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Experiences and support of Australian nurses who identify as a second victim: A mixed methods study 澳大利亚护士的经验和支持谁确定为第二受害者：一项混合方法研究
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-17 DOI: 10.1016/j.apnr.2025.151925
Monica Peddle , Madeline McPhillips , Rachel Cross , Lauren Zarb

Aims

In this study, researchers investigated experiences and key elements of effective support programs that promote recovery in nurses who identify as second victims in Australia.

Design

Sequential explanatory mixed methods investigated experiences of nurses who identify as second victims, including support received and any educational and training included.

Methods

Data were collected using survey and in-depth interviews. Survey data were analysed using descriptive and non-parametric testing and thematic analysis was used to analyse qualitative data.

Results

Forty-three nurses indicated involvement in a patient safety incident in the previous five years with 27 nurses completing the survey. Thirty-seven percent reported experiencing psychological distress and 33% physical symptoms. Only 4% reported experiencing weak colleague support while 22% reported poor supervisor and 56% poor organisational support. Qualitative data from seven interviews revealed five themes identified included the Education and training; Environment surrounding the event; Burden of reporting; a ‘You’ve just got to get on with it’ culture; and Ways to action positive change.

Conclusion

Empathy and support from trained peer support colleagues were key elements to recovery of nurses who identified as second victims. The role of culture, and family values and beliefs in support of second victims need further investigation. Support programs need to address, not only psychological consequences of a patient safety event on the nurse, but also physical ramifications. Support of supervisors and organisations following a patient safety event may facilitate retention of nurses. The role of education and training in support programs requires further investigation.
目的在这项研究中，研究人员调查了有效支持计划的经验和关键要素，这些计划促进了澳大利亚第二受害者护士的康复。设计顺序解释混合方法调查确定为第二受害者的护士的经历，包括获得的支持和任何教育和培训。方法采用问卷调查法和深度访谈法收集资料。使用描述性和非参数检验分析调查数据，并使用专题分析分析定性数据。结果43名护士表示在过去5年中参与过患者安全事件，其中27名护士完成了调查。37%的人报告有心理困扰，33%的人有身体症状。只有4%的人表示同事支持不足，22%的人表示上级支持不足，56%的人表示组织支持不足。七次访谈的定性数据揭示了确定的五个主题，包括教育和培训；活动周边环境；报告负担；a“你必须坚持下去”的文化；以及采取积极改变的方法。结论经培训的同伴支持同事的同情和支持是第二受害者护士康复的关键因素。文化、家庭价值观和信仰在支持第二受害者方面的作用需要进一步调查。支持项目不仅需要解决病人安全事件对护士的心理影响，还需要解决身体影响。在患者安全事件发生后，主管和组织的支持可能有助于留住护士。教育和培训在支持计划中的作用需要进一步调查。
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引用次数: 0
The effect of gender role stress on psychological distress in pregnant women 性别角色压力对孕妇心理困扰的影响
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-13 DOI: 10.1016/j.apnr.2025.151926
Serap Açıkgöz , Sakine Yılmaz , Sevda Güvenç

Aim

To examine the effect of gender role stress on psychological distress in pregnant women.

Background

Recognition and prevention of potential psychological as well as physiological adversities during pregnancy are critical in terms of reducing their impacts on mother and baby health and developing preventive health services.

Methods

This cross-sectional study was conducted with 182 volunteer pregnant women in Türkiye. Data were collected using a Personal Information Form, an Obstetric Characteristics Information Form, the Feminine Gender Role Stress Scale (FGRSS), and the Kessler Psychological Distress Scale (K10-PDS). Data analysis included independent samples t-test, one-way analysis of variance, Duncan test, Pearson correlation coefficient, and linear regression analysis.

Results

The mean K10-PDS score of the pregnant women was 37.55 ± 8.87, which showed they were likely to have a severe mental disorder. There was a statistically significant difference between scale scores according to education level, perceived income, intervention of people outside the home, marital adjustment, and the presence of a health problem during the current pregnancy (p < 0.05). It was determined that there was a weak negative relationship between the FGRSS and K10-PDS (r = −0.283; p < 0.001) and that feminine gender role stress had an effect on psychological distress (F = 7332; p < 0.001).

Conclusions

The results of the study draw attention to pregnant women's need for psychological support. To reduce the adverse psychological effects of gender role stress on pregnant women in prenatal care services, studies on factors affecting adaptation to the pregnancy process can be planned.
目的探讨性别角色应激对孕妇心理困扰的影响。背景认识和预防怀孕期间潜在的心理和生理逆境对于减少其对母婴健康的影响和发展预防性保健服务至关重要。方法采用横断面研究方法，对182名自愿怀孕的 kiye妇女进行研究。使用个人信息表、产科特征信息表、女性性别角色压力量表（FGRSS）和Kessler心理困扰量表（K10-PDS）收集数据。资料分析采用独立样本t检验、单因素方差分析、Duncan检验、Pearson相关系数和线性回归分析。结果孕妇K10-PDS平均（37.55±8.87）分，可能存在严重的精神障碍。根据教育水平、感知收入、家庭以外的人的干预、婚姻调整和当前怀孕期间是否存在健康问题，量表得分之间存在统计学上的显著差异(p <；0.05)。结果表明，FGRSS与K10-PDS呈弱负相关(r = - 0.283；p & lt;0.001)，女性性别角色压力对心理困扰有影响(F = 7332；p & lt;0.001)。结论本研究结果引起人们对孕妇心理支持需求的重视。为了减少产前护理服务中性别角色压力对孕妇的不良心理影响，可以有计划地研究影响怀孕过程适应的因素。
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引用次数: 0
Nurses' competence and needs to assist advance directives for institutionalized people with dementia and their family 护士的能力和需要协助预先指示的机构与痴呆症患者和他们的家人
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-10 DOI: 10.1016/j.apnr.2025.151924
Hui-Chen Chao , Yen-Lin Chen , Hsiu-Ching Lin , Jing-Jy Wang , Ya-Ping Yang
There is growing recognition of advance directives (AD) in dementia, however a gap remains between their perceived importance and actual implementation. This emphasizes the need to enhance healthcare professionals' support for people with dementia (PWD) with regards to making AD. This study aimed to investigate the competence, difficulties, and support needs of nurses in assisting institutionalized PWD to make AD. This mixed methods study included both quantitative and qualitative data analysis. Purposive sampling was used to recruit potential participants, and a self-developed questionnaire was used for data collection. Data were analyzed using descriptive statistics and t-test for quantitative information, and content analysis for qualitative information. A total of 188 questionnaires from 19 institutions were completed. The scores of knowledge, attitudes and skills in assisting PWD with making AD were 33.9, 39.4 and 39.5, respectively. The nurses stated that the difficulties in assisting PWD with making AD were a lack of relevant expertise, understanding the AD, and that they were unsure of how to handle conflicting viewpoints within the family. More in-service training and online courses on dementia and AD were required, as well as the creation of health education pamphlets and patient decision aids to help PWD and their families make decisions about AD. The results of this study can serve as a reference for understanding the competencies, improvements, needed support and in-service education of nurses in an institutional setting to assist PWD with making AD. We recommend the promotion of AD through related leading associations and their institutions.
人们越来越多地认识到预先指示（AD）在痴呆症中，然而，他们的重要性和实际执行之间仍然存在差距。这强调需要加强医疗保健专业人员对痴呆症患者（PWD）的支持，以制定AD。本研究旨在探讨护理人员协助院舍残疾人士进行辅助护理的能力、困难及支持需求。这项混合方法的研究包括定量和定性数据分析。采用目的性抽样方法招募潜在参与者，采用自行编制的问卷进行数据收集。定量信息采用描述性统计和t检验，定性信息采用内容分析。共完成了来自19所院校的188份问卷。在协助残疾人士作出决策的知识、态度及技能得分分别为33.9分、39.4分及39.5分。护士表示，在协助残疾人士作出护理决定时，困难在于缺乏相关的专业知识、不了解护理计划，以及不知道如何处理家庭内部的意见冲突。需要更多关于痴呆症和阿尔茨海默病的在职培训和在线课程，以及编写健康教育小册子和患者决策辅助工具，以帮助残疾人及其家属对阿尔茨海默病作出决定。本研究结果可为了解护理机构护士的能力、改善、所需支持及在职教育，协助残疾人士作出护理决定提供参考。我们建议通过相关的主要协会及其机构来推广AD。
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引用次数: 0
Factors influencing digital health competence among healthcare professionals: A cross-sectional study 影响医疗保健专业人员数字健康能力的因素：一项横断面研究
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-08 DOI: 10.1016/j.apnr.2025.151922
Goran ERFANI , Jemma McCREADY , Beckie GIBSON , Bethany NICHOL , John UNSWORTH , Erika JARVA , Kristina MIKKONEN , Marco TOMIETTO

Background

Improving healthcare professionals' digital health competence is critical to providing safer care. However, there is still a lack of empirical studies exploring the factors influencing healthcare professionals' digital health competence, even though significant investments have been made to advance digitalisation of healthcare globally.

Aim

This study aimed to identify the key characteristics influencing healthcare professionals' digital health competence.

Methods

Cross-sectional data was collected from 252 healthcare professionals using two instruments measuring the digital health competences and the associated educational and organisational factors in 2024 via an online and paper-based survey. Univariate and binary logistic regression analyses were performed to identify the key characteristics influencing digital health competence.

Results

Higher levels of education, working in a hospital, more professional experience, and increased use of digital solutions at work or during free time were associated with higher digital health competence. Higher qualifications were linked to greater digital health competence across several factors, with postgraduate degrees increasing health-related counselling competence and undergraduate degrees enhancing work-related attitudes and evaluating digital solutions. Professionals with university qualifications and those working in hospital settings showed higher ICT competence, while more years of professional experience increased ethical competence in using digital solutions.

Conclusions

Digital health competence development should prioritise healthcare professionals with lower educational levels. Additionally, such initiatives should include supporting those who work in non-hospital settings, have less professional experience, and use digital solutions less frequently at work or in their free time. Professional experience increases ethical competence in using digital solutions. Continuous professional development interventions and organisational policies should consider these factors to improve healthcare professionals' digital health competences.
提高医疗保健专业人员的数字健康能力对于提供更安全的护理至关重要。然而，尽管在推动全球医疗保健数字化方面进行了大量投资，但仍缺乏探索影响医疗保健专业人员数字健康能力的因素的实证研究。目的本研究旨在找出影响医疗保健专业人员数字健康能力的关键特征。方法通过在线和纸质调查，使用两种工具收集了252名医疗保健专业人员的横断面数据，以测量2024年的数字健康能力以及相关的教育和组织因素。采用单变量和二元逻辑回归分析来确定影响数字健康能力的关键特征。结果较高的教育水平、在医院工作、更多的专业经验以及在工作或空闲时间更多地使用数字解决方案与较高的数字健康能力相关。更高的学历与更强的数字健康能力有关，涉及多个因素，研究生学位提高了与健康相关的咨询能力，本科学位提高了与工作相关的态度和评估数字解决方案。具有大学学历的专业人员和在医院工作的专业人员显示出更高的信息通信技术能力，而更多年的专业经验提高了使用数字解决方案的道德能力。结论数字化卫生能力发展应优先考虑低学历卫生保健人员。此外，此类举措应包括支持那些在非医院环境中工作、专业经验较少、在工作或空闲时间较少使用数字解决方案的人员。专业经验增加了使用数字解决方案的道德能力。持续的专业发展干预措施和组织政策应考虑这些因素，以提高医疗保健专业人员的数字健康能力。
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引用次数: 0
Text-based fall prediction in hospital: Development and internal validation of a model to predict in-hospital falls in older patients using free text from daily nursing records 基于文本的住院跌倒预测：利用日常护理记录中的免费文本预测老年患者住院跌倒的模型的开发和内部验证
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-08 DOI: 10.1016/j.apnr.2025.151923
Marjolein Groeneveld , Wendy L.M. Leurs , Arthur R.A. Bouwman , Jimmy Schenk , Loes Lammers , Angelique Dierick , Erik Korsten , Carolien C.M.J. van der Linden

Aim

The aim of this study was to evelop a predictive model, estimating the probability of an in-hospital fall using previously identified associated words, and word combinations in daily nursing records. To assess the difference in discriminatory ability between the predictive model and currently used screening questions.

Background

Hospital falls are a persistent challenge. Identifying patients at high risk before fall incidents occur is essential to optimize preventive measures and reduce the burden on nursing staff.

Method

Words from daily nursing records were used as predictive variables to construct and validate the model. The DeLong's test was used to determine statistical differences between the developed model and the current screening questions.

Results

A total of 3255 consecutive admissions of patients aged 70 and over were included, of whom 110 experiences a fall. Upon internal validation, the predictive text model demonstrated moderate discriminatory ability (AUC-ROC 0. 737 (CI 95 % 0. 683–0.791)) and good calibration across a range of the risk groups. Compared to the screening questions (AUC-ROC 0.603 (CI 95 % 0.555–0.652)) the text model (AUC-ROC 0.734 (CI 95 % 0.679–0.788)) showed significantly better discriminatory ability (DeLong's − 3.93, p ≤0.001).

Conclusion

Daily nursing records can be used to estimate the probability of in-hospital falls. A text-based predictive model outperforms the currently employed screening questions and provides insights for the efficient use of fall prevention interventions. Further research should focus on improving the accuracy and external validation of the model and implementation strategies.
目的本研究的目的是建立一个预测模型，使用先前识别的相关单词和日常护理记录中的单词组合来估计住院跌倒的概率。评估预测模型与目前使用的筛选问题在区分能力上的差异。医院跌倒是一个持续的挑战。在跌倒事件发生之前识别高危患者对于优化预防措施和减轻护理人员的负担至关重要。方法以日常护理记录为预测变量，构建并验证模型。使用DeLong检验来确定开发的模型与当前筛选问题之间的统计差异。结果共纳入3255例70岁及以上连续入院患者，其中110例发生跌倒。经内部验证，预测文本模型具有中等的区分能力(AUC-ROC为0。（ci 95%）；683-0.791))和在一系列风险组之间进行良好的校准。与筛选题（AUC-ROC 0.603 (CI 95% 0.555-0.652)）相比，文本模型（AUC-ROC 0.734 (CI 95% 0.679-0.788)）具有更好的区分能力（DeLong’s - 3.93, p≤0.001）。结论日常护理记录可用于评估住院跌倒的发生概率。基于文本的预测模型优于目前使用的筛选问题，并为有效使用预防跌倒干预措施提供了见解。进一步的研究应侧重于提高模型和实施策略的准确性和外部验证。
{"title":"Text-based fall prediction in hospital: Development and internal validation of a model to predict in-hospital falls in older patients using free text from daily nursing records","authors":"Marjolein Groeneveld ,&nbsp;Wendy L.M. Leurs ,&nbsp;Arthur R.A. Bouwman ,&nbsp;Jimmy Schenk ,&nbsp;Loes Lammers ,&nbsp;Angelique Dierick ,&nbsp;Erik Korsten ,&nbsp;Carolien C.M.J. van der Linden","doi":"10.1016/j.apnr.2025.151923","DOIUrl":"10.1016/j.apnr.2025.151923","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of this study was to evelop a predictive model, estimating the probability of an in-hospital fall using previously identified associated words, and word combinations in daily nursing records. To assess the difference in discriminatory ability between the predictive model and currently used screening questions.</div></div><div><h3>Background</h3><div>Hospital falls are a persistent challenge. Identifying patients at high risk before fall incidents occur is essential to optimize preventive measures and reduce the burden on nursing staff.</div></div><div><h3>Method</h3><div>Words from daily nursing records were used as predictive variables to construct and validate the model. The DeLong's test was used to determine statistical differences between the developed model and the current screening questions.</div></div><div><h3>Results</h3><div>A total of 3255 consecutive admissions of patients aged 70 and over were included, of whom 110 experiences a fall. Upon internal validation, the predictive text model demonstrated moderate discriminatory ability (AUC-ROC 0. 737 (CI 95 % 0. 683–0.791)) and good calibration across a range of the risk groups. Compared to the screening questions (AUC-ROC 0.603 (CI 95 % 0.555–0.652)) the text model (AUC-ROC 0.734 (CI 95 % 0.679–0.788)) showed significantly better discriminatory ability (DeLong's − 3.93, <em>p</em> ≤0.001).</div></div><div><h3>Conclusion</h3><div>Daily nursing records can be used to estimate the probability of in-hospital falls. A text-based predictive model outperforms the currently employed screening questions and provides insights for the efficient use of fall prevention interventions. Further research should focus on improving the accuracy and external validation of the model and implementation strategies.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"82 ","pages":"Article 151923"},"PeriodicalIF":2.7,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The content analysis used in nursing research and the possibility of including artificial intelligence support: A methodological review 护理研究中使用的内容分析及包括人工智能支持的可能性：方法学回顾
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-04 DOI: 10.1016/j.apnr.2025.151919
Agnieszka Maj , Marta Makowska , Katarzyna Sacharczuk

Background

This article explores how AI supports nurses by employing content analysis for scientific nursing research.

Methods

A narrative literature review was conducted.

Results

The article summarizes the knowledge known about content analysis and outlines qualitative and quantitative content analysis concepts and simplifies the issues related to the coding process. It explains how to identify and assess quality during content analysis and gives examples of topics that can be investigated using it, especially in the field of nursing.

Conclusions

Knowledge of AI capabilities is needed to make positive use of it. These capabilities change very quickly and require constant knowledge updates. Legal and ethical regulations concerning the use of technology are still lacking, so AI outputs still require human verification of them.
本文探讨人工智能如何通过内容分析来支持护士进行科学的护理研究。方法采用叙事文献法。结果总结了内容分析的已知知识，概述了定性和定量的内容分析概念，简化了编码过程中的相关问题。它解释了如何在内容分析中识别和评估质量，并给出了可以使用它进行调查的主题示例，特别是在护理领域。结论要积极利用人工智能，需要了解人工智能的能力。这些功能变化非常快，需要不断更新知识。关于技术使用的法律和道德规范仍然缺乏，因此人工智能输出仍然需要人工验证。
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引用次数: 0
Development and usability evaluation of a nurse-led clinical decision support system (AI-AntiDelirium) for management of intensive care unit delirium: A mixed methods study 重症监护病房谵妄管理的护士主导临床决策支持系统（AI-AntiDelirium）的开发和可用性评估：一项混合方法研究
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-04 DOI: 10.1016/j.apnr.2025.151921
Shan Zhang , Shu Ding , Wei Cui , Xiangyu Li , Jun Wei , Ying Wu

Background

Clinical decision support systems (CDSS) have been identified to aid clinical decision-making, but few studies focus on the application of CDSS in intensive care unit (ICU) delirium, and particularly usability testing is not employed. We aimed to develop and conduct usability testing of Artificial Intelligence Assisted Prevention and Management for Delirium (AI-AntiDelirium), a CDSS designed to identify delirium and modifiable risk factors and prevent and manage delirium in the ICU.

Methods

Between January and April 2021, a cross-sectional study including 117 ICU nurses recruited for usability testing from four ICUs in two university-affiliated hospitals was conducted. The development of AI-AntiDelirium included needs assessment, function design, iterative design, agile development, and usability testing using the Delirium System Usability Evaluation Scale (Delirium-SUES).

Results

Based on the needs assessment, AI-AntiDelirium was developed to contain four main modules—delirium assessment tools, risk-factor assessment, nursing care plan, and care activity list—and was designed to provide individualized interventions based on patient risk factors. The mean Delirium-SUES score was 184.64 (full score: 210), indicating that AI-AntiDelirium was acceptable in terms of usefulness, ease of use, attitude, use tendency, and long-term effects.

Conclusions

Our study developed AI-AntiDelirium, a CDSS perceived as useful and easy to use. Incorporating usability evaluation when designing AI-AntiDelirium may be effective in and enhancing clinical staff use.
临床决策支持系统（CDSS）已被确定用于辅助临床决策，但很少有研究关注CDSS在重症监护病房（ICU）谵妄中的应用，特别是没有使用可用性测试。我们的目标是开发并进行人工智能辅助预防和管理谵妄（AI-AntiDelirium）的可用性测试，这是一个CDSS，旨在识别谵妄和可改变的风险因素，并预防和管理ICU中的谵妄。方法于2021年1月至4月，从两所大学附属医院的4个ICU中招募117名ICU护士进行可用性测试。AI-AntiDelirium的开发包括需求评估、功能设计、迭代设计、敏捷开发和使用Delirium系统可用性评估量表（Delirium- sues）进行可用性测试。结果基于需求评估，AI-AntiDelirium包含谵妄评估工具、风险因素评估、护理计划和护理活动清单四个主要模块，旨在根据患者的风险因素提供个性化干预。平均Delirium-SUES评分为184.64分（满分：210分），表明AI-AntiDelirium在有用性、易用性、态度、使用倾向和长期效果方面是可以接受的。结论本研究开发了AI-AntiDelirium，这是一种实用且易于使用的CDSS。在设计AI-AntiDelirium时纳入可用性评估可能会有效提高临床工作人员的使用。
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引用次数: 0
Measuring self-care in the general adult population: Cross-validation of the Self-care Inventory 测量一般成年人的自我照顾：自我照顾量表的交叉验证
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-02 DOI: 10.1016/j.apnr.2025.151920
Michela Luciani , Maddalena De Maria , Claudio Barbaranelli , Paola Claudia Fazio , Barbara Riegel , Davide Ausili

Introduction

Self-care is essential for health promotion, disease management and social justice. Robust, theory-based tools are needed for its measurement. The Self-care Inventory (SCI) was developed to measure self-care behaviours in adults regardless of their health status. The aims of this study are to measure validity of the SCI in an Italian sample and measurement equivalence in US and Italian samples.

Methods

We recruited 340 Italian and 294 US adults with convenience sampling. The Self-care Inventory, new General Self-Efficacy Scale, Positivity Scale, Perceived Stress Scale, and a clinical and sociodemographic questionnaire were administered online. Confirmatory factor analysis (CFA) was used to assess the factor structure of the SCI. Measurement equivalence testing was conducted using Multiple Group Confirmatory Factor Analysis, testing configural, metric, scalar, and strict invariance. For the Italian version of the SCI, reliability and construct validity were also tested.

Results

The SCI factorial structure was confirmed by CFA in the Italian sample. As for measurement equivalence, the Self-care maintenance scale demonstrated full metric and partial scalar invariance, indicating similar cognitive frameworks between US and Italian respondents. The Self-care Monitoring and Self-care Management scales achieved partial metric invariance. Reliability indices were satisfactory: Cronbach’s alpha and Global Reliability Index ranged from 0.69 to 0.84, and test-retest reliability values ranged from 0.70 to 0.84. Construct validity was supported by significant correlations between SCI scales and measures of self-efficacy, positivity, and perceived stress.

Conclusion

The SCI is valid and reliable for measuring self-care behaviours in the Italian population. Measurement equivalence show that SCI can be used cross-culturally and results from Italian and US samples are comparable. Our results support the use of the SCI in national and international self-care research and practice.Keywords: self-care, general adult population, measurement equivalence, validity, reliability.
自我保健对健康促进、疾病管理和社会公正至关重要。它的测量需要稳健的、基于理论的工具。自我照顾量表（SCI）被开发用来测量成人的自我照顾行为，无论他们的健康状况如何。本研究的目的是测量SCI在意大利样本的效度以及美国和意大利样本的测量等效性。方法采用方便抽样法，招募意大利成年人340人，美国成年人294人。自我护理量表、新一般自我效能量表、积极性量表、感知压力量表以及临床和社会人口学问卷在线进行。采用验证性因子分析（CFA）评估脊髓损伤的因子结构。采用多组验证性因子分析进行测量等效性检验，检验结构、度量、标量和严格不变性。对意大利语版SCI进行了信度和构念效度测试。结果意大利样本经CFA证实了SCI的析因结构。在测量等效性方面，自我护理维持量表表现出完全度量和部分标量不变性，表明美国和意大利受访者的认知框架相似。自我保健监测和自我保健管理量表实现了部分度量不变性。信度指标令人满意：Cronbach’s alpha和Global Reliability Index在0.69 ~ 0.84之间，重测信度值在0.70 ~ 0.84之间。建构效度在SCI量表与自我效能感、积极性和感知压力之间具有显著的相关性。结论SCI测量意大利人群的自我护理行为是有效可靠的。测量等效性表明SCI可以跨文化使用，意大利和美国样本的结果具有可比性。我们的研究结果支持SCI在国内和国际自我护理研究和实践中的应用。关键词：自我保健；普通成人；测量等效性；
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引用次数: 0
Family caregivers' perception of pressure ulcer prevention devices and equipment for patients with cerebrovascular and spinal disease 家庭照顾者对脑血管及脊柱疾病患者压疮预防装置及设备的认知。
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-01 DOI: 10.1016/j.apnr.2024.151893
Hyein Choi , Sunghee H. Tak

Background

Family caregivers play a crucial role in preventing pressure ulcers in patients with cerebrovascular and spinal diseases. Despite the availability of advanced devices, including Internet of Things(IoT) based smart mattresses, the adoption and effectiveness of these technologies are influenced by caregivers' experiences and perceptions.

Objective

To investigate the experiences and perceptions of family caregivers regarding pressure ulcer prevention devices and equipment, with a focus on the factors influencing the intention to adopt IoT-based smart mattresses.

Design

A cross-sectional survey study.

Setting(s) and participants

159 family caregivers of patients with cerebrovascular and spinal diseases, who had experiences with pressure ulcer prevention devices.

Methods

Data for this study were collected through survey questionnaires. Descriptive statistics, frequency analysis and multiple regression analysis were conducted.

Results

Caregivers reported using an average of 1.69 types of pressure ulcer prevention equipment, with cushions (37.7 %) and mattresses (44.0 %) being the most commonly used. Ease of use and comfort were identified as key factors contributing to their satisfaction. The multiple regression model (R2 = 0.54, p < .001) revealed that ease of use (p < .01), perceived usefulness (p < .01), and perceived necessity (p < .01) were significant predictors of participants' intention to adopt smart mattresses. In addition, the number of digital devices owned by caregivers was positively associated with the intention to adopt smart mattress (p < .001).

Conclusions

The findings of this study show the importance of usability and digital inclusion in the adoption of smart health technologies by caregivers. A user-centered approach to device development is recommended to better meet the practical needs of family caregivers.
背景：家庭照顾者在预防脑血管和脊柱疾病患者的压疮中起着至关重要的作用。尽管有先进的设备，包括基于物联网（IoT）的智能床垫，但这些技术的采用和有效性受到护理人员的经验和看法的影响。目的：了解家庭护理人员对压疮预防器械和设备的体验和认知，重点分析影响家庭护理人员采用物联网智能床垫意愿的因素。设计：横断面调查研究。环境和参与者：159名脑血管和脊柱疾病患者的家庭照顾者，他们有使用压疮预防装置的经历。方法：本研究采用问卷调查的方式收集资料。进行描述性统计、频率分析和多元回归分析。结果：护理人员平均使用1.69种压疮预防设备，其中最常用的是坐垫（37.7%）和床垫（44.0%）。易用性和舒适性被确定为影响他们满意度的关键因素。结论：本研究结果表明可用性和数字包容对护理人员采用智能健康技术的重要性。建议采用以用户为中心的方法来开发设备，以更好地满足家庭照顾者的实际需求。
{"title":"Family caregivers' perception of pressure ulcer prevention devices and equipment for patients with cerebrovascular and spinal disease","authors":"Hyein Choi ,&nbsp;Sunghee H. Tak","doi":"10.1016/j.apnr.2024.151893","DOIUrl":"10.1016/j.apnr.2024.151893","url":null,"abstract":"<div><h3>Background</h3><div>Family caregivers play a crucial role in preventing pressure ulcers in patients with cerebrovascular and spinal diseases. Despite the availability of advanced devices, including Internet of Things(IoT) based smart mattresses, the adoption and effectiveness of these technologies are influenced by caregivers' experiences and perceptions.</div></div><div><h3>Objective</h3><div>To investigate the experiences and perceptions of family caregivers regarding pressure ulcer prevention devices and equipment, with a focus on the factors influencing the intention to adopt IoT-based smart mattresses.</div></div><div><h3>Design</h3><div>A cross-sectional survey study.</div></div><div><h3>Setting(s) and participants</h3><div>159 family caregivers of patients with cerebrovascular and spinal diseases, who had experiences with pressure ulcer prevention devices.</div></div><div><h3>Methods</h3><div>Data for this study were collected through survey questionnaires. Descriptive statistics, frequency analysis and multiple regression analysis were conducted.</div></div><div><h3>Results</h3><div>Caregivers reported using an average of 1.69 types of pressure ulcer prevention equipment, with cushions (37.7 %) and mattresses (44.0 %) being the most commonly used. Ease of use and comfort were identified as key factors contributing to their satisfaction. The multiple regression model (R<sup>2</sup> = 0.54, <em>p</em> &lt; .001) revealed that ease of use (<em>p</em> &lt; .01), perceived usefulness (<em>p</em> <em>&lt;</em> .01), and perceived necessity (<em>p</em> <em>&lt;</em> .01) were significant predictors of participants' intention to adopt smart mattresses. In addition, the number of digital devices owned by caregivers was positively associated with the intention to adopt smart mattress (<em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>The findings of this study show the importance of usability and digital inclusion in the adoption of smart health technologies by caregivers. A user-centered approach to device development is recommended to better meet the practical needs of family caregivers.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"81 ","pages":"Article 151893"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the perspectives of early-stage postoperative glioblastoma patients and their caregivers on end-of-life care planning: An exploratory qualitative interview study 探讨胶质母细胞瘤术后早期患者及其护理者对临终关怀计划的看法：一项探索性质的访谈研究。
IF 2.7 4区 医学 Q1 NURSING
Applied Nursing Research
Pub Date : 2025-02-01 DOI: 10.1016/j.apnr.2024.151897
Chia-Yi Chien , Lu-Ting Kuo , Cheng-Pei Lin

Aim

Compare the convergent and divergent viewpoints of early-stage postoperative patients with glioblastoma and their caregivers on end-of-life care planning in Taiwan.

Background

Decision-making capacity in patients with glioblastoma may be compromised as disease progresses, making early future care planning essential to ensure that the provided care aligns with patients' goals. However, within many Asian cultures, the tendency to avoid discussions about death can lead patients to feel hesitant about addressing end-of-life care options. This reluctance may impact the quality of care provided and increase the surrogate decision-making burden on caregivers.

Methods

An exploratory qualitative study with semi-structured qualitative interviews was conducted on early-stage postoperative glioblastoma–caregiver dyads at a medical center in Northern Taiwan informed by social constructivism. Thematic analysis with analytical rigor enhanced by dual coders and exploration of convergent and divergent views.

Results

We interviewed 7 patient–caregiver dyads (n = 14). More than half of patients were male (median age: 62 y/o). Primary Caregivers were primarily their spouses (median age: 47 y/o). Convergent viewpoints include death-prolonging treatment refusal, end-of-life fulfillment, timing of end-of-life care discussions, end-of-life concerns, and advance end-of-life care arrangement. Divergent viewpoints include life value (quality vs. quantity), lack transparent and shared discussions (explicit vs. implicit), and decision-making paradigm (individualistic vs. collective).

Conclusions

Early end-of-life care discussions for patients with glioblastoma are crucial to address differing values and cultural emphasis on family harmony. Transparent communication reduces caregiver stress and supports informed decisions on advance care planning, symptom management, and financial or social support.
目的：比较台湾地区胶质母细胞瘤术后早期患者及其照护者对临终关怀计划的认同与分歧。背景：胶质母细胞瘤患者的决策能力可能会随着疾病的进展而降低，因此早期的未来护理计划对于确保提供的护理符合患者的目标至关重要。然而，在许多亚洲文化中，避免讨论死亡的倾向会导致患者在处理临终关怀选择时感到犹豫。这种不情愿可能会影响所提供护理的质量，并增加护理人员的替代决策负担。方法：采用半结构化质性访谈法，对台湾北部某医疗中心术后早期胶质母细胞瘤护理者进行探索性质性研究。专题分析与分析的严谨性加强了双重编码和探索趋同和分歧的观点。结果：我们采访了7对患者-护理者（n = 14）。超过一半的患者为男性（中位年龄：62岁）。主要照顾者主要是他们的配偶（年龄中位数：47岁）。趋同的观点包括拒绝延长死亡治疗、临终关怀的实现、临终关怀讨论的时机、临终关怀的关注和提前临终关怀的安排。分歧的观点包括生命价值（质量vs数量），缺乏透明和共享的讨论（显性vs隐性），以及决策范式（个人主义vs集体主义）。结论：胶质母细胞瘤患者的早期临终关怀讨论对于解决不同的价值观和强调家庭和谐的文化至关重要。透明的沟通减少了护理人员的压力，并支持在预先护理计划、症状管理以及经济或社会支持方面做出明智的决定。
{"title":"Exploring the perspectives of early-stage postoperative glioblastoma patients and their caregivers on end-of-life care planning: An exploratory qualitative interview study","authors":"Chia-Yi Chien ,&nbsp;Lu-Ting Kuo ,&nbsp;Cheng-Pei Lin","doi":"10.1016/j.apnr.2024.151897","DOIUrl":"10.1016/j.apnr.2024.151897","url":null,"abstract":"<div><h3>Aim</h3><div>Compare the convergent and divergent viewpoints of early-stage postoperative patients with glioblastoma and their caregivers on end-of-life care planning in Taiwan.</div></div><div><h3>Background</h3><div>Decision-making capacity in patients with glioblastoma may be compromised as disease progresses, making early future care planning essential to ensure that the provided care aligns with patients' goals. However, within many Asian cultures, the tendency to avoid discussions about death can lead patients to feel hesitant about addressing end-of-life care options. This reluctance may impact the quality of care provided and increase the surrogate decision-making burden on caregivers.</div></div><div><h3>Methods</h3><div>An exploratory qualitative study with semi-structured qualitative interviews was conducted on early-stage postoperative glioblastoma–caregiver dyads at a medical center in Northern Taiwan informed by social constructivism. Thematic analysis with analytical rigor enhanced by dual coders and exploration of convergent and divergent views.</div></div><div><h3>Results</h3><div>We interviewed 7 patient–caregiver dyads (<em>n</em> = 14). More than half of patients were male (median age: 62 y/o). Primary Caregivers were primarily their spouses (median age: 47 y/o). Convergent viewpoints include death-prolonging treatment refusal, end-of-life fulfillment, timing of end-of-life care discussions, end-of-life concerns, and advance end-of-life care arrangement. Divergent viewpoints include life value (quality vs. quantity), lack <em>transparent and shared discussions</em> (explicit vs. implicit), and decision-making paradigm (individualistic vs. collective).</div></div><div><h3>Conclusions</h3><div>Early end-of-life care discussions for patients with glioblastoma are crucial to address differing values and cultural emphasis on family harmony. Transparent communication reduces caregiver stress and supports informed decisions on advance care planning, symptom management, and financial or social support.</div></div>","PeriodicalId":50740,"journal":{"name":"Applied Nursing Research","volume":"81 ","pages":"Article 151897"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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