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识别支持关于参与试验的知情决策所需的同意信息组成部分:一项对癌症患者女性的访谈研究

Identifying components in consent information needed to support informed decision making about trial participation: An interview study with women managing cancer.

作者信息

Abhyankar Purva, Velikova Galina, Summers Barbara, Bekker Hilary L

机构信息

Leeds Institute of Health Sciences, University of Leeds, UK.

Leeds Institute for Molecular Medicine, St James's Institute of Oncology, University of Leeds, UK.

出版信息

Soc Sci Med. 2016 Jul;161:83-91. doi: 10.1016/j.socscimed.2016.05.040. Epub 2016 May 27.

Abstract

BACKGROUND

Research governance requires patients give informed consent to participate in clinical trials. However, there are concerns that consent information may not support patient participation decisions. This study investigates the utility of consent information in supporting women's trial participation decisions when receiving treatment for cancer.

DESIGN

An interview study with women receiving cancer treatments at a medical oncology outpatient clinic in Yorkshire (UK). All women over 18 years, not admitted to a hospital ward and who had currently or previously been invited to take part in a trial were invited to take part in the study over a three month period. Interviews were audio-tape recorded, transcribed and analysed using thematic analysis.

RESULTS

Of those eligible (n = 41), 21 women with breast (n = 11), ovarian (n = 8) and endometrial (n = 2) cancer participated (mean age = 57 years). Eighteen had made at least one trial decision and three were considering taking part in a trial. Findings are synthesised under two analytical themes: 1) Influence of the cancer and cancer treatment context on decision making for trial participation; and 2) Experiences of the consenting process and their influence on decision making.

CONCLUSIONS

Designing trial information to represent explicitly the trial participation decision as being between standard care and study-related care options is more likely to effectively support patients in making informed decisions between standard care treatments and taking part in a trial.

摘要

背景

研究治理要求患者在参与临床试验时给予知情同意。然而,有人担心同意信息可能无法支持患者的参与决策。本研究调查了同意信息在支持癌症治疗女性的试验参与决策方面的效用。

设计

对在英国约克郡一家肿瘤内科门诊接受癌症治疗的女性进行访谈研究。所有18岁以上、未入住医院病房且目前或之前被邀请参加试验的女性,在三个月的时间内被邀请参加该研究。访谈进行录音、转录并使用主题分析法进行分析。

结果

在符合条件的41名女性中,21名患有乳腺癌(11名)、卵巢癌(8名)和子宫内膜癌(2名)的女性参与了研究(平均年龄57岁)。18人至少做出了一项试验决策,3人正在考虑参加试验。研究结果归纳为两个分析主题:1)癌症和癌症治疗背景对试验参与决策的影响;2)同意过程的经历及其对决策的影响。

结论

将试验参与决策明确表示为标准护理和与研究相关的护理选择之间的选择,来设计试验信息,更有可能有效地支持患者在标准护理治疗和参加试验之间做出明智的决策。

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