Clinical research nurses perspective on recruitment challenges and lessons learnt from a large multi-site observational study

Background Recruitment of large numbers of study participants within a designated time frame for multi-site clinical research studies is a significant challenge faced by researchers. If a study does not manage to recruit targeted number of participants, it could have a significant impact on the statistical significance of the research. Purpose This paper highlights the challenges of recruitment for a large multi-site UK-based tuberculosis observational study ‘PREDICT’. Methods It uses a case study analysis from the research nurses perspective, and descriptive information retrieved from non-recruitment log forms to understand reasons for potential recruits not participating. Results Some of the main challenges to recruitment included patients not attending their clinic appointments, time required to obtain site-specific permissions and courier timings for blood sample collection. This paper also outlines key reasons for potential recruits who did not participate. Some of the common barriers to participation for non-recruited participants were work and family commitments, additional blood tests and language barriers. Conclusion Successful strategies which were implemented to overcome some of the challenges during the study are presented. This paper, therefore, aims to present the challenges faced, lessons learnt and successful strategies implemented to inform the planning of similar longitudinal studies of this scale in future.

A scale development study: Hemodialysis comfort scale version II

Aim Aim of this study was to develop a valid and reliable measuring tool in order to evaluate comfort of patients receiving hemodialysis treatment. Background There has been available a scale developed to evaluate comfort of hemodialysis patients “HDCS (Hemodialysis Comfort Scale).” Due to HDCS consisted of nine items and evaluated comfort in two sub-dimensions, researchers who developed HDCS, stated that number of scale items and dimensions is not sufficient to fully evaluate comfort. Therefore, (Hemodialysis Comfort Scale Version II) HDCS-II was developed with this research and its development process were discussed in this article. Materials and Methods Sample of this methodological research was consisted of 436 chronic hemodialysis patients, treated at five hemodialysis centers between October 2018 and May 2019. In process of creation item pool, comfort theory and literature was examined. The items in the old scale were also revised and included. Thereby a new question pool of 87 items was created. This draft scale was sent for expert opinion. In validity of scale; content validity index, exploratory and confirmatory factor analysis were used. In reliability study; Item analysis, cronbach’s alpha reliability coefficient, parallel form reliability and item analysis based on upper-lower group averages were used. Results There was consistency between expert views relating to items in scale. According to exploratory factor analysis, scale consisted of six dimensions. Cronbach alpha coefficient of 26-item scale was 0.79. Alpha values of the six factor in scale were, respectively; for physical relief 0.83, for physical ease 0.71, for psychospiritual ease 0.87, for psychospiritual transcendence 0.85, for environmental transcendence 0.82, and for sociocultural ease 0.61. Conclusion HDCS-II is a 5-point likert type and consists of 26 items and 6 factors. This scale is a valid and reliable measurement tool that can be used to determine comfort of patients undergoing hemodialysis treatment.

Type 2 diabetes self-management: spirituality, coping and responsibility

Background In England, although The National Institute of Health and Care Excellence recommends that patients’ religious beliefs should be incorporated into individual healthcare plans, these components are often neglected in diabetes management care plans. A literature review identified a paucity of research regarding how the spirituality of British people may influence their approach to their self-management of type 2 diabetes (T2D). Aims To explore how the spirituality of a small group of adults with T2D, living in England, influenced their coping strategies and self-management of diet and exercise. Methods Biographic Narrative Interpretive Method of two interviews per participant and thematic analysis for data interrogation ( n = 8). Data as glycated haemoglobin, living situation, age, length of time since T2D diagnosis, body mass index and diabetic medicines contextualised the interview data. Results Participants’ spirituality, health beliefs, coping and sense of responsibility for T2D self-management overlapped in complex layers. Three themes were generated: (a) spirituality influences expectations in life; (b) beliefs influence coping styles of diabetes self-management; and (c) responsibility influences diabetes self-management. A model was created to assist nurses in addressing these components. Conclusion Nurses should consider how patients’ self-management of T2D may be influenced by their spirituality, health beliefs, coping and sense of responsibility.