Department of Anesthesiology, Michigan Institute for Clinical and Health Research, University of Michigan Health System, Ann Arbor; Center for Bioethics and Social Sciences in Medicine, University of Michigan Health System, Ann Arbor; Michigan Institute for Clinical and Health Research, University of Michigan Health System, Ann Arbor.
Department of Physical Medicine and Rehabilitation, Michigan Institute for Clinical and Health Research, University of Michigan Health System, Ann Arbor; Michigan Institute for Clinical and Health Research, University of Michigan Health System, Ann Arbor.
Acad Pediatr. 2018 May-Jun;18(4):370-375. doi: 10.1016/j.acap.2017.06.005. Epub 2017 Jun 10.
Despite the importance of child assent, there is little consensus on what information should be disclosed and what information is most important to children for decision-making. This study was designed to compare children's/adolescents' priorities for research information with the information parents believe is most important to their children.
Child-parent dyads completed separate and independent surveys regarding information (risks, benefits, etc) that they perceived to be most important to the child to make decisions about participating in a hypothetical randomized controlled trial. Parents responded in the context of what information they believed their child (not themselves) would think important.
Fifty-five parent-child dyads completed surveys. Although all information was deemed important, children/adolescents put greater emphasis on privacy and less on knowing the purpose of the study and the benefits compared with what their parents believed was important to their child. Adolescents (13-17 years old) placed greater importance on knowing the procedures, direct benefits, and the voluntary nature of participation compared with younger children (8-12 years old). Parents of older girls in particular placed greater emphasis on their daughter's need to know the purpose of the study, the procedures, benefits, and voluntary nature, compared with parents of boys.
Results show that the information priorities of children/adolescents considering participation in a randomized controlled trial differ from that which their parents think is important to them. Pediatric researchers can use this knowledge to ensure that parents do not conflate their own expectations/priorities with those of their child and that children receive the information they need.
尽管儿童同意的重要性不言而喻,但对于应该披露哪些信息以及哪些信息对儿童决策最重要,尚未达成共识。本研究旨在比较儿童/青少年对研究信息的优先事项与父母认为对孩子最重要的信息。
儿童-家长二人组分别完成了关于他们认为对孩子做出参与假设性随机对照试验决策最重要的信息(风险、收益等)的独立调查。父母的回答是基于他们认为自己的孩子(而不是他们自己)会认为什么信息重要。
55 对父母-孩子完成了调查。尽管所有信息都被认为很重要,但儿童/青少年更强调隐私,而不是了解研究目的和收益,这与他们父母认为对孩子重要的信息相比有所不同。青少年(13-17 岁)比年幼的孩子(8-12 岁)更强调了解程序、直接收益和参与的自愿性质。特别是年龄较大的女孩的父母比男孩的父母更强调女儿需要了解研究目的、程序、收益和自愿性质。
研究结果表明,考虑参与随机对照试验的儿童/青少年的信息优先事项与父母认为对他们重要的信息不同。儿科研究人员可以利用这些知识来确保父母不会将自己的期望/优先事项与孩子的期望/优先事项混淆,并确保孩子获得他们需要的信息。