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Polfuss M, Mooney-Doyle K, Keller M, Gralton KS, Giambra B, Vance A. Developing a Family Resource: Considerations for Family Member Research Participation. JOURNAL OF FAMILY NURSING 2023; 29:202-222. [PMID: 36935575 DOI: 10.1177/10748407231157433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
When individuals participate in health care research, the choice often affects the entire family. Researchers are responsible for protecting participants and minimizing any burdens the research may place on them. Resources to educate potential study participants about these issues from a family perspective are lacking. A family-focused, evidence-based resource was created for individuals and families to prompt discussion prior to their consenting to enrollment in research. The resource includes key relevant questions to consider related to their study participation and was revised based on input from family nurse scientists and a hospital-based family advisory group. This resource raises awareness of the importance of employing a family lens when designing research and during the recruitment and enrollment of participants. Adopting a family lens in health care research will support the participant's ability to make an informed choice regarding participation and may ultimately enhance the experience of participants and their families and study outcomes.
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Affiliation(s)
- Michele Polfuss
- University of Wisconsin - Milwaukee, Milwaukee, WI, USA
- Children's Wisconsin, Milwaukee, WI, USA
| | | | | | | | - Barbara Giambra
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati, Cincinnati, OH, USA
| | - Ashlee Vance
- Michigan State University, Detroit, USA
- Michigan State University, East Lansing, MI, USA
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Alarjeh G, Boufkhed S, Alrjoub W, Guo P, Yurduşen S, Ahmed F, Abdal-Rahman M, Alajarmeh S, Alnassan A, Al-Awady S, Kutluk T, Harding R, Shamieh O. Communication and information sharing with pediatric patients including refugees with advanced cancer, their caregivers, and health care professionals in Jordan: a qualitative study. Front Oncol 2023; 13:1118992. [PMID: 37182158 PMCID: PMC10172987 DOI: 10.3389/fonc.2023.1118992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/11/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction Effective communication in pediatric palliative cancer care is an important aspect of practice to enhance patient- and family-centered care, and to optimize decision-making. However, little is known about communication preferences practices from the perspectives of children, caregivers and their health care professionals (HCPs) in the Middle Eastern region. Furthermore, involving children in research is crucial but limited. This study aimed to describe the communication and information-sharing preferences and practices of children with advanced cancer, their caregivers, and health care professionals in Jordan. Methods A qualitative cross-sectional study was conducted using semi-structured face to face interviews with three groups of stakeholders (children, caregivers and HCPs). Purposive sampling recruited a diverse sample from inpatient and outpatient settings at a tertiary cancer center in Jordan. Procedures were in line with the Consolidated criteria for reporting qualitative research (COREQ) reporting guidelines. Verbatim transcripts were thematically analyzed. Findings Fifty-two stakeholders participated: 43 Jordanian and 9 refugees (25 children, 15 caregivers and 12 HCPs). Four major themes emerged: 1) Hiding information between the three stakeholders which includes parents who hide the information from their sick children and ask the HCPs to do so to protect the child from distressful emotions and children who hide their suffering from their parents to protect them from being sad; 2) Communication and sharing of clinical versus non-clinical information; 3) Preferred communication styles such as use of a companionate approach by acknowledging patients and caregivers' suffering, building a trustful relationship, proactive information sharing, considering child age and medical status, parents as facilitators in communication, and patients' and caregivers' health literacy; 4) Communication and information sharing with refugees where they had dialect issues, which hindered effective communication. Some refugees had unrealistically high expectations regarding their child's care and prognosis, which posed challenges to communication with staff. Discussion The novel findings of this study should inform better child-centered practices and better engage them in their care decisions. This study has demonstrated children's ability to engage in primary research and to express preferences, and parents' ability to share views on this sensitive topic.
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Affiliation(s)
- Ghadeer Alarjeh
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
- Department of Palliative care, King Hussein Cancer Center (KHCC), Amman, Jordan
- *Correspondence: Ghadeer Alarjeh, ; Omar Shamieh,
| | - Sabah Boufkhed
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, United Kingdom
| | - Waleed Alrjoub
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
- Department of Palliative care, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Ping Guo
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
- School of Nursing and Midwifery, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Sema Yurduşen
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye
- Department of Psychology, Ankara Science University, Ankara, Türkiye
| | - Fahad Ahmed
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye
- Department of Public Health, Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Türkiye
| | - Mousa Abdal-Rahman
- Department of Palliative care, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Sawsan Alajarmeh
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
- Department of Palliative care, King Hussein Cancer Center (KHCC), Amman, Jordan
| | - Anwar Alnassan
- Department of Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Shireen Al-Awady
- Department of Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Türkiye
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, United Kingdom
| | - Omar Shamieh
- Center for Palliative & Cancer Care in Conflict (CPCCC), King Hussein Cancer Center (KHCC), Amman, Jordan
- Department of Palliative care, King Hussein Cancer Center (KHCC), Amman, Jordan
- College of Medicine, the University of Jordan, Amman, Jordan
- *Correspondence: Ghadeer Alarjeh, ; Omar Shamieh,
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Nebeker C, Gholami M, Kareem D, Kim E. Applying a Digital Health Checklist and Readability Tools to Improve Informed Consent for Digital Health Research. Front Digit Health 2021; 3:690901. [PMID: 34713167 PMCID: PMC8521887 DOI: 10.3389/fdgth.2021.690901] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/17/2021] [Indexed: 11/24/2022] Open
Abstract
Background: As research involving human participants increasingly occurs with the aid of digital tools (e.g., mobile apps, wearable and remote pervasive sensors), the consent content and delivery process is changing. Informed consent documents to participate in research are lengthy and difficult for prospective participants to read and understand. As the consent communication will need to include concepts and procedures unique to digital health research, making that information accessible and meaningful to the prospective participant is critical for consent to be informed. This paper describes a methodology that researchers can apply when developing a consent communication for digital health research. Methods: A consent document approved by a US institutional review board was deconstructed into segments that aligned with federal requirements for informed consent. Three researchers independently revised each segment of text with a goal of achieving a readability score between a 6–8th grade level. The team then consulted with an external readability expert well-versed in revising informed consent documents into “plain language.” The resulting text was evaluated using Microsoft Word and Online-Utility accessibility software. The final step involved adding visual images and graphics to complement the text. The Digital Health Checklist consent prototype builder was then used to identify areas where the consent content could be expanded to address four key domains of Access and Usability, Privacy, Risks and Benefits, and Data Management. Results: The approved consent was evaluated at a 12.6 grade reading level, whereas the revised language by our study team received 12.4, 12, and 12.58, respectively. The final consent document synthesized the most readable of the three revised versions and was further revised to include language recommended by the software tool for improving readability, which resulted in a final revised consent readability score of a 9.2 grade level. Moreover, word count was reduced from 6,424 in the original consent to 679 in the rewritten consent form. Conclusion: Utilizing an iterative process to design an accessible informed consent document is a first step in achieving meaningful consent to participate in digital health research. This paper describes how a consent form approved by an institutional review board can be made more accessible to a prospective research participant by improving the document readability score, reducing the word count and assessing alignment with the Digital Health Checklist.
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Affiliation(s)
- Camille Nebeker
- Research Center for Optimal Digital Ethics in Health, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.,Design Lab, University of California, San Diego, La Jolla, CA, United States
| | - Maryam Gholami
- Research Center for Optimal Digital Ethics in Health, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.,Design Lab, University of California, San Diego, La Jolla, CA, United States
| | - Daniah Kareem
- Research Center for Optimal Digital Ethics in Health, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States.,Design Lab, University of California, San Diego, La Jolla, CA, United States
| | - Emily Kim
- Research Center for Optimal Digital Ethics in Health, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
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