Russell F M, Carapetis J R, Liddle H, Edwards T, Ruff T A, Devitt J
Centre for International Child Health, University of Melbourne Department of Paediatrics, Flemington Road, Parkville, Melbourne 3052, Australia.
J Med Ethics. 2005 Aug;31(8):490-4. doi: 10.1136/jme.2002.002279.
To pilot informed consent materials developed for Aboriginal parents in a vaccine trial, and evaluate their design and the informed consent process.
Cross sectional quantitative and qualitative survey of 20 Aboriginal and 20 non-Aboriginal women in Alice Springs. Information about the proposed research was presented to Aboriginal participants by an Aboriginal researcher, using purpose designed verbal, visual, and written materials. Non-Aboriginal participants received standard materials developed by the sponsor. Questionnaires were used to evaluate recall and understanding immediately and five days later. Qualitative analysis of Aboriginal participants' interviews was performed.
There were no differences between the groups in understanding of diseases prevented by the vaccine, the potential risks of participating, or the voluntary nature of participation. Most Aboriginal participants had difficulty with the concept of a "licensed" versus "unlicensed" vaccine. The non-Aboriginal group had a good understanding of this. Aboriginal participants identified the use of the flipchart, along with a presentation by a doctor and Aboriginal health worker, as preferred delivery modes. Group presentations were preferred rather than one-on-one discussions. The use of the questionnaire posed considerable methodological difficulties.
A one-off oral presentation to Aboriginal participants is unlikely to produce "informed consent". Key but unfamiliar concepts require identification and particularly considered presentation.
在一项疫苗试验中试用为原住民父母制定的知情同意材料,并评估其设计及知情同意过程。
对爱丽丝泉市的20名原住民女性和20名非原住民女性进行横断面定量和定性调查。一名原住民研究人员使用专门设计的口头、视觉和书面材料,向原住民参与者介绍拟开展的研究。非原住民参与者收到了主办方制定的标准材料。通过问卷调查在介绍后立即以及五天后评估回忆情况和理解程度。对原住民参与者的访谈进行了定性分析。
两组在对疫苗预防疾病的理解、参与的潜在风险或参与的自愿性质方面没有差异。大多数原住民参与者对“许可”疫苗与“未许可”疫苗的概念理解困难。非原住民组对此理解良好。原住民参与者认为使用活动挂图,以及医生和原住民卫生工作者的介绍是更可取的传达方式。小组介绍比一对一讨论更受欢迎。问卷的使用带来了相当大的方法学困难。
对原住民参与者进行一次性口头介绍不太可能产生“知情同意”。关键但不熟悉的概念需要识别并特别考虑其呈现方式。