Ethical Issues Related to Data Collection Methods in Trauma Researches

Over the past few decades, there is an increasing in studies on traumatic patients (violence, road accidents, natural disasters, terrorist attacks). In some trauma studies collecting the data from patients, especially mentally weak patients, may lead to remembering memories of bitter experience which can cause a feelings of discomfort, upset, anxiety, embarrassment and shame in narrowing the injury (1-2).
Concerns and anxiety in patients during the study are related to their condition of injury. Injured patients with higher age or severe injury experience more worry during the study period than others (3). However, the findings of studies show that only a few trauma patients report their concerns and discomforts about research topics or methodology (4). On the other hand, only some patients are able to predict properly the inconvenience conditions of participating in the study. Consequently, this situation at the informed consent phase leads to a not informed decision. Therefore, inability to predict the research condition, accurately and completely, can lead to some challenge in informed consent process (5). There are different data collection methods such as; interviewing, focus group discussion, internet questionnaire, self-declaration questionnaire which can be used in non-experimental trauma studies. Nevertheless, using the questionnaire or interviewing methods are most used by the researcher in trauma studies. The discomforts effects of data collection methods which patients may experience vary in different studies. Some patients experience extreme emotions when they talk about the injury (6-7). In an interview, more information is provided by interviewees rather than the questionnaire method and these conditions may lead to having more experience embarrassment in patients. This is one of the potential risks in interviewing method and it is necessary to be considered by research ethics committee and researchers. Meanwhile, some studies show that the use of electronic questionnaire has greater discomfort effect on patients compared to paper-based questionnaires or face-to-face interviews (7).
The Experience of emotions in patients is related to perceived helpfulness among them. The results of some studies have shown that patients in interview method feel more usefulness compared to the questionnaire method, so the experience of feeling anxiety in this group is far less. For example, in case of child abuse, parents feel that their experiences will be useful for the community and raise awareness of families about related issues (2, 8).
In addition, addressing to the issues of trauma patient's including; discomfort and anxiety during the study and the data collection can have considerable significance in two aspects: 1- uncertainty of research ethics committees in approving this type of studies; 2- the effect of the patient's discomfort on the validity of the study (6, 9).
While there are no uniform conditions for all participants in different types of studies, the same approach cannot be considered in different situations. Considering the principles of protecting human subjects in research ethical protocols including; respecting the participant’s autonomy, beneficence and non-maleficence and justice, it is necessary to investigate suitable data collection method for each participant in informed consent process. In this circumstance, researchers can identify those who may be at risk of negative emotions during the study period and minimize the risk to them by using the most appropriate method of data collection. Based on the research conditions, the type of data collection method can vary. Nevertheless, it can be expected that using the appropriate data collection method according to mental health and psychological condition of each participant lead to more adherence to research ethics principals and best risk benefit ratio balance. Moreover, this strategy needs to consider the random and systematic errors and adopt effective methods to control them.