You are invited to take part in a research study of hospital nurses who work rotating shift schedules (shiftwork). You were chosen for the study because you are employed as a hospital nurse and work on a rotating shift schedule. This form is part of a process called “informed consent” to allow you to understand this study before deciding whether to take part.
This study is being conducted by a researcher named Matthew Girton, who is a doctoral candidate at Walden University.
Background Information: The purpose of this study is to help identify the problems experienced by hospital nurses who work rotating shift schedules. A secondary aim of this study is to identify factors that moderate the impact of rotating shift schedules.
Procedures: If you agree to be in this study, you will be asked to:
1. Follow the link contained in this email to access the online questionnaire
2. Complete the online questionnaire containing questions about your work schedule, health, and social/domestic life. The questionnaire should take about 20 minutes to complete.
3. Keep a copy of this informed Consent Form with the understanding that completion of the online questionnaire will signify your consent to be in the study.
Voluntary Nature of the Study: Your participation in this study is voluntary. This means that everyone will respect your decision of whether or not you want to be in the study. If you decide to join the study now, you can still change your mind during the study. Your participation in this study will not affect your relationship with your employer in any way. Your employer will not be aware of your participation in this study.
Risks and Benefits of Being in the Study: There are no physical risks and no benefits to participating in the study. It is possible that completing this questionnaire may draw your attention to problems you experience in relation to working a rotating shift schedule and/or other factors. If you feel stressed or upset while completing the questionnaire, you may stop at any time. You may skip any questions that you feel are too personal.
Although there are no direct benefits for your participation, your contribution will help answer questions about the relationship between shiftwork and the health of hospital nurses. It is hoped that the information obtained from this research project will help guide efforts at improving the policies and procedures that affect the health of healthcare workers.
Compensation: There is no compensation for participation in the study.
Confidentiality: Any information you provide will be anonymous. No identifying information will be collected from you. The researcher will not use your data for any purposes other than research. Research records will be kept on a password-protected computer in a locked office. Only the researcher will have access to the records.
Contacts and Questions: If you have any questions about this study you may contact the researcher or his advisor. The researcher conducting this study is Matthew Girton. He can be reached by email at firstname.lastname@example.org or by phone at 610-462-5565. The researcher’s advisor is Dr. Silvia Bigatti who can be reached by email at email@example.com. If you want to talk privately about your rights as a participant, you can call Dr. Leilani Endicott. She is the Director of the Research Center at Walden University. Her phone number is 1-800-925-3368, extension 1210. Walden University’s approval number for this study is 04-02-09-0261824 and it expires on April 1, 2010.
You may retain this form to keep for your records.
I have read the above information and I feel I understand the study well enough to make a decision about my involvement. By completing the online questionnaire, I am agreeing to the terms described above.