Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
J Palliat Med. 2012 Mar;15(3):269-73. doi: 10.1089/jpm.2011.0304. Epub 2012 Feb 17.
In questionnaire-based research, human subject protection committees must assess the emotional impact of the study on participants. Without clear data about the risks and benefits of participating in such studies, however, review board members must use personal judgment to assess emotional harm.
To examine experiences of distress and value of participation in a study of prognosis communication among parents of children with cancer, and to identify factors associated with predominantly distressing research experiences.
We surveyed 194 parents of children with cancer (overall response rate, 70%), treated at the Dana-Farber Cancer Institute and Children's Hospital, Boston, Mass, in the first year after the child's cancer diagnosis. The survey focused on the child's prognosis and parent-physician communication; at the end, we asked parents how distressing and how useful completing the survey had been to them personally.
Only 1% of parents found research participation to be "very" distressing. The majority of parents were "not at all" distressed by participating (62%), and most reported that the questionnaire was at least "a little" useful to them personally (69%). Overall, 18% of parents gave higher ratings for distress than for utility. Parents were more likely to experience research participation as predominantly distressing when they found prognostic information to be upsetting (odds ratio [OR] 5.38, p=0.005).
Most participating parents were able to respond to questions about their child's prognosis with little or no distress. Even when distress was present, it was often accompanied by a perception that participating was of value.
在基于问卷的研究中,人体研究保护委员会必须评估研究对参与者的情绪影响。然而,由于缺乏有关参与此类研究的风险和收益的明确数据,审查委员会成员必须使用个人判断来评估情绪伤害。
检查在一项关于癌症患儿父母预后沟通的研究中,参与者的痛苦经历和参与价值,并确定与主要痛苦的研究经历相关的因素。
我们调查了马萨诸塞州波士顿丹娜-法伯癌症研究所和儿童医院治疗的 194 名癌症患儿的父母(总体响应率为 70%),这些患儿在癌症诊断后的第一年接受了治疗。调查重点是患儿的预后和父母与医生的沟通;在调查结束时,我们询问父母完成调查对他们个人的痛苦程度和有用程度。
只有 1%的父母认为研究参与“非常”痛苦。大多数父母对参与研究“毫不”感到困扰(62%),大多数人表示问卷调查对他们个人至少“有一点”有用(69%)。总体而言,18%的父母对痛苦的评价高于对效用的评价。当父母发现预后信息令人不安时,他们更有可能将研究参与视为主要痛苦(比值比 [OR] 5.38,p=0.005)。
大多数参与研究的父母能够在没有或几乎没有痛苦的情况下回答有关孩子预后的问题。即使存在痛苦,通常也伴随着一种参与是有价值的感知。