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Ethical issues in social research: difficulties encountered gaining access to children in hospital for research
K Stalker1, J Carpenter, C Connors
1Social Work Research Centre, University of Stirling, UK. kos1@stir.ac.uk
Insights
Gaining access to children in hospitals for social research proved challenging due to complex ethical review processes and data protection concerns. Streamlining these procedures is vital for successful child health research.
Area of Science:
- Pediatric Health Services Research
- Social Science Research Methodology
- Child Welfare Studies
Background:
- Investigated challenges in recruiting children for social research within healthcare settings.
- Focused on a 2-year study exploring experiences of children with prolonged hospital stays.
Purpose of the Study:
- To document and analyze difficulties in accessing pediatric populations for social research.
- To identify systemic barriers hindering social research with children in health care.
Main Methods:
- Sought ethical approval from multi-site and local research ethics committees (MREC, LREC).
- Required agreement from NHS trusts and nominated liaison persons for recruitment.
- Obtained consent from parents and children for guided conversations.
Main Results:
- Encountered significant and unexpected delays in the research access process.
- Ultimately recruited a sample of 15 children, falling short of the initial target of 24.
- Identified multiple contributing factors to access difficulties.
Conclusions:
- Similar access challenges reported by other social researchers in NHS settings.
- Barriers include ethics committee screening, data protection laws, confidentiality concerns, and child abuse awareness.
- Recommended streamlining access procedures and empowering children's participation in research decisions.
Background:
This paper recounts the difficulties experienced when the authors sought access to children in hospital for social research interviews. These were part of a 2-year study, funded by the Joseph Rowntree Foundation, aiming to explore the numbers, circumstances and experiences of children who spend prolonged periods in health care settings.
Methods:
As the intention was to carry out 'guided conversations' with 24 young people in various different NHS locations, permission to do so was sought from a multi-site research ethics committee (MREC), and from several local research ethics committees (LRECs). Agreement was then necessary from NHS trusts, which were asked to nominate a liaison person to help identify and recruit children to the study. Consent was also required from individual parents and children. A series of unexpected delays encountered during this process are discussed in some detail. Eventually a sample of 15 children was achieved.
Discussion:
The second part of the paper locates this experience within a wider context, noting that similar difficulties gaining access to children in NHS settings have recently been reported by other social researchers. Several possible reasons for this trend are identified and discussed. These relate to the role of MRECs and LRECs in screening social research proposals, recently implemented legislation about data protection, heightened concerns within the NHS about confidentiality and consent, and increasing awareness of the risk of child abuse in health care settings.
Conclusion:
Finally, some suggestions for facilitating the access process are discussed. They include the sensitive and appropriate application of research governance frameworks to social research - including studies within health care settings. Ethical considerations and adequate protection of children are vital but, the authors argue, wherever possible children themselves should be encouraged to decide whether or not to participate in research. In addition, unnecessarily complex access procedures may adversely affect research outcomes.
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