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.

A comparison of caregiver burden between long-term care and developmental disability family caregivers

Background As the United States’ population ages and health concerns rise, the family caregiver occupation will continue to be an integral part of the health care system. Aims It is important to examine the burden that family caregivers experience so they can seek out additional training and services to maintain their own well-being. The researchers examined caregiver burden from a perspective of developmentally disabled and long-term care. Methods The researchers examined difference in Zarit scores, guilt, burden and personal strain for 72 caregivers of people with developmental disability (DD) or people with long-term care (LTC) needs. The researchers also examined differences in these based on whether the individual was caregiving for family or “others”. Results For DD, there were significant differences in Zarit, role strain and personal strain; caring for others has significantly lower scores on these. Role strain was significantly higher than personal strain, which was significantly higher than guilt for both LTC and DD groups. Conclusions Given these findings, it is important to support family caregivers first and foremost with role strain, especially for those caring for family members with DD. This support could be given through personal counselling, caregiver training, non-profit social service resources, and support groups for family caregivers.