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儿童参与临床研究:影响家长同意决定的因素

Participation of children in clinical research: factors that influence a parent's decision to consent.

作者信息

Tait Alan R, Voepel-Lewis Terri, Malviya Shobha

机构信息

Department of Anethesiology, University of Michigan Health System, Ann Arbor, USA.

出版信息

Anesthesiology. 2003 Oct;99(4):819-25. doi: 10.1097/00000542-200310000-00012.

DOI:10.1097/00000542-200310000-00012
PMID:14508312
Abstract

BACKGROUND

Given the initiatives of the National Institutes of Health and other agencies to include children in research, it is important to understand the factors that influence their participation. This study was designed to identify factors that influence parents' decisions to consent to their child's participation in clinical research.

METHODS

This survey study consisted of 505 parents who had been approached for permission to allow their child to participate in a clinical anesthesia or surgery study at a large tertiary care children's hospital. Regardless of whether the parents consented to (consenters, n = 411), or declined (nonconsenters, n = 94) their child's participation in a study, they were offered the opportunity to complete a questionnaire eliciting information regarding factors that had influenced their decision.

RESULTS

Consenters exhibited less uncertainty in their decision making, were more trusting of the medical system, had greater understanding of the research, and believed that the environment in which consent was sought was less pressured than nonconsenters. Predictors of consent included low perceived risk, degree to which the parent read the consent document, characteristics of the consent document, parental understanding, perceived importance of the study, and perceived benefits.

CONCLUSIONS

Identification of factors that influence parents' decisions to allow their child to participate in a clinical research study will be important by way of developing strategies to improve the manner in which study information is disclosed and to ensure that parents are truly informed.

摘要

背景

鉴于美国国立卫生研究院及其他机构倡议将儿童纳入研究,了解影响他们参与研究的因素很重要。本研究旨在确定影响家长决定同意其子女参与临床研究的因素。

方法

这项调查研究包括505名家长,他们曾被征求是否允许其子女参与一家大型三级儿童专科医院的临床麻醉或手术研究。无论家长是否同意(同意者,n = 411)或拒绝(不同意者,n = 94)其子女参与研究,他们都有机会填写一份问卷,以获取有关影响其决定的因素的信息。

结果

同意者在决策时表现出较少的不确定性,对医疗系统更信任,对研究有更深入的理解,并且认为征求同意的环境比不同意者所感受到的压力更小。同意的预测因素包括感知到的低风险、家长阅读同意文件的程度、同意文件的特征、家长的理解、研究的感知重要性以及感知到的益处。

结论

确定影响家长决定让其子女参与临床研究的因素,对于制定改善研究信息披露方式的策略以及确保家长真正了解情况非常重要。

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