We have identified efforts by research ers to investigate interventions which seek to improve information delivery and consideration of information to enhance  informed consent .
The interventions used consistently improve patient knowledge , an important prerequisite for informed consent .
This is encouraging and these measures could be widely employed although we are not able to say with confidence which types of interventions are preferable .
Our results should be interpreted with caution due to the high levels of heterogeneity associated with many of the main analyses although we believe there is broad evidence of beneficial outcomes for patients with the pragmatic application of interventions .
BACKGROUND Achieving informed consent is a core clinical procedure and is required before any surgical or invasive procedure is undertaken .
However , it is a complex process which requires patients be provided with information which they can underst and and retain , opportunity to consider their options , and to be able to express their opinions and ask questions .
There is evidence that at present some patients undergo procedures without informed consent being achieved .
OBJECTIVES To assess the effects on patients , clinicians and the healthcare system of interventions to promote informed consent for patients undergoing surgical and other invasive healthcare treatments and procedures .
AUTHORS ' CONCLUSIONS Informed consent is an important ethical and practical part of patient care .
Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia.
BACKGROUND Provision of preoperative information can alleviate patients ' anxiety . However , the ideal method of delivering this information is unknown . Video information has been shown to reduce patients ' anxiety , although little is known regarding the effect of preoperative multimedia information on anxiety in patients undergoing regional anaesthesia . METHODS We r and omized 110 patients undergoing upper or lower limb surgery under regional anaesthesia into the study and control groups . The study group watched a short film ( created by the authors ) depicting the patient 's in-hospital journey including either a spinal anaesthetic or a brachial plexus block . Patients ' anxiety was assessed before and after the film and 1 h before and within 8 h after their operation , using the Spielberger state trait anxiety inventory and a visual analogue scale . RESULTS There was no difference in state and trait anxiety between the two groups at enrollment . Women had higher baseline state and trait anxiety than men ( P=0.02 ) . Patients in the control group experienced an increase in state anxiety immediately before surgery ( P<0.001 ) , and patients in the film group were less anxious before operation than those in the control group ( P=0.04 ) . After operation , there was a decrease in state anxiety from baseline in both groups , but patients in the film group were less anxious than the control group ( P=0.005 ) . CONCLUSIONS Preoperative multimedia information reduces the anxiety of patients undergoing surgery under regional anaesthesia . This type of information is easily delivered and can benefit many patients
We have identified efforts by research ers to investigate interventions which seek to improve information delivery and consideration of information to enhance  informed consent .
The interventions used consistently improve patient knowledge , an important prerequisite for informed consent .
This is encouraging and these measures could be widely employed although we are not able to say with confidence which types of interventions are preferable .
Our results should be interpreted with caution due to the high levels of heterogeneity associated with many of the main analyses although we believe there is broad evidence of beneficial outcomes for patients with the pragmatic application of interventions .
BACKGROUND Achieving informed consent is a core clinical procedure and is required before any surgical or invasive procedure is undertaken .
However , it is a complex process which requires patients be provided with information which they can underst and and retain , opportunity to consider their options , and to be able to express their opinions and ask questions .
There is evidence that at present some patients undergo procedures without informed consent being achieved .
OBJECTIVES To assess the effects on patients , clinicians and the healthcare system of interventions to promote informed consent for patients undergoing surgical and other invasive healthcare treatments and procedures .
AUTHORS ' CONCLUSIONS Informed consent is an important ethical and practical part of patient care .