Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
Methodological Problems: Dissemination Phase
The study of Efficacy of Nursing Coaching to Aid Ambulatory
Surgery Patients was completed in 2006 with a total subject
population of 102 subjects. The group who received the telephone
mediated Nurse-Coached Intervention numbered 52; the control
group called Usual Practice group numbered 50. The Nurse-
Coached Intervention was based upon assessment data from the
Symptom Distress Scale administered at 72 hours postoperatively.
(Subjects were also compared on this scale preoperatively and one
week postoperatively.) The Usual Practice is a nurse’s phoned
general query about postoperative status within 24 hours of
surgery. Usual Practice nursing advice or referral might follow but
there were no guidelines or plans for intervention. The number of
subjects was adequate but far fewer than initially planned. The
number reflects all the hurdles of an academic-clinical research
study: recruitment and attrition of subjects, resubmissions to
institutional review boards, replacement of academic research
assistants due graduations and human subject certification of these
team members, conflict between employment status and time
designated to the study for clinical researchers.
A special methodological hurdle for the nurse researchers making
calls to both intervention and control group subjects was to
maintain the researcher role. If a control group patient reported
distress, the research team member could refer the person for
assistance but could not deliver a Nurse-Coached Intervention in
response to the symptom. Team meetings over the course of the
grant frequently featured this concern and support for the
importance of maintaining the researcher role in order not to
contaminate the findings.
Statistics described the groups to be similar in age averaging 46;
co-morbidities 0.85; gender: male 31, female 20; marital status:
married 32 to single 19; education: mainly post secondary
education. These similarities probably arose from the urban
medical center location and the type of surgery – joint arthroscopy.
Three hypotheses based on the study aims guided data analysis.
Data analysis for each of the following hypotheses used repeated
measures multivariate analysis of variance (R-MANOVA).
Hypothesis 1 addressed the aim of the study to determine the
efficacy of a telephone mediated Nurse-Coached Intervention (NCI)
in promoting cognitive and emotional processing. Hypothesis 1
stated that at one-week post surgery, patients who received
telephone-mediated Nurse Coached Intervention (NCI), when
compared to a Usual Practice (UP) group, will have:
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