JMIR nursing最新文献

{"title":"Development of a Knowledge Base for an Integrated Older Adult Care Model (SMART System) Based on an Intervention Mapping Framework: Mixed Methods Study.","authors":"Rongrong Guo, Shuqin Xiao, Fangyu Yang, Huan Fan, Yanyan Xiao, Xue Yang, Ying Wu","doi":"10.2196/59276","DOIUrl":"10.2196/59276","url":null,"abstract":"<p><strong>Background: </strong>Although mobile health apps integrated with Internet of Things-enabled devices are increasingly used to satisfy the growing needs for home-based older adult care resulting from rapid population aging, their effectiveness is constrained by 3 key challenges: a focus on specific functions rather than on holistic and integrated support, absence of a solid theoretical framework for development, and a lack of personalized, real-time feedback to address diverse care needs. To overcome these limitations, we developed a knowledge-based clinical decision support system using mobile health technology-an intelligent and integrated older adults care model (SMART system).</p><p><strong>Objective: </strong>This study aims to systematically outline the development process and outcomes of a knowledge base and trigger rules for the SMART system.</p><p><strong>Methods: </strong>Our study adopted a user-centered approach guided by the nursing process and intervention mapping (IM) framework. We first identified older adult care needs through semistructured, in-depth interviews. Guided by the nursing process and informed by guidance from the World Health Organization's Integrated Care for Older People and World Health Organization International Classification of Functioning, Disability, and Health, along with the North American Nursing Diagnosis Association-I nursing diagnosis, we then determined care problems along with their underlying causes and risk factors and diagnostic criteria. Building on these findings, we applied the first 3 steps of the intervention mapping framework to formulate corresponding long-term and short-term care objectives, select appropriate evidence-based interventions, and match practical implementation approaches, which were grounded in rigorous evidence derived from systematic literature reviews, clinical guidelines, and expert insights. We also developed a set of trigger rules to link abnormalities in older adults with corresponding care problems and interventions in the SMART knowledge base.</p><p><strong>Results: </strong>The semistructured in-depth interviews identified 5 types of care needs-daily life care, health care, external support, social participation, and self-development-which formed the foundation of the SMART knowledge base. Based on this, we identified 138 care problems, each with associated causes and risk factors and diagnostic criteria. The objective matrix comprised 138 long-term and 195 short-term care objectives. Guided by 15 expert-defined selection criteria, we then selected 450 evidence-based interventions, each paired with at least 1 feasible and practical implementation approach. Additionally, we developed diagnostic rules to match the assessment data with relevant care problems and their causes and risk factors and intervention trigger rules to formulate personalized interventions based on individual characteristics, ensuring tailored care aligned with specific care objectives.</p","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e59276"},"PeriodicalIF":4.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857169","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":"Patients' Perception of a Brief Web- and Mindfulness-Based Intervention for Pain Following Discharge After Total Joint Arthroplasty: Qualitative Description.","authors":"Geraldine Martorella, Adam Wesley Hanley, Kathryn Elizabeth Muessig","doi":"10.2196/69010","DOIUrl":"10.2196/69010","url":null,"abstract":"<p><strong>Background: </strong>Important levels of pain are reported upon discharge from major surgery, with a risk of becoming chronic. Further, individuals express the need for support in managing pain after discharge. However, very few studies address pain management interventions in the postdischarge phase after surgery, including for individuals undergoing total joint arthroplasty (TJA). We have conducted a pilot randomized controlled trial testing a brief mindfulness intervention targeting people at risk for chronic postsurgical pain 2 weeks after surgery. Although the intervention we proposed was judged acceptable based on ratings obtained through a questionnaire, the nuanced perceptions of why and how it is considered acceptable are critical in refining the intervention. Moreover, the acceptability of mindfulness interventions in the perioperative context remains generally unknown and even more so in the postdischarge setting.</p><p><strong>Objective: </strong>The purpose of this study was to use qualitative data to explore the individual perception of acceptability of a brief 4-week, Web- and mindfulness-based intervention for pain following discharge after a TJA.</p><p><strong>Methods: </strong>A qualitative description was used to assess patients' perception of the preliminary version of the intervention for pain management following discharge after surgery. The qualitative assessment was done at the end of the 4-week intervention (6 weeks after surgery). Semistructured interviews with open-ended questions were used to encourage free expression from participants (n=16) before proceeding to content analysis.</p><p><strong>Results: </strong>When reflecting on the benefits of the intervention, the main themes that emerged were mindfulness, pain acceptance, and supplementary relief. Overall, the intervention was perceived as relevant and suitable during recovery, although participants experienced a few challenges related to the novelty of mindfulness practice. Engagement and readiness were discussed in relation to adherence to the intervention. Addressing expectations and personal beliefs before the intervention could improve participants' adherence. Offering additional support when spikes of pain occur could help overcome some challenges related to mindfulness practice during postoperative recovery.</p><p><strong>Conclusions: </strong>Given the increasing number of TJA surgeries performed annually and the effectiveness of nonpharmacological interventions, such as mindfulness-based approaches, in supporting recovery and well-being, efforts should be made to increase patient access to these promising adjunctive treatments. Combining nonpharmacological interventions before and after surgery may be an interesting avenue to optimize pain relief and recovery, as well as prevent complications. Finally, the use of technology could improve the accessibility, scalability, and adoption of these promising approaches for individuals with limited reso","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e69010"},"PeriodicalIF":4.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796294","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":"Evaluating Social Assistive Robots in Clinical Nursing Care: Mixed Method Pilot Study on Health Care Workers' Perceptions and Adoption.","authors":"Janika Leoste, Kadi Lubi, Kristel Marmor, Katrin Kangur","doi":"10.2196/70305","DOIUrl":"10.2196/70305","url":null,"abstract":"<p><strong>Background: </strong>The growing demand for older adults care due to aging populations and health care workforce shortages requires innovative solutions. Socially assistive robots (SARs) are increasingly explored for their potential to reduce workload by handling routine tasks. Yet, adoption can be hindered by various health care workers' concerns.</p><p><strong>Objective: </strong>This study examined the perceptions of health care workers toward SARs before and after a pilot use in a clinical nursing care setting. The study focused on SAR usability, emotional appropriateness, and readiness for adoption.</p><p><strong>Methods: </strong>A mixed methods pilot study was conducted at the East Tallinn Central Hospital's Nursing Care Clinic in collaboration with Tallinn University of Technology. The TEMI v3 (Robotemi) robot was used for 2 weeks for visitor guidance, goods delivery, and patrolling tasks. Health care workers filled in pre- and postintervention questionnaires with Likert-scale items and a broad open-ended question. Quantitative data were analyzed for changes in perceived safety, trust, and usability. Qualitative data underwent thematic analysis to understand participants' opinions.</p><p><strong>Results: </strong>Out of 45 involved health care workers, 20 completed the pretest questionnaire, and 5 completed the posttest questionnaire (a 75% attrition). Pretest results show that 17 of 20 (85%) participants had limited previous exposure to SARs and mixed perceptions of their role, with 9 (45%) viewing SARs as machines and 6 (30%) as somewhat human-like. Although 60% believed SARs could become mainstream within 5-10 years, there were concerns about the robot's emotional adequacy and job displacement. Posttest findings showed increased confidence in SARs, with all respondents perceiving them as safe tools. Qualitative results indicate improved trust and readiness to integrate SARs into daily routines, with 4 out of 5 (80%) being willing to advocate for SAR use. Still, participants noted limited impact on facilitating their jobs.</p><p><strong>Conclusions: </strong>The study indicates that short-term collaboration with SARs can enhance health care workers' confidence and their readiness for adoption. However, actual use would need proper emotional adequacy from the robot and aligning its functionalities with specific care needs. The future studies need to examine long-term impacts on care quality and job satisfaction, and also strategies to address generational differences and technophobia among health care staff. Transparent communication and proper training are required to ensure acceptance.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e70305"},"PeriodicalIF":4.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765871","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":"Readiness and Acceptance of Nursing Students Regarding AI-Based Health Care Technology on the Training of Nursing Skills in Saudi Arabia: Cross-Sectional Study.","authors":"Kamlah Al-Olaimat, Basma Salameh, Rasha Abdulhalim Alqadi, Abeer Alruwaili, Manal Hakami, Hanay Huwaydi ALanazi, Tahani Maharem, Fadia Ahmed Abdelkader Reshia","doi":"10.2196/71653","DOIUrl":"10.2196/71653","url":null,"abstract":"<p><strong>Background: </strong>The rapid advancements in artificial intelligence (AI) technologies across various sectors, including health care, necessitate the need for a comprehensive understanding of their applications. Specifically, the acceptance and readiness of nursing students as future health care professionals to adopt AI-based health care technologies, along with the factors influencing these attitudes, are critical for facilitating the effective integration of AI in health care settings.</p><p><strong>Objective: </strong>This study aimed to assess the readiness and acceptance of nursing students regarding the use of AI-based health care technologies in the nursing skills training in Saudi Arabia.</p><p><strong>Methods: </strong>A descriptive cross-sectional research design was used. A convenience sampling technique was applied to recruit 322 participants. Data were collected between June and September 2023 using a self-administered questionnaire that included the technology readiness index (TRI) and the technology acceptance scale.</p><p><strong>Results: </strong>Approximately 92.2% (297/322) of participants exhibited positive attitudes toward AI, and 74.8% (241/322) demonstrated innovativeness, indicating a generally favorable perception of AI. However, more than half of the students (59% [190/322] and 59.3% [191/322], respectively) reported feelings of discomfort and negative perceptions regarding AI use. Regarding TRI, 69.6% (224/322) of participants showed moderate readiness, while 30.4% (98/322) exhibited a high level of TRI. A substantial majority (320/322 99.4%) expressed acceptance of AI-based technologies in their training, with only 0.6% (2/322) reporting nonacceptance. Older students (aged >22 y) exhibited significantly higher levels of AI acceptance and readiness compared to younger students (P<.001). In addition, female students demonstrated significantly greater readiness and acceptance levels than male students (P=.003). Further, third-level students reported the highest mean scores in both acceptance and readiness (66.77 and 16.69, respectively; P=.002), while first-level students had the lowest (60.59 and 15.15). Among course groups, students enrolled in Maternal and Child Health Nursing reported the highest mean scores (65.19 and 16.30), whereas those in Community Health Nursing reported the lowest (57.50 and 14.38; P<.001).</p><p><strong>Conclusions: </strong>The findings indicate that nursing students demonstrated a generally positive level of readiness and acceptance toward the use of AI and related technologies in education and training. However, these levels remained moderate overall, highlighting the need to enhance awareness and deepen students' understanding of AI's potential to improve training effectiveness and health care quality.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e71653"},"PeriodicalIF":4.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755291","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":"Delivering an Electronic Health Record Based Educational Intervention Promoting Peri-Operative Non-Pharmacological Pain Care as Part of a Randomized Controlled Trial: Mixed Method Evaluation of Inpatient Nurses' Perspectives.","authors":"Sarah A Minteer, Cindy Tofthagen, Kathy Sheffield, Susanne Cutshall, Susan Launder, Jane Hein, Mary McGough, Christy M Audeh, Jon C Tilburt, Andrea L Cheville","doi":"10.2196/70332","DOIUrl":"10.2196/70332","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Best practice guidelines recommend educating surgical patients about non-pharmacological pain care (NPPC) techniques that can be used in addition to pain medication for perioperative pain management, given the risks for opioid misuse following surgery. As part of the parent non-pharmacologic options in postoperative hospital-based and rehabilitation pain management (NOHARM) clinical trial, we implemented the Healing After Surgery initiative, which leveraged the Epic electronic health record (EHR) to provide patients with education on NPPC techniques perioperatively. We disseminated educational materials directly to patients via the EHR patient portal and prompted patients to select the techniques they were most interested in using, which auto-populated the EHR so that their care team could view their preferences. We also built clinical decision support elements in the EHR to prompt and support inpatient nurses in providing patients with education and reinforcement for using their preferred NPPC techniques. Print materials, a website, a DVD, videos on hospital televisions, a toll-free number, and Zoom-based group calls provided additional education on NPPC techniques.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluated nurses' perceptions of barriers and facilitators to implementing the EHR-based Healing After Surgery initiative.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We invited inpatient nursing leaders and bedside nurses to participate in a semistructured interview. Inpatient nursing leaders were invited to complete a brief survey that asked them to rate their agreement with 7 items using a numeric rating scale (1=not at all, 10=a great deal).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Interview findings from 29 nurses revealed: (1) nurses gravitated towards providing NPPC techniques they were familiar with, (2) the initiative was patient-centric with opportunities to better engage patients, and (3) nurses experienced challenges implementing and prioritizing the intervention in the inpatient setting due to competing demands in a pandemic and postpandemic environment. Interviews revealed mixed effectiveness of implementation strategies. We received survey responses from 47 nursing leaders who indicated that their staff knew about the Healing After Surgery initiative (mean=7.53, SD=1.77) and what they were expected to do (mean=7, SD=1.88). They thought the Healing After Surgery initiative supported patients' pain management needs (mean=6.76, SD=2.24), endorsed it as a priority (mean=7.02, SD=2.56), and encouraged staff to support it (mean=5.98, SD=2.78). They indicated staff experienced some burden supporting the initiative (mean=3.93, SD=2.47), but supported some variation of the initiative continuing once the parent trial ended (mean=7.72, SD=2.62).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Nurses understood the intervention's benefit but struggled to implement unfamiliar NPPC techniques and prioritize the initiative due to other clin","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e70332"},"PeriodicalIF":4.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661168","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":"Effectiveness of m-Learning in Enhancing Knowledge Retention for Nurses' Lifelong Learning: Quasi-Experimental Study.","authors":"Daniel José Cunha, Paulo Machado, José Miguel Padilha","doi":"10.2196/72957","DOIUrl":"10.2196/72957","url":null,"abstract":"<p><strong>Background: </strong>The current information and communication technologies, digital literacy, and ease of access to communication and information devices by nurses provide them with new ways and intention to access information for technical-scientific updating, ensuring the quality and safety of health care. Mobile learning (m-learning) offers a flexible and accessible alternative for continuing professional education, overcoming barriers such as time constraints and financial burden.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of m-learning in nurses' knowledge retention of chronic obstructive pulmonary disease self-management, using a Massive Open Online Course with integrated virtual clinical simulation.</p><p><strong>Methods: </strong>A quasi-experimental pre- and posttest study was conducted, with no control group, among 168 nurses from a Portuguese hospital. The intervention included an asynchronous online course with 13 modules. Knowledge retention was assessed by comparing the mean scores before and after the course.</p><p><strong>Results: </strong>The results indicated a significant increase in knowledge retention. The participants' average score increased from 59.97% in the initial assessment to 84.05% in the final assessment (P<.001). Nurses with a master's degree exhibited a higher level of basic knowledge than those with a bachelor's degree. The course completion rate was 93.45%, reflecting significant engagement attributed to gamification and clinically relevant content.</p><p><strong>Conclusions: </strong>This study confirms the effectiveness of m-learning in improving knowledge retention in nursing. This strategy is a valuable approach to lifelong learning, promoting quality and safety in delivering health care. m-learning is useful in nurses' lifelong learning, offering flexibility and more effective support for clinical practice. Integrating virtual simulation and gamification boosted motivation and reduced drop-out rates, highlighting the potential of m-learning in lifelong learning in health care.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e72957"},"PeriodicalIF":4.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661169","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":"The Effectiveness of a Question-Embedded Movie Clips Learning Program in Nursing Students: A Quasi-Experimental Pretest-Posttest Study.","authors":"Chanokruthai Choenarom, Juraipon Samputtanon","doi":"10.2196/71111","DOIUrl":"10.2196/71111","url":null,"abstract":"<p><strong>Background: </strong>Technological innovations make significant impacts on nursing education. New teaching strategies are constantly emerging, offering students a dynamic and interactive educational experience. The Question-Embedded Movie Clips Learning program used in this study was developed based on the drill and practice learning principle, aiming to facilitate nursing students' skills and build their confidence before entering real clinical settings.</p><p><strong>Objective: </strong>This study aims to investigate the comparative effect between the newly developed Question-Embedded Movie Clips Learning program and the current practice of mind mapping exercises on students' learning outcomes and study satisfaction.</p><p><strong>Methods: </strong>This study adopted a quasi-experimental design using a pretest-posttest approach with nonequivalent groups. The study sample consisted of 132 third-year nursing students who enrolled in one of two class sections of the psychiatric nursing course at a university in Thailand. By flipping a coin, the first study section (n=62) was assigned to the intervention, and the second section (n=70) was assigned to the control group. During the 2-hour class sessions, students received identical learning structure and sequence, except for group exercises of either the Question-Embedded Movie Clips Learning program or the mind mapping. The data were collected through the pretest-posttest questionnaire, the perceived satisfaction with the learning experience scale, and the open-ended reflective questions.</p><p><strong>Results: </strong>A statistically significant increase was observed in the learning outcome scores of both the intervention group (t61=-30.48, 95% CI -10.59 to -9.28; P<.001) and the control group (t69=-27.04, 95% CI -8.19 to -7.07; P<.001); all t statistics reported are based on 2-tailed tests. There was, however, a statistically significant difference in the outcome scores between the 2 groups. Even after controlling for pretest scores, students in the experimental group had a significantly higher adjusted mean score than those in the control group (F1,129=67.67, P<.001).</p><p><strong>Conclusions: </strong>The study has provided empirical evidence that using the Question-Embedded Movie Clips Learning program along with traditional instruction in teaching therapeutic relationships and communication significantly improves learning outcomes.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e71111"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602446","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":"Using Large Language Models to Assess Burnout Among Health Care Workers in the Context of COVID-19 Vaccine Decisions and Health Beliefs: Retrospective Cohort Study.","authors":"Samaneh Omranian, Lu He, AkkeNeel Talsma, Arielle A J Scoglio, Susan McRoy, Janet W Rich-Edwards","doi":"10.2196/73672","DOIUrl":"10.2196/73672","url":null,"abstract":"<p><strong>Background: </strong>Burnout among health care workers affects their well-being and decision-making, influencing patient and public health outcomes. Health care workers' health beliefs and COVID-19 vaccine decisions may affect the risks of burnout. Therefore, understanding the interplay between these crucial factors is essential for identifying at-risk staff, providing targeted support, and addressing workplace challenges to prevent further escalation of burnout-related issues.</p><p><strong>Objective: </strong>This study examines how burnout is impacted by health beliefs and COVID-19 vaccine decisions among health care workers. Building on our previously developed Health Belief Model (HBM) classifier based on the HBM framework, which explains how individual perceptions of health risks and benefits influence behavior, we focused on key HBM constructs, including the perceived severity of COVID-19, perceived barriers to vaccination, and their relationship to burnout. We aim to leverage natural language processing techniques to automatically identify theoretically grounded burnout symptoms from comments authored by nurses in a large-scale, national survey and assess their associations with vaccine hesitancy and health beliefs.</p><p><strong>Methods: </strong>We analyzed 1944 open-ended comments written by 1501 vaccine-hesitant nurses, using data from the Nurses' Health Study surveys. We fine-tuned LLaMA 3, an open-source large language model with few-shot prompts and enhanced performance with structured annotation guidance and reasoning-aware inference. Comments were classified into burnout dimensions-Emotional Exhaustion, Depersonalization, and Inefficacy-based on the Maslach Burnout Inventory framework.</p><p><strong>Results: </strong>The model achieved a high weighted accuracy of 92% and an F1-score of 91% for Depersonalization. Emotional Exhaustion was identified in 52% (1003/1944) of comments, correlating strongly with perceived severity (189/323, 59%) and barriers to vaccination (281/650, 43%). Demographic analyses revealed significant variations in burnout prevalence, with older age groups reporting greater burnout.</p><p><strong>Conclusions: </strong>This study highlights the relationship between burnout and vaccine decision-making among health care workers, uncovering areas for further exploration. By exploring the complex interplay between psychological strain and vaccine hesitancy, this study sets the stage for developing transformative interventions and policies that could redefine workforce resilience and public health strategies.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e73672"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562194","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":"Supporting Web-Based Teaching and Learning of Virtual Care Skills and Competencies: Development of an Evidence-Informed Framework.","authors":"Lorelli Nowell, Sara Dolan, Sonja Johnston, Michele Jacobsen, Diane L Lorenzetti, Elizabeth Oddone Paolucci","doi":"10.2196/75868","DOIUrl":"10.2196/75868","url":null,"abstract":"<p><strong>Background: </strong>Professionals across caring disciplines have played a significant role in the development of virtual care, which uses remote technologies to offer support and services from a distance. As virtual care becomes increasingly essential, instructors must ensure that students are equipped with both interpersonal abilities and digital competencies, merging traditional hands-on methods with web-based learning. Despite its growing importance, there is a lack of comprehensive frameworks to guide the design and delivery of web-based learning experiences that foster the development of virtual caring skills and competencies among students in caring professions.</p><p><strong>Objective: </strong>This study aims to develop an evidence-informed framework to support web-based teaching and learning of virtual caring skills and competencies.</p><p><strong>Methods: </strong>We present a synthesis of our research resulting in an evidence-informed framework. We integrated findings from an evidence synthesis, surveys, and semistructured interviews with students and educators, and consultations with key stakeholders.</p><p><strong>Results: </strong>Principles of this framework include (1) connection and interaction; (2) compassion, empathy, and care; (3) vulnerability; (4) a client-centered focus; (5) inclusivity and accessibility; and (6) flexibility. The framework's four main domains are (1) virtual caring skills; (2) teaching and learning methods; (3) barriers to teaching, learning, and providing virtual care; and (4) facilitators of teaching, learning, and providing virtual care.</p><p><strong>Conclusions: </strong>This framework was developed by and for students and educators to aid in planning, promoting, and enhancing virtual caring skills development. It can be used to better equip students to provide virtual care, thereby positively impacting client care and outcomes. This framework can support educators, students, decision makers, and practice partners to build learning experiences aimed at preparing students to provide virtual care effectively.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e75868"},"PeriodicalIF":4.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562193","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":"Gamification as a Tool for Understanding Mental Disorders in Nursing Students: Qualitative Study.","authors":"Pablo Del Pozo-Herce, Alberto Tovar-Reinoso, Eva García Carpintero-Blas, Ana Casaux Huertas, Regina Ruiz de Viñaspre-Hernández, Antonio Martínez-Sabater, Elena Chover-Sierra, Marta Rodríguez-García, Raul Juarez-Vela","doi":"10.2196/71921","DOIUrl":"10.2196/71921","url":null,"abstract":"<p><strong>Background: </strong>Gamification has emerged as an innovative pedagogical strategy in the educational field, transferring game tools to the teaching-learning process to improve students' motivation and engagement.</p><p><strong>Objective: </strong>This study aims to describe nursing students' perceptions of mental disorders using interactive cards as a gamification tool.</p><p><strong>Methods: </strong>This research was carried out at the Nursing School of a University in Madrid, Spain, with the participation of 50 first-year students enrolled in the nursing degree's general and developmental psychology course. Data were collected through focus groups and reflective narratives with semistructured interview questions between March and April 2024. After data collection, transcripts were generated and subjected to thematic analysis following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.</p><p><strong>Results: </strong>A total of three themes emerged from the analysis: (1) perception and stigma of mental disorders, (2) emotional connection and personal reflection in learning about mental disorders, and (3) gamification tools and their impact on learning.</p><p><strong>Conclusions: </strong>Gamification, especially through interactive cards, is valuable for teaching psychology and mental disorders in nursing education. It enables students to gain a deeper clinical understanding of mental illnesses and explore their emotional and social dimensions. This methodology fosters emotional reflection, reduces stigma, and encourages active engagement, contributing to developing more empathetic, reflective, and better-prepared nursing professionals. Its integration into educational programs enhances academic and humanistic competencies essential for mental health care.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"8 ","pages":"e71921"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337305","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}