Population ageing together with the greater prevalence of multimorbidity add to the need for and complexity of healthcare services. This makes it important to encourage and empower patients with ...chronic diseases to take care of themselves. An associated goal of such efforts is to significantly reduce the burden on healthcare systems and positively impact patients’ health outcomes and quality of life. The paper presents a multi-criteria decision model for assessing the health and self-care of patients with chronic diseases in the home environment. The model is based on the DEX methodology and was tested on ten cases. The model assists with the timely recognition of relevant symptoms and signs in decision-making about health and self-care. It can be used to promote patients taking on an active role with respect to caring for their health and well-being. The model could be integrated into self-care processes. It might also serve as a basis for an interprofessional approach to supporting older patients with chronic diseases living as fully and independently as possible in the environment in which they feel most comfortable.
Abstract
Introduction
Poor adoption of electronic health records among healthcare workers can diminish their impact. Healthcare informatics solutions development should diligently acknowledge ...end-user needs. This study compares a user experience and perceived quality of the nursing process integration in two different applications for electronic documentation of the nursing care plan. Both applications were designed and tested in Slovenia.
Methods
In the first phase, final year undergraduate nursing students were recruited (n=73) and randomly assigned into two groups. Each group used one of the applications for a duration of five hours. A survey among students was conducted. In the second phase, additional students were recruited (n=40) and invited to participate in qualitative analysis of the unfavourably rated application.
Results
The modern, visually improved application was favourably rated by students in terms of all aspects of application usability. However, students reported a significant number of inadequacies regarding the nursing process methodology integration. On the contrary, the students using the poorly rated and visually outdated application reported no such concerns. Qualitative analysis of student reflections identified additional positive features of software design that were not detected in survey results analysis.
Conclusion
This study showed that a user-centred approach can be used to compare diverse electronic solutions. Detected discrepancies in findings using qualitative and quantitative analysis show the importance of integrating diverse research approaches for adequate evaluation of software solutions. Furthermore, this study design promotes empowerment of healthcare workers to participate in the development and critical evaluations of software solutions.
Ventilator-associated pneumonia is a hospital-acquired infection of the lungs occurring in mechanically ventilated patients. An active risk management approach can prevent the occurrence of the ...disease and promote positive organizational changes, subsequently decreasing mortality and hospitalization costs. Using scientific and clinical practice knowledge, a risk evaluation model was developed to identify patients more at risk of developing the disease. For this purpose, a Decision Expert qualitative multi-criteria decision method was used, in which alternatives are evaluated according to predetermined hierarchically arranged criteria. Characteristics of each evaluated alternative are described by the members of an interdisciplinary expert team and are represented by the values of the basic criteria. Values of hierarchically higher aggregated criteria are computed in an upwards fashion according to utility functions, which are defined as simple logical rules. This method is integrated into a software solution, DEXi. The approach is applicable to vastly diverse decision problems and has been successfully used before for health-related decision support. The designed model was tested using actual clinical data. Evaluations of alternatives that most distinctly demonstrated the functionality of the evaluation model were selected and are presented in the results. The evaluation model is intended to assist a holistic evaluation of the risk of developing ventilator-associated pneumonia, by considering patient-related risk factors and the use of preventive measures. The model incorporates nursing-specific data that have hitherto been poorly utilized in preventing ventilator-associated pneumonia and promotes the active engagement of nurses in confronting this interdisciplinary healthcare problem, which has gained more prominence with the onset of COVID-19 disease.
Slovenia has recognized student mobility as a key strategic goal of higher education development. This opens up opportunities for progress but also creates challenges that were highlighted during the ...Covid-19 epidemic. During this crisis, international students in Slovenia were faced with the decision whether to stay or return home. The reasons why they chose to remain/depart were determined by analysing the content of the answers to the open-ended question. Students mainly stayed for personal and health reasons, because of the epidemic, the accompanying measures and the pedagogical process. The reasons for leaving mainly featured psychosocial factors, the epidemic and related measures, personal reasons and access to healthcare. Due to psychosocial distress, international students experienced ag reat need during the epidemic for targeted support measures and especially for coordinated and accessible information.
Long-term care is more efficient and effective when it involves the active participation of the empowered patient and informal caregivers. To achieve this, it is necessary to guide the patient and ...informal caregivers through the systematic process of self-care. Well-documented observations and assessments are fundamental to plan further interventions of the interdisciplinary team. A systematic literature review revealed that the self-care process and the support of information technology are focused on just one chronic disease. Defined self-care process has a positive impact on the functionality and satisfaction of patients with comorbidity and on their caregivers. The model of the patient's self-care process should be an integral part of the long-term care.
Raziskovalno vprašanje (RV): Kakšne so možnosti za integracijo procesov dolgotrajne oskrbe in kakšne so posledice za oskrbo starejših oseb v domačem okolju? Namen: Raziskati možnosti za izboljšanje ...kakovosti in uspešnosti dolgotrajne oskrbe v domačem okolju z osredinjenostjo na prejemnika storitev. Cilj je analizirati obstoječe procese teh storitev, ki jih izvajajo formalni izvajalci. Prav tako na osnovi popisa procesov in analize oblikovati predloge za integracijo procesov ter podati hipotetično oceno učinkovitosti prenovljenega procesa. Metoda: Narejen je predlog modela prenovljenega procesa dolgotrajne oskrbe z uporabo eEPC pristopa k modeliranju procesov. Rezultati: Narejen je popis procesov za pomoč na domu in patronažno varstvo. Oblikovan je predlog prenovljenega procesa dolgotrajne oskrbe oseb v domačem okolju, ki vključuje tudi nekatere ključne usmeritve novega zakona na področju dolgotrajne oskrbe. Z integracijo in prenovo procesov se je zmanjšalo število začetnih in zaključnih dogodkov in dogodkov v procesu, število aktivnosti in odločitev. Ocena finančnega učinka integracije procesov oskrbe je narejena hipotetičnem primeru. Stroški oskrbe bi bili nižji skoraj za 20 %, število delovnih ur formalnih izvajalcev pa bi se zmanjšalo za 7 ur na mesec. Organizacija: Z integracijo storitev oskrbe oseb v domačem okolju in prenovo procesov je možno dosegati višjo kakovost storitev, optimizacijo kadrovskih virov in večjo stroškovno učinkovitost. Družba: S sistematičnim proučevanjem procesov dolgotrajne oskrbe, integracije in optimizacije se lahko zagotavlja kakovostna in kontinuirana oskrba, ki podpira samostojnost posameznika pri skrbi zase. To lahko pozitivno vpliva na kakovost življenja prejemnikov oskrbe in laičnih oskrbovalcev. Prenovljen proces lahko pozitivno vpliva na družbene izdatke. Originalnost: Po našem najboljšem vedenju do sedaj ni bil narejen popis procesov v patronažnem varstvu ali v pomoči na domu. Z implementacijo Zakona o dolgotrajni oskrbi v domačem okolju se bo lahko predlog procesa dolgotrajne oskrbe preverjal in smiselno dopolnjeval. Omejitve/nadaljnje raziskovanje: Model še ni preizkušen v praksi. S testiranjem in uporabo se bodo lahko razkrile pomanjkljivosti prenovljenega procesa. Njegovo kontinuirano nadgrajevanje, osnovano tudi na raziskovanju posameznih elementov modela procesa, bo lahko zagotavljalo dolgoročno uspešnost modela procesa. Za to je pomembno nadaljnje proučevanje dejanskih finančnih in drugih učinkov predlaganega modela procesa prek strukturnih kazalnikov učinkovitosti prenove procesa.
Current international policies converge to the need of empowering patients and families in becoming more autonomous in the self-caring and management of their noncommunicable diseases (NCDs). Given ...their professional scope, nurses are the most well-positioned health professionals to answer this societal challenge. In the literature, health coaching and the use of information and communication technologies (ICTs) emerge as two still under-used contributions to nursing practice in this regard. Given the lack of instruments and research developed so far in the use of health coaching and ICTs during nurses training, we aim to develop a scale that explores nursing students’ perceptions regarding their coaching skills of people with NCDs and the potential role of ICTs in this domain.
After a comprehensive literature review, an initial items list (n = 39) was delineated and discussed by a panel of international experts. After conceptual and structural consensus, the pre-validated version of the Personal and Technological Skills to coach people with noncommunicable diseases scale (PTSC-NCD scale) was created. Then, the pre-validated PTSC-NCD scale was translated to Portuguese, Finnish, Flemish and Slovenian following Beaton and colleagues’ recommendations, and applied to undergraduate nursing students in five European universities. Principal component analysis and reliability analysis were performed in each country through the statistical program Statistical Package for the Social Sciences (version 22.0). All ethical assumptions were complied with throughout this study.
874 nursing students enrolled in the study, predominantly female (71.1%) and with a mean age of 22.4 years (SD = 5.49). After data analysis across international settings, three dimensions emerged: Coaching Centred Personal Skills (F1); Digital Technology Improving Patient-Centred Care (F2); and Digital Technology Improving Relational Skills (F3). All the dimensions showed good reliability (Cronbach's alpha >.80).
The PTSC-NCD scale evidence good validity and reliability indicators across different international settings.
Students, Nursing, Technology, Coaching, Noncommunicable diseases.
Z demografskimi spremembami in z naraščanjem obolevnosti se spreminja vloga pacienta v sodobnem zdravstvu. Izpostavlja se njegova aktivna vloga, predvsem v primeru prisotnosti kroničnih nenalezljivih ...boleznih, ki so vedno pogosteje prisotne med odraslimi prebivalci razvitega sveta, še posebej med starostniki. To pomeni naraščajoče breme za zdravstvo, slabšo kakovost življenja in večjo odvisnost pacienta pri vsakodnevnih opravilih. Zato je pomembno, da zna pacient kar najbolje skrbeti zase v času zdravja in bolezni. Namen doktorske disertacije je oblikovati model procesa samooskrbe pacienta, ga smiselno umestiti v širši kontekst strokovne obravnave pacienta s posebno pozornostjo na prepletanju s procesi v zdravstvu in vključevanju v njih. Za uspešno implementacijo procesa je treba identificirati ključne elemente tega procesa in opredeliti strokovno podporo. Uporabljen je bil pristop akcijske znanosti, ki je za doseganje ciljev doktorske disertacije vključeval metode, kot so prenos konteksta, analiza konteksta, metoda modeliranja procesov in gradnja odločitvenega modela. Oblikovan je bil model procesa samooskrbe pacienta s kroničnimi nenalezljivimi boleznimi. Ključni element procesa samooskrbe je odločanje pacienta glede ukrepov v podporo zdravju. Informacijska podpora odločanju temelji na večparametrskem pristopu, kar zagotavlja transparentno in pravočasno ukrepanje pacienta v primeru slabšanja bolezenske simptomatike. Model procesa samooskrbe je smiselno umeščen v oblikovan ekosistem pacienta v domačem okolju, ki poudarja, da morajo vključeni strokovnjaki zagotavljati dinamično ravnovesje. Narejena je bila kontekstualna opredelitev koncepta samooskrbe, ki je prilagojena slovenskemu okolju. Samooskrba pacienta s kroničnimi nenalezljivimi boleznimi je ključen del celostne oskrbe teh pacientov. Model procesa samooskrbe teh pacientov do sedaj ni bil identificiran, zato njegova opredelitev predstavlja pomemben doprinos k znanosti. Z identifikacijo bistvenih elementov tega procesa in z njegovim vključevanjem v procese zdravstvene obravnave pacienta lahko zagotovimo, da bo strokovna podpora pri samooskrbi zagotavljala dinamično ravnovesje pacientovega ekosistema. Informacijska podpora pri odločanju zagotavlja transparentno sprejemanje odločitev. Pacient s kroničnimi nenalezljivimi boleznimi se mora pravočasno odločati glede posameznih vidikov zdravja in iskanja strokovne pomoči. S tem se lahko dosega optimalno raven zdravja in dobrega počutja. Opredelitev koncepta samooskrbe bo lahko slovenske raziskovalce spodbudila k večjemu raziskovanju elementov samooskrbe pacienta in oblikovanju učinkovitih strokovnih intervencij. Oblikovani proces samooskrbe z vsemi bistvenimi elementi je lahko podprt z digitalno tehnologijo in mora postati pomemben del zdravstvenega sistema.