The development of digital health services reflects not only the technical development of services but also a change in attitude and the way of thinking. It has become a cornerstone for engaging and ...activating patients and citizens in health management while living at home. Digital health services are also aimed at enhancing the efficiency and quality of services, while simultaneously providing services more cost-effectively. In 2020, the COVID-19 pandemic accelerated worldwide the development and use of digital services in response to requirements for social distancing and other regulations.
The aim of this review is to identify and summarize how digital health services are being used among patients and citizens while living at home.
The Joanna Briggs Institute (JBI) methodology for scoping reviews was used as guidance. A search conducted in 3 databases (CINAHL, PubMed, Scopus) resulted in 419 papers. The reporting was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review (PRISMA-ScR), and the analysis of the included papers was performed using a framework consisting of 5 clusters describing the use of digital health services. After screening and excluding papers that did not match the inclusion criteria, 88 (21%) papers from 2010 to 2022 were included in the final analysis.
Results indicated that digital health services are used in different situations and among different kinds of populations. In most studies, digital health services were used in the form of video visits or consultations. The telephone was also used regularly for consultations. Other services, such as remote monitoring and transmitting of recorded information and the use the of internet or portals for searching information, were observed as well. Alerts, emergency systems, and reminders were observed to offer possibilities of use, for example, among older people. The digital health services also showed to have potential for use in patient education.
The development of digital services reflects a shift toward the provision of care regardless of time and place. It also reflects a shift toward emphasis on patient-centered care, meaning activating and engaging patients in their own care as they use digital services for various health-related purposes. Despite the development of digital services, many challenges (eg, adequate infrastructure) still prevail worldwide.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
To identify different nursing informatics competence (NIC) profiles in nurses, examine the factors associated with profile memberships and examine the associations of the derived profiles with the ...nurses' perception of the usefulness of a health information system (HIS).
A cross-sectional study.
A sample of 3610 registered nurses responded to a nationwide survey in March 2020. A latent profile analysis was performed to identify NIC profiles based on three competence areas: nursing documentation, working in digital environment, and ethics and data protection. A multinomial logistic regression was carried out to examine the associations of demographic and background variables with the profile membership. Linear regression analyses were carried out to examine the association between the profile membership and perceived HIS usefulness.
Three NIC profiles were identified and labelled as low, moderate and high competence groups. A younger age, recent graduation year, sufficient orientation and high-rated proficiency as an HIS user were associated with nurses belonging to a high or moderate competence group relative to a low competence group. Competence group membership was associated with perceived HIS usefulness. The high competence group consistently expressed the highest usefulness of the HIS and the low competence group the lowest.
Tailored training and support should be provided for nurses with different levels of informatics competence, thereby facilitating their ability to respond to increasingly digitalized work. This could contribute to higher usefulness of the HIS in terms of supporting the nurses' work tasks and promoting the quality of care.
This was the first study exploring latent profiles of informatics competence in nurses. Insights from this study are useful for nursing management to identify different competence profiles of their employees, provide support and training to meet their needs, and promote the successful use of an HIS.
Title. Evaluating nursing documentation – research designs and methods: systematic review.
Aim. This paper is a report of a review conducted to assess the research methods applied in the evaluation ...of nursing documentation.
Data sources. The material was drawn from three databases: CINAHL, PubMed and Cochrane using the keywords nursing documentation, nursing care plan, nursing record system, evaluation and assessment. The search was confined to relevant electronically‐retrievable studies published in the English language from 2000 to 2007. This yielded 41 studies, including two reviews.
Methods. Content analysis produced a classification into three themes: nursing documentation, patient‐centred documentation and standardized documentation. Each study was assessed according to its research design, methodology, sample size and focus of data collection. In addition, the studies categorized under the heading of standardized documentation were assessed in terms of their outcomes.
Results. Most of the studies (n = 19) focused on patient‐centred documentation. Most (n = 20) were retrospective studies and used data collected from patient records (n = 35). An audit instrument was used to assess nursing documentation in almost all the studies. Studies classified under the heading of standardized documentation showed more positive than negative effects with respect to quality, the nursing process and terminology use, knowledge level and acceptance of computer use in documentation.
Conclusion. The use of structured nursing terminology in electronic patient record systems will extend the scope of documentation research from assessing the quality of documentation to measuring patient outcomes. More data should also be collected from patients and family members when evaluating nursing documentation.
In the European Union (EU), there are over half a million medical devices, varying from pacemakers to software. Medical devices play an important role in health care as they are used in diagnosis, ...prevention, monitoring, prediction, prognosis, treatment, or to alleviate disease. Medical devices are regulated in the EU by the Medical Device Regulation (MDR), which came into force on 25 April 2017 and into application on 26 May 2021. The demand for regulation arose from the need to establish a transparent, robust, predictable, and sustainable regulatory framework. This study aims to examine how the managers and regulatory professionals in health technology enterprises perceived the application of the MDR and what were their information needs regarding the MDR.
A link to an online questionnaire was sent to 405 managers and regulatory professionals representing health technology enterprises in Finland. The study included 74 respondents. Descriptive statistics were used to describe and summarise the characteristics of the dataset.
Information related to the MDR was fragmented and the necessary information was sought from multiple information sources, while the Finnish Medicines Agency (Fimea) was regarded as the most important source of information and training provider. To some extent, the managers and regulatory professionals expressed their dissatisfaction with the performance of Fimea. The managers and regulatory professionals were not very familiar with the ICT systems provided by the EU. The size of an enterprise affected how many medical devices it manufactures and generally affected the views about the MDR.
The managers and regulatory professionals understood the role of the MDR regarding the safety and transparency of medical devices. The available information regarding the MDR did not properly fit the needs of users and there seemed to be a gap in information quality. The managers and regulatory professionals had some difficulties understanding the available information. Based on our findings, we believe it is paramount to evaluate the challenges faced by Fimea and how it could improve its performance. To some extent, the MDR is regarded as a burden for smaller enterprises. It is important to highlight the benefits of ICT systems and to develop them to better meet the information needs of enterprises.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Only few studies so far have examined recovery from work during workday breaks. In this intervention study, based on the effort-recovery model and the conservation of resources theory, we examined ...how to enhance recovery during lunch breaks. More specifically, we examined the within-person effects of lunchtime park walks and relaxation exercises on employees' levels of concentration, strain, and fatigue experienced at the end of a working day. We moreover tested whether detachment from work and enjoyment experienced during lunch breaks transmitted the effects of these activities to well-being outcomes. Participants in the park walk (n = 51) and relaxation (n = 46) groups were asked to complete a 15-min exercise during their lunch break on 10 consecutive working days. Afternoon well-being, lunchtime detachment, and lunchtime enjoyment were assessed twice a week before, during, and after the intervention, altogether for 5 weeks. Multilevel analysis results showed that park walks at lunchtime were related to better concentration and less fatigue in the afternoon through enjoyment. Relaxation exercises were related to better concentration in the afternoon via detachment. In addition, relaxation exercises were directly linked to lower levels of strain and fatigue in the afternoon. Our study suggests that on days on which employees engage in recovering activities during lunch breaks, they experience higher levels of well-being at the end of a working day. These results add to the theory-based knowledge on recovery during workday breaks and highlight the importance of breaks for organizational practices.
Aim
The study aims to describe the impacts of different data structuring methods used in nursing records or care plans. This systematic review examines what kinds of structuring methods have been ...evaluated and the effects of data structures on healthcare input, processes and outcomes in previous studies.
Materials and Methods
Retrieval from 15 databases yielded 143 papers. Based on Population (Participants), Intervention, Comparators, Outcomes elements and exclusion and inclusion criteria, the search produced 61 studies. A data extraction tool and analysis for empirical articles were used to classify the data referring to the study aim. Thirty‐eight studies were included in the final analysis.
Findings
The study design most often used was a single measurement without any control. The studies were conducted mostly in secondary or tertiary care in institutional care contexts. The standards used in documentation were nursing classifications or the nursing process model in clinical use. The use of standardised nursing language (SNL) increased descriptions of nursing interventions and outcomes supporting daily care, and improving patient safety and information reuse.
Discussion
The nursing process model and classifications are used internationally as nursing data structures in nursing records and care plans. The use of SNL revealed various positive impacts. Unexpected outcomes were most often related to lack of resources.
Limitations
Indexing of SNL studies has not been consistent. That might cause bias in database retrieval, and important articles may be lacking. The study design of the studies analysed varied widely. Further, the time frame of papers was quite long, causing confusion in descriptions of nursing data structures.
Conclusion
The value of SNL is proven by its support of daily workflow, delivery of nursing care and data reuse. This facilitates continuity of care, thus contributing to patient safety. Nurses need more education and managerial support in order to be able to benefit from SNL.
Aims
The aim of this study was to measure the inter‐rater reliability of the Oulu Patient Classification and to discuss existing methods of reliability testing.
Background
The Oulu Patient ...Classification, part of the RAFAELA® System, has been developed to assist nursing managers with the proper allocation of nursing resources. Due to the increased intensity of inpatient care during recent years, there is a need for the reliability testing of the classification, which has been in clinical use for 20 years.
Design
Retrospective statistical study.
Methods
To test inter‐rater reliability, a pair of nurses classified the same patients, without knowledge of each other's ratings, as a part of annually conducted standardization. Data on the parallel classifications (n = 19,997) was obtained from inpatient units (n = 32) with different specialties at a university hospital in Finland during 2010–2015. Parallel classification practices were also analysed. The reliability of the overall classification and its subareas were calculated using suitable statistical coefficients.
Results
Inter‐rater reliability coefficients were a reliable or almost perfect means of considering the nursing intensity category and various practices, but there were detectable differences between subareas. The lowest agreement levels occurred in the subareas ‘Planning and Coordination of Nursing Care’ and ‘Guiding of Care/Continued Care and Emotional Support’.
Conclusions
There is a need to develop the descriptions of subareas and to clarify the related concepts. Precise nursing documentation can promote a high level of agreement and reliable results. The traditional overall proportion of agreement does not provide an adequate picture of reliability – weighted kappa coefficients should be used instead.
•Privacy concerns are common among active telehealth service users.•Lack of necessary skills for telehealth service use are associated with privacy concerns.•Benefits of telehealth services might ...help in mitigating privacy concerns.
Seeking and receiving care requires disclosure of personal information which is recorded as health data in electronic health records. Thereafter, restricting the flow of information is dependent on data protection, information security, ethical conduct, and law. Privacy concerns may arise as patients’ options concerning privacy have been balanced to cater both the privacy of patients and the needs of healthcare, as well as secondary use of data.
This study examined privacy concerns among the users of a national patient portal in a representative sample of Finnish adults aged 20 to 99 years old (n = 3,731). We used logistic regression analysis with population weights to seek answers to which factors are associated with privacy concerns. The cross-sectional survey data was collected in 2020.
Every third patient portal user had privacy concerns. Those who were 50 to 59 years old (p = 0.030) had privacy concerns more often than 20 to 49-year-olds. Those who had financial difficulties (p = 0.003) also had privacy concerns more often while those, who had good digital skills (p=<0.026), did not need guidance on telehealth service use (p=<0.001) and found telehealth service use to be beneficial (p = 0.008), had privacy concerns less often.
The usefulness of telehealth seems to play an important role in privacy concerns. Another important factor is the skills required to use telehealth services. We encourage providing guidance to those who lack the necessary skills for telehealth service use. We also encourage putting effort not only into data protection and information security measures of telehealth services, but also into providing transparent and comprehensible privacy information for the service users as privacy concerns are common.
In recent years, there has been an increasing interest in psychological need satisfaction and its role in promoting optimal functioning. The DRAMMA model integrates existing need and recovery models ...to explain why leisure is connected to optimal functioning (i.e., high well-being and low ill-being). It encompasses six psychological needs: detachment, relaxation, autonomy, mastery, meaning, and affiliation (DRAMMA). While the individual needs of the DRAMMA model have been previously shown to relate to different aspects of optimal functioning, a longitudinal study examining the entire model has not been conducted before. In this longitudinal field study covering leisure and work episodes, we tested the within-person reliability and (construct and criterion) validity of the operationalization of the DRAMMA model in a sample of 279 German employees. Participants filled out measures of DRAMMA need satisfaction and optimal functioning at five measurement times before, during, and after vacation periods in 2016 and 2017. The six-factor model showed good fit to the data. In the multilevel models, relaxation, detachment, autonomy, and mastery had the most consistent within-person effects on optimal functioning, while the relationships between optimal functioning, meaning, and affiliation were considerably weaker. In conclusion, DRAMMA need satisfaction can aid and nurture employees’ optimal functioning.
Purpose
The study had three aims. We investigated, first, how six recovery experiences (i.e., detachment, relaxation, control, mastery, meaning, and affiliation) during off-job time suggested by the ...DRAMMA model (Newman et al. in J Happiness Stud 15(3):555–578.
https://doi.org/10.1007/s10902-013-9435-x
, 2014) are related to well-being (i.e., vitality, life satisfaction, and work ability). Second, we examined how age related to these outcomes, and third, we investigated whether age moderated the relationships between recovery experiences and well-being outcomes.
Methods
A sample of 909 Finnish teachers responded to an electronic questionnaire (78% women, average age 51 years). The data were analyzed with moderated hierarchical regression analyses.
Results
Detachment from work, relaxation, control, and mastery were associated with higher vitality. Detachment, relaxation, meaning, and affiliation were related to higher life satisfaction. Older age was related to lower work ability, but not to vitality or life satisfaction. Older teachers benefited more from control and mastery during off-job time than did younger teachers in terms of vitality, whereas younger teachers benefited more from relaxation in terms of all well-being outcomes.
Conclusions
Detachment, relaxation, control, mastery, meaning, and affiliation during off-job time were related to higher well-being, supporting the DRAMMA model. Age moderated the relationships between control, mastery, and relaxation and vitality and life satisfaction. The role of aging in recovery from work needs further research.
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