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从协议因素的结构方程模型预测青少年哮喘研究参与决策。

Predicting adolescent asthma research participation decisions from a structural equations model of protocol factors.

机构信息

Center for Family and Adolescent Research, Oregon Research Institute, Albuquerque, New Mexico 87102, USA.

出版信息

J Adolesc Health. 2012 Sep;51(3):252-8. doi: 10.1016/j.jadohealth.2011.12.015. Epub 2012 Mar 3.

Abstract

PURPOSE

To examine similarities and differences in the process that parents and adolescents use to make decisions concerning participation in an asthma clinical trial. We hypothesized that a single conceptual model, tested through structural equations modeling, could explain adolescent assent and parent consent for adolescent research participation.

METHODS

One hundred nine adolescents enrolled with at least one parent and received an asthma evaluation from a pediatric asthma specialist and then evaluated a hypothetical asthma research protocol. Family members independently evaluated the protocol and made research participation decisions.

RESULTS

Perceived risk, benefit, and compensation were direct predictors of participation decisions for parents and adolescents. Adolescents perceived direct study benefit from the relationship with the physician, however parents did not. Parent decisions were most strongly associated with perceived risk, and parents associated discomfort with risk more strongly than did adolescents. Protocol procedures contributed to perceptions of benefit and discomfort for parents and adolescents.

CONCLUSIONS

Parent and adolescent research participation decisions are influenced by protocol variables in similar ways, although there are differences that account for disagreements within families. Findings may help investigators develop protocols that appeal to parents and adolescents and highlight issues of particular importance to address during the process of informed consent.

摘要

目的

探讨父母和青少年在参与哮喘临床试验决策过程中的相似点和不同点。我们假设,通过结构方程模型测试的单一概念模型,可以解释青少年同意和父母同意青少年参与研究的情况。

方法

109 名青少年及其至少一位家长参与,他们均接受了儿科哮喘专家的哮喘评估,然后评估了一个假设的哮喘研究方案。家庭成员独立评估方案并做出研究参与决策。

结果

感知风险、利益和补偿是父母和青少年参与决策的直接预测因素。青少年从与医生的关系中直接感受到研究的好处,但家长却没有。父母的决策与感知风险的关联最强,而父母对风险的不适与青少年相比更为强烈。方案程序为家长和青少年对利益和不适的感知做出了贡献。

结论

尽管存在导致家庭内部意见分歧的差异,但父母和青少年的研究参与决策受到方案变量的影响方式相似。研究结果可能有助于研究人员制定对父母和青少年有吸引力的方案,并强调在知情同意过程中需要特别注意的问题。

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本文引用的文献

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Informative inducement: study payment as a signal of risk.信息性激励:研究报酬作为风险的信号。
Soc Sci Med. 2010 Feb;70(3):455-464. doi: 10.1016/j.socscimed.2009.10.047. Epub 2009 Nov 18.
4
Clinical trials: the viewpoint of children.临床试验:儿童的观点。
Arch Dis Child. 2007 Aug;92(8):712-3. doi: 10.1136/adc.2006.114207. Epub 2007 Apr 3.

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