Abstract
Objective:
This study examined parental beliefs about participating in clinical trials involving greater than minimal risk to their neonate, and explored their views of their experiences.
Study Design:
In this qualitative descriptive study, parents in the neonatal intensive care unit (NICU) who had been approached for permission for their neonates to be enrolled in research were asked to describe their decisions about their consent for or disagreement to their neonate's research participation. A total of 27 parents from three different hospital NICUs in the Mid-Atlantic region of the United States participated. Transcribed interviews were analyzed using qualitative content analysis.
Results:
Participant decisions developed through a dynamic process of meaning-making based on their beliefs about themselves and their neonates. The processes involved making sense of the chaos that they perceived in the environment and their own vulnerability, through taking control of their situation.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Burgess E, Singhal N, Amin H, McMillan DD, Devrome H . Consent for clinical research in the neonatal intensive care unit: a retrospective survey and a prospective study. Arch Dis Child Fetal Neonatal Ed 2003; 88: F280–F285; discussion F285–F286.
Singhal N, Oberle K, Burgess E, Huber-Okrainec J . Parents' perceptions of research with newborns. J Perinatol 2002; 22: 57–63.
Zupancic JA, Gillie P, Streiner DL, Watts JL, Schmidt B . Determinants of parental authorization for involvement of newborn infants in clinical trials. Pediatrics 1997; 99: 1–6.
Stenson BJ, Becher JC, McIntosh N . Neonatal research: the parental perspective. Arch Dis Child 2004; 89: F321–F323.
Mason SA, Allmark PJ . Obtaining informed consent to neonatal randomised controlled trials: interviews with parents and clinicians in the Euricon study. Lancet 2000; 356: 2045–2051.
Snowdon C, Garcia J, Elbourne D . Making sense of randomization; responses of parents of critically ill babies to random allocation of treatment in a clinical trial. Soc Sci Med 1997; 45: 1337–1355.
Sandelowski M . Whatever happened to qualitative description? Res Nurs Health 2000; 23: 334–340.
Gorden RL . Interviewing: Strategy, Techniques, and Tactics. Dorsey Press: Homewood, Ill, 1969 xiii, 388 pp.
Hsieh HF, Shannon SE . Three approaches to qualitative content analysis. Qualitative Health Research 2005; 15: 1277–1288.
Ryan GHB . Techniques to identify themes. Field Methods 2003; 15: 85–109.
Lincoln YS, Guba EG . Naturalistic Inquiry. Sage Publications: Beverly Hills, Calif, 1985 416 pp.
Guba EG . Criteria for assessing the trustworthiness of naturalistic inquiries. Ectj-Educational Communication and Technology Journal 1981; 29: 75–91.
Docherty SL, Miles MS, Holditch-Davis D . Worry about child health in mothers of hospitalized medically fragile infants. Adv Neonatal Care 2002; 2: 84–92.
Clark SM, Miles MS . Conflicting responses: the experiences of fathers of infants diagnosed with severe congenital heart disease. J Soc Pediatr Nurs 1999; 4: 7–14.
Thomasgard M, Metz WP . The vulnerable child syndrome revisited. J Dev Behav Pediatr 1995; 16: 47–53.
Gennaro S, York R, Brooten D . Anxiety and depression in mothers of low birthweight and very low birthweight infants: birth through 5 months. Issues in Comprehensive Pediatric Nursing 1990; 13: 97–109.
Pederson DR, Bento S, Chance GW, Evans B, Fox AM . Maternal emotional responses to preterm birth. Am J Orthopsychiatry 1987; 57: 15–21.
Noone J . Concept analysis of decision making. Nursing Forum 2002; 37 (3): 21–32.
Lipshitz R, Klein G, Orasanu J, Salas E . Focus article: taking stock of naturalistic decision making. Journal of Behavioral Decision Making 2001; 14: 331–352.
Lipshitz R . Converging themes in the study of decision making in realistic settings. In: Klein GA, Orasnu J, Calderwood R, Zsambok C (eds). Decision Making in Action: Models and Methods. Ablex Pub.: Norwood, NJ, 1993, pp 103–137.
American Academy of Pediatrics CoB. Informed consent, parental permission, and assent in pediatric practice. Pediatrics 1995; 95: 314–317.
Snowdon C, Elbourne D, Garcia J . Zelen randomization: attitudes of parents participating in a neonatal clinical trial. Controlled Clin Trials 1999; 20: 149–171.
Schwartz B . (Dorwin Cartwright Professor of Social Theory and Social Action, Swarthmore, PA) Electronic mail correspondence with Frances R. Ward (School of Nursing, University of Pennsylvania, Philadelphia, PA) 2006 Dec. 21.
Snowdon C, Elbourne D, Garcia J . ‘It was a snap decision’: parental and professional perspectives on the speed of decisions about participation in perinatal randomised controlled trials. Soc Sci Med 2006; 62: 2279–2290.
McMackin J, Slovic P . When does explicit justification impair decision making? Applied Cognitive Psychology 2000; 14: 527–541.
Wilson TD, Schooler JW . Thinking too much—introspection can reduce the quality of preferences and decisions. J Pers Soc Psychol 1991; 60: 181–192.
Wilson TD, Lisle DJ, Schooler JW, Hodges SD, Klaaren KJ, Lafleur SJ . Introspecting about reasons can reduce post-choice satisfaction. Personality and Social Psychology Bulletin 1993; 19: 331–339.
Bechara A . The role of emotion in decision-making: evidence from neurological patients with orbitofrontal damage. Brain Cogn 2004; 55: 30–40.
Chuang SC . Sadder but wiser or happier and smarter? A demonstration of judgment and decision making. J Psychol 2007; 141: 63–76.
Johnston JH, Driskell JE, Salas E . Vigilant and hypervigilant decision making. J Appl Psychol 1997; 82: 614–622.
Penticuff JH, Arheart KL . Effectiveness of an intervention to improve parent-professional collaboration in neonatal intensive care. The Journal of Perinatal and Neonatal Nursing 2005; 19: 187–202.
Acknowledgements
This study was completed while author was doctoral student at The University of Pennsylvania and was supported by Ruth L Kirschstein National Research Service Award for Pre-Doctoral Fellowship 1 F31 NR008962 (NINR) 2005–2007, Sigma Theta Tau Xi Chapter Research Grant 2006–2007, CTRC UL1-RR-024134, research on Vulnerable Women, Children and Families 5-T32-NR-007100 (NIH) 2004–2005.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ward, F. Chaos, vulnerability and control: parental beliefs about neonatal clinical trials. J Perinatol 29, 156–162 (2009). https://doi.org/10.1038/jp.2008.139
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2008.139
Keywords
This article is cited by
-
Clinical research for life-threatening illnesses requiring emergency hospitalisation: a critical interpretive synthesis of qualitative data related to the experience of participants and their caregivers
Trials (2023)
-
Parental and staff perspectives of NICU research procedures
BMC Pediatrics (2016)
-
The ethical issues regarding consent to clinical trials with pre-term or sick neonates: a systematic review (framework synthesis) of the empirical research
Trials (2015)
-
Author response
Journal of Perinatology (2009)
-
Parental decision-making in NICU
Journal of Perinatology (2009)