The nurse's role in the informed consent process

Guideline and Implementation of Osteosarcoma Nursing Care for Children and Adolescents

Clinical trials on pediatric oncology use therapeutic techniques with the overwhelming majority of children's cancer patients obtaining therapy via clinical investigation procedures. Medical treatment is scheduled according to a specific protocol for enrolled patients. These protocols often do not refer to nursing care. Nursing care, on the other hand, must complement the medical care specified in the medical research protocol. Safe treatment administration, assessment of treatment responses, patients' and families' education, and communication with the whole medical team are just a few of the critical nursing tasks that should be properly managed. Nursing care standards have been developed in this study to strike a good balance between the procedure for clinical research and the nursing care connected with it. These recommendations outline the nursing activities and considerations that must be made while caring for pediatric cancer patients who are engaged in a specific clinical investigation procedure. The objective of this study is to outline the procedure through which nursing care guidelines could be developed and evaluated. The goal of this study was to find out the involvement of nurses in the process of health education for osteosarcoma and family patients.

Barriers and Facilitators to Obtaining Informed Consent in a Critical Care Pediatric Research Ward in Southern Malawi

Informed consent is an ethical requirement in clinical research. Obtaining informed consent is challenging in resource-constrained settings. We report results of a formative qualitative study that examined factors that facilitate and hinder informed consent for clinical research among critically ill children in Malawi. We argue that truly informed consent in a pediatric intensive care unit (PICU) is challenged by parental distress, time constraints when balancing care for critically ill patients with research-related tasks, and social hierarchies and community mistrust toward certain research procedures. We interviewed health care providers and parents of children attending a critical care unit to identify potential challenges and solicit strategies for addressing them. Providers and caregivers suggested practical solutions to enhance research participant understanding of clinical trial research, including the use of visual materials, community engagement strategies, and using patients as advocates in promoting understanding of research procedures.

Nurses’ Perceptions of Phase I Clinical Trials in Pediatric Oncology: A Review of the Literature

A review of literature was conducted to explore nurses’ perceptions of phase I clinical trials in pediatric oncology. Specifically, nurses’ perceptions of the goals and outcomes, the nurse’s role, and the informed consent process in pediatric oncology phase I clinical trials were investigated. Findings on possible factors influencing the nurses’ perceptions and the quality of work-life of nurses working at pediatric phase I clinical trial centers were also searched. However, despite an extensive review of published works, no studies on nurses’ perceptions of phase I trials in pediatric oncology were found. Therefore, this literature review consists of findings in similar or related studies such as nurses’ perceptions of experimental therapies in the adult setting, adult patients’ perceptions, parents’ perceptions, or oncologists’perceptions of phase I clinical trials.

Osteosarcoma Nursing Care Guidelines: A Tool to Enhance the Nursing Care of Children and Adolescents Enrolled on a Medical Research Protocol

Clinical trials dominate the therapeutic approaches used in pediatric oncology with the majority of pediatric oncology patients receiving treatment on medical research protocols. These protocols detail the medical treatment that enrolled patients will receive. Nursing care is not described in these documents. However, nursing care must complement the medical care as written in the medical research protocol. Administering treatments safely, assessing treatment responses, educating patients and families, and communicating with the entire health care team are some of the essential nursing responsibilities that must be carefully orchestrated. Nursing care guidelines, as described here, were created to provide the careful balance between the medical research protocol and associated nursing care. These guidelines describe the nursing actions and considerations involved in caring for pediatric oncology patients enrolled on a particular medical research protocol. The purpose of this article is to describe the process used to create and evaluate nursing care guidelines.

The clinical trials nurse as subject advocate for minority and culturally diverse research subjects

Minority involvement in clinical trials is necessary to promote diversification in health-related research. The clinical trials nurse is uniquely qualified to advocate for and ensure the success of the minority participant in clinical trials research during the processes of recruitment, informed consent, and retention of subjects. This article incorporates a review of literature in conjunction with the American Nurses Association's standard of practice number 7 regarding ethics to demonstrate how the role of the clinical trials nurse as subject advocate can facilitate successful participation of minorities in clinical trial research.

An exploratory survey of nurses' perceptions of phase I clinical trials in pediatric oncology

This study suggests that nurses' perceptions of pediatric oncology phase I clinical trials are diverse and mixed but are more likely to be positive than negative. Improving future treatments, medical benefit, improved quality of life, and hope were cited as potential benefits of phase I clinical trials, but nurses felt that families were hoping for a cure. Toxicities, false hope, and decreased quality of life were perceived as potential negative outcomes. Acting as a patient advocate was viewed as the most important nursing role, and providing information was identified to be the most important purpose of informed consent. Although not statistically significant, data suggest that age, experience, and practice setting may influence nurses' perceptions. Younger or less experienced nurses were more likely to report either positive or negative perceptions, whereas older or more experienced nurses expressed mixed or moderate perceptions. Inpatient nurses reported more negative perceptions compared with outpatient nurses. The respondents report that caring for patients on phase I had both positive and negative effects on their quality of nursing work life.

Quality of informed consent: measuring understanding among participants in oncology clinical trials

PURPOSE/OBJECTIVES

To describe newly enrolled clinical trial subjects' knowledge and understanding of the oncology clinical trials in which they were participating.

DESIGN

Descriptive, correlational.

SETTING

The oncology center of a small community hospital in New England.

SAMPLE

8 patients who consented to enroll in oncology clinical trials.

METHODS

The Quality of Informed Consent questionnaire was sent to 17 potential participants who recently had consented to participate in oncology clinical trials.

MAIN RESEARCH VARIABLES

Knowledge of the basic elements of informed consent and participants' understanding of the clinical trials in which they were enrolled.

FINDINGS

Scores on the Quality of Informed Consent questionnaire indicated that participants had a good overall understanding of the basic elements of informed consent as well as the clinical trials in which they were enrolled. However, half of the sample failed to understand that clinical trial treatment is not standard treatment and may involve additional risk when compared with standard treatment.

CONCLUSIONS

The results of this investigation provide valuable feedback regarding participants' understanding of the informed consent process. The Quality of Informed Consent questionnaire may be a useful tool for monitoring the quality of the informed consent process and contributing to patients' understanding of clinical trials and the research process.

IMPLICATIONS FOR NURSING

The Quality of Informed Consent questionnaire may provide valuable feedback regarding clinical trial participants' understanding of clinical trials and the research process. Individual responses to questions on the questionnaire may be used to aid personalized patient education and validation of the informed consent throughout trial enrollment. Future research efforts need to focus on the development of reliable tools to measure participants' understanding of informed consent and nursing interventions that improve the informed consent process as well as enhance patients' understanding of the research process.