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AnteayerCIN: Computers, Informatics, Nursing

Nurses' Experiences of Using Nursing Care Plans in the Electronic Medical Record in an Acute Medical Setting: A Mixed-Methods Study

imageNursing care plans within electronic medical record systems have the potential to support nurses in planning and prioritizing patient care; however, there is a gap in the literature related to nurses' experiences of how this may occur. The aims of this mixed-methods study included exploring nurses' documentation adherence, identifying barriers and enablers to care plans documentation, and making recommendations to enhance nurses' use of care plans within electronic medical records. An audit of 142 patients revealed the majority had at least one care plan initiated in the electronic medical record (n = 120, 84.5%), 63 patients had a care plan initiated within 24 hours of admission (n = 63, 44.4%), and only three had care plans documented against in the previous 48 hours (2.11%). Data from six focus groups were developed into two themes (each with two subthemes): “Mind the Gap” and “Making It Work for Us.” Barriers and enablers were identified and mapped to 10 of the 14 domains of the Theoretical Domains Framework. There was large variability in nurses' knowledge and understanding related to the need for care plans documentation. Assessment of usability and/or redesign of care plans within electronic medical records must align to nursing workflows to support clinical care delivery.

Associations of eHealth Literacy With Cervical Cancer and Human Papillomavirus Awareness Among Women in Türkiye: A Cross-sectional Study

imageInternet is women's primary source of information about cervical cancer and human papillomavirus. The aim of this study was to determine the associations of electronic health literacy with cervical cancer and human papillomavirus awareness among women of reproductive age. This is a cross-sectional study. The research sample consisted of 330 women of reproductive age (15-49 years), who were admitted to family health centers. The data were collected between July and August 2023 using eHealth Literacy Scale and the Cervical Cancer and Human Papillomavirus Awareness Questionnaire. Multiple linear regression analysis was performed to explore the predictors of cervical cancer and human papillomavirus awareness. In this study, the mean score of women's knowledge about cervical cancer and human papillomavirus was found to be low (4.54 ± 3.94), and the mean score of threat perception was found to be moderate (45.60 ± 6.54). eHealth literacy was found to be a predictor of women's knowledge about cervical cancer and human papillomavirus and threat perception. This result suggests that eHealth literacy should be considered for interventions to increase knowledge and awareness of women about cervical cancer and human papillomavirus.

Predicting Sleep Quality in Family Caregivers of Dementia Patients From Diverse Populations Using Wearable Sensor Data

imageThis study aimed to use wearable technology to predict the sleep quality of family caregivers of people with dementia among underrepresented groups. Caregivers of people with dementia often experience high levels of stress and poor sleep, and those from underrepresented communities face additional burdens, such as language barriers and cultural adaptation challenges. Participants, consisting of 29 dementia caregivers from underrepresented populations, wore smartwatches that tracked various physiological and behavioral markers, including stress level, heart rate, steps taken, sleep duration and stages, and overall daily wellness. The study spanned 529 days and analyzed data using 70 features. Three machine learning algorithms—random forest, k nearest neighbor, and XGBoost classifiers—were developed for this purpose. The random forest classifier was shown to be the most effective, boasting an area under the curve of 0.86, an F1 score of 0.87, and a precision of 0.84. Key findings revealed that factors such as wake-up stress, wake-up heart rate, sedentary seconds, total distance traveled, and sleep duration significantly correlated with the caregivers' sleep quality. This research highlights the potential of wearable technology in assessing and predicting sleep quality, offering a pathway to creating targeted support measures for dementia caregivers from underserved groups. The study suggests that such technology can be instrumental in enhancing the well-being of these caregivers across diverse populations.

Managing Postembolization Syndrome Through a Machine Learning–Based Clinical Decision Support System: A Randomized Controlled Trial

imageAlthough transarterial chemoembolization has improved as an interventional method for hepatocellular carcinoma, subsequent postembolization syndrome is a threat to the patients' quality of life. This study aimed to evaluate the effectiveness of a clinical decision support system in postembolization syndrome management across nurses and patient outcomes. This study is a randomized controlled trial. We included 40 RNs and 51 hospitalized patients in the study. For nurses in the experimental group, a clinical decision support system and a handbook were provided for 6 weeks, and for nurses in the control group, only a handbook was provided. Notably, the experimental group exhibited statistically significant improvements in patient-centered caring attitude, pain management barrier identification, and comfort care competence after clinical decision support system implementation. Moreover, patients' symptom interference during the experimental period significantly decreased compared with before the intervention. This study offers insights into the potential of clinical decision support system in refining nursing practices and nurturing patient well-being, presenting prospects for advancing patient-centered care and nursing competence. The clinical decision support system contents, encompassing postembolization syndrome risk prediction and care recommendations, should underscore its role in fostering a patient-centered care attitude and bolster nurses' comfort care competence.

The Development and Impact of a Respiratory Patient Care Mobile Application on Nursing Students

Por: Kim · Hyewon
imageThis study aimed to develop a virtual experiential application for respiratory patient care and evaluate its impact on nursing students' knowledge, self-efficacy, clinical practice anxiety, and performance confidence. This application with gamification elements was developed following a structured approach encompassing assessment, design, development, implementation, and evaluation. The experimental group consisted of 21 third-year university students who engaged with the application multiple times a day for 1 week; the control group, comprising 21 students, received traditional prelearning. Data were collected 1 week before and immediately before the clinical practice commencement, from March 7 to 24, 2023, using an online survey. Nursing knowledge, self-efficacy, clinical practice anxiety, and performance confidence were evaluated. Significant improvements were observed in the experimental group's knowledge of respiratory patient care, self-efficacy, clinical practice anxiety, and performance confidence. The application proved to be an effective learning resource and assisted students in implementing the nursing process to enhance patient conditions; it highlighted nursing educators' necessity in developing and evaluating educational content. The developed application was effective in enhancing student nurses' competence and confidence, affecting nursing education and patient care.

The Impact of Artificial Intelligence-Assisted Learning on Nursing Students' Ethical Decision-making and Clinical Reasoning in Pediatric Care: A Quasi-Experimental Study

imageThe integration of artificial intelligence such as ChatGPT into educational frameworks marks a pivotal transformation in teaching. This quasi-experimental study, conducted in September 2023, aimed to evaluate the effects of artificial intelligence–assisted learning on nursing students' ethical decision-making and clinical reasoning. A total of 99 nursing students enrolled in a pediatric nursing course were randomly divided into two groups: an experimental group that utilized ChatGPT and a control group that used traditional textbooks. The Mann-Whitney U test was employed to assess differences between the groups in two primary outcomes: (a) ethical standards, focusing on the understanding and applying ethical principles, and (b) nursing processes, emphasizing critical thinking skills and integrating evidence-based knowledge. The control group outperformed the experimental group in ethical standards and demonstrated better clinical reasoning in nursing processes. Reflective essays revealed that the experimental group reported lower reliability but higher time efficiency. Despite artificial intelligence's ability to offer diverse perspectives, the findings highlight that educators must supplement artificial intelligence technology with strategies that enhance critical thinking, careful data selection, and source verification. This study suggests a hybrid educational approach combining artificial intelligence with traditional learning methods to bolster nursing students' decision-making processes and clinical reasoning skills.

Effect of Infection Control Simulation Based on a Negative Pressure Isolation Room Using Mixed Reality

imageThis study aimed to examine the effectiveness of an infection control simulation using mixed reality, comparing simulation fidelity with a high-fidelity mannequin (MN) group and problem-based learning with written cases group. This study used a three-group pretest-posttest quasi-experimental design. Two universities with similar curricula were conveniently selected, and a total of 72 nursing students were recruited. Participants were randomly assigned to three groups of 24 each. In the final analysis, there were 22 participants in the mixed reality groups, 21 in the mannequin groups, and 23 in the problem-based learning with written cases groups. Data were analyzed using descriptive statistics and the χ2, Kruskal-Wallis, and Wilcoxon signed rank tests. The mixed reality groups had a significantly positive effect on clinical reasoning ability and clinical competence than the problem-based learning with written cases groups, whereas the mannequin groups had a significantly positive effect on clinical competence than the problem-based learning with written cases groups. Mixed reality simulation is an appropriate simulation method that enhances learning immersion, satisfaction, and self-confidence in simulation. Additionally, it can substitute for mannequin simulation in terms of clinical reasoning ability and clinical competence. This study suggests that it is important to the various approaches in simulation fidelity to diversely enhance the competency of nursing students in simulation outcomes.

Research Trends in Family-Centered Care for Children With Chronic Disease: Keyword Network Analysis

imageFamily-centered care is an approach to promote the health and well-being of children with chronic diseases and their families. This study aims to explore the knowledge components, structures, and research trends related to family-centered care for children with chronic conditions. We conducted the keyword network analysis in three stages using the keywords provided by the authors of each study: (1) search and screening of relevant studies, (2) keyword extraction and refinement, and (3) data analysis and visualization. The core keywords were child, adolescence, parent, and disabled. Four cohesive subgroups were identified through degree centrality. Research trends in the three phases of a recent decade have been changed. With the systematic understanding of the context of the knowledge structure, the future research and effective strategy establishment are suggested based on family-centered care for children with chronic disease.

A Microlearning-Based Self-directed Learning Chatbot on Medication Administration for New Nurses: A Feasibility Study

imageNew nurses must acquire accurate knowledge of medication administration, as it directly affects patient safety. This study aimed to develop a microlearning-based self-directed learning chatbot on medication administration for novice nurses. Furthermore, the study had the objective of evaluating the chatbot feasibility. The chatbot covered two main topics: medication administration processes and drug-specific management, along with 21 subtopics. Fifty-eight newly hired nurses on standby were asked to use the chatbot over a 2-week period. Moreover, we evaluated the chatbot's feasibility through a survey that gauged changes in their confidence in medication administration knowledge, intrinsic learning motivation, satisfaction with the chatbot's learning content, and usability. After using the chatbot, participants' confidence in medication administration knowledge significantly improved in all topics (P

Digital Literacy and Associated Factors in Older Adults Living in Urban South Korea: A Qualitative Study

imageThis study aimed to explore digital literacy among community-dwelling older adults in urban South Korea. A semistructured interview guide was developed using the Digital Competence ( 2.0 framework, which emphasizes the competencies for full digital participation in five categories: information and data literacy, communication and collaboration, content creation, safety, and problem-solving. The data were analyzed using combined inductive and deductive content analysis. Inductive analysis identified three main categories: perceived ability to use digital technology, responses to digital technology, and contextual factors. In the results of deductive analysis, participants reported varying abilities in using digital technologies for information and data literacy, communication or collaboration, and problem-solving. However, their abilities were limited in handling the safety or security of digital technology and lacked in creating digital content. Responses to digital technology contain subcategories of perception (positive or negative) and behavior (trying or avoidance). Regarding contextual factors, aging-related physical and cognitive changes were identified as barriers to digital literacy. The influence of families or peers was viewed as both a facilitator and a barrier. Our participants recognized the importance of using digital devices to keep up with the trend of digitalization, but their digital literacy was mostly limited to relatively simple levels.

Effect of Virtual Game–Based Integrated Clinical Practice Simulation Program on Undergraduate Nursing Students' Attitude Toward Learning

imageGame-based virtual reality simulation programs can capitalize on the advantages of non–face-to-face education while effectively stimulating the interest of trainees and improving training efficiency. This study aimed to develop a game-based virtual reality simulation program for nervous system assessment and to evaluate the effects of the program on the learning attitudes of nursing students. Using a one-group pretest-posttest design, 41 senior nursing students were enrolled, and their learning attitudes (self-directed learning attitude, academic self-efficacy, flow-learning experience, and learning presence) were evaluated. The effect of the program was statistically significant in self-directed learning attitude (t = −2.27, P = .027) and learning presence (t = −3.07, P = .003), but the difference was not statistically significant in academic self-efficacy (t = −1.97, P = .054) and learning flow (t = −0.74, P = .459). The virtual gaming simulation program can be used to effectively replace field training in situations wherein field training is limited, such as during the COVID-19 pandemic.

Virtual Reality–Based Education Program for Managing Behavioral and Psychological Symptoms of Dementia: Development and Feasibility Test

imageThis study aims to develop a virtual reality–based education program for managing behavioral and psychological symptoms of dementia for family carers of persons living with dementia and investigate the feasibility for users. The program was developed through literature review, interviews with family carers, surveys, and expert content validity assessment. User feasibility was evaluated quantitatively through a questionnaire on usefulness, ease of use, and satisfaction, and qualitatively through participant interviews. The program was produced in two parts, Type 1 and Type 2, consisting of three and six episodes, respectively. Participants showed a high level of satisfaction with overall program scores of 4.28 ± 0.66 and 4.34 ± 0.41 for the two evaluations. Participants also expressed that both programs were helpful, Type 1 for achieving changes in attitude associated with more understanding of persons living with dementia and Type 2 for acquiring coping methods through communication training. Use of the virtual reality device was not inconvenient and was identified as helpful due to the high immersion experience. Results of this study confirmed that family carers had no resistance to education using new technologies such as virtual reality devices and that virtual reality–based education could be effective for training family carers.

Identifying Latent Topics and Trends in Premature Infant–Related Nursing Studies Using a Latent Dirichlet Allocation Method

imageThis study aimed to identify topics and within-topic core keywords in premature infant–related nursing studies published in Korean and international academic journals using topic modeling and to compare and analyze the trends in Korean and international studies. Journal databases were searched to extract nursing studies involving premature infants from 1998 to 2020. Journal databases included MEDLINE, Web of Science, CINAHL, and EMBASE for international studies and DBpia, the National Digital Science Library, the Korea Citation Index, and the Research Information Sharing Service for Korean studies. Abstracts from the selected 182 Korean and 2502 international studies were analyzed using NetMiner4.4.3e. In results, four similar topics (Korean vs international) were “pain intervention” versus “pain management”; “breast feeding practice” versus “breast feeding”; “kangaroo mother care”; and “parental stress” versus “stress & depression.” Two topics that appeared only in the international studies were “infection management” and “oral feeding & respiratory care.” Overall, the international studies dealt with diverse topics directly associated with premature. Korean studies mainly dealt with topics related to mothers of premature infants, whereas studies related to premature infants were insufficient. Nursing research in Korea needs to be expanded to research topics addressing premature infants.
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