Compassionate nursing care and the use of digital health technologies: A scoping review

Technology acceptance and use among nursing staff in Latin American hospitals: A mixed methods study

Background

Digital health technologies can improve health outcomes and the efficiency of healthcare delivery when used appropriately. Nevertheless, the human-computer interaction is a concern in compassionate patient care and nurses' professional well-being.

Objective

To analyze the degree of technological acceptance and use within nurses in two Latin American university hospitals.

Design

A mixed methods study design.

Settings

Two Latin American university hospitals, one in Chile and the other in Colombia.

Participants

A total of 53 nurses participated in the study. In phase 1, 31 nurses took part, with 15 from a Chilean hospital and 16 from a Colombian hospital. In phase 2, 22 nurses participated, with 14 in Chile and 8 in Colombia.

Methods

: A mixed methods sequential study was conducted in inpatient services. It was developed in three phases. First, a quantitative one with a call to all nurses in two institutions, in Chile and Colombia. A scale of the unified theory of acceptance and use of technology, adapted to nursing in Spanish, was employed following expert validation both facial and content aspects. Second, a qualitative one with four focus groups with service coordinator nurses and in-depth interviews with nursing managers or supervisors. These sessions were recorded and transcribed verbatim. Quantitative data were analyzed using descriptive statistics and hypothesis testing for mean differences, while qualitative data underwent content analysis. Finally in the third phase, both qualitative and quantitative data were integrated to establish the acceptability and use of the technology.

Results

Quantitative analysis revealed a statistically significant positive correlation between behavioural intention to use the system and facilitating conditions ( r ( 31 ) = 0.50 , p < . 01 ). Also, there is a positive correlation between behavioural intention to use the system and effort expectancy in Chile ( r ( 13 ) = 0.60 , p < . 05 ). Additionally, a statistically significant difference ( p < . 05 ) exists between the two institutions regarding social influence and facilitating conditions. Qualitative data confirmed these findings. Integration made it possible to specify the factors such as the performance expectancy, facilitating conditions, and anxiety determine the acceptability and use of technology by nurses in the studied institutions.

Conclusions

The degree of technological adoption among nursing staff in two Latin American university hospitals is currently 3.7 ± 0.4 (scale from 1 to 5). Understanding the aspects that affect the acceptance and use of technologies paves the way for achieving their best use in support of nursing care.

Registration

ING-256-2020, January 16, 2023.

Tweetable abstract

Nurses in Latin American show mixed tech acceptance. Understanding barriers is crucial for better care delivery #DigitalHealth #NurseTech.

Assessing the Uses, Benefits, and Limitations of Digital Technologies Used by Health Professionals in Supporting Obesity and Mental Health Communication: Scoping Review

BACKGROUND

Obesity and mental health issues present interconnected public health challenges that impair physical, social, and mental well-being. Digital technologies offer potential for enhancing health care communication between health professionals (HPs) and individuals living with obesity and mental health issues, but their effectiveness is not fully understood.

OBJECTIVE

This scoping review aims to identify and understand the different types of technologies used by HPs in supporting obesity and mental health communication.

METHODS

A comprehensive scoping review, which followed a validated methodology, analyzed studies published between 2013 and 2023 across 8 databases. The data extraction focused on HPs' use of communication technologies, intervention types, biopsychosocial considerations, and perceptions of technology use. The review was guided by the following research question: "What are the uses, benefits, and limitations of digital technologies in supporting communication between HPs and persons living with obesity and mental health issues?"

RESULTS

In total, 8 studies-featuring web-based platforms, social media, synchronous video calls, telephone calls, automated SMS text messaging, and email-met the inclusion criteria. Technologies such as virtual learning collaborative dashboards and videoconferencing, supported by automated SMS text messaging and social media (Facebook and WhatsApp groups), were commonly used. Psychologists, dietitians, social workers, and health coaches used digital tools to facilitate virtual appointments, diet and mental health monitoring, and motivational and educational support through group therapy, 1-on-1 sessions, and hybrid models. Benefits included enhanced access to care and engagement, personalized digital cognitive behavioral therapy, perceived stigma reduction, privacy, and improved physical health outcomes in weight reduction. However, improvements in mental health outcomes were not statistically significant in studies reporting P values (P≥.05). The limitations included engagement difficulties due to conflicting personal family and work commitments; variable communication mode preferences, with some preferring in-person sessions; and misinterpretations of SMS text messaging prompts. Conflicts arose from cultural and individual differences, weight stigma, and confusion over HP roles in obesity and mental health care.

CONCLUSIONS

Digital technologies have diversified the approaches HPs can take in delivering education, counseling, and motivation to individuals with obesity and mental health issues, facilitating private, stigma-reduced environments for personalized care. While the interventions were effective in obesity management, the review revealed a shortfall in addressing mental health needs. This highlights an urgent need for digital tools to serve as media for a deeper engagement with individuals' complex biopsychosocial needs. The integration of data science and technological advancements offers promising avenues for tailored digital solutions. The findings advocate the importance of continued innovation and adaptation in digital health care communication strategies, with clearer HP roles and an interdisciplinary, empathetic approach focused on individual needs.

Digital technologies in nursing: An umbrella review

BACKGROUND

Digital technologies promise to reduce nurses' workload and increase quality of care. However, considering the plethora of single and review studies published to date, maintaining a comprehensive overview of digital technologies' impact on nursing and effectively utilizing available evidence is challenging.

OBJECTIVE

This review aims (i) to map published reviews on digital nursing technologies, based on their aims and the specific technologies investigated, to synthesize evidence on how these technologies' uses is associated with (ii) nurses' work-related and organizational factors, professional behavior, and health and work safety and (iii) ethically relevant outcomes for people in need of care.

DESIGN

Preregistered overview of reviews (PROSPERO-ID: CRD42023389751).

SETTING(S)

We searched for systematic reviews in eight databases, five key journals, and reference lists of included reviews published in English until May 21, 2024.

METHODS

We used the AMSTAR 2 checklist to assess the methodological quality of included reviews reporting associations with nursing outcomes. The extracted data were analyzed by their frequency and narratively synthesized.

RESULTS

We identified 213 reviews on digital technologies' uses in the nursing sector. Most of these focused on information and communication technologies. The most frequently reported research objectives encompass technology usage and/or general experiences with it and technology-related consequences for care recipients. Regarding work-related and organizational factors, beneficial impacts were found for the execution of nursing tasks, information management and job control. Depending on the technology type, reviews reported mixed effects for documentation activities, communication/collaboration and mainly negative effects on nurses' workload. Concerning occupational safety and health-related and further nurse outcomes, reviews reported mostly positive effects on nurses' job satisfaction and professional competence. Adverse effects related to mental and physical strain, such as increased frustration, fatigue, and burnout. Regarding ethically relevant outcomes, robotic and telecare technologies had the most reported findings. Most evidence concerned effects on the principles of beneficence/non-maleficence and respect for autonomy.

CONCLUSIONS

Digital nursing technologies' legitimacy hinges on their impact on patient outcomes and nurses' work, safety, and health. This review identifies a diverse array of these technologies, with both positive and negative effects. However, due to narrative limitations, meta-analysis was impractical. Future research should quantitatively assess the effects of various digital nursing technologies on work, safety, health, and ethical outcomes.

TWEETABLE ABSTRACT

Research on digital tech in nursing lacks focus on key work factors, occupational health and ethical outcomes. #NursingTech #ResearchGaps.

Compassion through technology: Digital empathy concept analysis and implications in nursing

Objective

Digital empathy is an emerging concept in telehealth nursing, emphasizing emotional engagement and compassionate communication in virtual care settings. Despite its importance, digital empathy remains underexplored. This concept analysis aims to define digital empathy in nursing, explore its key attributes, antecedents, consequences, challenges, and actionable recommendations for practice.

Methods

Using Walker and Avant's eight-step framework, a comprehensive literature review was conducted on digital empathy in telehealth nursing. A total of 52 sources were reviewed, comprising 46 research articles, four books, and two web pages, published between 2000 and 2024.

Results

This concept analysis identifies key attributes of digital empathy in nursing, including authenticity, trust-building, communication effectiveness, emotional engagement, adaptability, technological proficiency, and cultural sensitivity critical for meaningful connections in telehealth. Antecedents encompass digital literacy, emotional intelligence, supportive infrastructures, and cultural competence, emphasizing individual, contextual, and organizational factors. Consequences include enhanced patient satisfaction, trust, adherence to treatment, improved nurse well-being, and organizational benefits such as team cohesion and reduced staff turnover. Challenges such as cultural variability, technological limitations, and the lack of validated measurement tools highlight barriers to effective implementation.

Conclusion

This concept analysis underscores the vital role of digital empathy in telehealth nursing. By incorporating its attributes and antecedents, healthcare organizations can enhance patient outcomes and foster supportive, patient-centered environments. Addressing measurement and technological gaps will be pivotal in fully realizing the benefits of digital empathy in telehealth. Actionable recommendations include implementing targeted training, developing standardized tools, and leveraging artificial intelligence advancements to enhance empathetic communication in telehealth.

Educational video for adherence to vaginal pessary in pelvic organ prolapse treatment

OBJECTIVES

to construct and assess an educational video to promote the adherence of women with pelvic organ prolapse to vaginal pessary use.

METHODS

this is a methodological study, with a longitudinal design and quantitative analysis. The pre-production (synopsis, argument, script, storyboard), production and post-production stages were covered. Content and technical assessments were carried out by judges from the health and communication areas, respectively, and appearance assessment by the target audience.

RESULTS

the video was the first to be developed on the topic on the national scene, considered assessed from the point of view of appearance and content, presenting an overall Content Validity Index of 0.99 and a level of agreement among judges of 91.1% to 100%. Assessment by the target audience reached a percentage of 96% to 100%.

CONCLUSIONS

the educational video is an instrument capable of promoting adherence to pessary in women indicated for this therapeutic approach.

Psychometric properties of instruments used to measure the informatics competence of nurses: A systematic review

AIM

This systematic review aimed to assess the psychometric properties of existing nursing informatics scales of competence and provide an evidence-based basis for selecting the most appropriate assessment instruments for specific populations.

BACKGROUND

Informatics competency is one of the fundamental competencies that nurses should have. Using an informatics competency assessment instrument is an effective way to identify competency gaps and develop a professional development plan to address them. However, no systematic reviews summarizing and assessing the psychometric properties of all nursing informatics competency assessment instruments exist.

DESIGN

This study systematically reviews measurement properties using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology.

METHODS

Eight electronic databases (PubMed, Embase, Web of Science, CINAHL Complete, MEDLINE, PsychInfo, China National Knowledge Infrastructure and WanFang Data) were systematically searched from inception until January 10, 2024. Methodological quality was assessed using the COSMIN Risk of Bias Checklist. We used the COSMIN criteria to summarize and rate the psychometric properties.

RESULTS

Twenty-seven studies reported twenty-five various versions of the instruments. Eighteen instruments assessed only one to three psychometric properties. No studies report cross-cultural effectiveness/measurement invariance and measurement error. The quality of evidence for structural validity or internal consistency for the three instruments failed to satisfy the COSMIN criteria. The SANICS-C has moderate to high-quality evidence of adequate content validity and internal consistency. In the end, the SANICS-C was an A recommendation, three instruments were C recommendations and the rest were B recommendations.

CONCLUSION

The Nursing Informatics Competencies Scale for Nursing Students, SANICS-C and ICAT can be used to assess the informatics competencies of undergraduate, graduate and doctoral nursing students, respectively. The C-NICAS-FR is recommended for the assessment of nurses' informatics competence. The Self-Assessment Questionnaire for Nursing Informatics Competencies of Nursing Manager can be recommended for assessing nurse leaders' informatics competencies. Future research needs to validate these instruments' cross-cultural applicability further and comprehensively assess their psychometric properties. Along with emerging technologies, researchers should continually revisit and revise existing assessment instruments and develop instruments to assess the informatics competencies of nursing teachers.

Experiences of healthcare professionals, patients and families with video calls to stimulate patient- and family-centred care during hospitalization: A scoping review

AIM

To synthesize the literature on the experiences of patients, families and healthcare professionals with video calls during hospital admission. Second, to investigate facilitators and barriers of implementation of video calls in hospital wards.

DESIGN

Scoping review.

METHODS

PubMed, CINAHL and Google Scholar were searched for relevant publications in the period between 2011 and 2023. Publications were selected if they focused on experiences of patients, families or healthcare professionals with video calls between patients and their families; or between families of hospitalized patients and healthcare professionals. Quantitative and qualitative data were summarized in data charting forms.

RESULTS

Forty-three studies were included. Patients and families were satisfied with video calls as it facilitated daily communication. Family members felt more engaged and felt they could provide support to their loved ones during admission. Healthcare professionals experienced video calls as an effective way to communicate when in-person visits were not allowed. However, they felt that video calls were emotionally difficult as it was hard to provide support at distance and to use communication skills effectively. Assigning local champions and training of healthcare professionals were identified as facilitators for implementation. Technical issues and increased workload were mentioned as main barriers.

CONCLUSION

Patients, families and healthcare professionals consider video calls as a good alternative when in-person visits are not allowed. Healthcare professionals experience more hesitation towards video calls during admission, as it increases perceived workload. In addition, they are uncertain whether video calls are as effective as in-person conservations.

IMPLICATIONS FOR THE CLINICAL PRACTICE

When implementing video calls in hospital wards, policymakers and healthcare professionals should select strategies that address the positive aspects of family involvement at distance and the use of digital communication skills.

PATIENT CONTRIBUTION

No patient or public contribution.

Pre-Registration Nursing Students' Perceptions of Digital Health Technology on the Future of Nursing: A Qualitative Exploratory Study

BACKGROUND

Health informatics competencies, digital health education, and nursing students' perceptions of technology are critical to ensure a future digitally capable health care workforce.

PURPOSE

To explore preregistration students' perceptions of digital health technology impact on their role as nurses.

METHODS

Using a qualitative exploratory approach, students from 2 Australian universities were purposively sampled. Data were collected through photo-elicitation from 3 focus groups and thematically analyzed. Photo-elicitation provided reference points to encourage more in-depth exploration.

RESULTS

Themes included fear of the unknown and who am I? Nursing in a digital world . Human interaction was fundamental to their nursing role and digital health technology could depersonalize care, creating tension around their reason for choosing a nursing career.

CONCLUSIONS

Educators should prepare students to redefine their nursing identity by exploring how digital health technology augments their practice and critical thinking skills, while addressing fear of a perceived threat to the future of nursing.

Experiences of Electronic Health Records' and Client Information Systems' Use on a Mobile Device and Factors Associated With Work Time Savings Among Practical Nurses: Cross-Sectional Study

BACKGROUND

The transmission of clinical information in nursing predominantly occurs through digital solutions, such as computers and mobile devices, in today's era. Various technological systems, including electronic health records (EHRs) and client information systems (CISs), can be seamlessly integrated with mobile devices. The use of mobile devices is anticipated to rise, particularly as long-term care is increasingly delivered in environments such as clients' homes, where computers are not readily accessible. However, there is a growing need for more user-centered data to ensure that mobile devices effectively support practical nurses in their daily activities.

OBJECTIVE

This study aims to analyze practical nurses' experiences of using EHRs or CISs on a mobile device in their daily practice. In addition, it aims to examine the factors associated with work time savings when using EHRs/CISs on a mobile device.

METHODS

A cross-sectional study using an electronic survey was conducted in spring 2022. A total of 3866 practical nurses participated in the survey based on self-assessment. The sample was limited to practical nurses who used EHRs or CISs on a mobile device and worked in home care or service housing within the social welfare or health care sector (n=1014). Logistic regression analysis was used to explore the factors associated with work time savings.

RESULTS

The likelihood of perceiving work time savings was higher among more experienced EHR/CIS users compared with those with less experience (odds ratio [OR] 1.59, 95% CI 1.30-1.94). Participants with 0-5 years of work experience were more likely to experience work time savings compared with those who had worked 21 years or more (OR 2.41, 95% CI 1.43-4.07). Practical nurses in home care were also more likely to experience work time savings compared with those working in service housing (OR 1.95, 95% CI 1.23-3.07). A lower grade given for EHRs/CISs was associated with a reduced likelihood of experiencing work time savings (OR 0.76, 95% CI 0.66-0.89). Participants who documented client data in a public area were more likely to experience work time savings compared with those who did so in the nurses' office (OR 2.33, 95% CI 1.27-4.25). Practical nurses who found documentation of client data on a mobile device easy (OR 3.05, 95% CI 2.14-4.34) were more likely to experience work time savings compared with those who did not. Similarly, participants who believed that documentation of client data on a mobile device reduced the need to memorize things (OR 4.10, 95% CI 2.80-6.00) were more likely to experience work time savings compared with those who did not.

CONCLUSIONS

To enhance the proportion of practical nurses experiencing work time savings, we recommend that organizations offer comprehensive orientation and regular education sessions tailored for mobile device users who have less experience using EHRs or CISs and find mobile devices less intuitive to use.

Effects of remote dignity therapy on mental health among patients with hematologic neoplasms and their significant others: A randomized controlled trial

BACKGROUND

Families of patients with hematologic neoplasms involved in dignity therapy have exhibited a remarkable improvement in psychological well-being and family functioning. However, the applicability and generalizability of family participatory dignity therapy are limited as it is influenced by factors such as intervention time, place, and participants. Whether remote support from significant others is feasible and effective remains unknown.

OBJECTIVES

This study aimed to confirm the efficacy of significant others participating in remote dignity therapy (r-DT) on hope, dignity loss, meaning of life, and sense of stigma among patients with hematologic neoplasms as well as their significant others' depression and anxiety.

DESIGN

A randomized, single-blinded, two-arm, parallel-group controlled trial.

SETTING(S) AND PARTICIPANTS

Participants included patients with hematologic neoplasms and their significant others, who were recruited from Fujian Medical University Union Hospital from May 2021 to January 2022.

METHODS

A total of 72 eligible participants (patients and significant others) agreed to participate, and were randomly assigned to an intervention group (n = 35) or a control group (n = 37). Each pair of participants in the intervention group participated in two or three conversations based on the online video function of the WeChat platform, performed by one therapist in accordance with a specific communication outline. To evaluate the effects of the intervention, we assessed the patients' degree of dignity loss, hope level, meaning of life, and sense of stigma, as well as their significant others' depression, anxiety, and intimacy at baseline (T0), 15 days (T1), 30 days (T2), and 60 days (T3), and compared the scores between the two groups after the completion of the intervention. The Generalized Estimation Equation Model (GEE) was used to examine the effects of time, group, and their interaction.

RESULTS

The intervention group statistically significantly differed in lower dignity loss (t = 2.190, p = 0.032), higher hope level (t = -2.010, p = 0.049), and higher meaning of life (t = -2.066, p = 0.043) than the control group at T1. Regarding their significant others, the results of the comparison between the two groups showed that significant others in the intervention group had reduced levels of anxiety and depression at T1 and T2 (p < 0.05). The majority of patients (84.38 %) and significant others (75.00 %) provided positive evaluations of the program.

CONCLUSIONS

The r-DT showed a short-term positive effect on decreasing patients' dignity loss and promoting patients' hope and meaning of life; among their significant others, it decreased anxiety and depression.

TRIAL REGISTRATION

Registered in the China Clinical Trial Registry on 17 March 2021(ChiCTR2100044374).

TWEETABLE ABSTRACT

Remote dignity therapy decreased patients' dignity loss and promoted their hope and meaning of life; among their significant others, it decreased anxiety and depression.

Distant suffering: A concept analysis

BACKGROUND

Patients who are suffering may be commonly encountered in health care. The growing use of telehealth implies that encounters with patients who are suffering may increasingly take place at a distance. "Distant suffering" is a concept coined within sociology to describe the suffering of far-away others. It is conceptualized as a paradox, as distance changes the relation between the witness of suffering and the suffering encountered. Impacts may include a potential detriment to the sufferer and ethical implications for the witness.

OBJECTIVE

To explore the concept of distant suffering and any relevance, implications, or important avenues for potential research within the healthcare sciences.

DESIGN

Rodgers' evolutionary concept analysis.

DATA SOURCES

Databases of Web of Science, Medline, CINAHL and PsycInfo were searched for the terms "distant suffering" or "mediated suffering".

REVIEW METHOD

Attributes, surrogate or related terms, antecedents, consequences, and uses of the concept were extracted and synthesized.

RESULTS

Thirty articles published within the past ten years were selected for review from the search results. "Distant suffering" was characterized as comprising 1) mediated far-away suffering, 2) a "recognizer" or witness, and 3) a potential role of a moderator. Antecedents include shared understandings and socially-influenced responses. Consequences include responses like empathy, compassion, pity, also indifference, cynicism and compassion fatigue.

CONCLUSIONS

Further research to explore distant suffering from healthcare sciences' perspective could uncover valuable insights for those suffering, for healthcare workers, and any who are exposed to it. An improved understanding of how distant suffering is conveyed and moderated could enable targeted reduction of exposure or improve response to distant suffering. Such knowledge could help diminish negative consequences for those suffering, for healthcare workers who are caring at a distance for those suffering, or for others who encounter distant suffering in their occupations or in daily life via media, social media, or digital communications.

TWEETABLE ABSTRACT

New analysis finds that exposure to distant suffering may have important implications for health and health care.

Ethical acceptability of telemedicine: Nursing home resident's perspective on telemedical consultations

Objective

The use of telemedicine in health care has recently expanded, and with it the need to evaluate its use from an ethical perspective. Studies investigating the ethical acceptability of telemedical consultations (TC) in nursing homes are lacking, and in particular, the perspectives and experiences of older adults with TC are underrepresented. The objective of this study is to identify ethically relevant parameters in the acute care of nursing home residents using TC and to derive recommendations.

Methods

A combination of qualitative research methods was employed to gain a comprehensive understanding of the research topic. These included semi-structured face-to-face interviews and participant observations. Due to the phased design of the cluster-randomized controlled intervention trial in the overarching study project, our investigations were carried out in phases before and after the implementation of the telemedical systems in the nursing homes.

Results

We identified various ethical challenges associated with the use of TC, including those related to autonomy, participation, privacy, self-conception, beneficence, security and justice. Our analysis indicates that the use of TC for nursing home residents is ethically acceptable, provided that several recommendations to promote acceptability are considered.

Conclusion

Our findings provide insights into the variety of ethical challenges that can arise when using TC in nursing homes to provide care for older adults while also providing information on how these challenges can be addressed. Furthermore, these findings provide guidance for further research to improve the care of residents in nursing homes from an ethical perspective.

Providing compassionate care in a virtual context: Qualitative exploration of Canadian primary care nurses' experiences

Objective

Virtual care presents a promising opportunity to create new communication channels and increase access to healthcare. However, concerns have been raised around the potential for unintended emotional distances created through virtual care environments that could strain patient-provider relationships. While compassionate care is an enabler of emotional connectivity and a core tenant of nursing, little is known about whether or how nurses have adapted their compassion skills into virtual interactions. These concerns are particularly relevant in primary care, where there is a focus on relational continuity (i.e. relationship-based, longitudinal care) and a broad uptake of virtual care. The aim of this study was to explore the meaning of compassionate virtual care and to uncover how nurses operationalized compassionate care through virtual interactions in primary care.

Methods

We used a qualitative interpretive descriptive lens to conduct semistructured interviews with primary care nurses (Ontario, Canada) who had provided virtual care (i.e. video visits, remote patient monitoring, or asynchronous messaging). We used a thematic approach to analyze the data.

Results

We interviewed 18 nurse practitioners and two registered nurses. Participants described how: (1) compassionate care was central to nursing practice, (2) compassionate care was evolving through virtual nurse-patient interaction, and (3) nurses balanced practice with patients' expectations while providing virtual compassionate care.

Conclusions

There is an opportunity to better align nurses' understanding and operationalization of compassionate care in virtual primary care contexts. Exploring how compassionate care is operationalized in primary care settings is a necessary first step to building compassionate competencies across the nursing profession to support the continued virtual evolution of health service delivery.

Technology: A metaparadigm concept of nursing

Undoubtedly, technology continues to permeate the world at an unprecedented pace. The discipline of nursing is not alien to this phenomenon as nurses continue to employ various technological objects and applications in clinical practice, education, administration and research. Despite the centrality of technology in nursing, it has not been recognised as a metaparadigm domain of interest in the discipline of nursing. Thus, this paper sought to examine if technology truly reflected a metaparadigm domain using the four requirements posited by Fawcett. Using these requirements, we examined the onto-epistemology of technology in relation to nursing and conclude that technology potentially represents a distinct domain that intersects with nursing (particularly, from the humanities perspective). Also, technology encompasses some phenomena of interest to the discipline of nursing, demonstrates perspective-neutrality, and is international in scope and substance albeit with some nuances which do not fit well with nursing onto-epistemology. Put together, it is highlighted that technology intersects with the existing metaparadigm domains (person, health, environment and nursing) which positions it as a potential phenomenon of interest to the discipline of nursing requiring further work to articulate its position and role.

The effect of digitalization on the career intentions of nursing students: A cross-sectional study

AIM

We investigate how the confirmation of expectations about digital technology in the workplace affects the career intentions of nursing students. We also explore the role of task fit in mediating (1) digital technology satisfaction and job satisfaction and (2) digital technology satisfaction and career intentions.

BACKGROUND

The turnover of graduating geriatric nursing students is very high and rising. To support the work of nursing staff, elderly care institutions are beginning to adopt digital technologies that aid in nursing tasks. However, it is unclear whether students' perceptions of those digital technologies have an impact on their career intentions.

DESIGN

This is a cross-sectional study.

METHODS

We recruited 549 geriatric nursing students. Data were collected from December 2022 to March 2023. The questionnaire included seven sections: expectation confirmation, perceived usefulness, perceived safety, digital technology satisfaction, task fit, job satisfaction and career intentions. The validity and reliability of the model were confirmed.

RESULTS

The results show that the confirmation of students' expectations for the digital technology used in elderly care services has a positive impact on their career intentions. However, the results do not confirm the impact of perceived security on digital technology satisfaction, or the effect of job satisfaction on career intentions.

CONCLUSION

Elderly care institutions and educators should monitor the current state of the digital work environment to ensure that it can adequately support students in their work. They should ensure the use of advanced and appropriate technology tools in teaching and clinical environments to provide a richer and more vivid learning experience. These initiatives can support nursing students in their transition from school to practice and increase their willingness to stay in the profession.

Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review

BACKGROUND

Digital therapeutics are patient-facing digital health interventions that can significantly alter the health care landscape. Despite digital therapeutics being used to successfully treat a range of conditions, their uptake in health systems remains limited. Understanding the full spectrum of uptake factors is essential to identify ways in which policy makers and providers can facilitate the adoption of effective digital therapeutics within a health system, as well as the steps developers can take to assist in the deployment of products.

OBJECTIVE

In this review, we aimed to map the most frequently discussed factors that determine the integration of digital therapeutics into health systems and practical use of digital therapeutics by patients and professionals.

METHODS

A scoping review was conducted in MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. Relevant data were extracted and synthesized using a thematic analysis.

RESULTS

We identified 35,541 academic and 221 gray literature reports, with 244 (0.69%) included in the review, covering 35 countries. Overall, 85 factors that can impact the uptake of digital therapeutics were extracted and pooled into 5 categories: policy and system, patient characteristics, properties of digital therapeutics, characteristics of health professionals, and outcomes. The need for a regulatory framework for digital therapeutics was the most stated factor at the policy level. Demographic characteristics formed the most iterated patient-related factor, whereas digital literacy was considered the most important factor for health professionals. Among the properties of digital therapeutics, their interoperability across the broader health system was most emphasized. Finally, the ability to expand access to health care was the most frequently stated outcome measure.

CONCLUSIONS

The map of factors developed in this review offers a multistakeholder approach to recognizing the uptake factors of digital therapeutics in the health care pathway and provides an analytical tool for policy makers to assess their health system's readiness for digital therapeutics.

Digital transformation of healthcare during the COVID-19 pandemic: Patients’ teleconsultation acceptance and trusting beliefs

The COVID-19 pandemic boosted the digital transformation of many services, including healthcare, and access to medical care using teleconsultation has increased rapidly. Thus, a growing number of online platforms have been developed to accommodate patients’ needs. This paper examines the factors that predict the intention to use medical teleconsultation by extending the unified theory of acceptance and use of technology (UTAUT2) with the three dimensions of trusting beliefs and self-efficacy. A survey was administered to patients who had used a teleconsultation platform during the pandemic period. As one of the largest studies to date, a sample of 1233 respondents was collected and analyzed using a partial least squares approach, often mobilized in the information systems (IS) domain. Furthermore, a deep analysis using all recommended metrics was performed. The results highlight the significance of trusting beliefs, and self-efficacy in the adoption of digital healthcare services. These findings contribute to both theory and practice in COVID-19 research.

Artificial intelligence technologies and compassion in healthcare: A systematic scoping review

Background

Advances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored.

Objectives

The aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare?

Materials and methods

A systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011-2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice.

Results

Searches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, n = 1 to 2021, n = 47 and from Jan-Aug 2022 n = 35 articles). Overarching themes related to the review questions were: (1) Developments and debates (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) How AI technologies enhance compassion (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) Gaps in knowledge (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) Key areas for development (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships.

Conclusion

There is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a human-AI system of intelligent caring comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships.

Implications

In a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring.

Understanding the Antecedents and Effects of mHealth App Use in Pandemics: A Sequential Mixed-Method Investigation

Pandemics such as COVID-19 pose serious threats to public health and disrupt the established systems for obtaining healthcare services. Mobile health (mHealth) apps serve the general public as a potential method for coping with these exogenous challenges. However, prior research has rarely discussed the antecedents and effects of mHealth apps and their use as a coping method during pandemics. Based on the technology acceptance model, empowerment theory, and event theory, we developed a research model to examine the antecedents (technology characteristics and event strength) and effects (psychological empowerment) of mHealth apps and their use. We tested this research model through a sequential mixed-method investigation. First, a quantitative study based on 402 Chinese mHealth users who used the apps during the COVID-19 pandemic was conducted to validate the theoretical model. A follow-up qualitative study of 191 online articles and reviews on mHealth during the COVID-19 pandemic was conducted to cross-validate the results and explain the unsupported findings of the quantitative study. The results show that (1) the mHealth app characteristics (perceived usefulness and perceived ease of use) positively affect mHealth app use; (2) mHealth app use positively affects the psychological empowerment of mHealth users; and (3) the characteristics of pandemic events (event criticality and event disruption) have positive moderating effects on the relationship between mHealth app characteristics and mHealth app use. This study explains the role of mHealth apps in the COVID-19 pandemic on the micro-level, which has implications for the ways in which mHealth apps are used in response to public pandemics.

The Current Contexts of Newly Graduated Nurses’ Competence: A Content Analysis

Producing and sustaining a competent nursing workforce is imperative to protect the public. Identifying current issues and trends in nursing competence can strengthen insights and provide direction for the future nursing workforce. A summative content analysis was performed; PubMed, CINAHL, and Scopus were searched for content from the last ten years. A total of 3225 titles and abstracts regarding nursing competence were identified and analysed using the big-data analysis software Leximancer. Five themes were discovered from the analysis: (1) standardisation of nursing competencies with emerging competencies, (2) assessment competency levels, (3) graduates’ expectations and achievement, (4) safe and quality practice with teamwork, and (5) competency curriculum development. This found standardised nursing competencies, which suggests prioritising which core competencies should be focused on during education to produce competent generalist professional nurses, and employers could help nursing graduates improve their competence in specialised areas. This review also suggests that further education strategies should be developed to better prepare graduates for culturally safe practice to meet the needs of diverse minority populations and for informatics competency during the COVID-19 pandemic. Competence assessment methods must be extensively investigated to measure nursing competencies both longitudinally and cross-sectionally.