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A Machine Learning-Based Prediction Model for the Probability of Fall Risk Among Chinese Community-Dwelling Older Adults. 基于机器学习的中国社区老年人跌倒风险概率预测模型。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-02 DOI: 10.1097/CIN.0000000000001202
Zhou Zhou, Danhui Wang, Jun Sun, Min Zhu, Liping Teng

Fall is a common adverse event among older adults. This study aimed to identify essential fall factors and develop a machine learning-based prediction model to predict the fall risk category among community-dwelling older adults, leading to earlier intervention and better outcomes. Three prediction models (logistic regression, random forest, and naive Bayes) were constructed and evaluated. A total of 459 people were involved, including 156 participants (34.0%) with high fall risk. Seven independent predictors (frail status, age, smoking, heart attack, cerebrovascular disease, arthritis, and osteoporosis) were selected to develop the models. Among the three machine learning models, the logistic regression model had the best model fit, with the highest area under the curve (0.856) and accuracy (0.797) and sensitivity (0.735) in the test set. The logistic regression model had excellent discrimination, calibration, and clinical decision-making ability, which could aid in accurately identifying the high-risk groups and taking early intervention with the model.

跌倒是老年人中常见的不良事件。本研究旨在识别跌倒的基本因素,并开发一种基于机器学习的预测模型,以预测社区老年人的跌倒风险类别,从而尽早干预并获得更好的治疗效果。研究构建并评估了三种预测模型(逻辑回归、随机森林和天真贝叶斯)。研究共涉及 459 人,其中 156 人(34.0%)有高跌倒风险。建立模型时选择了七个独立的预测因素(虚弱状态、年龄、吸烟、心脏病、脑血管疾病、关节炎和骨质疏松症)。在三个机器学习模型中,逻辑回归模型的拟合度最高,曲线下面积(0.856)、准确度(0.797)和灵敏度(0.735)在测试集中都是最高的。逻辑回归模型具有良好的判别、校准和临床决策能力,有助于准确识别高危人群,并利用该模型采取早期干预措施。
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引用次数: 0
The Impact of Undergraduate Informatics Education on Nurses' Acceptance of Information and Communication Technologies: A Cross-sectional Study. 本科信息学教育对护士接受信息和通信技术的影响:横断面研究。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-01 DOI: 10.1097/CIN.0000000000001185
Waad Ali, Bette Mariani, Evelyn Lengetti

This study aimed to examine if exposure to undergraduate nursing informatics educational modalities (ie, lecture, laboratory, and clinical experiences) made a difference in the acceptance of information and communication technologies among nurses in the practice setting. Also, to examine if there was a relationship between selected demographic characteristics and nurses' acceptance of information and communication technologies, a cross-sectional design was used for this study. The Technology Acceptance Model was the theoretical framework for this study. The modified Nursing Acceptance Survey was used to collect data based on the Technology Acceptance Model. The results indicated that exposure to undergraduate informatics education significantly influenced nurses' acceptance of information and communication technologies. The results identified laboratory and clinical as educational modalities influencing nurses' acceptance of information and communication technologies. Demographic characteristics have no statistically significant relationship to nurses' acceptance of information and communication technologies. The results showed that undergraduate informatics education statistically influences nurses' acceptance of information and communication technologies. Findings provide insight into that undergraduate informatics education is important for accepting information and communication technologies among nurses in the practice setting. Also, the findings recognized laboratory and clinical experiences as effective learning modalities for accepting information and communication technologies.

本研究旨在探讨本科护理信息学教育模式(即授课、实验室和临床经验)是否会影响护士在实践环境中对信息和通信技术的接受程度。此外,为了研究选定的人口统计特征与护士对信息和通信技术的接受程度之间是否存在关系,本研究采用了横断面设计。技术接受模型是本研究的理论框架。在技术接受模型的基础上,使用修改后的护理接受度调查来收集数据。结果表明,接受本科信息学教育对护士接受信息和通信技术有重大影响。结果表明,实验室和临床是影响护士接受信息和通信技术的教育模式。人口统计学特征与护士对信息和通信技术的接受程度无明显关系。结果显示,本科信息学教育对护士接受信息和通信技术的影响具有统计学意义。研究结果使人们认识到,本科信息学教育对于护士在实践环境中接受信息和通信技术非常重要。此外,研究结果还确认实验室和临床经验是接受信息和通信技术的有效学习方式。
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引用次数: 0
Letters to the Editor. 致编辑的信
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-01 DOI: 10.1097/CIN.0000000000001186
Elliot Loughran, Madison Kane, Tami H Wyatt, Alex Kerley, Sarah Lowe, Xueping Li
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引用次数: 0
Can Artificial Intelligence Chatbots Improve Mental Health?: A Scoping Review. 人工智能聊天机器人能否改善心理健康?范围综述》。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-01 DOI: 10.1097/CIN.0000000000001155
Cara Gallegos, Ryoko Kausler, Jenny Alderden, Megan Davis, Liya Wang

Background and objectives: Mental health disorders, including anxiety and depression, are the leading causes of global health-related burden and have increased dramatically since the 1990s. Delivering mental healthcare using artificial intelligence chatbots may be one option for closing the gaps in mental healthcare access. The overall aim of this scoping review was to describe the use, efficacy, and advantages/disadvantages of using an artificial intelligence chatbot for mental healthcare (stress, anxiety, depression).

Methods: PubMed, PsycINFO, CINAHL, and Web of Science databases were searched. When possible, Medical Subject Headings terms were searched in combination with keywords. Two independent reviewers reviewed a total of 5768 abstracts.

Results: Fifty-four articles were chosen for further review, with 10 articles included in the final analysis. Regarding quality assessment, the overall quality of the evidence was lower than expected. Overall, most studies showed positive trends in improving anxiety, stress, and depression.

Discussion: Overall, using an artificial intelligence chatbot for mental health has some promising effects. However, many studies were done using rudimentary versions of artificial intelligence chatbots. In addition, lack of guardrails and privacy issues were identified. More research is needed to determine the effectiveness of artificial intelligence chatbots and to describe undesirable effects.

背景和目标:包括焦虑症和抑郁症在内的精神疾病是造成全球健康相关负担的主要原因,自 20 世纪 90 年代以来,精神疾病的发病率急剧上升。使用人工智能聊天机器人提供心理保健服务可能是缩小心理保健服务差距的一种选择。本范围综述的总体目标是描述使用人工智能聊天机器人进行心理保健(压力、焦虑、抑郁)的用途、功效和优缺点:方法:检索了 PubMed、PsycINFO、CINAHL 和 Web of Science 数据库。在可能的情况下,结合关键词搜索医学主题词。两位独立审稿人共审阅了 5768 篇摘要:结果:54 篇文章被选中进行进一步审查,其中 10 篇文章被纳入最终分析。在质量评估方面,证据的总体质量低于预期。总体而言,大多数研究在改善焦虑、压力和抑郁方面显示出积极的趋势:讨论:总体而言,使用人工智能聊天机器人促进心理健康具有一些积极的效果。然而,许多研究使用的是初级版本的人工智能聊天机器人。此外,还发现了缺乏防护措施和隐私问题。需要进行更多的研究来确定人工智能聊天机器人的有效性,并描述其不良影响。
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引用次数: 0
A Study to Determine Consensus for Nursing Documentation Reduction in Times of Crisis. 研究确定危机时刻减少护理文件的共识。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-01 DOI: 10.1097/CIN.0000000000001180
Stephanie H Hoelscher, Susan McBride, Serena Bumpus, Richard E Gilder, Elizabeth Elkind

Nurses faced numerous challenges during the pandemic, particularly with the increased burden of electronic documentation. Surges in patient volume and visits led to rapid changes in nursing documentation, prompting diverse responses from regulatory and healthcare organizations. Nurses expressed safety concerns and struggled with changes, calling for national standards and regulatory support. Policy relaxations, such as the 1135 Waiver, sparked debate on the future of nursing care plan documentation. Using mixed-methods exploratory design, the study identified modifications of nursing documentation during crises, commonalities in documentation burden reduction for applicability beyond pandemics, and consensus on the definition of "surge." Documentation patterns were assessed from February to November 2022, involving 175 North American nurse leaders and informaticists. Data analysis included descriptive statistics, thematic analysis, and Pearson correlation coefficient. Significant differences were found between rural and urban settings ( P = .02), with urban areas showing higher odds of changes to care plans (odds ratio, 4.889; 95% confidence interval, 1.27-18.78). Key findings highlighted the persistence of postcrisis documentation changes and varied definitions of surge criteria based on organizational leadership, policy, and mandates. The study yielded insights for modifying documentation, offering policy recommendations, and emphasizing ongoing collaboration and evidence-based approaches for future nursing practices.

在大流行病期间,护士面临着众多挑战,尤其是电子文档负担的加重。患者数量和就诊次数的激增导致护理文件的快速变化,引发了监管机构和医疗机构的不同反应。护士们表达了对安全的担忧,并努力应对变化,呼吁制定国家标准和监管支持。政策的放宽,如 1135 豁免,引发了对护理计划文件未来的讨论。本研究采用混合方法探索性设计,确定了危机期间护理文件的修改、减少文件负担以适用于大流行病以外情况的共性,以及对 "激增 "定义的共识。2022 年 2 月至 11 月期间,175 名北美护士长和信息学家参与了文件模式评估。数据分析包括描述性统计、主题分析和皮尔逊相关系数。农村和城市环境之间存在显著差异(P = 0.02),城市地区护理计划变更的几率更高(几率比为 4.889;95% 置信区间为 1.27-18.78)。主要发现强调了危机后文件变更的持续性,以及基于组织领导力、政策和授权的不同激增标准定义。这项研究为修改文件、提供政策建议以及强调未来护理实践中的持续合作和循证方法提供了启示。
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引用次数: 0
Automated Dispensing Cabinets and Nursing Workarounds: How Nurses Silently Adapt Clinical Work. 自动配药柜和护理工作:护士如何默默地调整临床工作。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-01 DOI: 10.1097/CIN.0000000000001148
Emma J Watts, Jennifer Jackson
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引用次数: 0
The Impact of Artificial Intelligence-Assisted Learning on Nursing Students' Ethical Decision-making and Clinical Reasoning in Pediatric Care: A Quasi-Experimental Study. 人工智能辅助学习对护理专业学生儿科护理伦理决策和临床推理能力的影响:准实验研究
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-01 DOI: 10.1097/CIN.0000000000001177
Hyewon Shin, Jennie C De Gagne, Sang Suk Kim, Minjoo Hong

The integration of artificial intelligence such as ChatGPT into educational frameworks marks a pivotal transformation in teaching. This quasi-experimental study, conducted in September 2023, aimed to evaluate the effects of artificial intelligence-assisted learning on nursing students' ethical decision-making and clinical reasoning. A total of 99 nursing students enrolled in a pediatric nursing course were randomly divided into two groups: an experimental group that utilized ChatGPT and a control group that used traditional textbooks. The Mann-Whitney U test was employed to assess differences between the groups in two primary outcomes: ( a ) ethical standards, focusing on the understanding and applying ethical principles, and ( b ) nursing processes, emphasizing critical thinking skills and integrating evidence-based knowledge. The control group outperformed the experimental group in ethical standards and demonstrated better clinical reasoning in nursing processes. Reflective essays revealed that the experimental group reported lower reliability but higher time efficiency. Despite artificial intelligence's ability to offer diverse perspectives, the findings highlight that educators must supplement artificial intelligence technology with strategies that enhance critical thinking, careful data selection, and source verification. This study suggests a hybrid educational approach combining artificial intelligence with traditional learning methods to bolster nursing students' decision-making processes and clinical reasoning skills.

将人工智能(如 ChatGPT)融入教育框架标志着教学领域的一次关键变革。这项准实验研究于 2023 年 9 月进行,旨在评估人工智能辅助学习对护理专业学生伦理决策和临床推理的影响。共有 99 名护理专业学生参加了儿科护理课程的学习,他们被随机分为两组:使用 ChatGPT 的实验组和使用传统教科书的对照组。采用 Mann-Whitney U 检验来评估两组在两个主要结果上的差异:(a) 道德标准,侧重于理解和应用道德原则;(b) 护理流程,侧重于批判性思维技能和整合循证知识。对照组在道德标准方面的成绩优于实验组,在护理流程方面则表现出更好的临床推理能力。反思性论文显示,实验组的可靠性较低,但时间效率较高。尽管人工智能能够提供不同的视角,但研究结果强调,教育者必须通过加强批判性思维、谨慎选择数据和源头验证的策略来补充人工智能技术。本研究提出了一种将人工智能与传统学习方法相结合的混合教育方法,以提高护理专业学生的决策过程和临床推理能力。
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引用次数: 0
Using a Mobile Application to Promote Patient Education for Patients With Liver Cirrhosis. 使用移动应用程序促进肝硬化患者教育。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-01 DOI: 10.1097/CIN.0000000000001189
Wen-Ying Lee, Ting-Ting Lee, I-Ching Hou, Chao-Yu Guo, Ming-Yao Chen, Mary Etta Mills

Patient education and self-management are essential for patients with liver cirrhosis. Based on Fisher and Fisher's Information-Motivation-Behavior Skills model, a Cirrhosis Care App was developed to support the education and self-management of these patients. To evaluate the effectiveness of the application, a randomized controlled trial was conducted with patients having liver cirrhosis who were being followed up in the outpatient area of ​​a medical center in Taiwan. The experimental group used the app for 1 month, whereas a control group continued to receive conventional patient education. A pretest and posttest questionnaire was used to evaluate the app's effectiveness in improving the knowledge and practice of self-care. In addition, a questionnaire was developed based on the Technology Acceptance Model to understand satisfaction with the app. Results showed that following the implementation of the Cirrhosis Care App, patients' self-care knowledge and ability to promote self-care practice improved. User satisfaction with the app was measured and reflected in its frequency of use. This study confirmed that the Cirrhosis Care App, based on the Information-Motivation-Behavior Skills model, can improve patient knowledge and self-care practice and be actively promoted to benefit patients with cirrhosis.

患者教育和自我管理对肝硬化患者至关重要。根据费舍尔和费舍尔的 "信息-动机-行为技能 "模型,我们开发了肝硬化护理应用程序,以支持这些患者的教育和自我管理。为了评估该应用程序的有效性,我们对在台湾一家医疗中心门诊部接受随访的肝硬化患者进行了随机对照试验。实验组使用该应用程序一个月,而对照组则继续接受传统的患者教育。实验组采用了前测和后测问卷来评估该应用在提高自我护理知识和实践方面的效果。此外,还根据 "技术接受模型 "编制了一份问卷,以了解对该应用程序的满意度。结果显示,肝硬化护理应用程序实施后,患者的自我护理知识和促进自我护理实践的能力得到了提高。用户对该应用程序的满意度通过其使用频率得到了衡量和反映。这项研究证实,基于信息-动机-行为技能模型的肝硬化护理应用程序能够提高患者的知识水平和自我护理实践能力,并能得到积极推广,使肝硬化患者受益。
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引用次数: 0
Letters to the Editor. 致编辑的信
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-01 DOI: 10.1097/CIN.0000000000001174
Amnuay Kleebayoon, Viroj Wiwanitkit
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引用次数: 0
Using Large Language Models to Address Health Literacy in mHealth: Case Report. 使用大型语言模型解决移动医疗中的健康扫盲问题:案例报告。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-10-01 DOI: 10.1097/CIN.0000000000001152
Elliot Loughran, Madison Kane, Tami H Wyatt, Alex Kerley, Sarah Lowe, Xueping Li

The innate complexity of medical topics often makes it challenging to produce educational content for the public. Although there are resources available to help authors appraise the complexity of their content, there are woefully few resources available to help authors reduce that complexity after it occurs. In this case study, we evaluate using ChatGPT to reduce the complex language used in health-related educational materials. ChatGPT adapted content from the SmartSHOTS mobile application, which is geared toward caregivers of children aged 0 to 24 months. SmartSHOTS helps reduce barriers and improve adherence to vaccination schedules. ChatGPT reduced complex sentence structure and rewrote content to align with a third-grade reading level. Furthermore, using ChatGPT to edit content already written removes the potential for unnoticed, artificial intelligence-produced inaccuracies. As an editorial tool, ChatGPT was effective, efficient, and free to use. This article discusses the potential of ChatGPT as an effective, time-efficient, and open-source method for editing health-related educational materials to reflect a comprehendible reading level.

医学主题与生俱来的复杂性往往使制作面向公众的教育内容具有挑战性。虽然有一些资源可以帮助作者评估其内容的复杂性,但很少有资源可以帮助作者在内容复杂化之后降低复杂性。在本案例研究中,我们对使用 ChatGPT 减少健康相关教育材料中的复杂语言进行了评估。ChatGPT 采用了 SmartSHOTS 移动应用程序的内容,该应用程序面向 0 到 24 个月大儿童的看护者。SmartSHOTS 有助于减少接种疫苗的障碍,提高接种疫苗的依从性。ChatGPT 减少了复杂的句子结构,并根据三年级的阅读水平重写了内容。此外,使用 ChatGPT 来编辑已撰写的内容还能消除人工智能产生的不准确内容。作为一种编辑工具,ChatGPT 是有效、高效和免费的。本文讨论了 ChatGPT 作为一种有效、省时、开源的编辑健康相关教育材料的方法的潜力,以反映可理解的阅读水平。
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引用次数: 0
期刊
Cin-Computers Informatics Nursing
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