Nurses' Experience Regarding Barriers to Providing Internet Plus Continuous Nursing: Mixed Methods Study.

Background: The novel medical model of "Internet Plus continuous nursing" has received much attention under the dual background of aging and digitalization in China. However, there is a scarcity of studies that report on the potential barriers and challenges associated with the implementation of this practice.

Objective: This study aimed to investigate and understand nurses' experience regarding barriers to providing Internet Plus continuous nursing.

Methods: A sequential mixed methods design was adopted. In the first phase, a self-made questionnaire was used to quantify the barriers and challenges into 3 domains: management, relational, and information continuity. In the second phase, nurses who participated in the Internet Plus continuous nursing program were invited to attend semistructured interviews to further explore, explain, and understand the complexities behind these data, obtaining more detailed information on participants' experiences, perspectives, and meanings.

Results: A total of 4638 participants from 312 hospitals were selected for the final analysis; the adjusted mean score of the survey was 3.49 (SD 0.83). Among the 3 domains, management continuity had the lowest score (mean 3.32, SD 0.97), followed by relational continuity (mean 3.44, SD 0.9) and information continuity (mean 3.62, SD 0.92). The results of the multivariable analysis showed that age, education level, and a greater number of working years were predictors of continuity for Internet Plus continuous nursing (P<.001). Following the qualitive study, 8 subthemes emerged from 72 initial codes and were grouped into 3 themes: organizational changes, practice changes, and future directions.

Conclusions: This mixed methods study revealed that Chinese nurses may have differential challenges when providing Internet Plus continuous nursing, particularly in management continuity. To better benefit patients and improve health care delivery, health care organizations and policymakers should implement strategies to improve interdisciplinary relationships, establish and perfect organizational management, and enhance communication.