Wouter Leclercq

Impact paragraph 205 14 IMPACT PARAGRAPH In this paragraph a reflection in layman’s language is presented on the achieved or expected scientific and social impact of the results of the research described in this thesis. By answering four questions the impact of this thesis is explained. Research What is the main aim of the research described in the thesis and what are the main results and conclusions? In chapter 1 the general aim of this thesis is stated as: to study methods of improving patient counselling before and after an operation. More specifically 1. To study history as well as the current and future status of the surgical informed consent (SIC) process. 2. To evaluate various characteristics of SIC of general, orthopaedic and plastic surgeons in daily practice 3. To report on perceptions and experiences of young adults undergoing bariatric surgery regarding the SIC process. 4. To assess the relation between SIC and Shared Decision Making (SDM) in general surgery. 5. To analyse characteristics of malpractice claims and Medical Disciplinary Board (MDB) decisions regarding SIC in the Netherlands. 6. To evaluate currently used SIC forms in general surgery in the Netherlands and to provide a best-practice SIC form for surgeon and patient. 7. To evaluate the effect of a personalised e-health-care programme on ‘return to normal activities’ after surgery. In chapter 9 we concluded that: 1. An adequate implementation of the elements of the SIC process will contribute to an optimal patient care. Training both patient and surgeon supported by e-health tools may improve the SIC process in daily practice. 2. Overall knowledge of Dutch general, orthopaedic and plastic surgeons regarding SIC is far from optimal. Education, dedication and the use of innovative tools are needed to improve SIC in daily practice in the Netherlands. 3. The SIC process in young adults undergoing bariatric surgery requires improvement Educational material on possible scenarios after bariatric surgery including risks and lifetime consequences should be developed. 4. Shared decision making (SDM) and SIC share certain aspects but SDM-Q-9 and SDM- Q-Doc questionnaires are inadequate for SIC related research.