Perception of Informed Consent and Its Associated Factors among Surgical Patients Attending Public Hospitals in North Shoa Zone, Oromia, Ethiopia, 2024: A Mixed Methods Study

Background Informed consent is a critical process in surgical procedures, ensuring that patients are fully aware of the risks, benefits, and alternatives to a proposed treatment. Poor patient perception of informed consent can undermine shared decision-making, limit patients' autonomy, increase anxiety, and result in postoperative dissatisfaction. This study aimed to assess the perception of informed consent and its associated factors among surgical patients attending public hospitals in North Shoa Zone, Oromia, Ethiopia. Methods A cross-sectional mixed-methods study was conducted on 375 surgical patients from June 1 to July 15, 2024. Quantitative and qualitative data were collected using systematic random sampling and purposive sampling, respectively. A pretested, interviewer-administered questionnaire was used for the quantitative study, and the data were entered into Epidata version 4.6 and analyzed with statistical package of social science version 26. Variables with a p-value < 0.25 in bivariable logistic regression analysis were included in the multivariable analysis, with significance declared at p-value ≤ 0.05. For the qualitative study, thematic analysis was done, and results were triangulated with quantitative findings. Results A total of 360 patients participated in the study, giving a response rate of 96%. The study revealed that the poor perception of informed consent for surgical procedures was 35% (95% CI: 30.1%–40.2%). Inability to read and write (AOR = 7.79; 95% CI: 3.40–17.86), rural residency (AOR = 2.78; 95% CI: 1.32–5.86), not informing family before signing consent (AOR = 7.54; 95% CI: 2.20–25.83), informed consent not written in the patient's mother tongue (AOR = 4.21; 95% CI: 1.32–13.45), poor patient-physician relationship (AOR = 4.09; 95% CI: 1.99–8.43), and poor knowledge of informed consent (AOR = 4.79; 95% CI: 2.39–9.56) were independent predictors of poor perception of informed consent for surgical procedures. For the qualitative study, twelve participants were interviewed through an in-depth interview, and three themes emerged: inadequate provision of information to patients, autonomy/decision-making, and insufficient time for discussion and decision-making. Conclusions In this study, nearly one third (35%) of surgical patients had a poor perception of informed consent. Therefore, hospital managers, the Ethiopian Federal Ministry of Health, and policymakers should develop strategies and raise awareness about informed consent among surgical patients.