Regenerative medicine: Stroke survivor and carer views and motivations towards a proposed stem cell clinical trial using placebo neurosurgery

Health Expect. 2018 Feb;21(1):367-378. doi: 10.1111/hex.12632. Epub 2017 Oct 12.

Abstract

Background: Few studies explore stroke survivor views and motivations towards stem cell therapy (SCT). This qualitative study explores the views and motivations of both stroke survivors and their partners/carers towards a proposed 2-arm Phase III Randomised Controlled Trial (RCT) comparing intracerebral insertion of stem cells with placebo neurosurgery in stroke survivors with disability.

Objective: To explore views and motivations towards a proposed 2-arm stem cell trial and identify factors that may impede and enhance participation.

Design: This study adopts a naturalistic design to explore the complexity of this field, employing a participatory action-research approach comprising a specialized Conversation (World) Café form of focus group. Data were collected via 5 Conversation Cafés with stroke survivors (age 40-75) and partners/carers between June and October 2016. Of 66 participants, 53 (31 male, 22 female) were stroke survivors and 13 (6 female, 7 male) were partners/carers. Qualitative data were analysed using a thematic approach.

Discussion and conclusion: Stroke survivor views and motivations reflect anticipation of the personal and future benefits of regenerative medicine. Partners/carers sought to balance the value of stroke survivor hope with carrying the weight of hope as carer, a conflict burden adding to known caregiver burden. All participants expressed the need for during and post-trial psychological support. This study provides a rare opportunity to explore the prospective views and motivations of stroke survivors and their partners/carers towards a proposed Phase III 2-arm RCT. This adds weight to qualitative evidence exploring capacity, consent, decision making, perceptions of treatment risk and supports required for clinical trial participation.

Keywords: caregiver burden; consent; regenerative medicine; treatment decision-making.

Publication types

  • Clinical Trial, Phase III

MeSH terms

  • Adult
  • Aged
  • Caregivers / psychology*
  • Community-Based Participatory Research
  • Female
  • Focus Groups
  • Humans
  • Male
  • Middle Aged
  • Motivation*
  • Neurosurgery*
  • Prospective Studies
  • Regenerative Medicine / methods*
  • Stem Cell Transplantation*
  • Stroke / psychology*
  • Stroke Rehabilitation / methods
  • Survivors / psychology*