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Challenges of Creating a Peer Support Online Community for Patients With Diabetes-A Case Study. 为糖尿病患者创建同伴支持在线社区的挑战--案例研究。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-27 DOI: 10.1097/CIN.0000000000001198
Arantxa Bujanda-Sainz de Murieta, Minna Isomursu, Paula Escalada-Hernández, Leticia San Martín-Rodríguez, Cristina García-Vivar, Nelia Soto-Ruiz

This study aims to explore the challenges and strategies in creating online communities for individuals with diabetes, emphasizing their role in fostering connections among individuals facing similar health conditions. Using a single-case approach, we investigated the design process of a diabetes online community using the classic waterfall model. Participants were recruited from a diabetes local association, and usability was assessed using the System Usability Scale and the think-aloud method. Subsequently, semistructured interviews were conducted to evaluate functionality and user experience. Data collection was conducted from August until December 2023. The development of the community unveiled significant usability challenges, highlighting the need for user feedback and improvement. Ethical considerations, including anonymity, usage conditions, privacy terms, and health information sharing, emerged as critical areas requiring meticulous attention. Furthermore, healthcare professional moderation was deemed essential to ensure a secure environment. Users expressed strong interest in enhanced interaction features and personalized notifications. Although online diabetes communities hold potential for peer support, addressing usability challenges, ethical considerations, and moderation issues is essential. This study emphasizes the ongoing necessity for research to enhance the development of patient communities, ensuring accessibility, mitigating ethical risks, and leveraging nurses as moderators.

本研究旨在探讨为糖尿病患者创建在线社区的挑战和策略,强调这些社区在促进面临类似健康状况的个人之间的联系方面所发挥的作用。我们采用单一案例的方法,利用经典的瀑布模型调查了糖尿病在线社区的设计过程。我们从一个糖尿病地方协会招募了参与者,并使用系统可用性量表和思考-朗读法对可用性进行了评估。随后进行了半结构式访谈,以评估功能和用户体验。数据收集工作从 2023 年 8 月一直持续到 12 月。社区的开发揭示了可用性方面的重大挑战,强调了用户反馈和改进的必要性。伦理方面的考虑,包括匿名性、使用条件、隐私条款和健康信息共享,都是需要细致关注的关键领域。此外,医疗保健专业人员的控制被认为是确保安全环境的关键。用户对增强互动功能和个性化通知表示出浓厚的兴趣。尽管在线糖尿病社区具有提供同伴支持的潜力,但解决可用性挑战、伦理考虑和管理问题至关重要。这项研究强调,有必要持续开展研究,以加强患者社区的发展,确保其可访问性,降低道德风险,并利用护士作为主持人。
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引用次数: 0
Bedside Nurse Documentation Practices: At the Patient Bedside or Not? 床边护士记录实践:在病人床边还是不在病人床边?
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-01 DOI: 10.1097/CIN.0000000000001165
Holly E Gauthier-Wetzel

High-quality care requires precise and timely provider documentation. Hospitals have used technology to document patient care within both the inpatient and outpatient areas and long-term care facilities. Research has demonstrated, by revealing a reduction in medical errors, that there has been a worldwide improvement in our community health and welfare since the implementation and utilization of documenting patient care electronically. Although electronic documentation has proven to be an improvement in patient record keeping, the most efficient location in which this documentation is to occur remains a question. At the location where this project took place, only the ICU had computers within the patient rooms for documentation purposes. This project evaluated bedside nurses' opinions related to the efficiency of documentation practices compounded by the location where documentation took place. The options were at the patient's bedside, on a workstation on wheels, or at the nursing station. Surveys were provided to bedside nursing staff both before and after computers were installed in patients' rooms in surgical and medical/surgical nursing units at a Veteran Affairs Medical Center located in the Northeastern region of the United States. The results of this project inconclusively answer the question posed: "Which mode of entry do nurses feel is more efficient to document patient care, on a computer in the patient room, at the nurses' station, or on a workstation on wheels?" Innovative strategies should be explored to develop a user-friendly design for computers located within the patient rooms for patient documentation.

高质量的护理要求提供者准确及时地记录。医院已在住院病人、门诊病人和长期护理设施中使用技术来记录病人护理。研究表明,通过减少医疗差错,自从实施和使用电子记录病人护理以来,我们的社区健康和福利在世界范围内得到了改善。尽管电子文档已被证明是对病人记录保存的一种改进,但在什么地方进行最有效的文档记录仍然是一个问题。在开展本项目的地点,只有重症监护室在病房内配备了用于记录的电脑。本项目评估了床旁护士对记录工作效率的看法,并对记录地点进行了评估。可以选择在病人床边、轮式工作站或护理站。在位于美国东北部地区的一家退伍军人事务医疗中心的外科和内科/外科护理单元的病人房间安装电脑之前和之后,都对床边护理人员进行了调查。这个项目的结果并没有最终回答所提出的问题:"护士们认为哪种输入方式记录病人护理更有效率,是在病房的电脑上,还是在护士站,或是在带轮子的工作站上?应探索创新策略,为病房内用于记录病人护理情况的计算机开发用户友好型设计。
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引用次数: 0
Hotspots and Global Trends of Nursing Research on Mobile Applications in Nursing From 2012 to 2023: A Bibliometric Analysis. 2012 年至 2023 年有关护理领域移动应用的护理研究热点与全球趋势:文献计量分析》。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-01 DOI: 10.1097/CIN.0000000000001163
Tao Li, Tingting Huang, Jing Gao

The rapid integration of mobile applications in healthcare has prompted an evolutionary change in nursing domain. This study aimed to systematically analyze the basic publication characteristics, research priorities, emerging trends, and thematic evolutions concerning mobile applications in nursing, providing an overview of the field's developmental trajectory and future directions. This was a descriptive bibliometric study. Data were collected on July 5, 2023, from the Web of Science database and analyzed by using the Bibliometrix package in R software. The search strategy yielded 417 documents authored by 1969 researchers, cited 12 595 references, and featured 1213 author keywords, spanning from 2012 to 2023. Research on mobile applications in nursing exhibited several key trends: (1) substantial collaboration among authors; (2) significant growth in the number of publications; (3) self-management was the most prominent hot topic; and (4) an evolution of research themes from general topics to a more specific focus on people-centered and problem-centered research. The corpus of literature pertaining to research on mobile applications within the nursing domain is anticipated to expand continually. Future research and practice in the nursing field are expected to benefit significantly from multidisciplinary collaboration and advancements in emerging technologies, including artificial intelligence.

移动应用在医疗保健领域的快速融合促使护理领域发生了演变。本研究旨在系统分析有关护理领域移动应用的基本出版特点、研究重点、新兴趋势和主题演变,为该领域的发展轨迹和未来方向提供一个概览。这是一项描述性文献计量学研究。数据于 2023 年 7 月 5 日从 Web of Science 数据库中收集,并使用 R 软件中的 Bibliometrix 软件包进行分析。通过检索策略,共检索到1969名研究人员撰写的417篇文献,引用了12 595条参考文献,涉及1213个作者关键词,时间跨度为2012年至2023年。有关护理领域移动应用的研究呈现出以下几个主要趋势:(1)作者之间开展了大量合作;(2)发表论文的数量显著增加;(3)自我管理是最突出的热门话题;(4)研究主题从一般性主题演变为以人为本和以问题为中心的研究。有关护理领域移动应用研究的文献库预计将不断扩大。未来护理领域的研究和实践将极大地受益于多学科合作和新兴技术(包括人工智能)的进步。
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引用次数: 0
Codesigning an E-Health Intervention for Surgery Preparation and Recovery. 针对手术准备和恢复的电子健康干预进行代码设计。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-01 DOI: 10.1097/CIN.0000000000001137
Cory Williams, Lee Woods, Adam Stott, Jed Duff

Surgery is a significant part of healthcare, but its demand is increasing, leading to challenges in managing patient care. Inefficient perioperative practices and traditional linear models contribute to adverse outcomes and patient anxiety. E-health interventions show promise in improving surgical care, but more research is needed. The purpose of this study was to involve patients and healthcare workers during the design phase of an e-health intervention that aims to support the perioperative care of elective surgery preparation and recovery. This study used an Information Systems Research Framework to guide collaborative codesign through semistructured interviews and cocreation workshops. Semistructured interviews collected insights on the perioperative journey and e-health needs from healthcare workers and consumers, resulting in the creation of a patient surgery journey map, experience map, and a stakeholder needs table. Collaborative work between consumers and healthcare workers in the cocreation workshops identified priority perioperative journey issues and proposed solutions, as well as prioritizing application software needs, guiding the development of the wireframe. The development of an e-health application aimed at supporting surgery preparation and recovery is a significant step toward improving patient engagement, satisfaction, and postsurgical health outcomes.

外科手术是医疗保健的重要组成部分,但其需求却在不断增加,从而给患者护理管理带来了挑战。低效的围手术期实践和传统的线性模式造成了不良后果和患者焦虑。电子健康干预有望改善手术护理,但还需要更多的研究。本研究的目的是让患者和医护人员参与到旨在支持择期手术准备和恢复的围手术期护理的电子健康干预的设计阶段。本研究采用信息系统研究框架,通过半结构式访谈和共同创造研讨会来指导合作编码设计。半结构式访谈收集了医护人员和消费者对围手术期旅程和电子健康需求的见解,并由此创建了患者手术旅程地图、体验地图和利益相关者需求表。消费者和医护人员在共同创造研讨会上合作确定了围手术期过程中的重点问题和建议的解决方案,并确定了应用软件需求的优先次序,从而为线框的开发提供了指导。旨在支持手术准备和恢复的电子健康应用程序的开发是朝着提高患者参与度、满意度和术后健康结果迈出的重要一步。
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引用次数: 0
Bedside Nurse Documentation Practices: At the Patient Bedside or Not? 床边护士记录实践:在病人床边还是不在病人床边?
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-01 DOI: 10.1097/CIN.0000000000001203
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引用次数: 0
Optimize and Thrive: An Electronic Health Record Optimization Program Case Study. 优化与发展:电子病历优化计划案例研究。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-01 DOI: 10.1097/CIN.0000000000001161
Sarah Hathaway, Melinda Earle

Although electronic health record optimization programs are common in healthcare organizations, a dearth of published evaluations of these programs exists. Little is known about the ability of optimization programs to handle flooding requests for change and achieve their objectives of cost savings, value, quality of care, and efficiency. This program evaluation reviewed one organization's electronic health record clinical optimization program. The evaluation examines the implementation of the insulin dosing calculator project at five hospitals within a large nonprofit healthcare organization using interviews, project documents, reported insulin dosing errors, and workflow observation to determine if the program provides sufficient structure and processes to successfully implement large optimization projects and achieve the project's desired outcomes. This evaluation finds that the optimization program processes support the implementation of large projects. The program can improve the planning of human resources to increase productivity and reduce waste. A clearer definition of meaningful project outcomes at the onset would allow the program to measure and communicate its accomplishments across the organization.

尽管电子病历优化项目在医疗机构中很常见,但已发表的对这些项目的评估却很少。人们对优化项目是否有能力处理大量的变更请求,并实现节约成本、提高价值、改善医疗质量和效率的目标知之甚少。本项目评估回顾了一家机构的电子病历临床优化项目。评估通过访谈、项目文件、胰岛素剂量错误报告和工作流程观察,对一家大型非营利性医疗机构的五家医院实施胰岛素剂量计算器项目的情况进行了检查,以确定该项目是否提供了足够的结构和流程来成功实施大型优化项目并实现项目的预期成果。评估发现,优化计划流程支持大型项目的实施。该计划可以改善人力资源规划,提高生产率,减少浪费。在一开始就对有意义的项目成果进行更明确的定义,将使该计划能够在整个组织范围内衡量和交流其成就。
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引用次数: 0
Construction of an Early Risk Prediction Model for Type 2 Diabetic Peripheral Neuropathy Based on Random Forest. 基于随机森林的 2 型糖尿病周围神经病变早期风险预测模型的构建
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-01 DOI: 10.1097/CIN.0000000000001157
Zhengang Wei, Xiaohua Wang, Liqin Lu, Su Li, Wenyan Long, Lin Zhang, Shaolin Shen

Diabetic peripheral neuropathy is a major cause of disability and death in the later stages of diabetes. A retrospective chart review was performed using a hospital-based electronic medical record database to identify 1020 patients who met the criteria. The objective of this study was to explore and analyze the early risk factors for peripheral neuropathy in patients with type 2 diabetes, even in the absence of specific clinical symptoms or signs. Finally, the random forest algorithm was used to rank the influencing factors and construct a predictive model, and then the model performance was evaluated. Logistic regression analysis revealed that vitamin D plays a crucial protective role in preventing diabetic peripheral neuropathy. The top three risk factors with significant contributions to the model in the random forest algorithm eigenvalue ranking were glycosylated hemoglobin, disease duration, and vitamin D. The areas under the receiver operating characteristic curve of the model ware 0.90. The accuracy, precision, specificity, and sensitivity were 0.85, 0.83, 0.92, and 0.71, respectively. The predictive model, which is based on the random forest algorithm, is intended to support clinical decision-making by healthcare professionals and help them target timely interventions to key factors in early diabetic peripheral neuropathy.

糖尿病周围神经病变是糖尿病晚期致残和致死的主要原因。我们利用医院电子病历数据库进行了一次回顾性病历审查,确定了 1020 名符合标准的患者。本研究的目的是探索和分析 2 型糖尿病患者发生周围神经病变的早期风险因素,即使没有特定的临床症状或体征。最后,采用随机森林算法对影响因素进行排序并构建预测模型,然后对模型的性能进行评估。逻辑回归分析表明,维生素 D 在预防糖尿病周围神经病变方面起着至关重要的保护作用。在随机森林算法特征值排序中,对模型有显著贡献的前三个风险因素是糖化血红蛋白、病程和维生素 D。准确度、精确度、特异性和灵敏度分别为 0.85、0.83、0.92 和 0.71。该预测模型基于随机森林算法,旨在为医护人员的临床决策提供支持,帮助他们针对早期糖尿病周围神经病变的关键因素及时采取干预措施。
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引用次数: 0
Implementation of a Childhood Lead Poisoning Prevention Program Data and Outcomes Management System Based on the Omaha System: A Pre-Post Evaluation. 基于奥马哈系统的儿童铅中毒预防计划数据和结果管理系统的实施:岗前评估。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-01 DOI: 10.1097/CIN.0000000000001144
Taffany B Hwang, Noella Tataw, Anshu Mohllajee, Neysa Ernst, Brigit VanGraafeiland, Karen A Monsen
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引用次数: 0
Recruitment and Retention Issues in a Technology-Based Intervention Among Korean American Midlife Women With Depressive Symptoms. 在有抑郁症状的美籍韩裔中年妇女中开展的基于技术的干预中的招募和保留问题》。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-01 DOI: 10.1097/CIN.0000000000001159
Eun-Ok Im, Wonshik Chee, Seo Yun Kim, Sandra Dunbar, Andrew H Miller, Sudeshna Paul, Moonju Lee, Wooho Jung

The number of health technology-based intervention studies has grown significantly. However, issues in the recruitment and retention for such studies, especially of Asian Americans, have rarely been discussed. The purpose of this paper was to discuss issues in the recruitment and retention of a specific group of Asian Americans-Korean American midlife women with depressive symptoms-into a technology-based intervention study using computers and mobile devices with a measurement device and to provide directions for future participant recruitment and retention in technology-based intervention studies. The written memos of research team members and the written records of research team meetings were analyzed using a content analysis. The issues in the recruitment and retention process included (1) low recruitment and retention rates; (2) the perceived long intervention period; (3) strict inclusion/exclusion criteria; (4) concerns related to the use of a measurement device; and (5) the perceived adequacy of monetary incentives. Based on the issues identified in the study, several suggestions are made for future recruitment and retention of racial/ethnic minorities in technology-based intervention studies (eg, appropriate intervention period, innovative and creative motivation strategies, acceptable measurement scales and devices, and adequate monetary reimbursement).

以健康技术为基础的干预研究数量大幅增长。然而,关于此类研究的招募和留用问题,尤其是亚裔美国人的招募和留用问题,却鲜有讨论。本文旨在讨论一项基于技术的干预研究在招募和保留特定亚裔美国人群体--有抑郁症状的韩裔美国中年妇女--时所遇到的问题,该研究使用了电脑和带有测量设备的移动设备,并为未来基于技术的干预研究的参与者招募和保留提供了方向。本研究采用内容分析法对研究小组成员的书面备忘录和研究小组会议的书面记录进行了分析。招募和保留过程中存在的问题包括:(1)招募和保留率低;(2)认为干预时间过长;(3)严格的纳入/排除标准;(4)对使用测量设备的担忧;以及(5)认为货币激励措施不够充分。根据研究中发现的问题,我们对未来在基于技术的干预研究中招募和留住少数种族/人种提出了一些建议(例如,适当的干预期、创新和创造性的激励策略、可接受的测量量表和设备,以及适当的货币补偿)。
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引用次数: 0
Toward Reliable Symptom Coding in Electronic Health Records for Symptom Assessment and Research: Identification and Categorization of International Classification of Diseases, Ninth Revision, Clinical Modification Symptom Codes. 在电子健康记录中为症状评估和研究进行可靠的症状编码:国际疾病分类,第九修订版,临床修改症状代码的识别和分类》(International Classification of Diseases, Ninth Revision, Clinical Modification Symptom Codes)。
IF 1.3 4区 医学 Q4 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Pub Date : 2024-09-01 DOI: 10.1097/CIN.0000000000001146
Tru Cao, Veronica Brady, Meagan Whisenant, Xueying Wang, Yuxuan Gu, Hulin Wu

To date, symptom documentation has mostly relied on clinical notes in electronic health records or patient-reported outcomes using disease-specific symptom inventories. To provide a common and precise language for symptom recording, assessment, and research, a comprehensive list of symptom codes is needed. The International Classification of Diseases, Ninth Revision or its clinical modification ( International Classification of Diseases, Ninth Revision, Clinical Modification ) has a range of codes designated for symptoms, but it does not contain codes for all possible symptoms, and not all codes in that range are symptom related. This study aimed to identify and categorize the first list of International Classification of Diseases, Ninth Revision, Clinical Modification symptom codes for a general population and demonstrate their use to characterize symptoms of patients with type 2 diabetes mellitus in the Cerner database. A list of potential symptom codes was automatically extracted from the Unified Medical Language System Metathesaurus. Two clinical experts in symptom science and diabetes manually reviewed this list to identify and categorize codes as symptoms. A total of 1888 International Classification of Diseases, Ninth Revision, Clinical Modification symptom codes were identified and categorized into 65 categories. The symptom characterization using the newly obtained symptom codes and categories was found to be more reasonable than that using the previous symptom codes and categories on the same Cerner diabetes cohort.

迄今为止,症状记录大多依赖于电子健康记录中的临床笔记或使用疾病特异性症状清单的患者报告结果。为了给症状记录、评估和研究提供通用而精确的语言,需要一个全面的症状编码清单。国际疾病分类第九版》或其临床修订版(International Classification of Diseases, Ninth Revision, Clinical Modification)有一系列指定用于症状的代码,但并不包含所有可能出现的症状代码,而且该范围内并非所有代码都与症状有关。本研究旨在确定第一份《国际疾病分类,第九版,临床修正》普通人群症状代码列表,并对其进行分类,同时证明这些代码可用于描述 Cerner 数据库中 2 型糖尿病患者的症状特征。从统一医学语言系统元词库(Unified Medical Language System Metathesaurus)中自动提取了潜在症状代码列表。两位症状学和糖尿病方面的临床专家对该列表进行了人工审核,以识别并将代码归类为症状。共确定了 1888 个《国际疾病分类》第九版临床修订版症状代码,并将其分为 65 类。在同一 Cerner 糖尿病队列中,使用新获得的症状代码和类别进行症状特征描述比使用以前的症状代码和类别更为合理。
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引用次数: 0
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Cin-Computers Informatics Nursing
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