Ambiguity Tolerance and Caregiver Grief |
Informed Consent
| 25% |
Consent to Participate in a Research Study
Principal Researcher: Megan Kale-Cheever (mkale@uark.edu)
Faculty Advisor: Alishia Ferguson, PhD, LMSW (ajfergus@uark.edu)
INVITATION TO PARTICIPATE
Description: This study consists of completing a survey that will take approximately 5-10 minutes to complete. This survey will ask questions about your feelings and experiences as a caregiver and about how you deal with complex problems. You are being asked to participate because you are the caregiver of someone who is living with dementia.
Purpose: The purpose of this study is to investigate feelings of loss in caregivers of individuals with dementia, and whether these feelings may be impacted by a person’s ability to deal with complex situations and problems.
Risks: There will be a slight risk of losing confidentiality, but all reasonable efforts to safeguard confidentiality will be taken as described below. There is also a slight risk that some of the questions may affect you emotionally. You are free to skip any question you choose or to discontinue the survey at any time.
Benefits: Your participation will contribute to a body of knowledge about caregiver grief and allow researchers to better understand and predict the causes of distress and grief in caregivers of individuals with dementia.
Cost: No, there will be no cost associated with participation.
Participant’s Rights: Please understand that your participation is voluntary. If you do not wish to participate in this study, you may decline. Neither you nor your care recipient not your relationship with any agency will be affected in any way if you refuse to participate. Also, you may choose to withdraw without consequence at any time while completing the survey.
Confidentiality: All information will be kept confidential to the extent allowed by applicable State and Federal law. The survey is anonymous. After survey completion, there will be no way to connect your survey to your identity. All data is stored in a password protected electronic format. All survey results will be reported in group format.
Results of the Study: At the conclusion of the study you will have the right to request feedback about the results. You may contact the Faculty Advisor, Alishia Ferguson, or Principal Researcher, Megan Kale-Cheever, to receive a copy of the survey results.
Questions about the Study: You have the right to contact the Principal Researcher or Faculty Advisor as listed below for any concerns that you may have:
Megan Kale-Cheever (mkale@uark.edu or 479-769-0590)
Alishia Ferguson, PhD, LMSW (ajfergus@uark.edu)
You may also contact the University of Arkansas Research Compliance office listed below if you have questions about your rights as a participant, or to discuss any concerns about, or problems with the research.
Ro Windwalker, CIP
Institutional Review Board Coordinator
Research Compliance
109 MLKG
Fayetteville, AR 72701-1201
479-575-2208
irb@uark.edu
I have read the above statement. I understand the purpose of the study as well as the potential benefits and risks that are involved. I understand that participation is voluntary. I understand that significant new findings developed during this research may be shared with the participant. I understand that no rights have been waived by electronically signing the consent form.
Principal Researcher: Megan Kale-Cheever (mkale@uark.edu)
Faculty Advisor: Alishia Ferguson, PhD, LMSW (ajfergus@uark.edu)
INVITATION TO PARTICIPATE
Description: This study consists of completing a survey that will take approximately 5-10 minutes to complete. This survey will ask questions about your feelings and experiences as a caregiver and about how you deal with complex problems. You are being asked to participate because you are the caregiver of someone who is living with dementia.
Purpose: The purpose of this study is to investigate feelings of loss in caregivers of individuals with dementia, and whether these feelings may be impacted by a person’s ability to deal with complex situations and problems.
Risks: There will be a slight risk of losing confidentiality, but all reasonable efforts to safeguard confidentiality will be taken as described below. There is also a slight risk that some of the questions may affect you emotionally. You are free to skip any question you choose or to discontinue the survey at any time.
Benefits: Your participation will contribute to a body of knowledge about caregiver grief and allow researchers to better understand and predict the causes of distress and grief in caregivers of individuals with dementia.
Cost: No, there will be no cost associated with participation.
Participant’s Rights: Please understand that your participation is voluntary. If you do not wish to participate in this study, you may decline. Neither you nor your care recipient not your relationship with any agency will be affected in any way if you refuse to participate. Also, you may choose to withdraw without consequence at any time while completing the survey.
Confidentiality: All information will be kept confidential to the extent allowed by applicable State and Federal law. The survey is anonymous. After survey completion, there will be no way to connect your survey to your identity. All data is stored in a password protected electronic format. All survey results will be reported in group format.
Results of the Study: At the conclusion of the study you will have the right to request feedback about the results. You may contact the Faculty Advisor, Alishia Ferguson, or Principal Researcher, Megan Kale-Cheever, to receive a copy of the survey results.
Questions about the Study: You have the right to contact the Principal Researcher or Faculty Advisor as listed below for any concerns that you may have:
Megan Kale-Cheever (mkale@uark.edu or 479-769-0590)
Alishia Ferguson, PhD, LMSW (ajfergus@uark.edu)
You may also contact the University of Arkansas Research Compliance office listed below if you have questions about your rights as a participant, or to discuss any concerns about, or problems with the research.
Ro Windwalker, CIP
Institutional Review Board Coordinator
Research Compliance
109 MLKG
Fayetteville, AR 72701-1201
479-575-2208
irb@uark.edu
I have read the above statement. I understand the purpose of the study as well as the potential benefits and risks that are involved. I understand that participation is voluntary. I understand that significant new findings developed during this research may be shared with the participant. I understand that no rights have been waived by electronically signing the consent form.