Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials

Background. In stressful situations, decision making processes related to informed consent may be compromised. Given the profound levels of distress that surrogates of children in pediatric intensive care units (PICU) experience, it is important to understand what factors may be influencing the deci...

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Main Authors: Laura E. Slosky, Marilyn Stern, Natasha L. Burke, Laura A. Siminoff
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:International Journal of Pediatrics
Online Access:http://dx.doi.org/10.1155/2014/676023
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author Laura E. Slosky
Marilyn Stern
Natasha L. Burke
Laura A. Siminoff
author_facet Laura E. Slosky
Marilyn Stern
Natasha L. Burke
Laura A. Siminoff
author_sort Laura E. Slosky
collection DOAJ
description Background. In stressful situations, decision making processes related to informed consent may be compromised. Given the profound levels of distress that surrogates of children in pediatric intensive care units (PICU) experience, it is important to understand what factors may be influencing the decision making process beyond the informed consent. The purpose of this study was to evaluate the role of clinician influence and other factors on decision making regarding participation in a randomized clinical trial (RCT). Method. Participants were 76 children under sedation in a PICU and their surrogate decision makers. Measures included the Post Decision Clinician Survey, observer checklist, and post-decision interview. Results. Age of the pediatric patient was related to participation decisions in the RCT such that older children were more likely to be enrolled. Mentioning the sponsoring institution was associated with declining to participate in the RCT. Type of health care provider and overt recommendations to participate were not related to enrollment. Conclusion. Decisions to participate in research by surrogates of children in the PICU appear to relate to child demographics and subtleties in communication; however, no modifiable characteristics were related to increased participation, indicating that the informed consent process may not be compromised in this population.
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spelling doaj-art-7e676f0abef64a79aa38c1065744faa82025-02-03T06:10:52ZengWileyInternational Journal of Pediatrics1687-97401687-97592014-01-01201410.1155/2014/676023676023Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical TrialsLaura E. Slosky0Marilyn Stern1Natasha L. Burke2Laura A. Siminoff3Division of Developmental and Behavioral Sciences, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USADepartment of Rehabilitation and Mental Health Counseling, University of South Florida, 13301 Bruce B. Downs Boulevard, MHC 1632, P.O. Box 12, Tampa, FL 33612, USADepartment of Psychology, University of South Florida, 4202 East Fowler Avenue, PCD4118G, Tampa, FL 33620, USADepartment of Social and Behavioral Health, Virginia Commonwealth University, P.O. Box 980149, Richmond, VA 23298, USABackground. In stressful situations, decision making processes related to informed consent may be compromised. Given the profound levels of distress that surrogates of children in pediatric intensive care units (PICU) experience, it is important to understand what factors may be influencing the decision making process beyond the informed consent. The purpose of this study was to evaluate the role of clinician influence and other factors on decision making regarding participation in a randomized clinical trial (RCT). Method. Participants were 76 children under sedation in a PICU and their surrogate decision makers. Measures included the Post Decision Clinician Survey, observer checklist, and post-decision interview. Results. Age of the pediatric patient was related to participation decisions in the RCT such that older children were more likely to be enrolled. Mentioning the sponsoring institution was associated with declining to participate in the RCT. Type of health care provider and overt recommendations to participate were not related to enrollment. Conclusion. Decisions to participate in research by surrogates of children in the PICU appear to relate to child demographics and subtleties in communication; however, no modifiable characteristics were related to increased participation, indicating that the informed consent process may not be compromised in this population.http://dx.doi.org/10.1155/2014/676023
spellingShingle Laura E. Slosky
Marilyn Stern
Natasha L. Burke
Laura A. Siminoff
Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials
International Journal of Pediatrics
title Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials
title_full Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials
title_fullStr Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials
title_full_unstemmed Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials
title_short Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials
title_sort decision making in the picu an examination of factors influencing participation decisions in phase iii randomized clinical trials
url http://dx.doi.org/10.1155/2014/676023
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