Evidence map›Paper›PMID 36471294›Full record

ArticleBMC medical ethics2022

Guardians and research staff experiences and views about the consent process in hospital-based paediatric research studies in urban Malawi: A qualitative study.

Mtisunge Joshua Gondwe, Neema Mtunthama Toto, Charity Gunda, Markus Gmeiner, Ian J C MacCormick, David Lalloo, Michael Parker, Nicola Desmond

Abstract read
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Article in BMC medical ethics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mtisunge Joshua GondweMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi. mtisungejoshua@gmail.com.ORCID 0000-0003-2091-1488
Neema Mtunthama TotoMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Charity GundaMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Markus GmeinerRadboud University Medical Centre, Nijmegen, The Netherlands.
Ian J C MacCormickMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
David LallooLiverpool School of Tropical Medicine, Liverpool, UK.
Michael ParkerThe Ethox Centre, University of Oxford, Oxford, UK.
Nicola DesmondMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.

Funding

Wellcome Trust Strategic Award 096527
6 · The paper itself

Abstract

backgroundObtaining consent has become a standard way of respecting the patient's rights and autonomy in clinical research. Ethical guidelines recommend that the child's parent/s or authorised legal guardian provides informed consent for their child's participation. However, obtaining informed consent in paediatric research is challenging. Parents become vulnerable because of stress related to their child's illness. Understanding the views held by guardians and researchers about the consent process in Malawi, where there are limitations in health care access and research literacy will assist in developing appropriate consent guidelines.

methodsWe conducted 20 in-depth interviews with guardians of children and research staff who had participated in paediatric clinical trial and observational studies in acute and non-acute settings in the Southern Region of Malawi. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Interviews were compared across studies and settings to identify differences and similarities in participants' views about informed consent processes. Data analysis was facilitated by NVIVO 11 software.

resultsAll participants across study types and settings reported that they associated participating in research with therapeutic benefits. Substantial differences were noted in the decision-making process across study settings. Guardians from acute studies felt that the role of their spouses was neglected during consenting, while staff reported that they had problems obtaining consent from guardians when their partners were not present. Across all study types and settings, research staff reported that they emphasised the benefits more than the risks of the study to participants, due to pressure to recruit. Participants from non-acute settings were more likely to recall information shared during the consent process than participants in the acute setting.

conclusionThe health care context, culture and research process influenced participants' understanding of study information across study types and settings. We advise research managers or principal investigators to define minimum requirements that would not compromise the consent process and conduct study specific training for staff. The use of one size fits all consent process may not be ideal. More guidance is needed on how these differences can be incorporated during the consent process to improve understanding and delivery of consent. Trial registration Not applicable.

Indexed as

Informed ConsentParentsResearch PersonnelChildClinical Trials as TopicHospitalsHumansMalawiObservational Studies as TopicQualitative ResearchAcute settingNon-acute settingPaediatric informed consent

Identifiers

PMID36471294
PMCPMC9720930

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.