López-Parra Maria, Zamora-Carmona Francesc, Sianes-Gallén Mònica, López-González Esmeralda, Gil-Rey Dolors, Costa-Ventura Helena, Borrás-Sánchez Miriam, Rayo-Posadas Gemma, Arizu-Puigvert Marta, Vives-Vilagut Roser
Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc Taulí 1, Sabadell, 08206 Barcelona, Spain.
Institut Català de la Salut, North Metropolitan, 08924 Barcelona, Spain.
Healthcare (Basel). 2022 Jun 2;10(6):1036. doi: 10.3390/healthcare10061036.
The informed consent (IC) of subjects participating in experimental studies is the mainstay to comply with the ethical principle of autonomy to ensure that the participation is voluntary. This experience was performed within the context of a single-center randomized clinical trial in elective prosthetic surgery. Obtaining IC in clinical trials is not without difficulties, and especially in the case of vulnerable populations it can be very challenging. This work aimed to identify the difficulties during the IC process for a clinical trial in subjects older than 65 years old and quantify and describe the use of IC in front of a witness.
This is a mixed methodology study with a qualitative part (focus group with 4 nurses involved in the inclusion of subjects) and a quantitative part describing the characteristics of patients who signed IC forms.
The main difficulties identified are related to comprehension, sensory impairments, education level, and time. IC in front of witnesses was used in 20 patients out of 508.
The participation of subjects older than 65 years old in clinical trials requires an adaptation of the process. The use of IC in front of a witness should always be considered in studies including elderly subjects.
参与实验研究的受试者的知情同意是遵循自主伦理原则以确保参与是自愿的关键所在。本经验是在一项择期假体手术单中心随机临床试验的背景下开展的。在临床试验中获取知情同意并非毫无困难,尤其是对于弱势群体而言可能极具挑战性。这项工作旨在识别65岁以上受试者临床试验知情同意过程中的困难,并对有证人在场情况下知情同意的使用进行量化和描述。
这是一项混合方法研究,包括一个定性部分(对4名参与受试者纳入工作的护士进行焦点小组访谈)和一个定量部分,描述签署知情同意书的患者特征。
确定的主要困难与理解、感官障碍、教育水平和时间有关。508名患者中有20名在有证人在场的情况下签署了知情同意书。
65岁以上受试者参与临床试验需要对流程进行调整。在包括老年受试者的研究中应始终考虑在有证人在场的情况下使用知情同意。