The cost of questionnaire based research. .

The emotional cost to patients and researchers of questionnaire based research has recently been assessed in a study on the implementation of guidelines for women presenting with breast disorders in primary care. (1) The possible distress experienced by patients was considered and contrasted with the need of researchers to remain objective and resist any pressure to respond to patient questions and anxieties. However, the impact of the Bristol and Alder Hey Inquiries will mean that future studies must tackle these issues at an early stage in the planning process. Effective communication will become mandatory not just in the clinical setting but in any situation where health workers and patients interact. The term "health worker" is wide and includes non-clinical researchers. Clearly the need to ensure patients are satisfied with the quality of information and care that they receive is critical to the future of questionnaire based studies. A failure to meet this standard may lead to further limitations on clin ically based research.

The traditional relationship between a doctor and a patient has been paternalistic. (2) The doctor has identified what is best for patients and then protected them from unpleasant experiences. The Hippocratic view of health care rejected any open partnership with patients in favour of an approach comparable to a father caring for his vulnerable child. …