Freeman T R, Bass M J
Department of Family Medicine, University of Western Ontario, Canada.
Fam Pract. 1992 Mar;9(1):36-41. doi: 10.1093/fampra/9.1.36.
In a time when informed consent requires knowledge of the risks and benefits of medical care and technology to be communicated to the public, perceptions of benefits and risks of these techniques and procedures take on special importance. The purpose of the present study was to examine the determinants of maternal tolerance of vaccine-related side-effects in their children. A questionnaire was sent to 226 mothers of young children in southwestern Ontario seeking their opinion of the benefits and risks of selected medical procedures. It asked them to identify the risk of serious reactions they would tolerate for a new vaccine with benefits similar to that of pertussis vaccine. The response rate to the questionnaire was 92%. This group of young, well-educated mothers had high regard for some of the most common procedures and treatments used in family practice. The less common and more invasive procedures (heart surgery, brain surgery) were viewed as carrying almost as much risk as benefit. Abortion was perceived as involving more risk than benefit. Levels of acceptable risk with respect to a hypothetical new childhood vaccine were determined. A risk level of 1 in 1 million was the most popular level of acceptable risk, chosen by 25% of the respondents. The next most frequently chosen risk level was 1 in 100,000, chosen by 22%. Tolerance of possible vaccine side-effects did not differ with maternal age, education or prior experience with adverse vaccine or drug reactions. A summary net benefit score was derived for four technologies commonly used in family practice (antibiotics, vaccinations, birth control pills and X-rays).(ABSTRACT TRUNCATED AT 250 WORDS)
在一个需要将医疗护理和技术的风险与益处告知公众以获取知情同意的时代，对这些技术和程序的益处与风险的认知就显得尤为重要。本研究的目的是调查母亲对其子女疫苗相关副作用的耐受程度的决定因素。向安大略省西南部的226名幼儿母亲发放了一份问卷，询问她们对某些选定医疗程序的益处和风险的看法。问卷要求她们确定对于一种益处与百日咳疫苗相似的新疫苗，她们能容忍的严重反应风险。问卷的回复率为92%。这群年轻且受过良好教育的母亲对家庭医疗中一些最常见的程序和治疗评价很高。不太常见且侵入性更强的程序（心脏手术、脑部手术）被认为风险与益处几乎相当。堕胎被认为风险大于益处。确定了对于一种假设的新型儿童疫苗可接受的风险水平。百万分之一的风险水平是最受欢迎的可接受风险水平，25%的受访者选择了这一水平。其次最常被选择的风险水平是十万分之一，22%的受访者选择了这一水平。母亲对可能的疫苗副作用的耐受程度与母亲的年龄、教育程度或之前疫苗或药物不良反应的经历无关。得出了家庭医疗中常用的四种技术（抗生素、疫苗接种、避孕药和X光）的综合净益处评分。（摘要截选至250词）
