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Nurses’ perceptions of social rejection, resilience and well‐being during COVID‐19: A national comparative study


Aims and Objectives

To determine the level of social rejection and well-being of nurses, whether resilience is a mediator between them and to compare nurses who worked versus did not work on COVID-19 wards.


During the COVID-19 pandemic health care workers reported psychological distress and social rejection.


An online survey was sent to nursing social media groups in Israel. Respondents completed a Demographic, Social Rejection, Resilience and General Well-being questionnaire.


Two hundred and forty-seven nurses responded. The majority were female with a mean age of 43.6 years Approximately one-third were worried about infecting their family members and many agreed that their family fears that the nurse will infect them. Nurses reported their partner, family members, neighbours and the public physically distanced themselves from them. Approximately one quarter reported feeling lonely. Statistically significant differences were found between those who worked versus not work on a COVID-19 unit on general well-being, and social rejection. No differences were found in resilience scores.


Social rejection was felt by many nurses as shown by an inverse relationship between the closeness of the relationship and the sense of social rejection and a high level of loneliness and depression. A higher level of social rejection and lower well-being were found among nurses working on COVID-19 wards as opposed to those who did not. General well-being was found to be exceptionally low during COVID-19. Resilience did not mediate the relationship between social rejection and general well-being.

Relevance to clinical practice

Perceived social rejection might be associated with decreased well-being. The level of resilience is related to the level of well-being among nurses in general. Nurses not working in COVID-19 wards have higher levels of well-being and less social rejection compared with nurses working in these wards.

A model of nurses’ intention to care of patients with COVID‐19: Mediating roles of job satisfaction and organisational commitment


Aim and Objectives

This study aims to test the hypothesis that job satisfaction and organisational commitment might play a mediating roles between workload, quality of supervision, extra‐role behaviour, pay satisfaction and intention to care of patients with COVID‐19.


Given the high incidence of coronavirus and shortage of nurses in Iranian hospitals, learning about nurses’ intention to care for patients with COVID‐19 is important.


In this cross‐sectional study, 648 Iranian nurses were surveyed during March 2020. The online questionnaire consisted of two parts. The mediating role was explored for the following: job satisfaction and commitment in the association of workload, quality of supervisor, extra‐role behaviours, and pay satisfaction with the intention to care. The study adhered to STROBE checklist for cross‐sectional studies.


The results of this study show that job satisfaction and organisational commitment mediated the relationship of nurses’ workload, quality of supervisor, extra‐role behaviours, and pay satisfaction with the intention to care for patients with COVID‐19.


The results of the study indicate the importance of job satisfaction and organisational commitment as mechanisms that help to understand the association of nurses’ workload, quality of supervisor, extra‐role behaviours and pay satisfaction with the intention to care during the COVID‐19 pandemic.

Relevance to clinical practice

Hospital managers need to attend to the role of nurses’ job satisfaction and other organisational factors to ensure that they can cope with the challenges of the COVID‐19 pandemic.

Differentiating research and quality improvement activities: A scoping review and implications for clinical scholarship



Differentiating activities that are research or quality improvement (QI) is challenging.


Compare tools that distinguish research from QI and evaluate the utility of tools to determine whether institutional review board (IRB) approval is required for a test-project.


Scoping review of the literature to identify tools that distinguish QI from research. Two reviewers independently screened records in PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Google Scholar and extracted information from tools. Inclusion criteria were English language peer-reviewed publications or publicly available tools with scoring systems to differentiate between research and QI. The reporting of this review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We then applied a test-project to evaluate the utility of the tools.


One-hundred forty sources were reviewed; 13 met inclusion criteria. Tools consistently used project intent/purpose, design and intervention as differentiating criteria; additional criteria varied. Five studies described tool development, and one reported that the tool had been tested. Our application of a test-project proved challenging as tools commonly presented research and QI as discrete activities.


Based on the core criteria common across tools to distinguish research from QI, we propose a simple four-criteria decision tool for assessing the need for IRB submission.