) study participants were referred from other health facilities. Above half 62.9% women were responding that the consent form written with in their mother tongue. The majority 302 (81.2%) study participants reported that surgical informed consent was taken by GP/resident, followed by obstetrician-gynecologists 44 (11.8%) and nurse/midwives 26 (7%). More than half 208 (56%) respondents reported that they received informed consent counseling immediately before surgery. The consent form was signed by the patients themselves 352 (94.6%) while the rest 20 (5.4%) were signed by their relatives (Table 3).
5.4 Healthcare provider related factors
5.4.1 Patient to health provider relationship
Figure 2: Patient to health care providers’ relationship status at JMC, Jimma, Ethiopia, 2020.
Women were asked to assess patient to health care providers while they received provision informed consent. Out of total interviewed study participants 179 (48 %) of women had good patient to health providers’ relationship (Figure 2).
5.5 Women satisfaction on surgical informed consent
Women were scored highest satisfaction value on three satisfaction measurement items; i.e. on awareness of benefit of operation, involvement in the discussion about operation and involvement in decision making its accounts 79.1%, 89.5% and 91.2% respectively. In contrast to this the respondents scored lowest satisfaction value on five patient satisfaction measurement items; i.e. on alternative of operation, chance to express opinions, the chance to ask questions, the amount of information provided about operation and the explanation about operation its accounts 24.7%, 30.1%, 33.3%, 44.9%, and 46.2% respectively (Table 4)
Figure 3 : The overall mean satisfaction level of respondents on surgical informed consent at Jimma Medical center, Jimma, Ethiopia 2020.
Women were asked to assess their level of satisfaction with the SIC they received prior to their surgical procedure on a five-point scale. The finding of this study showed that 160 (43%) of respondents were satisfied and the rest 212 (57%) of respondents were dissatisfied on informed consent provision (Figure 6).
Factors associated with Satisfaction of informed consent
In bivariate logistic regression 15 variables which had p-value less than 0.25 was considered as candidate variable for multivariate logistic analysis. These variables were age, educational status, residence, marital status, occupation, parity, type of surgery, referred history from other health facility, language of written consent form, timing of consent, time taken to provide informed consent, person signing the consent form, professional request the operation, knowledge to wards SIC and patient to healthcare providers relationships (Table 5).
In multivariable logistic analysis 5 variables had p-value less than 0.05. These variables were residence, referred history from other hospital, language of written consent form, time spent while provided SIC and patient to healthcare provider relationship statistically significant with outcome variable (Table 6).
The result of multivariable logistic regression analysis showed that the respondents who came from urban setting 2.2 times (AOR: 2.279, 95% CI: 1.257-4.131) more likely satisfied than those who came from rural residence. Respondents who haven’t referred history from other health setting were 1.8 times (AOR: 1.856, 95% CI: 1.033-3.337) more likely satisfied towards provision of informed consent compared to those who have referred history from other health facility.
Women received written informed consent with their mother tongue were two times (AOR: 2.076, 95% CI: 1.143-3.773) more likely satisfied towards informed consent than counterpart. Patients who had received information about surgical informed consent for 10 minutes duration were 5.2 times (AOR: 5.227, 95% CI: 2.499-10.936) more likely satisfied on provision of informed consent than patients who have received the information for less than 5 minute.
Furthermore women had good patient to health care providers relationship were 5.4 times (AOR: 5.419, 95% CI: 3.103-9.464) more likely satisfied towards informed consent process than counterpart.