JMIR nursing最新文献

{"title":"Sociotechnical Challenges of Digital Health in Nursing Practice During the COVID-19 Pandemic: National Study.","authors":"Karen Livesay, Sacha Petersen, Ruby Walter, Lin Zhao, Kerryn Butler-Henderson, Robab Abdolkhani","doi":"10.2196/46819","DOIUrl":"10.2196/46819","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has accelerated the use of digital health innovations, which has greatly impacted nursing practice. However, little is known about the use of digital health services by nurses and how this has changed during the pandemic.</p><p><strong>Objective: </strong>This study explored the sociotechnical challenges that nurses encountered in using digital health services implemented during the pandemic and, accordingly, what digital health capabilities they expect from the emerging workforce.</p><p><strong>Methods: </strong>Five groups of nurses, including chief nursing information officers, nurses, clinical educators, nurse representatives at digital health vendor companies, and nurse representatives in government bodies across Australia were interviewed. They were asked about their experience of digital health during the pandemic, their sociotechnical challenges, and their expectations of the digital health capabilities of emerging nurses to overcome these challenges. Interviews were deductively analyzed based on 8 sociotechnical themes, including technical challenges, nurse-technology interaction, clinical content management, training and human resources, communication and workflow, internal policies and guidelines, external factors, and effectiveness assessment of digital health for postpandemic use.</p><p><strong>Results: </strong>Sixteen participants were interviewed. Human factors and clinical workflow challenges were highly mentioned. Nurses' lack of knowledge and involvement in digital health implementation and evaluation led to inefficient use of these technologies during the pandemic. They expected the emerging workforce to be digitally literate and actively engaged in digital health interventions beyond documentation, such as data analytics and decision-making.</p><p><strong>Conclusions: </strong>Nurses should be involved in digital health interventions to efficiently use these technologies and provide safe and quality care. Collaborative efforts among policy makers, vendors, and clinical and academic industries can leverage digital health capabilities in the nursing workforce.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e46819"},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10136436","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":"Underestimated Factors Regarding the Use of Technology in Daily Practice of Long-Term Care: Qualitative Study Among Health Care Professionals.","authors":"Sjors W M Groeneveld,&nbsp;Marjolein E M den Ouden,&nbsp;J E W C van Gemert-Pijnen,&nbsp;Rudolph M Verdaasdonk,&nbsp;Harmieke van Os-Medendorp","doi":"10.2196/41032","DOIUrl":"https://doi.org/10.2196/41032","url":null,"abstract":"<p><strong>Background: </strong>Increasing life expectancy is resulting in a growing demand for long-term care; however, there is a shortage of qualified health care professionals (HCPs) to deliver it. If used optimally, technology can provide a solution to this challenge. HCPs play an important role in the use of technology in long-term care. However, technology influences several core aspects of the work that HCPs do, and it is therefore important to have a good understanding of their viewpoint regarding the use of technology in daily practice of long-term care.</p><p><strong>Objective: </strong>The aim of this study was to identify the factors that HCPs consider as relevant for using technology in daily practice of long-term care.</p><p><strong>Methods: </strong>In this qualitative study, 11 focus groups were organized with 73 HCPs. The focus group discussions were guided by an innovative game, which was specifically developed for this study. The content of the game was categorized into 4 categories: health care technology and me; health care technology, the patient, and me; health care technology, the organization, and me; and facilitating conditions. The perspectives of HCPs about working with technology were discussed based on this game. The focus groups were recorded and transcribed, followed by an inductive thematic analysis using ATLAS.ti 9x (ATLAS.ti Scientific Software Development GmbH).</p><p><strong>Results: </strong>Overall, 2 main domain summaries were developed from the data: technology should improve the quality of care and acceptance and use of technology in care. The first factor indicates the need for tailored and personalized care and balance between human contact and technology. The second factor addresses several aspects regarding working with technology such as trusting technology, learning to work with technology, and collaboration with colleagues.</p><p><strong>Conclusions: </strong>HCPs are motivated to use technology in daily practice of long-term care when it adds value to the quality of care and there is sufficient trust, expertise, and collaboration with colleagues. Their perspectives need to be considered as they play a crucial part in the successful use of technology, transcending their role as an actor in implementation. On the basis of the findings from this study, we recommend focusing on developing technology for situations where both efficiency and quality of care can be improved; redefining the roles of HCPs and the impact of technology hereon; involving HCPs in the design process of technology to enable them to link it to their daily practice; and creating ambassadors in care teams who are enthusiastic about working with technology and can support and train their colleagues.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e41032"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10413233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031473","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 Continuous Glucose Monitoring and Data Sharing to Encourage Collaboration Among Older Adults With Type 1 Diabetes and Their Care Partners: Qualitative Descriptive Study.","authors":"Alycia A Bristol, Michelle Litchman, Cynthia Berg, Ernest Grigorian, Denise Small, Ashley Glazener, Christopher Jones, Nancy A Allen","doi":"10.2196/46627","DOIUrl":"10.2196/46627","url":null,"abstract":"<p><strong>Background: </strong>Persons with diabetes use continuous glucose monitoring (CGM) to self-manage their diabetes. Care partners (CPs) frequently become involved in supporting persons with diabetes in the management of their diabetes. However, persons with diabetes and CP dyads may require more communication and problem-solving skills regarding how to share and respond to CGM data.</p><p><strong>Objective: </strong>The purpose of this study was to describe the experiences of persons with diabetes and CPs who participated in the Share \"plus\" intervention, which addresses dyadic communication strategies, problem-solving, and action planning to promote sharing of CGM data among the dyad.</p><p><strong>Methods: </strong>Ten dyads participated in the Share \"plus\" telehealth intervention. Participants were interviewed during and after the Share \"plus\" intervention. Thematic analysis was used to analyze interview data.</p><p><strong>Results: </strong>During postsession interviews, dyads described feeling a sense of shared responsibility yet viewed the persons with diabetes as ultimately responsible for the disease. Additionally, dyads shared that communication patterns improved and were able to recognize the negative aspects of previously established communication patterns. Dyads reported communication focused on hypoglycemia episodes while also differing in the frequency they reviewed CGM data and set alerts. Overall, dyads expressed positive reactions to the Share \"plus\" intervention.</p><p><strong>Conclusions: </strong>Share \"plus\" was helpful in promoting positive CGM-related communication among dyads and encouraged more CP support. CPs play an important role in supporting older adults with type 1 diabetes. Communication strategies help support dyad involvement in CGM data sharing and self-management among persons with diabetes.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e46627"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10413231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9977852","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":"Experiences of a Novel Structured Foot Examination Form for Patients With Diabetes From the Perspective of Health Care Professionals: Qualitative Study.","authors":"Susanne Andersson,&nbsp;Isabella Scandurra,&nbsp;Ulrika Nyström,&nbsp;Marika Varemo,&nbsp;Ulla Hellstrand Tang","doi":"10.2196/45501","DOIUrl":"https://doi.org/10.2196/45501","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a growing threat to public health, and secondary diseases like foot complications are common. Foot ulcers affect the individual's quality of life and are a great cost to society. Regular foot examinations prevent foot ulcers and are a recommended approach both in Sweden and worldwide. Despite existing guidelines, there are differences in the execution of the foot examination, which results in care inequality. A structured foot examination form based on current guidelines was developed in this study as the first step toward digitalized support in the daily routine, and was validated by diabetes health care professionals.</p><p><strong>Objective: </strong>The study aimed to validate a structured foot examination form by assessing health care professionals' experiences of working with it \"foot side\" when examining patients with diabetes.</p><p><strong>Methods: </strong>Semistructured interviews were held in a focus group and individually with 8 informants from different diabetes professions, who were interviewed regarding their experiences of working with the form in clinical practice. The users' data were analyzed inductively using qualitative content analysis. The study is part of a larger project entitled \"Optimised care of persons with diabetes and foot complications,\" with Västra Götaland Region as the responsible health care authority, where the results will be further developed.</p><p><strong>Results: </strong>Experiences of working with the form were that it simplified the foot examination by giving it an overview and a clear structure. Using the form made differences in work routines between individuals apparent. It was believed that implementing the form routinely would contribute to a more uniform execution. When patients had foot ulcers, the risk categories (established in guidelines) were perceived as contradictory. For example, there was uncertainty about the definition of chronic ulcers and callosities. The expectations were that the future digital format would simplify documentation and elucidate the foot examination, as well as contribute to the accessibility of updated and relevant data for all individuals concerned.</p><p><strong>Conclusions: </strong>The foot examination form works well as a support tool during preventive foot examination, creates a basis for decision-making, and could contribute to a uniform and safer foot examination with more care equality in agreement with current guidelines.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05692778; https://clinicaltrials.gov/ct2/show/NCT05692778.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e45501"},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10249662","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":"Performance of the Large Language Model ChatGPT on the National Nurse Examinations in Japan: Evaluation Study.","authors":"Kazuya Taira, Takahiro Itaya, Ayame Hanada","doi":"10.2196/47305","DOIUrl":"10.2196/47305","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;ChatGPT, a large language model, has shown good performance on physician certification examinations and medical consultations. However, its performance has not been examined in languages other than English or on nursing examinations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to evaluate the performance of ChatGPT on the Japanese National Nurse Examinations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We evaluated the percentages of correct answers provided by ChatGPT (GPT-3.5) for all questions on the Japanese National Nurse Examinations from 2019 to 2023, excluding inappropriate questions and those containing images. Inappropriate questions were pointed out by a third-party organization and announced by the government to be excluded from scoring. Specifically, these include \"questions with inappropriate question difficulty\" and \"questions with errors in the questions or choices.\" These examinations consist of 240 questions each year, divided into basic knowledge questions that test the basic issues of particular importance to nurses and general questions that test a wide range of specialized knowledge. Furthermore, the questions had 2 types of formats: simple-choice and situation-setup questions. Simple-choice questions are primarily knowledge-based and multiple-choice, whereas situation-setup questions entail the candidate reading a patient's and family situation's description, and selecting the nurse's action or patient's response. Hence, the questions were standardized using 2 types of prompts before requesting answers from ChatGPT. Chi-square tests were conducted to compare the percentage of correct answers for each year's examination format and specialty area related to the question. In addition, a Cochran-Armitage trend test was performed with the percentage of correct answers from 2019 to 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 5-year average percentage of correct answers for ChatGPT was 75.1% (SD 3%) for basic knowledge questions and 64.5% (SD 5%) for general questions. The highest percentage of correct answers on the 2019 examination was 80% for basic knowledge questions and 71.2% for general questions. ChatGPT met the passing criteria for the 2019 Japanese National Nurse Examination and was close to passing the 2020-2023 examinations, with only a few more correct answers required to pass. ChatGPT had a lower percentage of correct answers in some areas, such as pharmacology, social welfare, related law and regulations, endocrinology/metabolism, and dermatology, and a higher percentage of correct answers in the areas of nutrition, pathology, hematology, ophthalmology, otolaryngology, dentistry and dental surgery, and nursing integration and practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;ChatGPT only passed the 2019 Japanese National Nursing Examination during the most recent 5 years. Although it did not pass the examinations from other years, it performed very close to the passing level, even in those containing que","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e47305"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9778975","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":"A Nurse-Led Telehealth Program for Diabetes Foot Care: Feasibility and Usability Study.","authors":"Hsiao-Hui Ju,&nbsp;Rashmi Momin,&nbsp;Stanley Cron,&nbsp;Jed Jularbal,&nbsp;Jeffery Alford,&nbsp;Constance Johnson","doi":"10.2196/40000","DOIUrl":"https://doi.org/10.2196/40000","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus can lead to severe and debilitating foot complications, such as infections, ulcerations, and amputations. Despite substantial progress in diabetes care, foot disease remains a major challenge in managing this chronic condition that causes serious health complications worldwide.</p><p><strong>Objective: </strong>The primary aim of this study was to examine the feasibility and usability of a telehealth program focused on preventive diabetes foot care. A secondary aim was to descriptively measure self-reported changes in diabetes knowledge, self-care, and foot care behaviors before and after participating in the program.</p><p><strong>Methods: </strong>The study used a single-arm, pre-post design in 2 large family medical practice clinics in Texas. Participants met individually with the nurse practitioner once a month for 3 months using synchronous telehealth videoconferencing. Each participant received diabetes foot education guided by the Integrated Theory of Health Behavior Change. Feasibility was measured with rates of enrollment and program and assessment completion. Usability was measured with the Telehealth Usability Questionnaire. Diabetes knowledge, self-care, and foot care behaviors were measured with validated survey instruments at baseline, 1.5 months, and 3 months.</p><p><strong>Results: </strong>Of 50 eligible individuals, 39 (78%) enrolled; 34 of 39 (87%) completed the first videoconference and 29 of 39 (74%) completed the second and third videoconferences. Of the 39 who consented, 37 (95%) completed the baseline assessment; 50% (17/34) of those who attended the first videoconference completed the assessment at 1.5 months, and 100% (29/29) of those who attended the subsequent videoconferences completed the final assessment. Overall, participants reported a positive attitude toward the use of telehealth, with a mean Telehealth Usability Questionnaire score of 6.24 (SD 0.98) on a 7-point scale. Diabetes knowledge increased by a mean of 15.82 (SD 16.69) points of 100 (P<.001) from baseline to 3 months. The values for the Summary of Diabetes Self-Care Activities measure demonstrated better self-care, with participants performing foot care on average 1.74 (SD 2.04) more days per week (P<.001), adhering to healthy eating habits on average 1.57 (SD 2.12) more days per week (P<.001), and being physically active on average 1.24 (SD 2.21) more days per week (P=.005). Participants also reported an improvement in the frequency of foot self-examinations and general foot care behaviors. The mean scores for foot care increased by a mean of 7.65 (SD 7.04) points (scale of 7 to 35) from baseline to 3 months postintervention (P<.001).</p><p><strong>Conclusions: </strong>This study demonstrates that a nurse-led telehealth educational program centered on diabetes foot care is feasible, acceptable, and has the potential to improve diabetes knowledge and self-care, which are precursors to preventing debilit","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e40000"},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10282908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9698931","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":"Smartphone-Based Remote Monitoring for Chronic Heart Failure: Mixed Methods Analysis of User Experience From Patient and Nurse Perspectives.","authors":"Alice Auton, Sameer Zaman, Yorissa Padayachee, Jack W Samways, Nicholas M Quaife, Mark Sweeney, Indira Tenorio, Nick W F Linton, Graham D Cole, Nicholas S Peters, Jamil Mayet, Carys Barton, Carla Plymen","doi":"10.2196/44630","DOIUrl":"10.2196/44630","url":null,"abstract":"<p><strong>Background: </strong>Community-based management by heart failure specialist nurses (HFSNs) is key to improving self-care in heart failure with reduced ejection fraction. Remote monitoring (RM) can aid nurse-led management, but in the literature, user feedback evaluation is skewed in favor of the patient rather than nursing user experience. Furthermore, the ways in which different groups use the same RM platform at the same time are rarely directly compared in the literature. We present a balanced semantic analysis of user feedback from patient and nurse perspectives of Luscii, a smartphone-based RM strategy combining self-measurement of vital signs, instant messaging, and e-learning.</p><p><strong>Objective: </strong>This study aims to (1) evaluate how patients and nurses use this type of RM (usage type), (2) evaluate patients' and nurses' user feedback on this type of RM (user experience), and (3) directly compare the usage type and user experience of patients and nurses using the same type of RM platform at the same time.</p><p><strong>Methods: </strong>We performed a retrospective usage type and user experience evaluation of the RM platform from the perspective of both patients with heart failure with reduced ejection fraction and the HFSNs using the platform to manage them. We conducted semantic analysis of written patient feedback provided via the platform and a focus group of 6 HFSNs. Additionally, as an indirect measure of tablet adherence, self-measured vital signs (blood pressure, heart rate, and body mass) were extracted from the RM platform at onboarding and 3 months later. Paired 2-tailed t tests were used to evaluate differences between mean scores across the 2 timepoints.</p><p><strong>Results: </strong>A total of 79 patients (mean age 62 years; 35%, 28/79 female) were included. Semantic analysis of usage type revealed extensive, bidirectional information exchange between patients and HFSNs using the platform. Semantic analysis of user experience demonstrates a range of positive and negative perspectives. Positive impacts included increased patient engagement, convenience for both user groups, and continuity of care. Negative impacts included information overload for patients and increased workload for nurses. After the patients used the platform for 3 months, they showed significant reductions in heart rate (P=.004) and blood pressure (P=.008) but not body mass (P=.97) compared with onboarding.</p><p><strong>Conclusions: </strong>Smartphone-based RM with messaging and e-learning facilitates bilateral information sharing between patients and nurses on a range of topics. Patient and nurse user experience is largely positive and symmetrical, but there are possible negative impacts on patient attention and nurse workload. We recommend RM providers involve patient and nurse users in platform development, including recognition of RM usage in nursing job plans.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e44630"},"PeriodicalIF":0.0,"publicationDate":"2023-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10282903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9707031","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":"Information and Communication Technologies to Support the Provision of Respite Care Services: Scoping Review.","authors":"Aimee R Castro, Lydia Ould Brahim, Qirong Chen, Antonia Arnaert, Amélie Quesnel-Vallée, Karyn Moffatt, John Kildea, Vasiliki Bitzas, Carolyn Pang, Audrey-Jane Hall, Ariana Pagnotta, Argerie Tsimicalis","doi":"10.2196/44750","DOIUrl":"10.2196/44750","url":null,"abstract":"<p><strong>Background: </strong>Respite care is one of the most frequently requested support services by family caregivers. Yet, too often, respite care services are inaccessible, due in part to families' lack of knowledge regarding available services and a lack of service flexibility. Information and communication technologies (ICTs) may help to improve the flexibility of services available and families' knowledge of such services. However, an understanding of the use of ICTs and research in this area is lacking.</p><p><strong>Objective: </strong>The objective of this study was to provide a comprehensive overview of the academic literature on ICTs for supporting the provision of respite care services.</p><p><strong>Methods: </strong>A scoping review study was conducted. Six library databases were systematically searched for relevant literature. Key data were extracted into a summary chart. Text and quantitative data were coded using descriptive qualitative content analysis techniques, and the results were collated and summarized into a comprehensive narrative.</p><p><strong>Results: </strong>A total of 23 papers describing 15 unique ICT programs exploring the potential of ICTs to support respite care services met the inclusion criteria. ICTs supported the provision of respite care by facilitating information-sharing with families and providers, recruiting and training respite care providers, and coordinating services. Key design considerations for developing respite care ICTs were trustworthiness and participatory design methods. Implementation considerations included designing for complementarity with existing services, assessing the appropriate timing for introducing the ICT-based services, and ensuring adequate promotion strategies to raise awareness about the services.</p><p><strong>Conclusions: </strong>There is limited but promising research on the potential of ICTs to support the provision of respite care services. Further research should be conducted to advance the results of this review, ultimately aiming to build ICTs that can improve the quality of, and access to, respite care services.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e44750"},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10265430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9641378","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":"Usefulness of a Digitally Assisted Person-Centered Care Intervention: Qualitative Study of Patients' and Nurses' Experiences in a Long-term Perspective.","authors":"Mette Linnet Olesen,&nbsp;Sine Rossen,&nbsp;Rikke Jørgensen,&nbsp;Line Langballe Udbjørg,&nbsp;Helena Hansson","doi":"10.2196/46673","DOIUrl":"https://doi.org/10.2196/46673","url":null,"abstract":"<p><strong>Background: </strong>Person-centered care responsive to individual preferences, needs, and values is recognized as an important aspect of high-quality health care, and patient empowerment is increasingly viewed as a central core value of person-centered care. Web-based interventions aimed at empowerment report a beneficial effect on patient empowerment and physical activity; however, there is limited information available on barriers, facilitators, and user experiences. A recent review of the effect of digital self-management support tools suggests a beneficial effect on the quality of life in patients with cancer. On the basis of an overall philosophy of empowerment, guided self-determination is a person-centered intervention that uses preparatory reflection sheets to help achieve focused communication between patients and nurses. The intervention was adapted into a digital version called digitally assisted guided self-determination (DA-GSD) hosted by the Sundhed DK website that can be delivered face-to-face, via video, or by the combination of the 2 methods.</p><p><strong>Objective: </strong>We aimed to investigate the experiences of nurses, nurse managers, and patients of using DA-GSD in 2 oncology departments and 1 gynecology department over a 5-year implementation period from 2018 to 2022.</p><p><strong>Methods: </strong>This qualitative study was inspired by action research comprising the responses of 17 patients to an open-ended question on their experience of specific aspects of DA-GSD in a web questionnaire, 14 qualitative semistructured interviews with nurses and patients who initially completed the web questionnaire, and transcripts of meetings held between the researchers and nurses during the implementation of the intervention. The thematic analysis of all data was done using NVivo (QSR International).</p><p><strong>Results: </strong>The analysis generated 2 main themes and 7 subthemes that reflect conflicting perspectives and greater acceptability of the intervention among the nurses over time owing to better familiarity with the increasingly mature technology. The first theme was the different experiences and perspectives of nurses and patients concerning barriers to using DA-GSD and comprised 4 subthemes: conflicting perspectives on the ability of patients to engage with DA-GSD and how to provide it, conflicting perspectives on DA-GSD as a threat to the nurse-patient relationship, functionality of DA-GSD and available technical equipment, and data security. The other theme was what influenced the increased acceptability of DA-GSD among the nurses over time and comprised 3 subthemes: a re-evaluation of the nurse-patient relationship; improved functionality of DA-GSD; and supervision, experience, patient feedback, and a global pandemic.</p><p><strong>Conclusions: </strong>The nurses experienced more barriers to DA-GSD than the patients did. Acceptance of the intervention increased over time among the nurses in keeping wit","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e46673"},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9927932","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":"Process Evaluation of a Wireless Wearable Continuous Vital Signs Monitoring Intervention in 2 General Hospital Wards: Mixed Methods Study.","authors":"Jobbe P L Leenen,&nbsp;Henriëtte J M Rasing,&nbsp;Cor J Kalkman,&nbsp;Lisette Schoonhoven,&nbsp;Gijsbert A Patijn","doi":"10.2196/44061","DOIUrl":"https://doi.org/10.2196/44061","url":null,"abstract":"<p><strong>Background: </strong>Continuous monitoring of vital signs (CMVS) using wearable wireless sensors is increasingly available to patients in general wards and can improve outcomes and reduce nurse workload. To assess the potential impact of such systems, successful implementation is important. We developed a CMVS intervention and implementation strategy and evaluated its success in 2 general wards.</p><p><strong>Objective: </strong>We aimed to assess and compare intervention fidelity in 2 wards (internal medicine and general surgery) of a large teaching hospital.</p><p><strong>Methods: </strong>A mixed methods sequential explanatory design was used. After thorough training and preparation, CMVS was implemented-in parallel with the standard intermittent manual measurements-and executed for 6 months in each ward. Heart rate and respiratory rate were measured using a chest-worn wearable sensor, and vital sign trends were visualized on a digital platform. Trends were routinely assessed and reported each nursing shift without automated alarms. The primary outcome was intervention fidelity, defined as the proportion of written reports and related nurse activities in case of deviating trends comparing early (months 1-2), mid- (months 3-4), and late (months 5-6) implementation periods. Explanatory interviews with nurses were conducted.</p><p><strong>Results: </strong>The implementation strategy was executed as planned. A total of 358 patients were included, resulting in 45,113 monitored hours during 6142 nurse shifts. In total, 10.3% (37/358) of the sensors were replaced prematurely because of technical failure. Mean intervention fidelity was 70.7% (SD 20.4%) and higher in the surgical ward (73.6%, SD 18.1% vs 64.1%, SD 23.7%; P<.001). Fidelity decreased over the implementation period in the internal medicine ward (76%, 57%, and 48% at early, mid-, and late implementation, respectively; P<.001) but not significantly in the surgical ward (76% at early implementation vs 74% at midimplementation [P=.56] vs 70.7% at late implementation [P=.07]). No nursing activities were needed based on vital sign trends for 68.7% (246/358) of the patients. In 174 reports of 31.3% (112/358) of the patients, observed deviating trends led to 101 additional bedside assessments of patients and 73 consultations by physicians. The main themes that emerged during interviews (n=21) included the relative priority of CMVS in nurse work, the importance of nursing assessment, the relatively limited perceived benefits for patient care, and experienced mediocre usability of the technology.</p><p><strong>Conclusions: </strong>We successfully implemented a system for CMVS at scale in 2 hospital wards, but our results show that intervention fidelity decreased over time, more in the internal medicine ward than in the surgical ward. This decrease appeared to depend on multiple ward-specific factors. Nurses' perceptions regarding the value and benefits of the intervention varied. Impli","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"6 ","pages":"e44061"},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10196902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866395","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}