JMIR nursing最新文献

{"title":"Exploring the Impact of Virtual Reflection Groups on Advanced Practice Nurse Students During the COVID-19 Pandemic: Focus Group Study With Master's Students.","authors":"Jofrid Berit Høybakk,&nbsp;Andréa Aparecida Gonçalves Nes,&nbsp;Monica Evelyn Kvande,&nbsp;Marianne Trygg Solberg","doi":"10.2196/40418","DOIUrl":"https://doi.org/10.2196/40418","url":null,"abstract":"<p><strong>Background: </strong>In the master's program of advanced practice nursing at a Norwegian university college, the learning activity reflection groups were converted into virtual reflection group (VRG) meetings during the COVID-19 pandemic. Regardless of the students' clinical practices in different hospitals, they could participate in the same VRG meeting on the web together with the educator from the university college, and the clinical supervisors were invited to participate. The students were in the process of developing the core competence required in their role as advanced practice nurses (APNs), and they had increased responsibility in the implementation of the VRG meetings.</p><p><strong>Objective: </strong>In this study, we aimed to explore how master's students of advanced practice nursing experienced VRG meetings during the COVID-19 pandemic.</p><p><strong>Methods: </strong>A qualitative exploratory design was adopted using focus group interviews. A group of students in the master's program of advanced practice nursing participated in an interview that lasted for 60 minutes. They had experienced participating in the VRG meetings following a rigorous guide during their clinical practice. The data from the focus group were analyzed using qualitative content analysis.</p><p><strong>Results: </strong>The main findings of this study highlighted the importance of structure in VRG meetings, the role of increased responsibility in students' learning processes, the development of APN students' competencies, and increased professional collaboration with clinical supervisors. The APN students and clinical supervisors also continued their discussions in the clinical setting afterward, which strengthened the collaboration between students' education in the master's program and their clinical practice.</p><p><strong>Conclusions: </strong>VRG meetings gave the students the opportunity to lead professional discussions while reflecting thoroughly on the chosen patient cases from clinical practice. They experienced receiving feedback from fellow students, supervisors, and educators as stimulating their critical thinking development.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e40418"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40359101","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 Impact of Digital Health Transformation Driven by COVID-19 on Nursing Practice: Systematic Literature Review.","authors":"Robab Abdolkhani,&nbsp;Sacha Petersen,&nbsp;Ruby Walter,&nbsp;Lin Zhao,&nbsp;Kerryn Butler-Henderson,&nbsp;Karen Livesay","doi":"10.2196/40348","DOIUrl":"https://doi.org/10.2196/40348","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has accelerated the uptake of digital health innovations due to the availability of various technologies and the urgent health care need for treatment and prevention. Although numerous studies have investigated digital health adoption and the associated challenges and strategies during the pandemic, there is a lack of evidence on the impact on the nursing workforce.</p><p><strong>Objective: </strong>This study aims to identify the impact of digital health transformation driven by COVID-19 on nurses.</p><p><strong>Methods: </strong>The online software Covidence was used to follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Relevant scientific health and computing databases were searched for papers published from January 2020 to November 2021. Using the 8D sociotechnical approach for digital health in health care systems, the papers were analyzed to identify gaps in applying digital health in nursing practice.</p><p><strong>Results: </strong>In total, 21 papers were selected for content analysis. The analysis identified a paucity of research that quantifies the impact of the digital health transformation on nurses during the pandemic. Most of the initiatives were teleconsultation, followed by tele-intensive care unit (tele-ICU), and only 1 (5%) study explored electronic medical record (EMR) systems. Among the sociotechnical elements, the human-related factor was the most explored and the system measurement was the least studied item.</p><p><strong>Conclusions: </strong>The review identified a significant gap in research on how implementing digital health solutions has impacted nurses during the COVID-19 pandemic. This gap needs to be addressed by further research to provide strategies for empowering the nursing workforce to be actively involved in digital health design, development, implementation, use, and evaluation.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e40348"},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9431991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40530989","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":"Personality, Attitudes, and Behaviors Predicting Perceived Benefit in Online Support Groups for Caregivers: Mixed Methods Study.","authors":"Athena Milios,&nbsp;Ting Xiong,&nbsp;Karen McEwan,&nbsp;Patrick McGrath","doi":"10.2196/36167","DOIUrl":"https://doi.org/10.2196/36167","url":null,"abstract":"<p><strong>Background: </strong>Online support groups (OSGs) are distance-delivered, easily accessible health interventions offering emotional, informational, and experience-based support and companionship or network support for caregivers managing chronic mental and physical health conditions.</p><p><strong>Objective: </strong>This study aimed to examine the relative contribution of extraversion, agreeableness, neuroticism, positive attitudes toward OSGs on social networking sites, and typical past OSG use patterns in predicting perceived OSG benefit in an OSG for parents and caregivers of children with neurodevelopmental disorders.</p><p><strong>Methods: </strong>A mixed methods, longitudinal design was used to collect data from 81 parents across Canada. Attitudes toward OSGs and typical OSG use patterns were assessed using the author-developed Attitudes Toward OSGs subscale (eg, \"Online support groups are a place to get and give emotional support\") and Past Behaviors in OSGs subscale (eg, \"How often would you typically comment on posts?\") administered at baseline-before OSG membership. The personality traits of extraversion, agreeableness, and neuroticism were assessed at baseline using the Ten-Item Personality Inventory. Perceived OSG benefit was assessed using the author-developed Perceived OSG Benefit scale (eg, \"Overall, did you feel supported by other members in this group?\"), administered 2 months after the initiation of OSG membership.</p><p><strong>Results: </strong>A hierarchical regression analysis found that extraversion was the only variable that significantly predicted perceived OSG benefit (R²=0.125; P<.001).</p><p><strong>Conclusions: </strong>The key suggestions for improving future OSGs were facilitating more in-depth, customized, and interactive content in OSGs.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e36167"},"PeriodicalIF":0.0,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40620760","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' Experiences of Care With or Without the Support of an Interactive App During Neoadjuvant Chemotherapy for Breast Cancer: Interview Study.","authors":"Maria Fjell,&nbsp;Ann Langius-Eklöf,&nbsp;Marie Nilsson,&nbsp;Kay Sundberg","doi":"10.2196/39983","DOIUrl":"https://doi.org/10.2196/39983","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy (NACT) is often recommended for patients with breast cancer with more aggressive tumor characteristics. As with all chemotherapies, they can cause substantially disturbing symptoms. Most patients receive their treatment as outpatients, which means that they must take responsibility for self-care and management of symptoms at home for a long period. Patients with breast cancer undergoing chemotherapy may not receive sufficient support for management of treatment-related symptoms. For patients undergoing NACT, it has been concluded that information and supportive needs are not always met. In our previous study, the use of mobile health to support patients with breast cancer undergoing NACT reduced symptoms during treatment with the support of an interactive app. Therefore, it is important to investigate how patients experience their care and explore any specific contribution that the app may have brought in care.</p><p><strong>Objective: </strong>This study aims to explore patients' experiences of care with or without the support of an interactive app during NACT for breast cancer.</p><p><strong>Methods: </strong>This qualitative study was part of a larger randomized controlled trial and included 40 individual face-to-face interviews conducted with patients in both intervention and control groups after the end of NACT. The interviews were audio recorded, and the data were analyzed inductively using thematic analysis.</p><p><strong>Results: </strong>No major differences in experience of care were observed between the groups. A total of 4 overarching themes emerged. In the first theme, The health care context, patients described care as assessible, although sometimes there was a lack of time and continuity with nurses. In the second theme, Being a recipient of care, it emerged that the patients experienced a warm and positive atmosphere at the clinics. In the third theme, Taking an active role as a patient, patients described being active in searching for information and various ways of participation in their own care. In the fourth theme, The value of the app, patients who had used the app experienced it as a complementary source of information, creating a sense of security. Using the app provided patients with the support of being contacted by a nurse if needed, enabled self-care, and facilitated the planning of daily activities.</p><p><strong>Conclusions: </strong>Overall, patients' experiences of care were similar and mostly positive. However, for patients using the app, it provided additional support for information and self-care and enhanced participation in their own care. The easy access to a nurse gave patients a sense of security. The findings suggest integrating an interactive app as a complement to standard care to support patients with breast cancer during treatment.</p><p><strong>International registered report identifier (irrid): </strong>RR2-DOI: 10.1186/s12885-017-3450-y.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e39983"},"PeriodicalIF":0.0,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9412756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40699003","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' Experiences After Implementation of an Organization-Wide Electronic Medical Record: Qualitative Descriptive Study.","authors":"Rebecca M Jedwab,&nbsp;Elizabeth Manias,&nbsp;Alison M Hutchinson,&nbsp;Naomi Dobroff,&nbsp;Bernice Redley","doi":"10.2196/39596","DOIUrl":"https://doi.org/10.2196/39596","url":null,"abstract":"<p><strong>Background: </strong>Reports on the impact of electronic medical record (EMR) systems on clinicians are mixed. Currently, nurses' experiences of adopting a large-scale, multisite EMR system have not been investigated. Nurses are the largest health care workforce; therefore, the impact of EMR implementation must be investigated and understood to ensure that patient care quality, changes to nurses' work, and nurses themselves are not negatively impacted.</p><p><strong>Objective: </strong>This study aims to explore Australian nurses' postimplementation experiences of an organization-wide EMR system.</p><p><strong>Methods: </strong>This qualitative descriptive study used focus group and individual interviews and an open-ended survey question to collect data between 12 and 18 months after the implementation of an EMR across 6 hospital sites of a large health care organization in Victoria, Australia. Data were collected between November 2020 and June 2021, coinciding with the COVID-19 pandemic. Analysis comprised complementary inductive and deductive approaches. Specifically, reflexive thematic analysis was followed by framework analysis by the coding of data as barriers or facilitators to nurses' use of the EMR using the Theoretical Domains Framework.</p><p><strong>Results: </strong>A total of 158 nurses participated in this study. The EMR implementation dramatically changed nurses' work and how they viewed their profession, and nurses were still adapting to the EMR implementation 18 months after implementation. Reflexive thematic analysis led to the development of 2 themes: An unintentional divide captured nurses' feelings of division related to how using the EMR affected nurses, patient care, and the broader nursing profession. This time, it's personal detailed nurses' beliefs about the EMR implementation leading to bigger changes to nurses as individuals and nursing as a profession than other changes that nurses have experienced within the health care organization. The most frequent barriers to EMR use by nurses were related to the Theoretical Domains Framework domain of environmental context and resources. Facilitators of EMR use were most often related to memory, attention, and decision processes. Most barriers and facilitators were related to motivation.</p><p><strong>Conclusions: </strong>Nurses perceived EMR implementation to have a mixed impact on the provision of quality patient care and on their colleagues. Implementing technology in a health care setting was perceived as a complex endeavor that impacted nurses' perceptions of their autonomy, ways of working, and professional roles. Potential negative consequences were related to nursing workforce retention and patient care delivery. Motivation was the main behavioral driver for nurses' adoption of EMR systems and hence a key consideration for implementing interventions or organizational changes directed at nurses.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e39596"},"PeriodicalIF":0.0,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9328123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40555491","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":"Acceptability of an mHealth Family Self-management Intervention (myFAMI) for Pediatric Transplantation Families: Qualitative Focus.","authors":"Stacee Marie Lerret,&nbsp;Erin Flynn,&nbsp;Rosemary White-Traut,&nbsp;Estella Alonso,&nbsp;Alisha M Mavis,&nbsp;M Kyle Jensen,&nbsp;Caitlin G Peterson,&nbsp;Rachel Schiffman","doi":"10.2196/39263","DOIUrl":"https://doi.org/10.2196/39263","url":null,"abstract":"<p><strong>Background: </strong>Around 1800 pediatric transplantations were performed in 2021, which is approximately 5% of the annual rate of solid organ transplantations carried out in the United States. Effective family self-management in the transition from hospital to home-based recovery promotes successful outcomes of transplantation. The use of mHealth to deliver self-management interventions is a strategy that can be used to support family self-management for transplantation recipients and their families.</p><p><strong>Objective: </strong>The study aims to evaluate the acceptability of an mHealth intervention (myFAMI) that combined use of a smartphone app with triggered nurse communication with family members of pediatric transplantation recipients.</p><p><strong>Methods: </strong>This is a secondary analysis of qualitative data from family members who received the myFAMI intervention within a larger randomized controlled trial. Eligible participants used the app in the 30-day time frame after discharge and participated in a 30-day postdischarge telephone interview. Content analysis was used to generate themes.</p><p><strong>Results: </strong>A total of 4 key themes were identified: (1) general acceptance, (2) positive interactions, (3) home management after hospital discharge, and (4) opportunities for improvement.</p><p><strong>Conclusions: </strong>Acceptability of the intervention was high. Family members rated the smartphone application as easy to use. myFAMI allowed the opportunity for families to feel connected to and engage with the medical team while in their home environment. Family members valued and appreciated ongoing support and education specifically in this first 30 days after their child's hospital discharge and many felt it contributed positively to the management of their child's medical needs at home. Family members provided recommendations for future refinement of the app and some suggested that a longer follow-up period would be beneficial. The development and refinement of mHealth care delivery strategies hold potential for improving outcomes for solid organ transplantation patients and their families and as a model to consider in other chronic illness populations.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT03533049; https://clinicaltrials.gov/ct2/show/NCT03533049.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e39263"},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9338419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40606017","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 Outcomes of App-Based Health Coaching to Improve Dietary Behavior Among Nurses in a Tertiary Hospital: Pilot Intervention Study.","authors":"Wei Xiang Lim,&nbsp;Stephanie Fook-Chong,&nbsp;John Wah Lim,&nbsp;Wee Hoe Gan","doi":"10.2196/36811","DOIUrl":"https://doi.org/10.2196/36811","url":null,"abstract":"<p><strong>Background: </strong>At the workplace, health care workers face multiple challenges in maintaining healthy dietary behaviors, which is the major factor behind obesity. A hospital-wide mass health screening exercise showed an increasing trend in the prevalence of obesity and median BMI from 2004 to 2019, as well as a higher crude obesity rate among shift workers.</p><p><strong>Objective: </strong>We aimed to evaluate the effectiveness of mobile app-based health coaching and incentives for achieving weight loss from better dietary choices among hospital nurses.</p><p><strong>Methods: </strong>We conducted a pilot study from June 2019 to March 2020, involving the use of a health-coaching app by 145 hospital nurses over 6 months. Weight and BMI were self-reported, and food scores were calculated. Data among overweight nurses, shift work nurses, and incentive groups were analyzed.</p><p><strong>Results: </strong>A total of 61 nurses were included in the final analysis. Of these 61 nurses, 38 (62%) lost weight. The median percentage weight loss was 1.2% (IQR 0%-2.9%; P<.001), and the median decrease in BMI was 0.35 (IQR -0.15 to 0.82; P<.001), but they were not clinically significant. The median improvement in the food score was 0.4 (IQR 0-0.8). There was no difference between the incentive and nonincentive groups. A total of 49 (34%) participants engaged for ≥8 weeks.</p><p><strong>Conclusions: </strong>The study demonstrated an association between the use of app-based health coaching and the attainment of some weight loss in nurses, without a significant improvement in the food score. Incentives may nudge on-boarding, but do not sustain engagement.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e36811"},"PeriodicalIF":0.0,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9338416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40508327","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":"Understanding Whole-Person Health and Resilience During the COVID-19 Pandemic and Beyond: A Cross-sectional and Descriptive Correlation Study.","authors":"Sripriya Rajamani, Robin Austin, Elena Geiger-Simpson, Ratchada Jantraporn, Suhyun Park, Karen A Monsen","doi":"10.2196/38063","DOIUrl":"10.2196/38063","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has prompted an interest in whole-person health and emotional well-being. Informatics solutions through user-friendly tools such as mobile health apps offer immense value. Prior research developed a consumer-facing app MyStrengths + MyHealth using Simplified Omaha System Terms (SOST) to assess whole-person health. The MyStrengths + MyHealth app assesses strengths, challenges, and needs (SCN) for 42 concepts across four domains (My Living, My Mind and Networks, My Body, My Self-care; eg, Income, Emotions, Pain, and Nutrition, respectively). Given that emotional well-being was a predominant concern during the COVID-19 pandemic, we sought to understand whole-person health for participants with/without Emotions challenges.</p><p><strong>Objective: </strong>This study aims to use visualization techniques and data from attendees at a Midwest state fair to examine SCN overall and by groups with/without Emotions challenges, and to explore the resilience of participants.</p><p><strong>Methods: </strong>This cross-sectional and descriptive correlational study surveyed adult attendees at a 2021 Midwest state fair. Data were visualized using Excel and analyzed using descriptive and inferential statistics using SPSS.</p><p><strong>Results: </strong>The study participants (N=182) were primarily female (n=123, 67.6%), aged ≥45 years (n=112, 61.5%), White (n=154, 84.6%), and non-Hispanic (n=177, 97.3%). Compared to those without Emotions challenges, those with Emotions challenges were aged 18-44 (P<.001) years, more often female (P=.02), and not married (P=.01). Overall, participants had more strengths (mean 28.6, SD 10.5) than challenges (mean 12, SD 7.5) and needs (mean 4.2, SD 7.5). The most frequent needs were in Emotions, Nutrition, Income, Sleeping, and Exercising. Compared to those without Emotions challenges, those with Emotions challenges had fewer strengths (P<.001), more challenges (P<.001), and more needs (P<.001), along with fewer strengths for Emotions (P<.001) and for the cluster of health-related behaviors domain concepts, Sleeping (P=.002), Nutrition (P<.001), and Exercising (P<.001). Resilience was operationalized as correlations among strengths for SOST concepts and visualized for participants with/without an Emotions challenge. Those without Emotions challenges had more positive strengths correlations across multiple concepts/domains.</p><p><strong>Conclusions: </strong>This survey study explored a large community-generated data set to understand whole-person health and showed between-group differences in SCN and resilience for participants with/without Emotions challenges. It contributes to the literature regarding an app-aided and data-driven approach to whole-person health and resilience. This research demonstrates the power of health informatics and provides researchers with a data-driven methodology for additional studies to build evidence on whole-person health and resilience.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e38063"},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9152721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45964730","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’ Experiences Using an Interactive System to Assess and Manage Treatment-Related Symptoms of Patients With Pancreatic Cancer: Interview Study","authors":"Maria Mangsbacka, Tina Gustavell","doi":"10.2196/36654","DOIUrl":"https://doi.org/10.2196/36654","url":null,"abstract":"Background Treatment for pancreatic cancer entails symptom distress and a high burden of self-care. Patient-reported outcomes, collected with the support of mobile health (mHealth), have shown positive effects on symptom management, patient satisfaction, and quality of life for patients with cancer. For mHealth tools to become an integral part of clinical routine, experiences from health care professionals are needed. Objective The aim of this paper is to describe nurses’ experiences of integrating an interactive system (Interaktor) for symptom assessment and management into daily practice, when caring for patients following pancreaticoduodenectomy and during chemotherapy treatment due to pancreatic cancer. Methods Patients reported symptoms via the Interaktor app daily for 6 months. In the event of alarming symptoms, an alert was triggered to the patient’s nurse who then called the patient to offer advice and support. All nurses (n=8) who assessed patients were interviewed either individually or in a group. Transcribed interviews were analyzed using qualitative thematic analysis. Results mHealth can facilitate person-centered care by offering nurses a way to gain knowledge about patients and to build relationships. Further, obstacles to implementation could be seen due to a lack of structural prerequisites and uncertainty about multiple ways to interact with patients. Conclusions The Interaktor system can provide person-centered care. However, to implement mHealth tools as a clinical routine, focus needs to be placed on creating the necessary organizational conditions.","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46284546","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":"Normalizing Telemonitoring in Nurse-Led Care Models for Complex Chronic Patient Populations: Case Study.","authors":"Kayleigh Gordon,&nbsp;Emily Seto,&nbsp;Katie N Dainty,&nbsp;Carolyn Steele Gray,&nbsp;Jane DeLacy","doi":"10.2196/36346","DOIUrl":"10.2196/36346","url":null,"abstract":"<p><strong>Background: </strong>The implementation of telemonitoring (TM) has been successful in terms of the overall feasibility and adoption in single disease care models. However, a lack of available research focused on nurse-led implementations of TM that targets patients with multiple and complex chronic conditions (CCC) hinders the scale and spread to these patient populations. In particular, little is known about the clinical perspective on the implementation of TM for patients with CCC in outpatient care.</p><p><strong>Objective: </strong>This study aims to better understand the perspective of the clinical team (both frontline clinicians and those in administrative positions) on the implementation and normalization of TM for complex patients in a nurse-led clinic model.</p><p><strong>Methods: </strong>A pragmatic, 6-month implementation study was conducted to embed multicondition TM, including heart failure, hypertension, and diabetes, into an integrated nurse-led model of care. Throughout the study, clinical team members were observed, and a chart review was conducted of the care provided during this time. At the end of the study, clinical team members participated in qualitative interviews and completed the adapted Normalization Measure Development questionnaires. The Normalization Process Theory guided the deductive data analysis.</p><p><strong>Results: </strong>Overall, 9 team members participated in the study as part of a larger feasibility study of the TM program, of which 26 patients were enrolled. Team members had a shared understanding of the purpose and value of TM as an intervention embedded within their practice to meet the diverse needs of their patients with CCC. TM aligned well with existing chronic care practices in several ways, yet it changed the process of care delivery (ie, interactional workability subconstruct). Effective TM normalization in nurse-led care requires rethinking of clinical workflows to incorporate TM, relationship development between the clinicians and their patients, communication with the interdisciplinary team, and frequent clinical care oversight. This was captured well through the subconstructs of skill set workability, relational integration, and contextual integration of the Normalization Process Theory.</p><p><strong>Conclusions: </strong>Clinicians successfully adopted TM into their everyday practice such that some providers felt their role would be significantly and negatively affected without TM. This study demonstrated that smartphone-based TM systems complemented the routine and challenging clinical work caring for patients with CCC in an integrated nurse-led care model.</p>","PeriodicalId":73556,"journal":{"name":"JMIR nursing","volume":" ","pages":"e36346"},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9100369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46203255","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}