Investigation of social support as a mediator of the relationship between physical and psychological health among hospitalised patients.

AIM: To investigate the self-reported levels of social support from friends and family and from nurses as mediators of the relationship between self-rated physical and psychological condition in hospitalised patients. DESIGN: Cross-sectional study of adult inpatients at a large tertiary-care hospital in the northeast United States. METHODS: Multiple mediation analysis of survey data. RESULTS: In surveys received from 324 inpatients, one fourth of the variation in patients' self-rated psychological condition was explained by self-rated physical condition. Social support from family and friends mediated a significant proportion (11.0%) of the relationship between self-rated physical and psychological condition, however social support from nurses did not. CONCLUSION: Social support from family and friends can positively influence the psychological health of inpatients, but nurses are not an adequate replacement for the social support provided by family and friends. IMPLICATIONS FOR NURSING: Although nurses cannot replace the social support provided by family and friends, the assessment of social isolation and care planning of interventions to support patients is a fundamental nursing role. Technology to connect patients with friends and family should be used to mitigate isolation for hospitalised patients unable to receive in-person visits from loved ones. IMPACT: The influence of social support from family and friends and nurses was addressed. The study found social support from family and friends, but not nurses, to influence the relationship between physical and psychological ratings. This finding has implications for the role of nurses in the hospital setting. REPORTING METHOD: Strengthening the Reporting of Observational Studies in Epidemiology guidelines were followed.

Ethical challenges experienced by clinical research nurses:: A qualitative study.

BACKGROUND:: Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives (to implement research protocols and advance science), setting (research facilities), and nature of the nurse-participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether research nurses experience unique ethical challenges distinct from those experienced by nurses in traditional patient-care settings. RESEARCH OBJECTIVES:: The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice. RESEARCH DESIGN:: The study utilized a qualitative descriptive design with individual interviews. PARTICIPANTS AND RESEARCH CONTEXT:: Participating nurses (N = 12) self-identified as having experienced ethical challenges during screening. The majority were Caucasian (90%), female (83%), and worked in outpatient settings (67%). Approximately 50% had > 10 years of research experience. ETHICAL CONSIDERATIONS:: The human subjects review board approved the study. Written informed consent was obtained. FINDINGS:: Predominant themes were revealed: (1) the inability to provide a probable good, or/do no harm, and (2) dual obligations (identity as a nurse vs a research nurse). The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse-patient therapeutic relationship versus the research relationship. DISCUSSION:: Participants described ethical challenges specific to the research role. The issues are central to the nurse-participant relationship, patient advocacy, the nurse's role in implementing protocols, and/or advancing science. CONCLUSION:: Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution.

Nurses in clinical trials: perceptions of impact on the research enterprise.

Background: Clinical Research Nurses practice across a wide spectrum of roles and settings within the global research enterprise. Clinical Research Nurses working with clinical trials face a dual fidelity in their role, balancing integrity of the protocol and quality care for participants. Aims: The purpose of this study was to describe Clinical Research Nurses' experiences in clinical trials, educational preparation, and career pathways, to gain a deeper understanding of clinical research nursing contributions to the clinical research enterprise. Methods: An internet-based survey was conducted to collect demographic data and free text responses to four open-ended queries related to the experience of nurses working in clinical trials research, educational preparation, and role pathways. Qualitative content analysis was used to analyze free text responses. The study was guided by the Clinical Research Nursing Domain of Practice and Duffy's Quality Caring Model of relationship centered professional encounters. Results: Forty clinical research nurses responded to the open-ended questions with themes related to dual fidelity to study participants and protocols, relationships and nursing care, interdisciplinary team membership and contributing to science, emerging from the data. Gaps in educational preparation and professional pathways were identified. Conclusion: This study provides insights to unique clinical research nurse practice contributions in the clinical trial research enterprise within a context of Duffy's Quality Caring Model.

Building communities of practice: the research nurse round table.

This paper shares the experience of establishing a research nurse forum aimed at knowledge sharing, problem solving, and community building from the perspective of a group of clinical research nurses at Massachusetts General Hospital (MGH), a tertiary care center in Boston, -Massachusetts. We report on a sequence of developmental steps taken to create this forum as an example of best practice for research nurses. Logistical considerations, mission and goals, as well as outcomes and implications for practice are described, with the intent that others interested in building similar forums can replicate aspects of this model within their own practice settings.

Healing patterns revealed in middle school boys' experiences of being bullied using Roger's Science of Unitary Human Beings (SUHB).

PROBLEM: Although two of the primary risk factors for being bullied include "male" and "middle school" status, a gap in knowledge exists of middle school boys' personal accounts and meanings of being bullied and their healing. METHODS: Giorgi's descriptive phenomenological approach using open-ended semi-structured individual interviews was used to collect and analyze evidence related to middle school boys' lived experiences of being bullied and healing. Roger's Science of Unitary Human Beings (SUHB) guided interpretation of the healing patterns. FINDINGS: Three patterns of healing were identified in boys' experiences: meaning-making, self-transcendence, and nonviolently claiming personal power. CONCLUSIONS: Evidence of healing patterns exists in middle school boys' experiences of being bullied, offering a foundation for further research and practice focused on healing. When working with middle school boys who have been bullied, nurses need to ask about their experiences and promote their healing.

Promoting research utilization using a conceptual framework.

Since the early 1990s, evidence-based practice has gained momentum, but barriers persist between knowledge development and application in practice. The Massachusetts General Hospital re-engineered the Nursing Research Committee as one vehicle for promoting research-based practice. Using the Promoting Action on Research Implementation in Health Services framework, the mission and methods (context) to advance research-based practice are explicated. Characteristics of the membership, leadership, and practice environment that facilitate research utilization are delineated.