Wang Xueqin, Yu Xin, Appelbaum Paul S, Tang Hongyu, Yao Guizhong, Si Tianmei, Ma Yating, Li Tao, Yu Ling, Shi Chuan, Ma Yibin, Li Lingli
Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.
Peking University Sixth Hospital, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.
Schizophr Res. 2016 Jan;170(1):162-7. doi: 10.1016/j.schres.2015.11.019. Epub 2015 Dec 8.
This study explores the efficacy of a one-week informed consent information training process for improving competence to provide consent in stable community patients with schizophrenia over a one-year follow-up period.
A one-week training session designed to enhance competence to provide informed consent for research was conducted. The training was guided by a research protocol that provided detailed explanations of each major conceptual unit. Participants were followed for one year, and comprised 50 stable community outpatients with schizophrenia who were randomly assigned to either an intervention group (IG, n=33) or a control group (CG, n=17) that did not receive any training. The Chinese Mandarin MacArthur Competence Assessment Tool-Clinical Research (MacCAT-CR) was used to assess competence for informed consent pre-training (baseline), post-training (one week later), and at the end of one year.
A repeated measures analysis comparing the IG and CG at pre-training, post-training and the one-year follow-up revealed significant improvements in the Understanding and Appreciation subscale following the one-week training. However, by the end of one year, scores returned to baseline levels, with the exception of the Appreciation subscale, which was below baseline. There were significant main effects across time on the Appreciation and Reasoning subscales, indicating considerable changes over time. The CG showed no significant changes from pre-training to one week later or at one-year follow-up for all subscales.
The capacities of understanding and appreciation can be improved in stable community patients with schizophrenia after one week of training; however, this training effect is not sustained one year later. The results suggest that more intensive or periodic trainings may be needed to maintain long-term competence levels in patients with schizophrenia, particularly with regard to their capacity to appreciate the nature and consequences of study participation.
本研究探讨了为期一周的知情同意信息培训过程在一年随访期内提高稳定的社区精神分裂症患者同意能力的效果。
开展了为期一周的培训课程,旨在提高研究知情同意能力。培训以一份研究方案为指导,该方案对每个主要概念单元进行了详细解释。对50名稳定的社区精神分裂症门诊患者进行了一年的随访,这些患者被随机分为干预组(IG,n = 33)或未接受任何培训的对照组(CG,n = 17)。使用中文普通话版的麦克阿瑟临床研究能力评估工具(MacCAT-CR)在培训前(基线)、培训后(一周后)和一年结束时评估知情同意能力。
一项重复测量分析比较了干预组和对照组在培训前(基线)、培训后和一年随访时的情况,结果显示,为期一周的培训后,理解和领会子量表有显著改善。然而,到一年结束时,除领会子量表低于基线外,分数恢复到了基线水平。领会和推理子量表在不同时间有显著的主效应,表明随时间有相当大的变化。对照组在所有子量表上从培训前到一周后或一年随访时均无显著变化。
稳定的社区精神分裂症患者在接受一周培训后,理解和领会能力可得到提高;然而,这种培训效果在一年后无法持续。结果表明,可能需要更密集或定期的培训来维持精神分裂症患者的长期能力水平,特别是在他们领会研究参与的性质和后果的能力方面。