Hamilton S, Hepper J, Hanby A, Hewison J
Newsam Centre, Seacroft Hospital Site, York Road, Leeds, West Yorkshire LS14 6WB, UK.
J Med Ethics. 2007 Apr;33(4):229-33. doi: 10.1136/jme.2006.016006.
(1) To investigate the quality of consent gained for the use in research of tissue that is surplus after surgery. (2) To compare the use of two consent forms: a simple locally introduced form and a more complex centrally instigated form. (3) To discuss the attitudes of patients towards the use of their surplus tissue in research.
Data were collected through interviews and analysed with a combination of quantitative and qualitative analytical techniques.
Patients of the breast care unit at a teaching hospital were interviewed at home or in a quiet room at the hospital.
57 people were interviewed out of 81 approached, between October 2003 and March 2004. Most participants had a poor level of knowledge about the consent they had given, but reported being happy about having given it. The patients who had signed the locally introduced form had considerably more knowledge than those who had signed the centrally instigated form (z = -2.56; p<0.05). Participants considered being well informed to be less important than believing that their opinions were valued and respected.
The findings suggest that traditional models of informed consent are not universally applicable and, in this case, seem to overstate what people wish to know. The simple consent form achieved a better quality of informed consent and provided a better model of practice than the complex form, and it seemed that a focused approach to consent seeking is more effective and acceptable than more complex approaches.
(1)调查手术剩余组织用于研究时所获知情同意的质量。(2)比较两种知情同意书的使用情况:一种是当地采用的简单表格,另一种是中央发起的更复杂的表格。(3)探讨患者对其剩余组织用于研究的态度。
通过访谈收集数据,并结合定量和定性分析技术进行分析。
对一家教学医院乳腺护理单元的患者在其家中或医院的安静房间进行访谈。
在2003年10月至2004年3月期间,共邀请了81人,其中57人接受了访谈。大多数参与者对他们所给予的知情同意了解程度较低,但表示对给予同意感到满意。签署当地采用表格的患者比签署中央发起表格的患者了解的知识要多得多(z = -2.56;p<0.05)。参与者认为,被充分告知不如相信自己的意见得到重视和尊重重要。
研究结果表明,传统的知情同意模式并非普遍适用,在这种情况下,似乎夸大了人们想要了解的内容。简单的同意书比复杂的同意书获得了更高质量的知情同意,并提供了更好的实践模式,而且针对性的征求同意方法似乎比更复杂的方法更有效且更易被接受。