BACKGROUND Equipoise and role conflict have been previously identified as important factors in professionals' engagement with trials, inducing behaviours which can impact on recruitment. We explored these phenomena as potential explanations for the low levels of involvement of teenagers and young adults (TYA) with cancer in clinical trials in oncology. METHODS We report findings from interviews with 30 purposively sampled direct-care professionals involved in delivering cancer care and/or facilitating clinical trials in Scotland. We undertook qualitative descriptive analysis, focussed on identifying key issues and themes. RESULTS Interviewees largely identified as clinician-researchers and portrayed oncology as a specialty in which research was integral to care. They saw their primary responsibility as ensuring patients received the best treatment, but asserted that, in general, trials provided a vehicle for optimal care. Role conflict in its traditional form was rarely evident; however, other tensions were manifest. Professionals found the significant time costs of delivering trials difficult to reconcile with the increasing pressures on clinical services. They felt a responsibility to make prudent choices about the trials with which to engage. Guided by utilitarian principles, these choices were oriented towards benefiting the largest number of patients. This favoured trials in high volume diseases; as TYA tend to have rarer forms of cancer, professionals' support for-and TYA's access to-relevant trials was, by default, more limited. CONCLUSIONS Neither lack of individual equipoise nor experiences of traditional forms of role conflict accounted for the low levels of involvement of TYA with cancer in clinical trials. However, prominent tensions around the management of scarce resources provided an alternative explanation for TYA's limited access to cancer trials. The prevailing approach to decision-making about whether and which trials to support was recognised as contributing to inequalities in access and care. Professionals' choices, however, were made in the context of scarcity, and structured by incentives and sanctions understood by them as signalling governmental priorities. A franker discussion of the extent and distribution of the costs and benefits of trials work is needed, for change to be achieved.

中文翻译：

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临床研究人员和稀缺资源的保管人：对卫生专业人员对青少年参与癌症试验的障碍的观点进行的定性研究。

背景技术平衡和角色冲突先前已被确定为专业人员参与试验，诱发可能影响招聘的行为的重要因素。我们探索了这些现象，作为对青少年进行癌症临床试验的青少年水平（TYA）参与程度较低的潜在解释。方法我们报告了对30名有目的抽样的直接护理专业人员进行访谈的结果，这些专业人员参与了苏格兰的癌症治疗和/或促进临床试验。我们进行了定性描述性分析，重点是确定关键问题和主题。结果受访者在很大程度上被确定为临床研究人员，并将肿瘤学描述为一项专业，研究是护理不可或缺的一部分。他们认为，确保患者获得最佳治疗是他们的主要责任，但是他们断言，总体而言，试验提供了最佳护理的手段。传统形式的角色冲突很少见；但是，其他紧张局势也很明显。专业人士发现，进行临床试验所需的大量时间成本与临床服务压力的增加难以协调。他们有责任对参与的试验做出谨慎的选择。在功利主义原则的指导下，这些选择旨在使最大数量的患者受益。这有利于在大量疾病中进行试验；由于TYA倾向于患有罕见的癌症，因此默认情况下，专业人员对TYA的支持以及TYA获得相关试验的机会更加有限。结论既不缺乏个体能力也不缺乏传统形式的角色冲突的经验，不能解释TYA在临床试验中参与癌症的程度低。但是，围绕稀缺资源管理的紧张关系为TYA有限的癌症研究途径提供了另一种解释。关于是否支持和支持哪些试验的普遍决策方法被认为是造成获取和护理不平等的原因。然而，专业人员的选择是在稀缺情况下做出的，并由激励和制裁构成，他们认为激励和制裁是政府优先事项的信号。需要对试验工作的成本和收益的范围和分布进行坦率的讨论，以实现变更。