School of Nursing, Midwifery and Social Work, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, M13 9PL,UK.
Midwifery. 2012 Aug;28(4):E478-85. doi: 10.1016/j.midw.2011.08.006. Epub 2011 Sep 22.
to provide insight into pregnant women's experiences of participating in a large multi-centre randomised trial.
qualitative semi-structured interviews.
six UK maternity units.
women recruited to the Magpie Trial. The Magpie Trial was a trial of prophylactic anticonvulsants for women with severe pre-eclampsia. MEASUREMENTS FINDINGS: a number of major but related themes emerged regarding influences on the women's decision-making: unpredictability of pre-eclampsia; quality of information received; role of others in the decision-making process; perceived personal benefit from trial participation; and perception of voluntariness of joining.
the data presented give valuable insights into the women's views and experiences of decision-making. Research into many of the other elements of care given during pregnancy and childbirth is still needed, and with this need comes the ethical responsibility of researchers to ensure trials are performed in the most scientifically robust ways, which are also acceptable to women. To examine the experiences of those involved in trial participation and their views about doing so is a crucial way of advancing this. The QUOTE Study increases understanding of the experiences of women participating in a randomised controlled trial.
the general implication for practice is that procedures are needed that can improve the design and conduct of randomised trials and therefore ultimately enhance the experience for future women. Recommendations include informed consent should be tailored, recognising individual differences in the desire for information. For instance the time individuals need to make consent decisions varies, as do their desires to consult with family before agreeing.
深入了解孕妇参与大型多中心随机试验的体验。
定性半结构化访谈。
六家英国产科病房。
Magpie 试验招募的妇女。Magpie 试验是一项针对严重先兆子痫妇女预防性抗惊厥药物的试验。
出现了一些重大但相关的主题,这些主题涉及影响妇女决策的因素:先兆子痫的不可预测性;所获得信息的质量;他人在决策过程中的作用;从试验参与中获得的个人利益感知;以及对加入的自愿性感知。
所呈现的数据为深入了解妇女在决策过程中的观点和体验提供了有价值的见解。仍需要对妊娠和分娩期间护理的许多其他要素进行研究,随着这种需求的出现,研究人员承担着确保试验以最科学的方式进行的伦理责任,这种方式对妇女也是可以接受的。检查参与试验的人的经历及其对参与试验的看法是推进这一研究的关键途径。QUOTE 研究增加了对参与随机对照试验的妇女的经验的理解。
对实践的一般启示是需要有程序来改进随机试验的设计和进行,从而最终增强未来妇女的体验。建议包括需要定制知情同意书,认识到信息需求方面的个体差异。例如,个人做出同意决定的时间不同,他们在同意之前与家人协商的愿望也不同。