Cin-Computers Informatics Nursing最新文献

Smartwatch wearables are a promising health information technology to monitor older adults with complex chronic care needs. Pilot and feasibility studies have assessed smartwatch use with community-dwelling older adults, but less is known about their use in nursing homes. The purpose of this study was to test the feasibility and acceptability of smartwatch technology in a real-world nursing home setting to generate initial evidence about potential use. Using a qualitative descriptive approach, we conducted a pilot feasibility and acceptability study of smartwatch technology: Phase 1, pretrial semistructured interviews and focus groups with nursing home leaders, staff, and residents/families; Phase 2, a 7-day smartwatch trial deployment with residents; and Phase 3, posttrial semistructured interviews and focus groups. Themes related to feasibility findings included a part of the workflow and making the technology work. Themes related to acceptability findings included it's everywhere anyway, how will you protect me, knowing how you really are, more information = more control, and knowing how they are doing. These findings have important implications for the design of technology-supported interventions incorporating these devices within the unique context of residential nursing homes to best meet the needs of older adult residents, families, and staff caretakers.

Digital health literacy is emerging as an important element in chronic illness management, yet its relationship with clinical outcomes remains unclear. Utilizing data from the ongoing EXpanding Technology-Enabled, Nurse-Delivered Chronic Disease Care trial, this cross-sectional, correlational study explored the association between digital health literacy, health literacy, and patient outcomes, specifically blood pressure and hemoglobin A1c levels in 76 patients managing comorbid type 2 diabetes and hypertension. Results indicate patients had moderate digital health literacy, which was not significantly correlated with health literacy (r = 0.16, P = .169). Both bivariate and covariate-adjusted regression models indicated that digital health literacy was not significantly associated with patient outcomes (all P > .05, small effects). These findings suggest that although patients from diverse sociodemographic backgrounds may possess the digital health literacy to engage with digital health tools, this alone may not improve clinical outcomes. Although digital health literacy may not be directly related to improved clinical outcomes, future research should explore how digital health tools can be optimized to enhance patient engagement and address complex challenges in diverse populations managing chronic conditions.

Integrating technology into healthcare services has direct implications for the efficacy and performance of client care. In view of this, the aim was to identify the possibilities of using virtual reality glasses in healthcare. An integrative literature review was conducted in October 2024, searching in MEDLINE, LILACS, BDENF, Scopus, Web of Science, EMBASE, and Science Direct. Original articles were included without restriction on publication period or language, whereas duplicates and those not addressing the guiding question were excluded. The level of evidence was evaluated following Melnyk and Fineout-Overholt's method. Data were synthesized in tables, figures, and in narrative form. The 47 studies in the final sample were published between 2007 and 2024, with most conducted in Turkey and predominantly clinical trials. Various models of glasses were used, with VRBox being the most cited, and video interventions were prominent. Main focuses of use included areas such as rehabilitation, invasive procedures, preoperative care, obstetrics, examinations, dentistry, and wound care. The use of virtual reality glasses has proven effective for distraction, pain reduction, and anxiety management across various health domains. Experimental studies indicate a high level of scientific evidence, which is essential for evidence-based practices; however, more objective investigations are still needed.

Transitions from one EHR to another can be enormously disruptive to care. Nurses are the largest group of EHR users, but nurse experiences with EHR transitions have not been well documented. We sought to understand nurse experiences with an EHR transition at the US Department of Veterans Affairs. We used a mixed methods design, combining a cumulative 26 longitudinal interviews with 317 survey free-text responses and quantitative measures from a repeated cross-sectional survey, all from nurses at one of the first facilities to transition from the Department of Veterans Affairs' homegrown EHR to a commercial system. We conducted inductive/deductive content analysis of qualitative data and paired qualitative findings with descriptive statistics of survey questions. Analyses yielded insights about three key aspects of the transition: (1) EHR functionality: diverse perceived causes of challenges using the new EHR; (2) transition process: barriers and facilitators of nurses' EHR training and technical support; and (3) outcomes: nurse-perceived impacts on safety, quality, nurse satisfaction, and efficiency. Alongside improvements to EHR functionality, findings underscore the need for organizationally informed training and careful alignment between the new EHR and the organization's nursing practices-all of which have been undertaken by Department of Veterans Affairs nurses informed by this and other studies.

Nursing students often experience anxiety, stress, and fear during a clinical rotation in a mental health setting due to stressors and biases toward the setting as well as lack experience in caring for patients with mental health conditions. One in four people worldwide suffers from a mental disorder; therefore, it is critical that nurses feel confident interacting with these patients to provide equitable care. Undergraduate training is a critical period for changing students' attitudes toward this population. This study's goal was twofold. First, we offered students' exposure to common behaviors and symptoms displayed by a patient with mental illness through an engaging and immersive virtual reality simulation experience before taking care of patients in a clinical setting. Second, we aimed to determine if a virtual reality simulation will change students' attitude and stigma, favorably, toward patients with mental health conditions. We used a mixed-method comparative analysis to collect information and identify themes on undergraduate students' attitudes and stigma toward patients with mental health conditions. Our findings demonstrate that virtual reality simulations enhance awareness and sensitivity to the situations of others (empathy) while improving their communication skills. The use of virtual reality in a baccalaureate curriculum deepens the understanding of health equity in behavioral health for nursing students.

This study aimed to investigate the association between Korean adults' electronic health literacy and active participation in health decision-making while communicating with healthcare providers. A total of 421 adults 18 years and older were recruited from a survey panel developed by a survey company and completed an online survey asking about individual characteristics and electronic health literacy. Data were analyzed using descriptive statistics, independent-samples t tests, analysis of variance, and binomial logistic regression analysis. In results, for every one-unit increase in electronic health literacy, the rate of active participation in health decision-making was likely to increase by 3.62 times compared with the rate of passive participation in health decision-making. It was also likely to increase in those with a college degree or higher, those who used both Web sites and YouTube, those who perceived online health information to be useful, those who actively participated as a patient, and those with a desire to actively participate as a patient. To encourage active participation in health-related situations or decision-making processes, educational programs or interventions to improve individuals' electronic health literacy are needed. Healthcare providers must ensure that individuals feel comfortable expressing their preferences, needs, and values.

In a medical specialty clinic located in a rural community, a nursing team identified an opportunity to decrease the time nursing staff spent preparing charts for patients' upcoming clinical appointments. In collaboration with an informaticist, the nursing project team implemented a quality improvement project with a target goal of decreasing the average time spent preparing charts per patient by 20%, without increasing the number of discrepancies in the chart preparation process. The team used the define, measure, analyze, improve, and control framework to identify two interventions that could decrease time for chart preparation. A standardized chart preparation process was developed, and a condensed nursing view was created within the electronic health record. After the quality improvement project, the average time nurses spent on chart preparation per patient decreased by 18% after the standardized process and 16% after the condensed view was implemented.

Cancer predominantly affects older adults. An estimated 62% of the 15.5 million American cancer survivors are 65 years or older. Provision of supportive care is critical to this group; however, limited resources are available to them. As older survivors increasingly adopt technology, digital health programs have significant potential to provide them with longitudinal supportive care. Previously, we developed/tested a digital Cancer Survivorship Patient Engagement Toolkit for older adults, Cancer Survivorship Patient Engagement Toolkit Silver. The study examined the preliminary impact of the Cancer Survivorship Patient Engagement Toolkit Silver on older survivors' health outcomes. This was a 2-arm randomized controlled trial with two observations (baseline, 8 weeks) on a sample of 60 older cancer survivors (mean age, 70.1 ± 3.8 years). Outcomes included health-related quality of life, self-efficacy for coping with cancer, symptom burden, health behaviors, and patient-provider communication. Data were analyzed using descriptive statistics, linear mixed models, and content analysis. At 8 weeks, the Cancer Survivorship Patient Engagement Toolkit Silver group showed more improved physical health-related quality of life ( P < .001, effect size = 0.64) and symptom burden ( P = .053, effect size = -0.41) than the control group. Self-efficacy (effect size = 0.56), mental health-related quality of life (effect size = 0.26), and communication (effect size = 0.40) showed clinically meaningful effect sizes of improvement. Most participants reported benefits on health management (mean, 19.41 ± 2.6 [3-21]). Further research is needed with larger and more diverse older cancer populations.