Abstract:
Background: Obtaining informed consent from research participants is an ethical imperative. In
mental health research, cognitive deficits can impair the ability to provide individual consent.
This study explored the consenting practices of key research team members to enhance
comprehension in research involving individuals with schizophrenia and bipolar affective
disorder at the national referral mental health hospital in Uganda.
Methods: The study was conducted at a national referral mental hospital in Uganda. In-depth
interviews were conducted with 21purposively selected participants. Audio recordings were
transcribed, and transcripts were managed using NVivo 14. Data were analyzed using inductive
thematic analysis
Results: Two themes emerged from the findings: (1) key considerations during the Informed
consent process, and (2) reported practices for enhancing participants' understanding of the
research and medical terms. Researchers reported that participants' capacity to consent was
maintained through follow-up to see if they still had capacity in the course of participation. They
kept participants interested in consent discussions through building rapport, listening to them
attentively, and dedicating more time to ensure effective interaction. Caregivers played an
important role in consenting. Researchers perceived that comprehension of consent was
supported through reading the consent information to participants verbatim, using iterative
learning, and consultation with the community and health professionals who routinely interact
with participants.
Conclusion: Researchers reported using ongoing consent discussions, rapport building,
caregiver involvement, iterative learning, and adaptation of study information to local contexts.
These findings suggest the perceived value of contextual and relational factors in supporting
autonomy during the consent process for persons with schizophrenia and bipolar affective
disorder.