LETTER OF INFORMATION FOR CONSENT TO PARTICIPATE IN RESEARCH

TITLE OF PROJECT:

Self-perceptions, Personality, and Living with Chronic Fatigue Syndrome; Implications for Health and Well-being

Please read the following information about the study to be conducted.

I agree to participate voluntarily in a project being conducted by Fuschia M. Sirois, Ph.D. of the Department of Psychology at Bishop’s University, Lennoxville, Quebec and funded by the Canada Research Chairs program.

PURPOSE OF THE STUDY

The purpose of the study is to explore the interplay of self-perceptions and personality factors with adjustment to living with Chronic Fatigue Syndrome, as well as their role in outcomes related to health and well-being.

PROCEDURES

As a participant in this project, I will be asked to complete an online survey which includes questions about how I view my current and past self, my personality, my health behaviours, and my health and well-being.

This survey takes approximately 30 minutes to complete, although individual completion times may vary depending on your computer system. You may complete the survey at a location of your choice.

PARTICIPATION AND WITHDRAWAL

I am aware that at all times, I have the right to withdraw from the project without negative consequences. However, my responses will be anonymous and therefore I can only withdraw from this study up to the point that I click the “Submit Survey” button at the end of the survey.

CONFIDENTIALITY

Several steps will be taken to ensure the confidentiality of survey data you submit. All incoming surveys will be stored on a secure server and be accessible only by the researcher. The date and time of submission will be the only additional information attached to the surveys. Such information is used solely for the purpose of excluding duplicate submissions. Should you choose to enter the draw, the email address you provide will be used solely for the purpose of the draw and will be deleted after the draw is complete. However, your email address will not be linked to your survey responses.

All electronic data will be stored on a password protected computer in the researcher’s lab to further ensure privacy. Only the researcher and the research assistants directly associated with this study will have access to this information for the purposes of analysis and conducting the study. Any reports of this study made available to participants or sent to a scientific journal for publication will contain information that reflects group results and not information about specific individuals. Following the guidelines of the Canadian and American Psychological Associations, data will be retained for a period of 5 years after publication in a secure place, after which time it will be disposed of in a secure manner (e.g. shredded or electronically deleted).

All data collected will be confidential and the property of the researcher, and will be used strictly for the above-mentioned project. However, this data may also be used by the researchers for subsequent studies.

POTENTIAL RISKS AND DISCOMFORTS

There are no risks anticipated from participating in this study.

POTENTIAL BENEFITS

The potential benefits resulting in my participation are that I may become more aware of my personality and how it may have changed or stayed the same over time.

The results from this study may advance knowledge regarding how regarding how personality is linked to risk or resilience for health and well-being while living with a chronic health conditions.

FEEDBACK OF THE RESULTS OF THIS STUDY TO THE SUBJECTS

Research findings for this study will be available as a short report on the study website (www.ubishops.ca/FMCFSHTStudy) by June 30, 2015.

CONTACT INFORMATION

Dr. Sirois can be reached at (819) 822-9600, ext.2790 or by email at fsirois@ubishops.ca. The Research Ethics Board of Bishop’s University approved this project on July XX, 2013. If I have any ethical concerns regarding this project, I may contact Dr. Claude Charpentier, Chair of the Research Ethics Board of Bishop’s University at (819) 822-9600, ext. 2653 or by email at ccharpen@ubishops.ca or I may contact James Crooks, Interim Vice-Principal Academic of Bishop’s University at (819) 822-9600, ext. 2338 or by email at james.crooks@ubishops.ca.

I agree to participate in this project and I have made this decision based on the information I have received about it. I have read and understand the present consent form and I accept its stipulations.

I understand that by completing and submitting this electronic survey that I am giving my consent to participate in this study according to the terms outlined above.

It is recommended that you print out a copy of this letter of information for your records.

Pass it on:

Feel free to send the link for this page to other people with a chronic health condition such as Fibromyalgia, Chronic Fatigue Syndrome, or Hypertension who you know who might be interested in participating.
Do you wish to continue? To acknowledge that you have read and understood this information and would like to continue with the survey, please click on "I agree".
I agree
No, thank you

                   

http://www2.ubishops.ca/phwb/