Surrogate decision makers' attitudes towards research decision making for critically ill patients
Surrogate decision makers' attitudes towards research decision making for critically ill patients
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DOI：
10.1007/s00134-012-2625-x
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发表时间：
2012-10-01
影响因子：
38.9
通讯作者：
Scales, Damon C.
中科院分区：
文献类型：
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作者：
Barrett, Kali A.;Ferguson, Niall D.;Scales, Damon C.
为了考察替代决策者(SDMS)对他们参与ICU患者同意研究过程的态度和偏好，我们展示了五个ICU中的136名危重患者的SDMS，包括四个假设性研究情景：安慰剂对照RCT的基线干预研究；治疗并发症风险较高的研究；比较两种接受的治疗方法的研究；较短登记窗口的研究。对于每个人，我们询问SDMS他们是否愿意参与同意研究决策，并对他们对参与的舒适感和负担感的可接受性进行评级。使用医院焦虑和抑郁量表对参与者进行焦虑和抑郁症状筛查。对于基线情景，大多数SDMS希望参与研究决策(90%；95%可信区间84-95%)；不同研究组合的反应差异很小。大多数人认为他们的参与是可以接受的(85%；95%可信区间77-90%)，而一小部分人认为不能接受(2%；95%可信区间1-6%)。许多人对参与进来感到满意(50%；95%可信区间41-59%)，但当伤害风险较高(34%；95%可信区间26-43%)或注册窗口较短(41%；95%可信区间33-50%)时，这一数字减少。大多数人(62%)报告了焦虑症状，许多人(38%)有抑郁症状。大多数受访的SDMS希望参与危重疾病和无能力的亲人的研究决策。然而，当决策对时间敏感或感知到的风险更大时，他们希望参与其中的愿望存在变异性。
To examine the attitudes and preferences of surrogate decision makers (SDMs) regarding their involvement in the consent to research process for ICU patients.We presented 136 SDMs of critically ill patients in five ICUs with four hypothetical research scenarios: baseline interventional study of a placebo controlled RCT; study with higher risk of treatment complication; study comparing two accepted treatments; study with shorter enrolment window. For each we asked SDMs if they would want to be involved in the consent to research decision, and to rate the acceptability of their comfort with, and their sense of burden with their involvement. Participants were screened for symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale.For the baseline scenario, most SDMs wished to be involved in research decision making (90 %; 95 % CI 84-95 %); responses varied little across study permutations. The majority considered their involvement to be acceptable (85 %; 95 % CI 77-90 %), whereas, a small minority rated it as being unacceptable (2 %; 95 % CI 1-6 %). Many were comfortable with being involved (50 %; 95 % CI 41-59 %), but the number decreased when risk of harm was higher (34 %; 95 % CI 26-43 %) or enrolment window was shorter (41 %; 95 % CI 33-50 %). A majority (62 %) reported symptoms of anxiety and many (38 %) had symptoms of depression.Most of the interviewed SDMs wished to be involved in research decision making for critically ill and incapable loved ones. Variability existed, however, in their desire to be involved when decisions were time-sensitive or perceived risk was greater.