Female college student awareness of exposures to environmental toxins in personal care products and their effect on preconception health.

This research study investigated college women's usage of personal care products and their views on health effects from exposures during the preconception period. Many personal care products and cosmetics contain chemical ingredients that have been known to disrupt human endocrine and neurological systems, and contribute to infertility and adverse birth outcomes. Seventy-two female college students from a single, medium-sized university campus completed a researcher-developed questionnaire. Findings provide insight into the daily exposures young women experience during their reproductive years. Results can inform occupational and environmental health nurses about the personal daily exposures of young women when conducting risk assessments in the workplace or at a school, and can aid in developing interventions that support the environmental health of employees or future employees.

Strategies for promoting the scientific integrity of nursing research in clinical settings.

Magnet hospitals were surveyed to determine the processes used to promote the integrity of nursing research conducted in clinical settings. Results indicated that four central processes, institutional review board review, nursing research council review, nursing research mentorship, and reliance on personal and professional values, were used to educate, monitor, and oversee the integrity of research conducted by bedside nurse scientists. Staff development educators are challenged to provide instruction regarding the process of nursing research and all elements of scientific integrity. Research is needed to test the effectiveness of the processes identified in this investigation in promoting the quality and integrity of nursing research conducted in clinical settings.

Pressure ulcers and nutritional support: a partnership to improve patient outcomes.

Prevention of pressure ulcers in hospitalized patients represents a challenge with great financial impact for hospitals and serious consequences for patients. A partnership composed of dieticians and nurses was assembled to identify best practices for providing nutritional support and intervention to patients at risk for pressure ulcers. This article describes the process, outcomes, recommendations, and lessons learned by the pressure ulcer/nutrition work group.

Nurse responsiveness to cancer patient expressions of emotion.

OBJECTIVE: This theoretically based study examined nurse responses to cancer patient expressions of emotion using a videotaped, simulated cancer patient. METHODS: This study used an experimental crossover design with a videotaped patient expressing anger, sadness, and neutral emotion to elicit nurse responses. Seventy-four nurses from eight sites participated. Responses were coded using Roter interaction analysis system. Correlations explored relationships between variables that impact communication (age, gender, work experience, trait anxiety, work stress, self-efficacy). Regression models explored the effect of variables on nurse affective responsiveness. RESULTS: Patient expressions of sadness elicited more affective responses than anger. Expressions of anger or neutral emotion elicited more instrumental behaviors than sadness. Variables such as age, work stress and work experience were significantly correlated. No variables predicted affective responsiveness to patient expressions of anger or sadness. CONCLUSION: Nurse communication showed significant variation in response to patient emotional expressions. Understanding the relationships between demographic, personality, and work variables, and identification of new variables that influence nurse-patient communication, has implications for interventional studies. PRACTICE IMPLICATIONS: Over 90% of the participants indicated that the videotape simulation would be a useful method for teaching and practicing communication skills with patients expressing emotions.

Difficult communication in nursing.

PURPOSE: To describe difficult communication in nurse-patient interactions from nurses' perspectives. DESIGN: Grounded theory methodology and follow-up questionnaire. Focus groups of nurses were conducted to explore nurses' perceptions of difficult communication in nurse-patient interactions. METHODS: Using a semistructured interview script, the moderator guided six unit-based focus groups at a 220-bed, Roman Catholic, community hospital, and a recorder took field notes of the interactions. The sessions were audiotaped for transcription and analysis. Level I coding was done by the moderator and recorder after each group. Level II coding was done with the transcripts and conferral of two of the researchers. A follow-up questionnaire with a 5-point Likert scale was used to validate the 13 categories of difficult communication derived from the focus groups. FINDINGS: Five themes were identified: specific diagnoses and clinical situations, patient and family emotions, nurses' emotions, triangle of nurse-physician-patient communication, and nurse coping behaviors with difficult communication. Emotion was the core variable that made communication more difficult. CONCLUSIONS: The groups described five major themes in difficult communication. They also identified the heavy emotional component of nurse-patient communication and the difficulties arising in work relationships that complicated communication.

Quality of informed consent: measuring understanding among participants in oncology clinical trials.

PURPOSE/OBJECTIVES: To describe newly enrolled clinical trial subjects' knowledge and understanding of the oncology clinical trials in which they were participating. DESIGN: Descriptive, correlational. SETTING: The oncology center of a small community hospital in New England. SAMPLE: 8 patients who consented to enroll in oncology clinical trials. METHODS: The Quality of Informed Consent questionnaire was sent to 17 potential participants who recently had consented to participate in oncology clinical trials. MAIN RESEARCH VARIABLES: Knowledge of the basic elements of informed consent and participants' understanding of the clinical trials in which they were enrolled. FINDINGS: Scores on the Quality of Informed Consent questionnaire indicated that participants had a good overall understanding of the basic elements of informed consent as well as the clinical trials in which they were enrolled. However, half of the sample failed to understand that clinical trial treatment is not standard treatment and may involve additional risk when compared with standard treatment. CONCLUSIONS: The results of this investigation provide valuable feedback regarding participants' understanding of the informed consent process. The Quality of Informed Consent questionnaire may be a useful tool for monitoring the quality of the informed consent process and contributing to patients' understanding of clinical trials and the research process. IMPLICATIONS FOR NURSING: The Quality of Informed Consent questionnaire may provide valuable feedback regarding clinical trial participants' understanding of clinical trials and the research process. Individual responses to questions on the questionnaire may be used to aid personalized patient education and validation of the informed consent throughout trial enrollment. Future research efforts need to focus on the development of reliable tools to measure participants' understanding of informed consent and nursing interventions that improve the informed consent process as well as enhance patients' understanding of the research process.

A nurse's primer on recruiting participants for clinical trials.

PURPOSE/OBJECTIVES: To identify common barriers to the recruitment of participants for oncology clinical trials, identify strategies that would be useful in increasing enrollment of participants in oncology clinical trials, and describe the role of the clinical trial nurse in the recruitment process. DATA SOURCES: Published articles and abstracts, empirical studies, conference proceedings, references from bibliographies of pertinent articles and books, and computerized databases from 1994-2001. DATA SYNTHESIS: The barriers to participant recruitment in clinical trials may be categorized as being related to either the patient, healthcare provider, or protocol. CONCLUSIONS: Several achievable strategies for improving recruitment to oncology clinical trials exist. Nurses need to understand the complex and diverse factors that influence participant accrual to oncology clinical trials. Strategies to increase enrollment should focus on increased communications and education for patients and healthcare providers. Dedicated clinical trials nurses can play an integral part in the recruitment and accrual of patients to oncology clinical trials. IMPLICATIONS FOR NURSING: Clinical trial nurses play many important roles in the conduct of oncology clinical trials. To better plan and manage these investigations, nurses need to develop strategies to mitigate the complex and diverse factors that may influence accrual patterns.