Читать книгу Pediatric Epidemiology - Группа авторов - Страница 35

Involving children in research, in which children provide information that may result in risks for themselves or others, requires careful consideration of whether children have the capacity to understand informed consent. Research involving children in industrialised countries normally has to be approved by a research ethics committee, and co-operative research between an industrialised country and a low-income country should be approved by ethical research committees in both countries. Children should also be advised as to whom they may contact in case they become upset, experience traumatic memories or are worried for any other reason.

Instruments such as the ICAST-C may not always be used safely and ethically in some countries where there are policies and laws that might compromise confidentiality or limit respect for the autonomy of the child providing information. Wherever an instrument is used, the investigators need to carefully develop their protocol with respect to recruitment, participation, consent, incentives and provision of child protection within the context of legal, social, and medical systems where the study is performed.

The majority of researchers and policy makers have found that the benefits outweigh the problems of collecting contemporaneous child maltreatment data as evidenced by institutional review board-approved school surveys and household surveys around the world. One must be aware of children’s cognitive abilities, potential recall bias and, in the case of neglect, children’s specific needs. Adolescent respondents have demonstrated sufficient maturity to complete even long questionnaires and very few adverse reactions have been reported. It is obvious that some children may find it stressful to complete questionnaires about violence, but the findings are inconsistent and some children may even benefit from the surveys if they are followed up with possibilities for consultation or counselling. Several techniques are also available to increase comfort and privacy for children and adolescent responders. It is important to explain the survey carefully and to inform about confidentiality and each individual’s right to withdraw from the study [27].