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Parental experiences of being approached to join multiple neonatal clinical trials: qualitative study (PARENT)
Judy Richards1, Judith Rankin1, Ed Juszczak2
1Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
Insights
Parents of preterm infants generally accept multiple research study enrollments, prioritizing individual study risks and benefits. They value decision autonomy, though some experience fatigue or guilt, highlighting the need for ongoing consent and awareness of parental emotions.
Area of Science:
- Neonatal Research Ethics
- Clinical Trial Recruitment
- Parental Decision-Making
Background:
- Recruiting preterm infants for multiple research studies presents unique ethical considerations.
- Understanding parental experiences is crucial for improving trial enrollment processes.
Purpose of the Study:
- To explore parents' perceptions and experiences when approached for multiple research study enrollments for their preterm infant.
- To identify factors influencing parental decisions regarding concurrent trial participation.
Main Methods:
- Qualitative study employing 17 in-depth, semi-structured interviews.
- Participants were parents of preterm infants approached for multiple studies and who consented to at least one.
Main Results:
- Most parents did not perceive concurrent enrollment as a major issue, focusing on individual study risks/benefits.
- Some parents felt fatigued or experienced guilt when declining subsequent studies.
- Trust in healthcare professionals and belief in research benefits were key motivators for consent.
Conclusions:
- Parents value autonomy in decision-making regarding research participation.
- Research teams should be mindful of parental emotions like guilt and gratitude.
- Consideration of parental stress and infant condition is vital for informed and ongoing consent.
Objective:
To explore parents' perceptions and experience of being approached for enrolment of their preterm infant in more than one trial or study.
Design:
A qualitative study involving 17 in-depth semistructured interviews, with parents who had been approached for multiple studies and who subsequently consented for their infant(s) to join at least one. Parents who declined all studies were not approached.
Setting And Participants:
Parents of preterm infants receiving care at one of three neonatal intensive care units in the north of England.
Findings:
Most parents did not view concurrent participation in multiple trials or studies as a significant issue within the wider context of their infant's care. Most parents did not feel pressured into enrolling their infant into more than one study, but some suggested that participation in several provided justification for the subsequent refusal to join others, articulating feeling of guilt at saying 'no', and others appeared fatigued by multiple approaches. Parents focused on the perceived risks and benefits of each individual study and, while acknowledging that making a fully informed decision was not possible, largely agreed due to their belief in the benefits of research, trust in the health professionals caring for their baby and a range of complex personal motivations.
Conclusions:
Parents valued the autonomy to make decisions about participation and felt, with hindsight, that their decisions were right. Research teams could be more aware of parental feelings of guilt or gratitude that may motivate them to give consent. Similarly, the capacity of parents to fully remember details of multiple studies when they are stressed, and their infant is sick, should be taken into consideration, and continued efforts should be made to ensure ongoing consent to participation.
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