JMIR nursing最新文献

Background: Burnout among health care workers affects their well-being and decision-making, influencing patient and public health outcomes. Health care workers' health beliefs and COVID-19 vaccine decisions may affect the risks of burnout. Therefore, understanding the interplay between these crucial factors is essential for identifying at-risk staff, providing targeted support, and addressing workplace challenges to prevent further escalation of burnout-related issues.

Objective: This study examines how burnout is impacted by health beliefs and COVID-19 vaccine decisions among health care workers. Building on our previously developed Health Belief Model (HBM) classifier based on the HBM framework, which explains how individual perceptions of health risks and benefits influence behavior, we focused on key HBM constructs, including the perceived severity of COVID-19, perceived barriers to vaccination, and their relationship to burnout. We aim to leverage natural language processing techniques to automatically identify theoretically grounded burnout symptoms from comments authored by nurses in a large-scale, national survey and assess their associations with vaccine hesitancy and health beliefs.

Methods: We analyzed 1944 open-ended comments written by 1501 vaccine-hesitant nurses, using data from the Nurses' Health Study surveys. We fine-tuned LLaMA 3, an open-source large language model with few-shot prompts and enhanced performance with structured annotation guidance and reasoning-aware inference. Comments were classified into burnout dimensions-Emotional Exhaustion, Depersonalization, and Inefficacy-based on the Maslach Burnout Inventory framework.

Results: The model achieved a high weighted accuracy of 92% and an F1-score of 91% for Depersonalization. Emotional Exhaustion was identified in 52% (1003/1944) of comments, correlating strongly with perceived severity (189/323, 59%) and barriers to vaccination (281/650, 43%). Demographic analyses revealed significant variations in burnout prevalence, with older age groups reporting greater burnout.

Conclusions: This study highlights the relationship between burnout and vaccine decision-making among health care workers, uncovering areas for further exploration. By exploring the complex interplay between psychological strain and vaccine hesitancy, this study sets the stage for developing transformative interventions and policies that could redefine workforce resilience and public health strategies.

Background: Professionals across caring disciplines have played a significant role in the development of virtual care, which uses remote technologies to offer support and services from a distance. As virtual care becomes increasingly essential, instructors must ensure that students are equipped with both interpersonal abilities and digital competencies, merging traditional hands-on methods with web-based learning. Despite its growing importance, there is a lack of comprehensive frameworks to guide the design and delivery of web-based learning experiences that foster the development of virtual caring skills and competencies among students in caring professions.

Objective: This study aims to develop an evidence-informed framework to support web-based teaching and learning of virtual caring skills and competencies.

Methods: We present a synthesis of our research resulting in an evidence-informed framework. We integrated findings from an evidence synthesis, surveys, and semistructured interviews with students and educators, and consultations with key stakeholders.

Results: Principles of this framework include (1) connection and interaction; (2) compassion, empathy, and care; (3) vulnerability; (4) a client-centered focus; (5) inclusivity and accessibility; and (6) flexibility. The framework's four main domains are (1) virtual caring skills; (2) teaching and learning methods; (3) barriers to teaching, learning, and providing virtual care; and (4) facilitators of teaching, learning, and providing virtual care.

Conclusions: This framework was developed by and for students and educators to aid in planning, promoting, and enhancing virtual caring skills development. It can be used to better equip students to provide virtual care, thereby positively impacting client care and outcomes. This framework can support educators, students, decision makers, and practice partners to build learning experiences aimed at preparing students to provide virtual care effectively.

Background: Gamification has emerged as an innovative pedagogical strategy in the educational field, transferring game tools to the teaching-learning process to improve students' motivation and engagement.

Objective: This study aims to describe nursing students' perceptions of mental disorders using interactive cards as a gamification tool.

Methods: This research was carried out at the Nursing School of a University in Madrid, Spain, with the participation of 50 first-year students enrolled in the nursing degree's general and developmental psychology course. Data were collected through focus groups and reflective narratives with semistructured interview questions between March and April 2024. After data collection, transcripts were generated and subjected to thematic analysis following the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

Results: A total of three themes emerged from the analysis: (1) perception and stigma of mental disorders, (2) emotional connection and personal reflection in learning about mental disorders, and (3) gamification tools and their impact on learning.

Conclusions: Gamification, especially through interactive cards, is valuable for teaching psychology and mental disorders in nursing education. It enables students to gain a deeper clinical understanding of mental illnesses and explore their emotional and social dimensions. This methodology fosters emotional reflection, reduces stigma, and encourages active engagement, contributing to developing more empathetic, reflective, and better-prepared nursing professionals. Its integration into educational programs enhances academic and humanistic competencies essential for mental health care.

Background: Midwifery students often experience anxiety due to several factors, such as the clinical experiences faced. Simulation-based learning in nursing and midwifery studies using extended reality (XR) tools offers the opportunity to manage better educational processes while reducing this anxiety.

Objective: This study aims to evaluate the current knowledge and understanding of how the use of XR gesture-simulation-based tools allows a better understanding of the anxiety levels of midwives and nurses in educational settings.

Methods: We conducted a systematic review, a scientific literature search following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Using PubMed, IEEE, Scopus, and Web of Science, up to March 2024, 1005 articles were found to identify studies that reported the effectiveness of these technologies for gesture simulation in education and training on nursing and midwifery student anxiety. The inclusion-exclusion criteria were based on the PICO (population, intervention, control, and outcomes) framework. The population included nurses, midwives, and nursing and midwifery students of any kind using any virtual or augmented or mixed reality simulation training tool to perform a procedure aimed at reducing anxiety. In addition, the Cochrane risk of bias tool was used to evaluate the quality of the systematic review and the bias in the included studies. A narrative synthesis was conducted due to the heterogeneity of study designs and outcome measures. Key findings were summarized in a structured table and grouped according to the learning objective, simulating and performing procedures in an educational setting.

Results: Overall, 7 articles, involving a total of 428 participants, were included in this review. The findings indicate that XR can effectively reduce anxiety in midwifery and nursing education. However, the limited number of studies highlights a research gap in the field, particularly in the area of mixed reality, which warrants further exploration.

Conclusions: This systematic review highlights the potential of XR-based gesture-simulation tools in reducing anxiety among midwifery and nursing students. The included studies suggest that XR-enhanced training provides a more immersive and controlled learning environment, helping students manage stress and improve procedural confidence. However, the limited number of studies, methodological variations, and the underrepresentation of mixed reality applications indicate the need for further research. Future studies should focus on standardized anxiety measurement tools, larger sample sizes, and long-term impact assessments to strengthen the evidence base. Expanding research in this field could enhance the integration of XR technologies into midwifery and nursing education, ultimately improving both learning experiences and

Background: Diabetes has become a significant global health issue, particularly imposing a deep economic burden on low-income countries. Innovative and integrated digital solutions can reduce the impact of diabetes and enhance the quality of care. However, digital solutions have not been utilized before in Myanmar.

Objective: This study aimed to demonstrate the novel integrated effect of diabetes knowledge and registry tools on the performance of front-line health workers in primary health care settings.

Methods: A quasi-experimental study with an intervention and a control group was conducted in two townships from October 2022 to April 2023. For the first time, researchers trained the intervention group to use digital tools for diabetes control and performed monthly follow-ups. The study employed multiple linear regression models to explore the novel impact of digital tools on knowledge and performance scores, their correlations, and their association with covariates. Additionally, it assessed the cost-effectiveness of the intervention by using self-administered questionnaires as measurement tools formulated based on the National Diabetes Guidelines.

Results: A total of 96 participants were enrolled in the study, divided evenly into the two groups. The intervention group exhibited a significant increase in the mean knowledge scores from 85.81 to 99.25 (P<.001) and performance scores from 71.22 to 107.16 (P<.001). The intervention accounted for 43.2% of the variance in knowledge scores and 62.5% in performance scores (P<.001). A positive correlation was found between knowledge and performance scores (r=0.45, P<.001). The intervention was also cost-effective, with a cost-effectiveness analysis value of 0.711 and an incremental cost-effectiveness ratio of 10127.04 Kyats (US$ 4.83).

Conclusions: As the new integrated intervention yields significant economic gains and positive effects, researchers suggest policy makers replicate this intervention as a nationwide program and recommend scaling up the use of digital tools to improve knowledge and performance for diabetes control in frontline health workers.

Background: Unplanned extubation (UEX) is a critical indicator of nursing care quality. Existing research primarily focuses on pediatric intensive care units (PICUs), with limited data available from general pediatric surgery. Currently, most studies on this topic are mainly focused on PICUs, and there is a lack of research data regarding general pediatric surgery. Therefore, further research should be conducted based on this consideration.

Objective: This study aimed to analyze the high-risk factors for UEX in children and implement appropriate nursing strategies to reduce its incidence, ensuring clinical safety of pediatric patients.

Methods: A retrospective study (January 2018 - December 2023) included pediatric patients with indwelling catheters in general surgery. Exclusion criteria included mental disorders or abnormal Glasgow Coma Scale scores. Data on catheter days, UEX incidents, and risk factors were analyzed.

Results: A total of 1977 catheter days were recorded during the perioperative period, comprising 1079 days with urinary catheters, 768 days with postoperative wound drainage tubes, 68 days with gastric tubes, 46 days with peripheral central venous catheters, and 8 days with central venous catheters. During this period, 13 incidents of UEX occurred, yielding an overall UEX rate of 6.58 per 1000 catheter days. Urinary catheters accounted for the highest proportion of UEX incidents (8/13, 61.5%), followed by gastric tubes (3/13, 21.3%) and postoperative wound drainage tubes (2/13, 15.4%). The reintubation rate following UEX was 15.38% (2/13). Further analysis identified significant risk factors associated with UEX: (1) patient characteristics: age ≤3 years (8/13, 61.5%) and male sex (10/13, 76.9%); (2) clinical management: absence of physical restraints (10/13, 76.9%); and (3) temporal factors: incidents occurring during holidays (9/13, 69.2%). Multivariate analysis revealed that UEX risk was influenced by inter-related factors, including pediatric physiological characteristics (eg, limited self-regulation capacity), suboptimal catheter fixation methods, positional discomfort during patient movement, and variations in nursing interventions (eg, frequency of rounds and caregiver education).

Conclusions: Unplanned extubation in pediatric inpatients represents a critical clinical complication that may compromise treatment efficacy and prolong hospitalization. Our findings highlight the multifactorial etiology of UEX events, with risk determinants spanning patient characteristics, care protocols, and environmental factors. To mitigate these risks, we propose implementing evidence-based multidisciplinary preventive strategies, including standardized risk assessment protocols for high-risk subgroups (eg, male patients aged ≤3 years), enhanced staff training on age-appropriate restraint techniques and securement device utilization

Background: Patients with post-COVID-19 continue to experience lingering physical and psychological symptoms, requiring coordinated and continuous care. Addressing these needs is essential, especially in resource-limited settings.

Objective: The objectives of this paper are to study the issues and needs, as well as the nursing and continuous care systems for residents living with COVID-19, to design and develop a database system, develop continuous care guidelines, and evaluate the effectiveness of the database system for continuous monitoring and care for residents living with COVID-19 in Nakhon Pathom Province, Thailand.

Methods: Participatory action research was used to engage stakeholders and guide the development process.

Results: A total of 375 patients and family members affected by post-COVID-19 symptoms reported that symptoms persisted for approximately 6 months, with common symptoms including persistent cough and easy fatigue. These patients experienced reduced access to health care services, relying mainly on symptomatic treatment at local facilities and using telehealth nursing systems. They expressed a need for continuous care support from 50 professional nurses and village health volunteers. As a result, health care guidelines for post-COVID recovery were developed, comprising 5 core components: (1) self-care through digital information retrieval, (2) care via telehealth nursing systems, (3) physical health care services postrecovery, (4) mental health services postrecovery, and (5) continuous care for referral in case of postrecovery incidents. These guidelines were used to design a database system for continuous monitoring and care, which was evaluated as highly effective (mean 4.51, SD 0.59).

Conclusions: This research highlights the critical need for a proactive and comprehensive approach to managing post-COVID-19 care in Nakhon Pathom Province. By developing and implementing a database system for continuous monitoring and care, along with clear guidelines, the study effectively addresses the ongoing needs of individuals recovering from COVID-19. The integration of technology, along with continuous care provided by professional nurses and village health volunteers, has been shown to be highly effective in improving the quality of care. The findings suggest that adopting these strategies, along with implementing supportive policies on data management and communication systems focused on home visits, will significantly enhance health service management and better prepare the region for future public health challenges.

Background: The growing use of social media has created concerns about addiction, and thus, it is necessary to explore how personality traits and fear of missing out (FOMO) can be utilized to predict social media addiction (SMA).

Objectives: The purpose of this study was to investigate the connection between personality traits, FOMO, and SMA in university students in Saudi Arabia.

Methods: In this cross-sectional study, data were collected from nursing students using the shortened version of the big five inventory, fear of missing out scale, and SMA scale from May to September 2024.

Results: The study achieved a response rate of 66.7% (414/620), finally including a total of 411 participants. The majority of participants (247/411, 60.1%) had low FOMO scores, while SMA scores showed a different pattern, with a larger proportion (261/411, 63.5%) of participants scoring in the moderate range. In terms of gender differences, male participants exhibited higher levels of FOMO (t=3.86, P<.001) and SMA (t=2.51, P=.013) compared to female participants. Additionally, male participants scored higher in neuroticism (t=3.30, P=.001) and openness (t=1.98, P=.048). Regression analysis revealed that both conscientiousness (β=.357, P<.01) and FOMO (β=.213, P<.01) positively predicted SMA, while neuroticism (β=-.223, P<.01) and being female (β=-.098, P<.05) were associated with lower levels of addiction. The resulting model accounted for 35.8% of the variance.

Conclusions: The study provides evidence that conscientiousness and FOMO are positive predictors of SMA, while neuroticism is negatively correlated with it. Moreover, male participants exhibited higher levels of both FOMO and SMA in comparison to female participants. These findings emphasize the impact of personality traits and FOMO on SMA among university students.

Background: The current Information and Communication Technologies, digital literacy, and ease of access to communication and information devices by nurses provide them with new ways and intention to access information for technical-scientific updating, ensuring the quality and safety of health care. M-learning offers a flexible and accessible alternative for continuing professional education, overcoming barriers such as time constraints and financial burden.

Objective: To evaluate the effectiveness of m-learning in nurses' knowledge retention of Chronic Obstructive Pulmonary Disease self-management, using a Massive Open Online Course with integrated virtual clinical simulation.

Methods: A quasi-experimental pre- and post-test study was conducted, with no control group, with 168 nurses from a Portuguese hospital. The intervention included an asynchronous online course with 13 modules. Knowledge retention was assessed by comparing the mean scores before and after the course.

Results: The results indicated a significant increase in knowledge retention. The participants' average score increased from 59.97% in the initial assessment to 84.05% in the final assessment (p<.001). Nurses with a master's degree exhibited a higher level of basic knowledge than those with a bachelor's degree. The course completion rate was 93.45%, reflecting significant engagement attributed to gamification and clinically relevant content.

Conclusions: M-learning is useful in nurses' lifelong learning, offering flexibility and more effective support for clinical practice. Integrating virtual simulation and gamification boosted motivation and reduced drop-out rates, highlighting the potential of m-learning in lifelong learning in healthcare. This study confirms the effectiveness of m-learning in improving knowledge retention in nursing. This strategy is a valuable approach to lifelong learning, promoting quality and safety in delivering healthcare.

Clinicaltrial:

Unlabelled: Each year, nursing informatics researchers contribute to nursing and health informatics knowledge. The year 2024 emerged as yet another year of significant advances. In this editorial, I describe and highlight some of the key trends in nursing informatics research as published in JMIR Nursing in 2024. Artificial intelligence (AI), data science, mobile health (mHealth), and the integration of technology into nursing education and practice remain key research themes in the literature. Nursing informatics publications continue to grow in number. A greater number of AI and data science articles are being published, while at the same time, mHealth and technology research continues to be conducted in nursing education and practice contexts.