推进混合方法健康服务研究中的伦理学讨论。

Advancing discussion of ethics in mixed methods health services research.

机构信息

Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.

University of California San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, La Jolla, CA, USA.

出版信息

BMC Health Serv Res. 2021 Jun 15;21(1):577. doi: 10.1186/s12913-021-06583-1.

DOI:10.1186/s12913-021-06583-1

PMID:34126980

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8204431/

Abstract

BACKGROUND

To describe the ethical issues and experiences of scientists conducting mixed methods health services research and to advance empirical and conceptual discussion on ethical integrity in mixed methods health research.

METHODS

The study was conducted with 64 scholars, faculty and consultants from the NIH-funded Mixed Methods Research Training Program (MMRTP) for the Health Sciences. This was a cross-sectional study. Survey results were analyzed using descriptive statistics to characterize responses and open coding to summarize strategies about eight ethical mixed methods research issues. Respondents completed an online survey to elicit experiences related to eight ethical issues (informed consent, confidentiality, data management, burden, safety, equitable recruitment, communication, and dissemination) and strategies for addressing them.

RESULTS

Only about one-third of respondents thought their research ethics training helped them plan, conduct, or report mixed methods research. The most frequently occurring ethical issues were participant burden, dissemination and equitable recruitment (> 70% endorsement). Despite occurring frequently, < 50% of respondents rated each ethical issue as challenging. The most challenging ethical issues were related to managing participant burden, communication, and dissemination. Strategies reported to address ethical issues were largely not specific or unique to mixed methods with the exception of strategies to mitigate participant burden and, to a lesser degree, to facilitate equitable recruitment and promote dissemination of project results.

CONCLUSIONS

Mixed methods health researchers reported encountering ethical issues often yet varying levels of difficulty and effectiveness in the strategies used to mitigate ethical issues. This study highlights some of the unique challenges faced by mixed methods researchers to plan for and appropriately respond to arising ethical issues such as managing participant burden and confidentiality across data sources and utilizing effective communication and dissemination strategies particularly when working with a multidisciplinary research team. As one of the first empirical studies to examine mixed methods research ethics, our findings highlight the need for greater attention to ethics in health services mixed methods research and training.

摘要

背景

描述从事混合方法健康服务研究的科学家所面临的伦理问题和经验，推进混合方法健康研究中伦理完整性的实证和概念讨论。

方法

这项研究是在 NIH 资助的混合方法研究培训计划（MMRTP）的 64 名学者、教师和顾问中进行的。这是一项横断面研究。使用描述性统计分析对调查结果进行分析，以描述性的方式总结关于八项混合方法研究伦理问题的策略。受访者完成了一项在线调查，以了解与八项伦理问题（知情同意、保密、数据管理、负担、安全、公平招募、沟通和传播）相关的经验以及解决这些问题的策略。

结果

只有约三分之一的受访者认为他们的研究伦理培训有助于他们规划、进行或报告混合方法研究。最常出现的伦理问题是参与者负担、传播和公平招募（超过 70%的人表示赞同）。尽管频繁发生，但<50%的受访者认为每个伦理问题都具有挑战性。最具挑战性的伦理问题与管理参与者负担、沟通和传播有关。报告的解决伦理问题的策略在很大程度上不是混合方法特有的，除了减轻参与者负担的策略，以及在较小程度上促进公平招募和促进项目结果的传播的策略。

结论

混合方法健康研究人员报告说，他们经常遇到伦理问题，但在用于减轻伦理问题的策略的有效性和难度方面存在差异。这项研究强调了混合方法研究人员在规划和适当应对出现的伦理问题方面面临的一些独特挑战，例如在数据源之间管理参与者负担和保密性，并利用有效的沟通和传播策略，特别是在与多学科研究团队合作时。作为首批研究混合方法研究伦理的实证研究之一，我们的研究结果强调了需要更加关注健康服务混合方法研究和培训中的伦理问题。