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广泛同意将医疗保健与生物库相结合:在大型患者样本中了解和捐赠的原因。

Broad consent for health care-embedded biobanking: understanding and reasons to donate in a large patient sample.

机构信息

Institute of Epidemiology, Christan-Albrechts-Universität zu Kiel, Kiel, Germany.

Division of Biomedical Ethics, Institute of Experimental Medicine, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.

出版信息

Genet Med. 2018 Jan;20(1):76-82. doi: 10.1038/gim.2017.82. Epub 2017 Jun 22.

Abstract

PurposeTo facilitate ethically acceptable and practically successful health care-embedded biobanking, the attitudes and understanding of patients and their motivation to participate need to be explored.MethodsA questionnaire study was conducted among 760 outpatients of a northern German university hospital to assess their awareness of, and motivation for giving broad consent to health care-embedded biobanking, also addressing the issue of feedback on individual-level research findings.ResultsThe overall willingness to give broad consent was high (86.9%) in our study, even though the subjective and objective understanding of patients was found to be only modest. Most participants who consented did so for prosocial reasons (altruism, solidarity, reciprocity, gratitude), whereas self-interest or worries about disadvantages played only a marginal role. Better objective understanding was associated with both a greater demand for feedback on individual research findings and a higher willingness to consent. Intermittent modification of the information material provided by the hospital led to significantly improved objective understanding.ConclusionPatient willingness to give broad consent to health care-embedded biobanking is high, with prosocial reasons driving decision making more than factual knowledge and approval or disapproval of specific consent elements. Future efforts to improve the information material used in health care-embedded biobanking should therefore emphasize prosocial reasons to consent.

摘要

目的

为了促进在伦理上可接受和实际上成功的医疗保健嵌入式生物库,需要探索患者的态度和理解以及他们参与的动机。

方法

在德国北部一家大学医院的 760 名门诊患者中进行了一项问卷调查研究,以评估他们对医疗保健嵌入式生物库的广泛同意的认识和动机,同时也解决了关于个体研究结果反馈的问题。

结果

在我们的研究中,总体上愿意给予广泛同意的意愿很高(86.9%),尽管患者的主观和客观理解被发现只是适度的。大多数同意的参与者这样做是出于亲社会的原因(利他主义、团结、互惠、感激),而自身利益或对劣势的担忧只起了微不足道的作用。更好的客观理解与对个体研究结果的反馈的更高需求以及更高的同意意愿有关。医院提供的信息材料的间歇性修改导致客观理解显著提高。

结论

患者对医疗保健嵌入式生物库的广泛同意意愿很高,决策更多地受到亲社会原因的驱动,而不是事实知识和对具体同意要素的赞成或反对。因此,未来在医疗保健嵌入式生物库中改进使用的信息材料的努力应强调同意的亲社会原因。

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