Consent letter for participation in the study plan to determine family-centered education on the care burden of caregivers of burn patients referring to the emergency department of Shahid Motahari Medical Education Center.
Dear Sir/Madam
You are hereby invited to participate in the aforementioned research. The information related to this research is provided in this service sheet and you are free to participate or not participate in this research.
You don't have to make an immediate decision and you can ask your questions to the research team and consult with anyone you want to make a decision. Before signing this consent form, make sure that you have understood all the information in this form and that all your questions have been answered.
Name of research supervisor: Mahnazseyedoshohadaee.Student: Fatemeh Sadat Tajzadeh
know that the goals of this research are:
Holding training sessions with the content of the burn process, how to care for the wound, etc., to determine the impact on the care burden of burn victims
2. I know that my participation in this research is completely voluntary and I am not forced to participate in this research.
I was assured that if I am not willing to participate in this research, I will not be deprived of the usual diagnostic and therapeutic care and my therapeutic relationship with the treatment center and my treating doctor will not be disturbed.
3.I understand that even after agreeing to participate in the research, I can withdraw from the research whenever I want, after notifying the administrator, and my withdrawal from the research will not prevent me from receiving the usual medical services.
4. My cooperation in this research is as follows:
Completing the questionnaire of demographic information including age, gender, etc. and the care burden questionnaire related to the research
Participating in 4 training sessions with the content of information about the burn process, how to take care of the wound, proper nutrition, possible long-term effects of the burn (scar care, psychological complications, etc.), how to adapt to the complications of the disease, the time of re-referral
5. The possible benefits of my participation in this study are as follows:
The readiness of caregivers to provide care to burn patients, which is effective in improving the quality of life of patients and solving their educational needs and questions.
6. Possible damages and complications of participating in this study are as follows:
The researcher does not mention complications and harm.
7. If I do not want to participate in the study, the usual treatment method will be offered to me, the benefits and side effects of which are as follows:
The benefits of participating in the exam, benefiting from training sessions with the mentioned content for caregivers and solving the concerns and questions that arise for them in the way of caring for burn patients.
In case of unwillingness to participate in the study, the knowledge and information necessary to provide care for burn patients may not be provided.
8. I know that the people involved in this research have kept all the information related to me confidential and they are only allowed to publish the general and group results of this research without mentioning my name and details.
9. I understand that the research ethics committee can have access to my information for the purpose of monitoring the observance of my rights.
10. I understand that none of the costs of research interventions as described below will be my responsibility.
All training sessions for caregivers are free of charge.
11. Mrs. / Mr. ................... was introduced to me for answering and I was told that whenever there is a problem or question related to participation in the mentioned research I will share with them and ask for guidance. His address and landline and cell phone numbers were presented to me as follows:
12. I understand that if during and after conducting the research any problem, both physical and mental, occurs to me due to participating in this research, the treatment of complications, its costs and the related compensation will be the responsibility of the administrator.
13. I know that if I have any problems or objections regarding the participants or the research process, I can contact the Research Ethics Committee of Iran University of Medical Sciences at the address: Tehran, Hemat Highway between Chamran and Sheikh Fazlullah, Central Headquarters Building of Iran University of Medical Sciences. , 5th floor, room 503, refer and present your problem orally or in writing.
14. This information and informed consent form is prepared in two copies and after signing, one copy will be at my disposal and the other copy will be at the administrator's disposal.
I have read and understood the above-mentioned items, and based on that, I declare my informed consent to participate in this research.
Participant's signature:
Participant contact number:
I ……………… consider myself obliged to implement the obligations related to the executive in the above provisions and I undertake to ensure the rights and safety of the participants in this research.