University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA.
J Neurosci Nurs. 2010 Feb;42(1):47-57. doi: 10.1097/jnn.0b013e3181c1fdd9.
Cognitive deficits in participants and the abrupt and traumatic way in which many neurological conditions present are two examples of the unique challenges in recruiting and retaining participants with neurological injury for research studies. The purpose of this investigation was to identify obstacles to recruitment and retention in three ongoing research studies. These studies involve persons with neurological disorders across the continuum of care, from those newly diagnosed and with emergent presentation to those with more established chronic neurological conditions. For this analysis, we evaluated the effectiveness of the strategies employed to improve participation rates. The first study was a project funded by the National Institutes of Health designed to identify biomarkers of vasospasm in persons (n = 496) with aneurysmal subarachnoid hemorrhage who presented to the neurovascular intensive care unit (National Institute of Nursing Research, R01 NR004339). The purpose of the second study was to examine biobehavioral interactions in family caregivers (n = 59) of persons with a primary malignant brain tumor recruited in the community setting. The third project involved recruiting persons (n = 1,019) within an outpatient neurosurgical center to participate in a research registry. To determine differential effectiveness of strategies, consent and attrition rates were calculated at serial points over time in three studies, and recruitment and retention strategies were compared. Sentinel time points in participants' disease trajectories played a key role in determining whether those who were approached to participate gave consent and were retained, particularly in the studies involving persons with aneurysmal subarachnoid hemorrhage (consent = 85%; retention = 89%) and persons with primary malignant brain tumors and their caregivers (consent = 68%; retention = 83%). In addition, several specific recruiter and interviewer training techniques were associated with higher recruitment and retention. Targeted strategies to improve participation rates are vital for neuroscience nurses involved in any aspect of clinical research, including those who conduct studies, assist with data collection, and recruit potential participants.
参与者的认知缺陷以及许多神经状况的突然和创伤性表现，这两个因素是招募和保留神经损伤参与者进行研究的独特挑战的两个例子。本研究的目的是确定三项正在进行的研究中招募和保留参与者的障碍。这些研究涉及处于护理连续体中的神经障碍患者，从新诊断且表现为紧急情况的患者到患有更确定的慢性神经状况的患者。在这项分析中，我们评估了提高参与率所采用策略的有效性。第一项研究是由美国国立卫生研究院资助的一个项目，旨在识别蛛网膜下腔出血患者（n = 496）血管痉挛的生物标志物，这些患者就诊于神经血管重症监护病房（国家护理研究研究所，R01NR004339）。第二项研究的目的是研究社区中招募的原发性恶性脑肿瘤患者的家属照顾者的生物行为相互作用（n = 59）。第三个项目涉及在门诊神经外科中心招募患者（n = 1,019）参与研究登记。为了确定策略的不同效果，在三项研究中的不同时间点计算了同意和流失率，并比较了招募和保留策略。参与者疾病轨迹中的关键时间点在确定被邀请参与的人是否同意并保留方面起着关键作用，特别是在涉及蛛网膜下腔出血患者（同意率 = 85%；保留率 = 89%）和原发性恶性脑肿瘤患者及其照顾者的研究中（同意率 = 68%；保留率 = 83%）。此外，一些特定的招聘人员和访谈者培训技术与更高的招募和保留率相关。针对提高参与率的策略对于参与任何临床研究的神经科学护士都至关重要，包括那些进行研究、协助数据收集和招募潜在参与者的护士。
