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MORECare 研究方法指导制定:姑息治疗和临终关怀研究中伦理问题的建议。

MORECare research methods guidance development: recommendations for ethical issues in palliative and end-of-life care research.

机构信息

Department of Palliative Care, Policy & Rehabilitation, Cicely Saunders Institute, King's College London, London, UK and Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Palliat Med. 2013 Dec;27(10):908-17. doi: 10.1177/0269216313488018. Epub 2013 May 21.

Abstract

BACKGROUND

There is little guidance on the particular ethical concerns that research raises with a palliative care population.

AIM

To present the process and outcomes of a workshop and consensus exercise on agreed best practice to accommodate ethical issues in research on palliative care.

DESIGN

Consultation workshop using the MORECare Transparent Expert Consultation approach. Prior to workshops, participants were sent overviews of ethical issues in palliative care. Following the workshop, nominal group techniques were used to produce candidate recommendations. These were rated online by participating experts. Descriptive statistics were used to analyse agreement and consensus. Narrative comments were collated.

SETTING/PARTICIPANTS: Experts in ethical issues and palliative care research were invited to the Cicely Saunders Institute in London. They included senior researchers, service providers, commissioners, researchers, members of ethics committees and policy makers.

RESULTS

The workshop comprised 28 participants. A total of 16 recommendations were developed. There was high agreement on the issue of research participation and high to moderate agreement on applications to research ethics committees. The recommendations on obtaining and maintaining consent from patients and families were the most contentious. Nine recommendations were refined on the basis of the comments from the online consultation.

CONCLUSIONS

The culture surrounding palliative care research needs to change by fostering collaborative approaches between all those involved in the research process. Changes to the legal framework governing the research process are required to enhance the ethical conduct of research in palliative care. The recommendations are relevant to all areas of research involving vulnerable adults.

摘要

背景

针对姑息治疗人群,研究引发的特定伦理问题几乎没有指导。

目的

展示姑息治疗研究中涉及伦理问题的最佳实践的研讨会和共识制定过程和结果。

设计

使用 MORECare 透明专家咨询方法进行咨询研讨会。在研讨会之前,向参与者发送姑息治疗伦理问题概述。研讨会结束后,采用名义群体技术生成候选建议。这些建议由参与的专家在线评分。使用描述性统计分析来分析协议和共识。收集了叙述性评论。

地点/参与者:姑息治疗伦理问题和研究方面的专家受邀参加了伦敦西塞莉·桑德斯研究所的研讨会。他们包括资深研究人员、服务提供者、专员、研究人员、伦理委员会成员和政策制定者。

结果

研讨会共有 28 名参与者。共制定了 16 项建议。对于研究参与的问题有很高的共识,对于向研究伦理委员会申请的共识程度高到中等。从患者和家属那里获得和维持同意的建议最具争议性。根据在线咨询的评论,对 9 项建议进行了细化。

结论

姑息治疗研究的文化需要通过促进所有参与研究过程的人之间的合作方法来改变。需要对监管研究过程的法律框架进行修改,以加强姑息治疗中的研究伦理行为。这些建议与涉及弱势成年人的所有研究领域都相关。

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