Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
J Med Ethics. 2011 Jul;37(7):420-3. doi: 10.1136/jme.2010.035899. Epub 2010 Aug 16.
Paediatric clinical research faces unique challenges that compromise optimal recruitment of children into clinical trials. A main barrier to enrolment of children is parental misconceptions about the research process. In developing countries, there is a knowledge gap regarding parental perceptions of and attitudes towards their children's participation in clinical trials.
To explore such perceptions and attitudes in Lebanese parents.
33 in-depth interviews were conducted with parents with and without previous research experience. Interviews were tape-recorded, transcribed in colloquial Arabic, and later subjected to thematic analysis.
Benefit/risk ratio assessment was a major determinant of parental consent. Fear of adverse events or painful procedures in research was a recurring theme in most interviews. Whereas perception of direct benefit to the child, trust in the physician or institution, financial gains or having a positive previous experience in research facilitated consent, a complex informed consent form and misunderstanding of the term 'randomisation' hindered parental approval of participation.
Lebanese parents have perceptions of and attitudes towards children's participation in clinical trials that are similar to those reported from the industrialised world. Improving communication with parents and building trust between researchers and parents is important for successful recruitment. Investigators planning to conduct paediatric trials in developing countries need to simplify consent forms and devise new ways to explain randomisation.
儿科临床研究面临独特的挑战,这些挑战影响了儿童最佳入组临床试验的机会。阻碍儿童入组的一个主要障碍是家长对研究过程的误解。在发展中国家,关于家长对其子女参与临床试验的看法和态度,存在知识差距。
探讨黎巴嫩家长的这些看法和态度。
对有和没有既往研究经验的家长进行了 33 次深入访谈。访谈进行了录音,并以口语化的阿拉伯语记录下来,随后进行了主题分析。
受益/风险比评估是家长同意的主要决定因素。对研究中不良事件或痛苦程序的恐惧是大多数访谈中的一个反复出现的主题。而对孩子直接受益、对医生或机构的信任、经济收益或对研究的积极既往经验的认知,促进了同意的意愿,但复杂的知情同意书和对“随机化”一词的误解,阻碍了家长对参与的认可。
黎巴嫩家长对儿童参与临床试验的看法和态度与工业化国家报道的类似。改善与家长的沟通以及在研究人员和家长之间建立信任,对于成功招募至关重要。计划在发展中国家开展儿科试验的研究人员需要简化知情同意书,并设计新的方法来解释随机化。