Screening for Understanding of Research in the Inpatient Psychiatry Setting

Overview

Journal J Empir Res Hum Res Ethics

Specialty Medical Ethics

Date 2011 Sep 21

PMID 21931239

Citations 9

Authors

Norval J Hickman

Judith J Prochaska

Laura B Dunn

Affiliations

Soon will be listed here.

Abstract

People with mental illness constitute a substantial proportion of smokers and an important population for smoking cessation research. Obtaining informed consent in this population is a critical ethical endeavor. We examined performance on a three-item instrument (3Q) designed to screen for understanding of several key elements of research: study purpose, risks, and benefits. Patients were clinically diagnosed with primary unipolar depression (n = 40), a primary psychotic disorder (n = 32), both mood and psychotic disorders (n = 17), and primary bipolar disorder (n = 14). Among an ethnically diverse sample of 124 psychiatric inpatients approached for a smoking cessation trial, 107 (86%) performed adequately on the 3Q (i.e., obtained a score of at least 3 out of a possible 6). Patients were better able to identify the study risks and benefits than to describe the study purpose. The 3Q appears to be a useful tool for researchers working with vulnerable psychiatric patients.

Citing Articles

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References

Dunn L, Gordon N . Improving informed consent and enhancing recruitment for research by understanding economic behavior. JAMA. 2005; 293(5):609-12. DOI: 10.1001/jama.293.5.609. View

Appelbaum P . Decisional capacity of patients with schizophrenia to consent to research: taking stock. Schizophr Bull. 2005; 32(1):22-5. PMC: 2632185. DOI: 10.1093/schbul/sbi063. View

Palmer B, Dunn L, Appelbaum P, Jeste D . Correlates of treatment-related decision-making capacity among middle-aged and older patients with schizophrenia. Arch Gen Psychiatry. 2004; 61(3):230-6. DOI: 10.1001/archpsyc.61.3.230. View

Moser D, Schultz S, Arndt S, Benjamin M, Fleming F, Brems C . Capacity to provide informed consent for participation in schizophrenia and HIV research. Am J Psychiatry. 2002; 159(7):1201-7. DOI: 10.1176/appi.ajp.159.7.1201. View

Palmer B, Dunn L, Appelbaum P, Mudaliar S, Thal L, Henry R . Assessment of capacity to consent to research among older persons with schizophrenia, Alzheimer disease, or diabetes mellitus: comparison of a 3-item questionnaire with a comprehensive standardized capacity instrument. Arch Gen Psychiatry. 2005; 62(7):726-33. DOI: 10.1001/archpsyc.62.7.726. View

Palmer B, Cassidy E, Dunn L, Spira A, Sheikh J . Effective use of consent forms and interactive questions in the consent process. IRB. 2008; 30(2):8-12. View

Dunn L, Jeste D . Enhancing informed consent for research and treatment. Neuropsychopharmacology. 2001; 24(6):595-607. DOI: 10.1016/S0893-133X(00)00218-9. View

Moser D, Reese R, Hey C, Schultz S, Arndt S, Beglinger L . Using a brief intervention to improve decisional capacity in schizophrenia research. Schizophr Bull. 2005; 32(1):116-20. PMC: 2632198. DOI: 10.1093/schbul/sbi066. View

Roberts L, Warner T, Brody J . Perspectives of patients with schizophrenia and psychiatrists regarding ethically important aspects of research participation. Am J Psychiatry. 2000; 157(1):67-74. DOI: 10.1176/ajp.157.1.67. View

10.

Lidz C, Appelbaum P, Grisso T, Renaud M . Therapeutic misconception and the appreciation of risks in clinical trials. Soc Sci Med. 2004; 58(9):1689-97. DOI: 10.1016/S0277-9536(03)00338-1. View

11.

Jeste D, Palmer B, Appelbaum P, Golshan S, Glorioso D, Dunn L . A new brief instrument for assessing decisional capacity for clinical research. Arch Gen Psychiatry. 2007; 64(8):966-74. DOI: 10.1001/archpsyc.64.8.966. View

12.

Dunn L, Nowrangi M, Palmer B, Jeste D, Saks E . Assessing decisional capacity for clinical research or treatment: a review of instruments. Am J Psychiatry. 2006; 163(8):1323-34. DOI: 10.1176/ajp.2006.163.8.1323. View

13.

Roberts L . The ethical basis of psychiatric research: conceptual issues and empirical findings. Compr Psychiatry. 1998; 39(3):99-110. DOI: 10.1016/s0010-440x(98)90068-2. View

14.

Appelbaum P . Consent in impaired populations. Curr Neurol Neurosci Rep. 2010; 10(5):367-73. DOI: 10.1007/s11910-010-0123-5. View

15.

Dunn L . Capacity to consent to research in schizophrenia: the expanding evidence base. Behav Sci Law. 2006; 24(4):431-45. DOI: 10.1002/bsl.698. View

16.

Grady C . Vulnerability in research: individuals with limited financial and/or social resources. J Law Med Ethics. 2009; 37(1):19-27. DOI: 10.1111/j.1748-720X.2009.00347.x. View

17.

Dunn L, Kim D, Fellows I, Palmer B . Worth the risk? Relationship of incentives to risk and benefit perceptions and willingness to participate in schizophrenia research. Schizophr Bull. 2008; 35(4):730-7. PMC: 2696364. DOI: 10.1093/schbul/sbn003. View

18.

Prochaska J, Hall S, Hall S . Stage-tailored tobacco cessation treatment in inpatient psychiatry. Psychiatr Serv. 2009; 60(6):848. PMC: 2705755. DOI: 10.1176/ps.2009.60.6.848. View

19.

Carpenter Jr W, Gold J, Lahti A, Queern C, Conley R, Bartko J . Decisional capacity for informed consent in schizophrenia research. Arch Gen Psychiatry. 2000; 57(6):533-8. DOI: 10.1001/archpsyc.57.6.533. View

20.

Dunn L, Candilis P, Roberts L . Emerging empirical evidence on the ethics of schizophrenia research. Schizophr Bull. 2005; 32(1):47-68. PMC: 2632189. DOI: 10.1093/schbul/sbj012. View