Jesús Beltrán, Diana Achury, Ángel García-Peña, Daniel Fernández, Oscar Muñoz
{"title":"Lasting Empowerment After Discontinuing a Heart Failure Telemonitoring Program: A Randomized Controlled Trial.","authors":"Jesús Beltrán, Diana Achury, Ángel García-Peña, Daniel Fernández, Oscar Muñoz","doi":"10.1097/CIN.0000000000001597","DOIUrl":"https://doi.org/10.1097/CIN.0000000000001597","url":null,"abstract":"<p><p>This study evaluated the long-term effects of the ControlVit mobile application on clinical outcomes and patient empowerment in individuals with chronic heart failure (HF), 6 months after discontinuation of the app. In this open-label, randomized, controlled clinical trial, patients were assigned to either an intervention group receiving standard HF management plus the ControlVit app for 6 months or to a control group receiving standard care alone. After 6 months, app use was discontinued, and all participants were followed for an additional 6 months. The primary outcome was the composite of death or HF-related hospital readmission at 12 months, whereas secondary outcomes included changes in body weight, natriuretic peptide levels, New York Heart Association (NYHA) functional class, and patient empowerment, measured using the Empowerment Evaluation Scale (EES). A total of 140 patients were enrolled (28.6% women; mean age, 67 y). At 12 months, 8 patients (11.4%) in the intervention group and 3 patients (4.3%) in the control group experienced the primary outcome [relative risk (RR): 2.62; 95% CI: 0.73-9.52; P=.122). Empowerment levels were significantly higher among app users compared with controls (EES score: 4.68 ± 0.36 vs. 4.40 ± 1.91; P=.012). Use of SGLT2 inhibitors and ARNi increased significantly in both groups during follow-up (ControlVit: 60% to 85%, P<.001; Control: 51.4% to 75%, P<.001). Among outpatients with chronic HF participating in a structured HF program, the addition of a mobile telemonitoring application did not reduce mortality or HF readmissions 6 months after its discontinuation. However, the intervention was associated with sustained improvements in patient empowerment, suggesting a lasting behavioral impact beyond the period of active app use.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148451371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Machine-learning-based Fall-prediction Model for Inpatients in Military Hospitals.","authors":"YunJung Choi, WooJin Lee, Juyeon Baek","doi":"10.1097/CIN.0000000000001596","DOIUrl":"https://doi.org/10.1097/CIN.0000000000001596","url":null,"abstract":"<p><p>This case-control study develops a machine-learning (ML)-based fall-risk-prediction model for military-hospital inpatients, using electronic records (January 2020 to December 2023) from 11 military hospitals in South Korea. The dataset includes 1470 fall and 3478 nonfall cases, and 25 predictive factors are selected based on data completeness and previous studies. ML models, including logistic regression, decision trees, random forest (RF), and gradient boosting, are developed and evaluated using 10-fold cross-validation. The predictive performances of these models are compared with that of the Morse fall scale (MFS). RF exhibits superior performance, with accuracy, recall, F1-score, and area under the curve (AUC) of 0.76, 0.77, 0.76, and 0.83, respectively. The MFS exhibits a poor predictive capability of 0.02. The key predictive variables include the admission method (on foot), medical department (orthopedics), MFS score, activity status, and body mass index. The findings reveal the limitations of MFS and higher accuracies of ML models in predicting falls among young military inpatients, highlighting the suitability of ML models for improving fall-prevention strategies. Future research should integrate real-time patient conditions and key fall-related factors into prediction models and embed these into clinical decision-making systems.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robin R Austin, Sripriya Rajamani, Merve Altıner Yaş, Selda Secginli
{"title":"Whole-Person Health and Resilience in Older Adult Women: An App-aided Comparative Pilot Study in the United States and Türkiye.","authors":"Robin R Austin, Sripriya Rajamani, Merve Altıner Yaş, Selda Secginli","doi":"10.1097/CIN.0000000000001601","DOIUrl":"https://doi.org/10.1097/CIN.0000000000001601","url":null,"abstract":"<p><p>The aging population, particularly women, faces complex biopsychosocial health and social challenges, necessitating whole-person approaches and innovative research methods to better understand health and well-being to guide effective interventions. The objective of this pilot comparative cross-sectional study was to examine whole-person health and resilience of older adult women ages 65 and older in the United States and Türkiye. Data were collected from adult women in the United States (n=25) and Türkiye (n=25) between March and August 2024. Whole-person health was evaluated using the MyStrengths+MyHealth application, and resilience was measured using the 14-item Resilience Scale. Data were analyzed using descriptive and inferential statistics to examine between-group differences. The average age for the US participants was 78 (SD=6.2), and the average age for the Turkish participants was 68 (SD=2.8). There were significant differences in average self-reported strengths (P<0.001), challenges (P<.001), and needs (P<.001) between US and Turkish participants. US participants had a higher mean Resilience score [88.0 (SD=5.3)] versus Turkish participants [74.9 (SD=14.7)] (P<.001). The study revealed that both groups had above-average resilience and had both common strengths and differences in health challenges and needs. These findings highlight the importance of prioritizing a whole-person health approach when developing strengths-based interventions to address the complex and diverse needs of older women.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Catherine A Hebert, Christen Trinity, April Messer
{"title":"Nursing Perspectives on Documentation Burden in a Veterans Affairs Health Care System.","authors":"Catherine A Hebert, Christen Trinity, April Messer","doi":"10.1097/CIN.0000000000001591","DOIUrl":"https://doi.org/10.1097/CIN.0000000000001591","url":null,"abstract":"<p><p>The growing integration of the electronic health record in health systems has contributed to care improvements, yet is increasingly recognized as a source of stress and burnout for nurses. This study, conducted in a southeastern Veterans Affairs health system, used focus groups composed of 51 direct care nurses in shared governance councils practicing across inpatient and outpatient settings to assess their perspectives regarding documentation burden. Qualitative content analysis of focus group transcripts revealed 4 themes: poor usability, uncertainty, nonvalue added to patient care, and risk for error and liability. Fifteen subthemes were identified. Participants perceived much documentation as duplicative, nonimpactful on patient outcomes, and frequently driven by regulatory or quality reporting rather than clinical necessity. The findings reflect current literature and align with the American Nurses Informatics Association's Six Domains of Burden Framework, which underscores documentation burden as a modifiable, systems-level issue. Engaging direct care nurses through shared governance structures may support targeted solutions such as eliminating duplicate documentation, enhancing electronic documentation usability, and clarifying documentation standards. Health information systems redesign must focus on the safety and well-being of both nurses and patients to ensure the provision of quality nursing care and retention of a strong nursing workforce.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Effect of the Mobile Application on Treatment Adherence, Self-Management, and Quality of Life in Patients With Acute Myocardial Infarction.","authors":"Ezgi Kinici Dirik, Eylem Pasli Gürdoğan","doi":"10.1097/CIN.0000000000001593","DOIUrl":"10.1097/CIN.0000000000001593","url":null,"abstract":"<p><p>Ensuring patient adherence to treatments and lifestyle recommendations after discharge is crucial for effective postacute myocardial infarction (AMI) management. This study aimed to determine the impact of a mobile health application (mHealth) on treatment adherence, self-management, and quality of life in patients with their first-time AMI undergoing primary percutaneous coronary intervention. The randomized controlled study was conducted with 61 patients. The control group received standard discharge education with the educational booklet. In addition to these practices, the intervention group received mHealth support. They were followed up for 6 months postdischarge. Data were collected at the first, third, and sixth months. The patient information form, questioning compliance with lifestyle change recommendations, the Medical Adherence Report Scale, and the Myocardial Infarction Dimensional Assessment Scale were used in data collection. Compared to the control group, the patients in the intervention group had a better quality of life at all 3 follow-ups and better medication adherence at the sixth month. Also, it was determined that the patients in the intervention group had higher adherence with lifestyle recommendations regarding nutrition and physical exercise than in the control group ( P <.05). mHealth increases their adherence with treatment, including medication and lifestyle change recommendations, in the long term. In addition to the education provided at discharge, using a mobile health application was found to effectively improve patients' adherence to treatment, including medication and lifestyle changes. Consequently, patients' quality of life improved during the 6-month follow-up period. Innovative approaches that support self-management, such as mHealth, are considered promising additions to AMI control.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148393181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advancing Nurse-Led Self-Regulation in Multiple Sclerosis Management: Developing an Interactive Web-Based Program through Action Research: Multiple Sclerosis Management.","authors":"Ayyüce Tuba Koçak, Selda Arslan","doi":"10.1097/CIN.0000000000001584","DOIUrl":"https://doi.org/10.1097/CIN.0000000000001584","url":null,"abstract":"<p><p>This study aimed to develop an interactive web-based program, \"I Can Manage,\" to support nurse-led self-regulation in the management of Multiple Sclerosis (MS). An action research approach was adopted, utilizing the Spiral Technology Action Research model, which involves the stages of listen, plan, do, study, and act. The study was conducted with 16 nurses and persons with MS (pwMS). Data were collected through in-depth individual interviews and the System Usability Scale (SUS). In the \"Listen\" stage, existing programs were reviewed, and a descriptive phenomenological study was conducted. In the \"Plan\" stage, program features were designed based on self-regulation strategies. In the \"Do\" stage, these features were shared with participants and implemented. In the \"Study\" stage, participants reevaluated the program in terms of navigation and usability. In the \"Act\" stage, the program was presented to experts, and participants assessed it using the SUS. Themes that emerged included \"emotions that need to be managed,\" \"support required for self-management,\" \"provision of individualized services,\" \"barriers to self-management,\" and \"enhancement of care quality.\" The Content Validity Index (CVI) was 0.96. The mean SUS scores were 90.50±6.93 (nurses) and 88.25±6.87 (pwMS). This study demonstrates how nurses can take leadership roles in identifying patient needs and developing effective web-based programs to enhance self-management and care quality.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lee Taylor-Vaughan, Stefanie Boyles, Donna Eyler, Joseph C DeBoe, Ashlee Garcia, Sara Puma, Sheila Gephart
{"title":"Integrating Spatial Awareness Into Nursing EHR Design: A Scoping Review of Usability and Cognitive Load.","authors":"Lee Taylor-Vaughan, Stefanie Boyles, Donna Eyler, Joseph C DeBoe, Ashlee Garcia, Sara Puma, Sheila Gephart","doi":"10.1097/CIN.0000000000001473","DOIUrl":"https://doi.org/10.1097/CIN.0000000000001473","url":null,"abstract":"<p><strong>Background: </strong>Usability challenges in electronic health records drive documentation burden and cognitive overload, especially in high-acuity settings. Current electronic health record design often fails to accurately reflect real-world clinical environments, disrupting workflow and decision-making processes. Integrating spatial awareness, which aligns physical clinical equipment with its digital representation, may enhance usability by reducing cognitive strain and fostering intuitive interaction.</p><p><strong>Methods: </strong>This scoping review followed PRISMA-ScR guidelines. We searched 7 databases for peer-reviewed articles concerning the usability of electronic health records and cognitive load in relation to spatial awareness.</p><p><strong>Results: </strong>Thirty-five articles met the inclusion criteria. Many were in acute care (71.4%). End-user populations: physicians (n=22, 62.9%), nurses (n=14, 40.0%), and other roles (n=8, 22.9%). Key findings included visual integration (88.6%), kinesthetic interaction (34.3%), and auditory cues (5.7%). Conventional fixes commonly improved entry speed but rarely reduced fragmentation or enhanced SA; no study implemented full room- or device-aligned spatial mapping. Most evaluations used prototype or custom systems (n=20, 57.1%).</p><p><strong>Discussion: </strong>Despite advancements in interface technology, few systems achieve spatial integration within nursing workflows. Integrating spatial awareness represents a promising but untested design approach that warrants systematic evaluation alongside optimized, simpler solutions.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":"44 7","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effects of Flipped, Web-Based, and Traditional Learning Models on Clinical Nurses' Self-Directed Learning and Metacognition: A Randomized Trial Design.","authors":"Emine Şenyuva, Deniz Yildirim","doi":"10.1097/CIN.0000000000001464","DOIUrl":"10.1097/CIN.0000000000001464","url":null,"abstract":"<p><p>Global health crises, armed conflicts, and technological advancements such as artificial intelligence have made nursing care more complex, requiring clinical nurses to develop stronger self-directed learning and metacognitive thinking skills. However, most educational interventions focus on nursing students, with limited attention given to clinical nurses and the use of innovative learning methods. This study examined the effects of evidence-based practice training delivered through flipped learning, web-based learning, and traditional classroom methods on clinical nurses' self-directed learning and metacognitive thinking. A randomized controlled trial was conducted with 45 clinical nurses in a training and research hospital. Participants were randomly assigned to 1 of 3 groups: flipped learning, web-based learning, or traditional instruction. Data were collected using validated scales before the intervention, immediately after, and 1 month later. Findings indicated that both flipped and web-based learning significantly improved nurses' self-directed learning and metacognitive thinking skills compared to traditional learning. No significant difference was found between the flipped and web-based models. These results suggest that innovative, flexible learning approaches can enhance evidence-based practice capabilities among clinical nurses and should be integrated into continuing education programs to improve quality of care in clinical settings.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145902234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bridging the Gap Between Potential and Practice: An Integrative Review of Generative Artificial Intelligence in Nursing.","authors":"Lillian Campbell, Victoria L Tiase","doi":"10.1097/CIN.0000000000001481","DOIUrl":"10.1097/CIN.0000000000001481","url":null,"abstract":"<p><strong>Background: </strong>Generative artificial intelligence (GAI) has emerged as a transformative tool in health care, particularly with the integration of large language models (LLMs) into electronic health record (EHR) systems. These tools have the potential to enhance clinical decision-making, increase efficiencies, and decrease time in the EHR. However, despite expanding availability, adoption in nursing practice remains limited. This integrative review aimed to synthesize the literature and explore barriers related to the integration of GAI tools into nursing practice.</p><p><strong>Methods: </strong>We conducted an integrative search of peer-reviewed literature published between November 2022 and July 2025 to examine the current evidence while assessing for methodological quality. The retrieved articles were screened for title, abstract, and full text eligibility. We synthesized themes related to GAI adoption by nurses, focusing on ethical, educational, and workflow-related factors that influence use.</p><p><strong>Results: </strong>A total of 10 studies met criteria including 7 qualitative descriptive design, 2 case reports, and 1 experimental clinical trial. Four key barriers emerged: educational gaps, ethical concerns, data transparency issues, and workflow misalignment contributing to nurses' hesitancy to engage with GAI tools. Recommendations include involvement of nurses in the design, implementation, and evaluation of GAI tools and mandatory AI curricula in nursing education.</p><p><strong>Conclusions: </strong>Overcoming barriers requires nurse involvement in GAI design efforts, targeted education, and governance models that foster trust and usability. Nurse-centered integration of GAI tools has the potential to advance workforce efficiencies while preserving patient safety.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146152197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of Digital Burnout and Attention Control on Care Behaviors in Nurses: A Structural Equation Model.","authors":"Rabia Arpaci, Hacer Kabakoğlu, Derya Tanriverdi","doi":"10.1097/CIN.0000000000001385","DOIUrl":"10.1097/CIN.0000000000001385","url":null,"abstract":"<p><p>Digital burnout and attention control are likely to influence nurses' job performance, productivity, and care behaviors. However, there is a lack of studies investigating the impact of digital burnout and attention control on care behaviors. This descriptive study was conducted with 345 nurses working in different services of the state hospital in Turkey. Nurses have moderate levels of digital burnout and attention control problems, whereas they have above-average care behaviors. A positive moderate correlation was found between nurses' digital burnout levels and attention control problem levels ( r =0.361, P <.001). A negative moderate correlation was found between nurses' digital burnout levels and care behavior levels ( r =-0.309, P <.001). A negative weak correlation was found between nurses' attention control problem levels and care behavior levels ( r =-0.291, P < .001). It has been determined that digital burnout increases attention control problems (β=0.418, P <.001). Digital burnout (β=-0.215, P <.001) and attention control problems (β=-0.224, P <.001) negatively impacted care behaviors. Interventions should be implemented in clinical settings to reduce digital burnout and enhance nurses' attention control skills.</p>","PeriodicalId":520598,"journal":{"name":"Computers, informatics, nursing : CIN","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}