Understanding parents’ decision-making on participation in clinical trials in children’s heart surgery: a qualitative study

Nigel Drury, Julie Menzies, Clare Taylor, Timothy Jones, Anna Lavis

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Objectives: Few children undergoing heart surgery are recruited to clinical trials and little is known about the views and attitudes of parents towards trials. This study explored parents’ perspectives on decision-making about their child’s participation in a clinical trial during their elective cardiac surgery.

Design: Qualitative interview study.

Setting: Single-centre substudy of a multicentre, double-blind, randomised controlled trial to investigate the effects of remote ischaemic preconditioning in children undergoing cardiac surgery.

Participants: Parents of children approached to participate in the trial, both consenters and decliners.

Methods: Semistructured interviews were conducted face-to-face or by telephone following discharge, digitally audio-recorded, transcribed and thematically analysed.

Results: Of 46 patients approached for the trial, 24 consenting and 2 declining parents agreed to participate in an interview (21 mothers, 5 fathers). Parental decision-making about research was influenced by (1) potential risks or additional procedures; (2) personal benefit and altruism for the ‘cardiac community’; (3) information, preparation, timing and approach; and (4) trust in the clinical team and collaboration with researchers. All of these were placed within the context of their understanding of the trial and knowledge of research.

Conclusions: Parents of children undergoing cardiac surgery attach value to clinical research and are supportive of clinical trials when there is no or minimal perceived additional risk. These findings enhance our understanding of the factors that influence parents’ decision-making and should be used to inform the design and conduct of future paediatric surgical trials.

Trial registration number: ISRCTN12923441; Pre-results.
Original languageEnglish
Article numbere044896
Number of pages8
JournalBMJ open
Issue number2
Publication statusPublished - 23 Feb 2021

Bibliographical note

Funding Information:
Funding This work was supported by a grant from the Birmingham Children’s Hospital Research Foundation (BCHRF442) and an Intermediate Clinical Research Fellowship from the British Heart Foundation (FS/15/49/31612) awarded to NED. Lay review of study documents was funded by a PPI Bursary (RDS/WM-1318) from the National Institute for Health Research (NIHR) West Midlands Research Design Service. JCM is an NIHR 70@70 Senior Nurse and Midwife Research Leader, and CJT is funded by an NIHR Academic Clinical Lectureship.

Publisher Copyright:
© Author(s) (or their employer(s)) 2021.


  • clinical trials
  • paediatric cardiac surgery
  • qualitative research

ASJC Scopus subject areas

  • Medicine(all)


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