Meneguin Silmara, Zoboli Elma L C P, Domingues Raquel Z L, Nobre Moacyr R, César Luiz A M
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brasil.
Arq Bras Cardiol. 2010 Jan;94(1):4-9. doi: 10.1590/s0066-782x2010000100003.
In clinical tests, the Informed Consent is critical to preserve the ethics, but due to its high complexity level, it cannot be fully understood. This study assesses the Informed Consent as viewed by patients.
We addressed the issue of what do patients understand about the studies based on the IC.
We invited participants of outpatient clinical drug trials phase II, III and IV to answer a questionnaire with 29 questions, such as: why have you accepted to participate? Did you read the Informed Consent before signing it? By signing it, were you sure you have fully understood it? Eighty individuals (20 women and 60 men) showed up, from 106 patients. The variables of each question were considered as often as they appeared. The comparison of the averages among the groups was made by t tests of Student or Wilcoxon; and for associations, Chi-square or Likelihood Ratio, or Fisher's exact test.
Ages averaged 58.7 +/- 9.3 years. Concerning their reasons to taking part in the survey, 66.2% pointed out their own benefit; 42.5%, for science's sake; 25.0% claimed they were doing so at their doctor's request; 50% did not understand the Informed Consent properly; and 32.9% did not read it, but signed it. Among those who were administered placebo after randomization (n = 47), 66.7% did not understand the meaning of the informed consent. A strong correlation between failure to understand the meaning of placebo with literacy level (p = 0,02) was verified, which is an evidence that the smaller is the literacy level, the smaller is the understanding level.
The Informed Consent is poorly understood by patients and for some of them, trusting a doctor affected their decision in taking part in the clinical trial with drugs. Their literacy level also influenced their understanding of the term 'placebo'.
在临床试验中,知情同意书对于维护伦理道德至关重要,但由于其高度复杂性,患者无法完全理解。本研究评估了患者对知情同意书的看法。
我们探讨了基于知情同意书患者对研究了解多少这一问题。
我们邀请了门诊临床药物试验II期、III期和IV期的参与者回答一份包含29个问题的问卷,例如:您为什么同意参与?您在签署知情同意书之前阅读过吗?签署时,您确定自己完全理解了吗?106名患者中有80人(20名女性和60名男性)前来参与。每个问题的变量出现几次就统计几次。组间平均值的比较采用学生t检验或威尔科克森检验;对于关联性分析,采用卡方检验、似然比检验或费舍尔精确检验。
年龄平均为58.7±9.3岁。关于参与调查的原因,66.2%的人指出是为了自身利益;42.5%的人是出于对科学的考虑;25.0%的人声称是应医生要求;50%的人没有正确理解知情同意书;32.9%的人没有阅读但签署了。在随机分组后接受安慰剂治疗的患者中(n = 47),66.7%的人不理解知情同意书的含义。经证实,对安慰剂含义的理解不足与识字水平之间存在强烈相关性(p = 0.02),这表明识字水平越低,理解水平越低。
患者对知情同意书理解不足,对一些患者而言,信任医生影响了他们参与药物临床试验的决定。他们的识字水平也影响了他们对“安慰剂”一词的理解。