'Rumours' and clinical trials: a retrospective examination of a paediatric malnutrition study in Zambia, southern Africa
'Rumours' and clinical trials: a retrospective examination of a paediatric malnutrition study in Zambia, southern Africa
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DOI：
10.1186/1471-2458-10-556
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发表时间：
2010-09-17
影响因子：
4.5
通讯作者：
Kelly, Paul
中科院分区：
文献类型：
--
作者：
Kingori, Patricia;Muchimba, Maureen;Kelly, Paul
背景：许多在资源有限的环境中进行研究的公共卫生研究人员都经历过关于他们工作的负面“谣言”；据报道，在某些情况下，它们会带来严重的挑战并导致研究脱轨。然而，表面上看似“八卦”或“谣言”的东西也可以被视为和理解为代表当地关切的隐喻。对于不习惯参与者以这种方式表达担忧的研究人员来说，可能的反应可能是过度不安或相反的不屑一顾。本文是对国际研究小组在南部非洲赞比亚进行的一项营养不良研究的回顾性研究。还介绍了孩子参与这项研究的母亲的担忧以及一些以谣言形式表达的担忧。本文认为，这些焦虑有一个潜在的逻辑，简单地把它们当作“谣言”或“八卦”来驳斥它们，就会忽视促成它们产生的历史和社会经济因素。 方法：对参与研究的孩子的母亲和研究护士进行定性访谈。与母亲们进行了 25 次面对面访谈和 2 次焦点小组讨论 (FGD)。此外，还对参与试验的研究护士进行了面对面访谈。 结果：参与研究的孩子的母亲们以谣言的形式表达了一个突出的焦虑，即招募参加试验是孩子感染艾滋病毒的一个指标。其他担忧包括审判是巫术或撒旦教的幌子，孩子们的身体部位将被切除并出售。此外，为改善营养而给孩子们提供的流质奶类食品被怀疑营养不足，从而导致他们的病情恶化。这些焦虑所采取的形式，例如与盗窃身体部位有关的谣言以及对污名化状况的其他焦虑，提供了对此类环境中历史、社会经济和文化影响的洞察。结论：采用策略来理解当地问题应与研究目标相结合，以取得最佳成功。我们采访的参与者提出的担忧并非本研究所独有。它们是在历史、社会经济和文化背景以这种形式传达焦虑的国家中制作的。通过审查这项研究，我们表明，通过将这些“谣言”置于背景中，他们表达的担忧可以得到建设性的解决，进而导致研究目标的成功实施。
Background: Many public health researchers conducting studies in resource-constrained settings have experienced negative 'rumours' about their work; in some cases they have been reported to create serious challenges and derail studies. However, what may appear superficially as 'gossip' or 'rumours' can also be regarded and understood as metaphors which represent local concerns. For researchers unaccustomed to having concerns expressed from participants in this manner, possible reactions can be to be unduly perturbed or conversely dismissive. This paper represents a retrospective examination of a malnutrition study conducted by an international team of researchers in Zambia, Southern Africa. The fears of mothers whose children were involved in the study and some of the concerns which were expressed as rumours are also presented. This paper argues that there is an underlying logic to these anxieties and to dismiss them simply as 'rumours' or 'gossip' would be to overlook the historic and socio-economic factors which have contributed to their production.Methods: Qualitative interviews were conducted with the mothers whose children were involved in the study and with the research nurses. Twenty five face-to-face interviews and 2 focus group discussions (FGDs) were conducted with mothers. In addition, face-to-face interviews were conducted with research nurses participating in the trial.Results: A prominent anxiety expressed as rumours by the mothers whose children were involved in the study was that recruitment into the trial was an indicator that the child was HIV-infected. Other anxieties included that the trial was a disguise for witchcraft or Satanism and that the children's body parts would be removed and sold. In addition, the liquid, milk-based food given to the children to improve their nutrition was suspected of being insufficiently nutritious, thus worsening their condition. The form which these anxieties took, such as rumours related to the stealing of body parts and other anxieties about a stigmatised condition, provide an insight into the historical, socio-economic and cultural influences in such settings.Conclusions: Employing strategies to understand local concerns should accompany research aims to achieve optimal success. The concerns raised by the participants we interviewed are not unique to this study. They are produced in countries where the historic, socio-economic and cultural settings communicate anxieties in this format. By examining this study we have shown that by contextualizing these 'rumours', the concerns they express can be constructively addressed and in turn result in the successful conduct of research aims.