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Week_7_grp_research_Glog - Sess/on 9.2 4

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Sess/on 9.2 4<J9 WHO'S AFRAID OF THE RANDOMISKO CONTROLLED TRIAL? PARENTS' VIEWS OF AN SLT RESEARCH STUDY Margaret Glogowska, Sue Rouistone, Pam Enderby, Tim Peters and Rona Campbell Speecb and Language Therapy Research Unit Frenchay Hospital Bristol BS16 ILE email: margaret(S)speecb-therapy.org.uk Evidence-based health care is now a reality within the national heaith service (NHS) and the randomised controiled triai (RCT) is the linchpin of this movement. In modem heaith care, there has aiso been a shift towards understanding chent perspectives. With regard to chents' participation in research, much consideration has been given to ethicai issues and barriers to participation. However, less attention has heen paid to the paiticipants' views of ciinicai trials and understanding how they construe the research. This paper reports a study ofthe attitudes of parents whose children took part in an RCT. Data were coilected from tiie parents of 20 children, using quaiitative in-depth interviews. Parents talked about the meaning of their participation, their motivation for taking part and their understanding of the nature ofthe trial. The implications ofthe findings for ftiture research wili be considered. Background Within the NHS, the need to make heaJth care evidence-based is now wideiy accepted. A major feature ofthe evidence-biised movement is the appiication ofthe RCT. The RCT has come to be recognised as the best design for evaiuating treatments because it is the methodoiogy least prone to bias. Evidence disseminated by organisations such as the UK Cochrane Centre, the NHS Centre ibr Reviews and Dissemination and the NHS R&D Executive Heaith Technoiogy Assessment Programme is very often in the form of conciusions based on RCT and the systematic review and meta-anaiysis of RCT. In western heaith care, the 'medical rnodeP of disease has become powerfui and dominant, based on the premise that disease is brought about by aetioiogicai factors which change the structure and ftinctions ofthe body (Porter 1997, Scambler and Higgs 1998). However, another revolutionary drive has also been underway in the NHS. Among others, lliich (1976) and Kieinman (1988) challenged this model, claiming that it concentrates too narrowiy on the de-personalised 'body' and the capacity of technology to cure illness, rather than treating peopie as hoiistic entities within a social setting. Since then, sociai science has addressed itseif to the consdiiction of a 'social' model of health and to the expioration of the definitions of heaith anci iilness according to iay people rather than professionais. in some aspects of heaith care there has been an attempt to increase ciient and carer participation in the delivery of services and professionai understanding of their perspectives. Muir Gray (1999) highlighted the need for modern heaith care to evaluate services not oniy with respect to effectiveness but also appropriateness and necessity from
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500 .Scs'.uoi! 9.2 the viewpoint of those receiving them. Within speech and language therapy (SLT), van der
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Week_7_grp_research_Glog - Sess/on 9.2 4

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