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理解癌症临床试验参与者参与研究的决策:与知情同意、患者满意度和决策后悔相关的因素。

Understanding the decisions of cancer clinical trial participants to enter research studies: factors associated with informed consent, patient satisfaction, and decisional regret.

作者信息

Stryker Jo Ellen, Wray Ricardo J, Emmons Karen M, Winer Eric, Demetri George

机构信息

Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, rm 572, Atlanta, GA 30322, USA.

出版信息

Patient Educ Couns. 2006 Oct;63(1-2):104-9. doi: 10.1016/j.pec.2005.09.006. Epub 2005 Oct 19.

Abstract

OBJECTIVE

To understand the psychosocial outcomes related to decision-making processes of individuals eligible for participation in clinical trials.

METHODS

Individuals eligible to participate in selected clinical trials were contacted to complete two surveys; one shortly after participants were identified, and the second 6 weeks after the first survey was completed (N=50). Measures included subjective informed consent; satisfaction with decision-making; decisional regret; and timing of consent (early versus late signers). ANOVA and correlation coefficients were used to test the relationships between variables.

RESULTS

Early signers reported themselves to be less informed about the details of their particular clinical trials than later signers (M=81.9 versus 91.2; F=5.5; p=.02). There was a non-significant trend for early signers to be less satisfied with their decisions than late signers. Satisfaction with decision-making and subjective informed consent were both strongly associated with later decisional regret (r=-.32 and -.30, respectively). However, there was no relationship between timing of consent and decisional regret.

CONCLUSION

Participants who enroll in clinical trials quickly may not believe they fully understand the implications of trial participation. In general, participants who do not believe they fully understand the implications of trial participation, or who are less satisfied with their decision to enroll in the trial may ultimately feel regret about their decision to participate.

PRACTICE IMPLICATIONS

More effort is needed to ensure that clinical trial participants fully understand the risks and benefits of participation and are satisfied with their decision to enroll in a trial prior to signing consent forms.

摘要

目的

了解与符合参与临床试验条件的个体决策过程相关的社会心理结果。

方法

联系符合参与特定临床试验条件的个体,让他们完成两项调查;一项在确定参与者后不久进行,另一项在第一次调查完成6周后进行(N = 50)。测量指标包括主观知情同意;对决策的满意度;决策后悔;以及同意的时间(早期签署者与晚期签署者)。使用方差分析和相关系数来检验变量之间的关系。

结果

早期签署者报告称,他们对自己所参与的特定临床试验细节的了解不如晚期签署者(均值分别为81.9和91.2;F = 5.5;p = 0.02)。早期签署者对其决策的满意度略低于晚期签署者,但差异不显著。对决策的满意度和主观知情同意都与后期的决策后悔密切相关(相关系数分别为-0.32和-0.30)。然而,同意的时间与决策后悔之间没有关系。

结论

快速报名参加临床试验的参与者可能不认为自己完全理解参与试验的影响。一般来说,那些不认为自己完全理解参与试验的影响,或者对报名参加试验的决定不太满意的参与者,最终可能会对自己参与试验的决定感到后悔。

实践意义

需要做出更多努力,以确保临床试验参与者在签署同意书之前,充分理解参与试验的风险和益处,并对自己报名参加试验的决定感到满意。

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