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白内障手术临床试验中知情同意的决定因素:患者为何参与。

Determinants of informed consent in a cataract surgery clinical trial: why patients participate.

机构信息

University of Melbourne, Melbourne, Australia.

出版信息

Can J Ophthalmol. 2012 Apr;47(2):118-23. doi: 10.1016/j.jcjo.2012.01.006.

Abstract

OBJECTIVE

To identify the determinants of patients' decision-making for participation in a cataract surgery clinical trial in a tertiary care hospital.

DESIGN

Prospective observational study.

PARTICIPANTS

We interviewed by questionnaire 40 patients scheduled to have cataract surgery.

METHODS

The data collected from patients included attitudes about informed consent, evaluation of the provision of information, and sociodemographic variables.

RESULTS

Overall, 20 (50%) patients consented to enter the trial. All patients (n = 20;100%) in the consenting group expected positive implications compared to 6 (30%) in the nonconsenting group, who expected negative implications (p = 0.008). The majority of patients (90%) in the nonconsenting group felt that the degree of risk incurred by undergoing trial treatment was moderate to high. The perceived burden imposed on daily life by participating was seen by the nonconsenting group to be moderately higher in 11 patients (55%) compared to 3 patients (15%) in the consenting group (p = 0.026). Of the nonconsenting patients, 50% were dissatisfied with the attitudes of medical experiments as compared to 2% of those who did consent (p = 0.023).

CONCLUSION

The major reasons for participation in a cataract surgery trial were (i) expected positive implications resulting from involvement; and (ii) satisfaction with the attitudes of medical experiments. Patients who refused to enter the trial felt that the degree of risk as well as the burden imposed on daily life by participating were high. Demographic variables did not have any impact on a patients' decisions to accept or decline entry into the trial.

摘要

目的

确定在一家三级保健医院参与白内障手术临床试验的患者决策的决定因素。

设计

前瞻性观察性研究。

参与者

我们通过问卷对 40 名计划接受白内障手术的患者进行了访谈。

方法

从患者那里收集的数据包括对知情同意的态度、对信息提供的评估以及社会人口统计学变量。

结果

总体而言,有 20 名(50%)患者同意参加试验。所有同意组的患者(n=20;100%)都期望积极的影响,而不同意组的患者中有 6 名(30%)期望消极的影响(p=0.008)。不同意组的大多数患者(90%)认为接受试验治疗的风险程度中等偏高。不同意组的 11 名患者(55%)认为参与试验治疗对日常生活造成的负担比同意组的 3 名患者(15%)更高(p=0.026)。与同意组的 2%相比,不同意组的 50%的患者对医学实验的态度不满意(p=0.023)。

结论

参与白内障手术试验的主要原因是:(i)参与会带来预期的积极影响;以及(ii)对医学实验态度的满意。拒绝参加试验的患者认为参与的风险程度以及对日常生活造成的负担都很高。人口统计学变量对患者是否接受或拒绝参加试验没有任何影响。

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