JMIR nursing最新文献

{"title":"Developing and Testing a Protocol for Managing Cardiopulmonary Resuscitation of Patients with Suspected or Confirmed COVID-19: In Situ Simulation Study","authors":"A. Sowan, J. Heins, Christopher S. Dayton, Elizabeth Scherer, W. Tam, H. Saikumar","doi":"10.2196/38044","DOIUrl":"https://doi.org/10.2196/38044","url":null,"abstract":"Background Resuscitating patients with suspected or confirmed COVID-19 imposes unique challenges to organizations and code blue teams. Studies that applied the American Heart Association (AHA) COVID-19–related Interim Resuscitation Guideline and similar European guidelines are scarce. Objective This study aimed to develop and test a cardiopulmonary resuscitation protocol based on the AHA COVID-19–related Interim Resuscitation Guideline. Methods The study was conducted as an in situ simulation in a medical intensive care unit. The COVID-19 cardiopulmonary resuscitation protocol was created and validated by 11 health care team members and tested using 4 simulation sessions where 46 code blue team members participated. During the simulation, we observed role clarity, the effectiveness of communication, team dynamics, infection control measures, and the availability of essential supplies and equipment. Results The main issues identified in each simulation session were debriefed to the code blue teams and used to further revise the protocol. These include the assignment of tasks, availability of equipment and supplies, and failure of communication between the in-room and out-of-room teams. Solutions included changes in the placement of team members and roles and responsibilities; the creation of an isolation code medication package, a respiratory therapy kit, and an isolation code blue bag; and the use of two-way radios and N-95 masks with eye goggles to enhance communication between the teams. Conclusions This study shed light on the challenges to implement the AHA COVID-19–related Interim Resuscitation Guideline. The in situ simulation was an effective approach for rapid training, identifying unreliable equipment and ineffective and inefficient workflow, and managing the complexity of the physical environment.","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43323755","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":"Technology-Supported Guidance Models Stimulating the Development of Critical Thinking in Clinical Practice: Mixed Methods Systematic Review","authors":"Jaroslav Zlamal, Edith Roth Gjevjon, M. Fossum, Marianne Trygg Solberg, S. Steindal, Camilla Strandell-Laine, Marie Hamilton Larsen, A. A. Nes","doi":"10.2196/37380","DOIUrl":"https://doi.org/10.2196/37380","url":null,"abstract":"Background Nursing education has increasingly focused on critical thinking among nursing students, as critical thinking is a desired outcome of nursing education. Particular attention is given to the potential of technological tools in guiding nursing students to stimulate the development of critical thinking; however, the general landscape, facilitators, and challenges of these guidance models remain unexplored, and no previous mixed methods systematic review on the subject has been identified. Objective This study aims to synthesize existing evidence on technology-supported guidance models used in nursing education to stimulate the development of critical thinking in nursing students in clinical practice. Methods This mixed methods systematic review adopted a convergent, integrated design to facilitate thematic synthesis. This study followed the guidelines of the Joanna Briggs Institute Manual for Evidence Synthesis. Results We identified 3 analytical themes: learning processes implemented to stimulate critical thinking, organization of the learning process to stimulate critical thinking, and factors influencing the perception of the learning process. We also identified 4 guidance models, all based on facilitator or preceptorship models using tailored instructional or learning strategies and one or several technological tools that were either generic or custom-made for specific outcomes. The main facilitators of these technology-supported guidance models were nurse educators or nurse preceptors, and the main challenges in using technology-supported guidance models were the stress associated with technical difficulties or increased cognitive load. Conclusions Although we were able to identify 4 technology-supported guidance models, our results indicate a research gap regarding the use of these models in nursing education, with the specific aim of stimulating the development of critical thinking. Both nurse preceptors and nurse educators play a crucial role in the development of critical thinking among nursing students, and technology is essential for such development. However, technology-supported guidance models should be supervised to mitigate the associated stress. International Registered Report Identifier (IRRID) RR2-10.2196/25126","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49648243","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":"Outcomes of app-based health coaching to improve dietary behavior among nurses in a tertiary hospital: A Pilot Study (Preprint)","authors":"W. Lim, Chong Man Chung Stephanie Fook, J. Lim, W. Gan","doi":"10.2196/preprints.36811","DOIUrl":"https://doi.org/10.2196/preprints.36811","url":null,"abstract":"\u0000 UNSTRUCTURED\u0000 To evaluate the effectiveness of mobile application-based health-coaching and incentives in achieving weight-loss from better dietary choices among hospital nurses.\u0000 We conducted a pilot study from June 2019 to March 2020, involving the use of a health-coaching application by 145 hospital nurses over 6 months. Weight and body-mass index (BMI) are self-reported and food-scores are calculated. Data among overweight nurses, shift-work nurses and incentive groups were analyzed.\u0000 61 nurses were included in the final analysis. 38/61(62.3%) of the participants lost weight. Median percentage weight-loss is 1.2%(IQR 0,2.9)(P<0.001) and median decrease in BMI is 0.35(IQR -0.15,0,82)(P<0.001), but are not clinically significant. Median improvement in food-score is 0.4(IQR 0,0.8). There is no difference between the incentive and non-incentive groups. 49(34%) participants had ≥8 engaged weeks.\u0000 The study demonstrated an association between the use of application-based health-coaching and the attainment of some weight-loss in nurses even without significant improvement in food-scores. Incentives may nudge onboarding, but does not sustain engagement.\u0000","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42002258","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":"Web-Based Training for Nurses on Using a Decision Aid to Support Shared Decision-making About Prenatal Screening: Parallel Controlled Trial.","authors":"Alex Poulin Herron,&nbsp;Titilayo Tatiana Agbadje,&nbsp;Sabrina Guay-Bélanger,&nbsp;Gérard Ngueta,&nbsp;Geneviève Roch,&nbsp;François Rousseau,&nbsp;France Légaré","doi":"10.2196/31380","DOIUrl":"https://doi.org/10.2196/31380","url":null,"abstract":"<p><strong>Background: </strong>Nurses play an important role in supporting pregnant women making decisions about prenatal screening for Down syndrome. We developed a web-based shared decision-making (SDM) training program for health professionals focusing on Down syndrome screening decisions.</p><p><strong>Objective: </strong>In this study, we aim to assess the impact of an SDM training program on nurses' intention to use a decision aid with pregnant women deciding on prenatal screening for Down syndrome.</p><p><strong>Methods: </strong>In this 2-arm, parallel controlled trial, French-speaking nurses working with pregnant women in the province of Quebec were recruited by a private survey firm. They were allocated by convenience either to the intervention group (web-based SDM course that included prenatal screening) or to the control group (web-based course focusing on prenatal screening alone, with no SDM content). The primary outcome was the intention to use a decision aid. Secondary outcomes were psychosocial variables of intention, knowledge, satisfaction, acceptability, perceived usefulness, and reaction to the pedagogical approach. All outcomes were self-assessed through web-based questionnaires, including the space for written comments. We used 2-tailed Student t test and Fisher exact test to compare continuous and categorical variables between groups, respectively.</p><p><strong>Results: </strong>Of the 57 participants assessed for eligibility, 40 (70%) were allocated to the intervention (n=20) or control group (n=20) and 36 (n=18 in each) completed the courses. The mean age of the participants was 41 (SD 9) years. Most were women (39/40, 98%), White (38/40, 95%), clinical nurses (28/40, 70%), and had completed at least a bachelor's degree (30/40, 75%). After the intervention, the mean score of intention was 6.3 (SD 0.8; 95% CI 5.9-6.7) for the intervention group and 6.0 (SD 1.2; 95% CI 5.42-6.64) for the control group (scale 1-7). The differences in intention and other psychosocial variable scores between the groups were not statistically significant. Knowledge scores for SDM were significantly higher in the intervention group (79%, 95% CI 70-89 vs 64%, 95% CI 57-71; P=.009). The intervention was significantly more acceptable in the intervention group (4.6, 95% CI 4.4-4.8 vs 4.3, 95% CI 4.1-4.5; P=.02), and reaction to the pedagogical approach was also significantly more positive in the intervention group (4.7, 95% CI 4.5-4.8 vs 4.4, 95% CI 4.2-4.5; P=.02). There was no significant difference in overall satisfaction (or in perceived usefulness). Furthermore, 17 participants (9 in the intervention group and 8 in the control group) provided written comments on the intervention.</p><p><strong>Conclusions: </strong>This study focuses on web-based nursing education and its potential to support pregnant women's decision-making needs. It shows that nurses' intention to use a decision aid to enhance SDM in prenatal care is high, with or without ","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e31380"},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8826152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39700114","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":"Investigating #covidnurse Messages on TikTok: Descriptive Study.","authors":"Bhavya Yalamanchili,&nbsp;Lorie Donelle,&nbsp;Leo-Felix Jurado,&nbsp;Joseph Fera,&nbsp;Corey H Basch","doi":"10.2196/35274","DOIUrl":"https://doi.org/10.2196/35274","url":null,"abstract":"<p><strong>Background: </strong>During a time of high stress and decreased social interaction, nurses have turned to social media platforms like TikTok as an outlet for expression, entertainment, and communication.</p><p><strong>Objective: </strong>The purpose of this cross-sectional content analysis study is to describe the content of videos with the hashtag #covidnurse on TikTok, which included 100 videos in the English language.</p><p><strong>Methods: </strong>At the time of the study, this hashtag had 116.9 million views. Each video was coded for content-related to what nurses encountered and were feeling during the COVID-19 pandemic.</p><p><strong>Results: </strong>Combined, the 100 videos sampled received 47,056,700 views; 76,856 comments; and 5,996,676 likes. There were 4 content categories that appeared in a majority (>50) of the videos: 83 showed the individual as a nurse, 72 showed the individual in professional attire, 58 mentioned/suggested stress, 55 used music, and 53 mentioned/suggested frustration. Those that mentioned stress and those that mentioned frustration received less than 50% of the total views (n=21,726,800, 46.17% and n=16,326,300, 34.69%, respectively). Although not a majority, 49 of the 100 videos mentioned the importance of nursing. These videos garnered 37.41% (n=17,606,000) of the total views, 34.82% (n=26,759) of the total comments, and 23.85% (n=1,430,213) of the total likes. So, despite nearly half of the total videos mentioning how important nurses are, these videos received less than half of the total views, comments, and likes.</p><p><strong>Conclusions: </strong>Social media and increasingly video-related online messaging such as TikTok are important platforms for social networking, social support, entertainment, and education on diverse topics, including health in general and COVID-19 specifically. This presents an opportunity for future research to assess the utility of the TikTok platform for meaningful engagement and health communication on important public health issues.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e35274"},"PeriodicalIF":0.0,"publicationDate":"2022-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39822599","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":"An mHealth App-Based Self-management Intervention for Family Members of Pediatric Transplant Recipients (myFAMI): Framework Design and Development Study.","authors":"Riddhiman Adib, Dipranjan Das, Sheikh Iqbal Ahamed, Stacee Marie Lerret","doi":"10.2196/32785","DOIUrl":"10.2196/32785","url":null,"abstract":"<p><strong>Background: </strong>Solid-organ transplantation is the treatment of choice for children with end-stage organ failure. Ongoing recovery and medical management at home after transplant are important for recovery and transition to daily life. Smartphones are widely used and hold the potential for aiding in the establishment of mobile health (mHealth) protocols. Health care providers, nurses, and computer scientists collaboratively designed and developed mHealth family self-management intervention (myFAMI), a smartphone-based intervention app to promote a family self-management intervention for pediatric transplant patients' families.</p><p><strong>Objective: </strong>This paper presents outcomes of the design stages and development actions of the myFAMI app framework, along with key challenges, limitations, and strengths.</p><p><strong>Methods: </strong>The myFAMI app framework is built upon a theory-based intervention for pediatric transplant patients, with aid from the action research (AR) methodology. Based on initially defined design motivation, the team of researchers collaboratively explored 4 research stages (research discussions, feedback and motivations, alpha testing, and deployment and release improvements) and developed features required for successful inauguration of the app in the real-world setting.</p><p><strong>Results: </strong>Deriving from app users and their functionalities, the myFAMI app framework is built with 2 primary components: the web app (for nurses' and superadmin usage) and the smartphone app (for participant/family member usage). The web app stores survey responses and triggers alerts to nurses, when required, based on the family members' response. The smartphone app presents the notifications sent from the server to the participants and captures survey responses. Both the web app and the smartphone app were built upon industry-standard software development frameworks and demonstrate great performance when deployed and used by study participants.</p><p><strong>Conclusions: </strong>The paper summarizes a successful and efficient mHealth app-building process using a theory-based intervention in nursing and the AR methodology in computer science. Focusing on factors to improve efficiency enabled easy navigation of the app and collection of data. This work lays the foundation for researchers to carefully integrate necessary information (from the literature or experienced clinicians) to provide a robust and efficient solution and evaluate the acceptability, utility, and usability for similar studies in the future.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1002/nur.22010.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e32785"},"PeriodicalIF":0.0,"publicationDate":"2022-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8767472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39626375","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":"Exploring Reasons for Delayed Start-of-Care Nursing Visits in Home Health Care: Algorithm Development and Data Science Study.","authors":"Maryam Zolnoori,&nbsp;Jiyoun Song,&nbsp;Margaret V McDonald,&nbsp;Yolanda Barrón,&nbsp;Kenrick Cato,&nbsp;Paulina Sockolow,&nbsp;Sridevi Sridharan,&nbsp;Nicole Onorato,&nbsp;Kathryn H Bowles,&nbsp;Maxim Topaz","doi":"10.2196/31038","DOIUrl":"https://doi.org/10.2196/31038","url":null,"abstract":"<p><strong>Background: </strong>Delayed start-of-care nursing visits in home health care (HHC) can result in negative outcomes, such as hospitalization. No previous studies have investigated why start-of-care HHC nursing visits are delayed, in part because most reasons for delayed visits are documented in free-text HHC nursing notes.</p><p><strong>Objective: </strong>The aims of this study were to (1) develop and test a natural language processing (NLP) algorithm that automatically identifies reasons for delayed visits in HHC free-text clinical notes and (2) describe reasons for delayed visits in a large patient sample.</p><p><strong>Methods: </strong>This study was conducted at the Visiting Nurse Service of New York (VNSNY). We examined data available at the VNSNY on all new episodes of care started in 2019 (N=48,497). An NLP algorithm was developed and tested to automatically identify and classify reasons for delayed visits.</p><p><strong>Results: </strong>The performance of the NLP algorithm was 0.8, 0.75, and 0.77 for precision, recall, and F-score, respectively. A total of one-third of HHC episodes (n=16,244) had delayed start-of-care HHC nursing visits. The most prevalent identified category of reasons for delayed start-of-care nursing visits was no answer at the door or phone (3728/8051, 46.3%), followed by patient/family request to postpone or refuse some HHC services (n=2858, 35.5%), and administrative or scheduling issues (n=1465, 18.2%). In 40% (n=16,244) of HHC episodes, 2 or more reasons were documented.</p><p><strong>Conclusions: </strong>To avoid critical delays in start-of-care nursing visits, HHC organizations might examine and improve ways to effectively address the reasons for delayed visits, using effective interventions, such as educating patients or caregivers on the importance of a timely nursing visit and improving patients' intake procedures.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"4 4","pages":"e31038"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39634210","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":"Nurses’ Perspectives on an Electronic Medication Administration Record in Home Health Care: Qualitative Interview Study","authors":"Sara Karnehed, L. Erlandsson, Margaretha Norell Pejner","doi":"10.2196/35363","DOIUrl":"https://doi.org/10.2196/35363","url":null,"abstract":"Background eHealth is considered by policy makers as a prerequisite for meeting the demands of health care from the growing proportion of older people worldwide. The expectation about what the efficiency of eHealth can bring is particularly high in the municipal home health care sector, which is facing pressure regarding resources because of, for example, earlier discharges from hospitals and a growing number of patients receiving medications and treatments at home. Common eHealth services in home health care are electronic medication administration records (eMARs) that aim to communicate delegated tasks between professionals. However, there is an extensive gap in the research on how technology affects and is experienced by home health care professionals. Objective The objective of this paper is to shed light on how home care nurses experience eMARs in a Swedish municipality. Methods This qualitative interview study was conducted among home health care nurses using eMARs to facilitate communication and signing of delegated nursing tasks. The analysis of the interviews was performed using constructivist grounded theory, according to Charmaz. Results Of the 19 day-employed nurses in the municipality where an eMAR was used, 16 (84%) nurses participated in the study. The following two categories were identified from the focus group interviews: nurses become monitors and slip away from the point of care. The nurses experienced that they became monitors of health care through the increased transparency provided by the eMAR and the measurands they also applied, focusing on the quantitative aspects of the delegated nursing tasks rather than the qualitative aspects. The nurses experienced that their monitoring changed the power relations between the professions, reinforcing the nurses’ superior position. The experience of the eMAR was regarded as transitioning the nurses’ professional role—away from the point of care and toward more administration—and further strengthened the way of managing work through delegation to health care assistants. Conclusions Previous analyses of eHealth services in health care showed that implementation is a complex process that changes health care organizations and the work of health care professionals in both intended and unintended ways. This study adds to the literature by examining how users of a specific eHealth service experience its impacts on their daily work. The results indicate that the inscribed functions in an eHealth service may affect the values and priorities where the service is in use. This presents an opportunity for future research and for health care organizations to assess the impacts of specific eHealth services on health care professionals’ work and to further examine the effects of inscribed functions in relation to how they may affect actions and priorities at individual and organizational levels.","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45000133","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":"Experiences of Using a Self-management Mobile App Among Individuals With Heart Failure: Qualitative Study.","authors":"Myra Schmaderer,&nbsp;Jennifer N Miller,&nbsp;Elizabeth Mollard","doi":"10.2196/28139","DOIUrl":"https://doi.org/10.2196/28139","url":null,"abstract":"<p><strong>Background: </strong>Interventions that focus on the self-management of heart failure are vital to promoting health in patients with heart failure. Mobile health (mHealth) apps are becoming more integrated into practice to promote self-management strategies for chronic diseases, optimize care delivery, and reduce health disparities.</p><p><strong>Objective: </strong>The purpose of this study was to explore the experience of using a self-management mHealth intervention in individuals with heart failure to inform a future mHealth intervention study.</p><p><strong>Methods: </strong>This study used a qualitative descriptive design. Participants were enrolled in the intervention groups of a larger parent study using a mobile app related to self-management of heart failure. The purposive, convenient, criterion-based sample for this qualitative analysis comprised 10 patients who responded to phone calls and were willing to be interviewed. Inclusion criteria for the parent study were adults who were hospitalized at Nebraska Medical Center with a primary diagnosis and an episode of acute decompensated heart failure; discharged to home without services such as home health care; had access to a mobile phone; and were able to speak, hear, and understand English.</p><p><strong>Results: </strong>Study participants were middle-aged (mean age 55.8, SD 12 years; range 36-73 years). They had completed a mean of 13.5 (SD 2.2) years (range 11-17 years) of education. Of the 10 participants, 6 (60%) were male. Half of them (5/10, 50%) were New York Heart Association Classification Class III patients and the other half were Class IV patients. The intervention revealed four self-management themes, including (1) I didn't realize, and now I know; (2) It feels good to focus on my health; (3) I am the leader of my health care team; and (4) My health is improving.</p><p><strong>Conclusions: </strong>Participants who used a self-management mHealth app intervention for heart failure reported an overall positive experience. Their statements were organized into four major themes. The education provided during the study increased self-awareness and promoted self-management of their heart failure. The mHealth app supported patient empowerment, resulting in better heart failure management and improved quality of life. Participants advocated for themselves by becoming the leader of their health, especially when communicating with their health care team. Finally, the mHealth app was used by the participants as a self-management tool to assist in symptom management and improve their overall health. Future research should study symptom evaluation, medication tracking, and possibly serve as a health provider communication platform to empower individuals to be leaders in their chronic disease management.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"4 3","pages":"e28139"},"PeriodicalIF":0.0,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39324798","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":"Investigating Psychological Differences Between Nurses and Other Health Care Workers From the Asia-Pacific Region During the Early Phase of COVID-19: Machine Learning Approach","authors":"Yanhong Dong, Mei Chun Yeo, Xiang Cong Tham, R. Danuaji, T. H. Nguyen, Arvind K Sharma, Komalkumar Rn, Meenakshi Pv, M. S. Tai, Aftab Ahmad, B. Tan, R. Ho, M. C. H. Chua, Vijay K. Sharma","doi":"10.2196/32647","DOIUrl":"https://doi.org/10.2196/32647","url":null,"abstract":"Background As the COVID-19 pandemic evolves, challenges in frontline work continue to impose a significant psychological impact on nurses. However, there is a lack of data on how nurses fared compared to other health care workers in the Asia-Pacific region. Objective This study aims to investigate (1) the psychological outcome characteristics of nurses in different Asia-Pacific countries and (2) psychological differences between nurses, doctors, and nonmedical health care workers. Methods Exploratory data analysis and visualization were conducted on the data collected through surveys. A machine learning modeling approach was adopted to further discern the key psychological characteristics differentiating nurses from other health care workers. Decision tree–based machine learning models (Light Gradient Boosting Machine, GradientBoost, and RandomForest) were built to predict whether a set of psychological distress characteristics (ie, depression, anxiety, stress, intrusion, avoidance, and hyperarousal) belong to a nurse. Shapley Additive Explanation (SHAP) values were extracted to identify the prominent characteristics of each of these models. The common prominent characteristic among these models is akin to the most distinctive psychological characteristic that differentiates nurses from other health care workers. Results Nurses had relatively higher percentages of having normal or unchanged psychological distress symptoms relative to other health care workers (n=233-260 [86.0%-95.9%] vs n=187-199 [74.8%-91.7%]). Among those without psychological symptoms, nurses constituted a higher proportion than doctors and nonmedical health care workers (n=194 [40.2%], n=142 [29.5%], and n=146 [30.3%], respectively). Nurses in Vietnam showed the highest level of depression, stress, intrusion, avoidance, and hyperarousal symptoms compared to those in Singapore, Malaysia, and Indonesia. Nurses in Singapore had the highest level of anxiety. In addition, nurses had the lowest level of stress, which is the most distinctive psychological outcome characteristic derived from machine learning models, compared to other health care workers. Data for India were excluded from the analysis due to the differing psychological response pattern observed in nurses in India. A large number of female nurses emigrating from South India could not have psychologically coped well without the support from family members while living alone in other states. Conclusions Nurses were least psychologically affected compared to doctors and other health care workers. Different contexts, cultures, and points in the pandemic curve may have contributed to differing patterns of psychological outcomes amongst nurses in various Asia-Pacific countries. It is important that all health care workers practice self-care and render peer support to bolster psychological resilience for effective coping. In addition, this study also demonstrated the potential use of decision tree–based machine learning model","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68434132","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}