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Smith JM, Pearson KK, Roberson AE. Interface of Clinical Nurse Specialist Practice and Healthcare Technology. CLIN NURSE SPEC 2023; 37:169-176. [PMID: 37410561 DOI: 10.1097/nur.0000000000000755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
PURPOSE This article demonstrates the leadership role of the clinical nurse specialist in developing and implementing healthcare technology across the continuum of care. DESCRIPTION Three virtual nursing practices-facilitated self-care, remote patient monitoring, and virtual acute care nursing-illustrate how the clinical nurse specialist is well suited to transform traditional practice models to ones that use healthcare technology effectively. These 3 practices use interactive healthcare technology to gather patient data and allow communication and coordination with the healthcare team to meet patient-specific needs. OUTCOME Use of healthcare technology in virtual nursing practices led to early care team intervention, optimized care team processes, proactive patient outreach, timely access to care, and reduction in healthcare-associated errors and near-miss events. CONCLUSION Clinical nurse specialists are well positioned to develop innovative, effective, accessible, and high-quality virtual nursing practices. Integrating healthcare technology with nursing practice augments care for various patients, ranging from those with low illness severity in the outpatient setting to acutely ill patients in the inpatient hospital environment.
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Affiliation(s)
- Justin M Smith
- Author Affiliations: Department of Nursing, Mayo Clinic, Rochester, Minnesota
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Eze CE, Dorsch MP, Coe AB, Lester CA, Buis LR, Farris KB. Facilitators and barriers to blood pressure telemonitoring: A mixed-methods study. Digit Health 2023; 9:20552076231187585. [PMID: 37529536 PMCID: PMC10387707 DOI: 10.1177/20552076231187585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 06/23/2023] [Indexed: 08/03/2023] Open
Abstract
Background Telemonitoring of blood pressure (BP) may improve BP control. However, many patients are not using BP telemonitoring due to personal, technological, and health system barriers. Individuals are required to have electronic health literacy (e-HL), defined as knowledge and skills to use technology services effectively, such as BP telemonitoring. Objective The objective was to determine the facilitators and barriers experienced by patients with hypertension in telemonitoring of BP using the e-HL framework (e-HLF). Methods This study was a prospective mixed-methods study using a convergent design. We recruited a convenience sample of 21 patients with hypertension. The qualitative section was online or phone individual in-depth interviews based on the e-HLF, which has seven domains. The quantitative section was an online survey consisting of demographics, an e-HL questionnaire, and patient-provider communication preferences. A joint display was used in the mixed-methods analysis. Results Five themes including knowledge, motivation, skills, systems, and behaviors along with 28 subthemes comprising facilitators or barriers of BP telemonitoring were identified. The mixed-methods results showed concordance between the participants' e-HL status and their experiences in the ability to actively engage with BP monitoring and managing digital services (domain 3) of the e-HLF. Other e-HL domains showed discordance. Conclusion Patients may engage with BP telemonitoring when they feel the usefulness of concurrent access to telemonitoring services that suit their needs.
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Affiliation(s)
- Chinwe E Eze
- College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Corey A Lester
- College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
| | - Lorraine R Buis
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Karen B Farris
- College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
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Piskorz D, Díaz-Barreiro LA, López Santi R, Múnera A, Molina DI, Barroso WS, Wyss F, Ponte Negretti C, Galván Oseguera H, Palomo S, Díaz-Díaz E, Rosas Peralta M, Chávez Mendoza A, Alvarez Lopez H, García Zamora S, Peñaherrera Patiño E, Guerra López A, Puente Barragan A. Blood pressure telemonitoring and telemedicine for hypertension management-positions, expectations and feasibility of Latin-American practitioners. SURVEY carried out by several cardiology and hypertension societies of the Americas. Blood Press 2022; 31:236-244. [PMID: 36123802 DOI: 10.1080/08037051.2022.2123781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PURPOSE To assess the opinion of Latin-American physicians on remote blood pressure monitoring and telehealth for hypertension management. MATERIAL AND METHODS Cross-sectional survey of physicians residing in Latin-America. The study was conducted by the Mexico Hypertension Experts Group, Interamerican Society of Hypertension, Interamerican Society of Cardiology Epidemiology and Cardiovascular Prevention Council, and National Cardiologist Association of Mexico. An online survey composed of 40 questions using Google Forms was distributed from 7 December 2021, to 3 February 2022. The survey was approved by the GREHTA Ethics Committee and participation was voluntary and anonymous. Multiple logistic regression models were constructed to identify the challenges of telehealth. RESULTS 1753 physicians' responses were gathered. The responses came from physicians from different Latin-American countries, as follows: 24% from Mexico, 20.6% from Argentina, 14.7% from Colombia, 10.9% from Brazil, 8.7% from Venezuela, 8.2% from Guatemala and 3.2% from Paraguay. Responders with a high interest in carrying out their assistance task through remote telemonitoring reached 48.9% (821), while 43.6% are already currently conducting telemonitoring. A high number, 62%, claimed to need telemonitoring training. There is a direct relation between higher interest in telemonitoring and age, medical specialty, team working, residence in the biggest cities, expectations regarding telemedicine and reimbursement. CONCLUSIONS Remote monitoring is feasible in Latin-America. General practitioners and specialists from bigger cities seem eager and are self-perceived as well-trained and experienced. Facilities and resources do not seem to be a challenge but training reinforcement and telemedicine promotion is necessary for those physicians less motivated.PLAIN LANGUAGE SUMMARYWhat is the context?Hypertension is one of the leading worldwide modifiable risk factors for premature death. Strong evidence supports that effective treatment of this condition results in a significant reduction of hard outcomes.Only 20%-30% of hypertensive patients are within the blood pressure targets recommended by guidelines in Latin-America. There is an urgent need to implement innovative strategies to reverse this alarming health situation.What is new?Latin-American physicians were highly predisposed to telemonitoring practice. This high motivation was not influenced by hardware or software availability, technological knowledge or experience, by volume of monthly consultations, or by area (private-public) where the care activity is carried out.This high motivation may be supported by the conviction that this practice could be very useful as a complement to face-to-face assistance and a highly effective tool to improve adherence even though respondents considered that just 10% of the patients would prefer telemonitoring over office consultation.What is the impact?Facilities and resources do not seem to be a challenge but training reinforcement and telemedicine promotion is necessary for those physicians less motivated. The general perception is that it is necessary to move forward to resolve legal gaps and financial aspects.Physicians must adapt to changes and develop new communication strategies in a world where the unrestricted access to teleinformation makes patients self-perceived as experts.
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Affiliation(s)
| | | | | | | | | | | | - Fernando Wyss
- Services and Technology of Guatemala, Guatemala City, Guatemala
| | | | | | - Silvia Palomo
- Mexico Institute of Social Security, Mexico City, Mexico
| | | | | | - Adolfo Chávez Mendoza
- Cardiology Hospital, National Medical Center XXI Century, Mexico Institute of Social Security, Mexico City, Mexico
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Armbruster C, Knaub M, Farin-Glattacker E, von der Warth R. Predictors of Adherence to Cancer-Related mHealth Apps in Cancer Patients Undergoing Oncological or Follow-Up Treatment-A Scoping Review. Int J Environ Res Public Health 2022; 19:13689. [PMID: 36294265 PMCID: PMC9603736 DOI: 10.3390/ijerph192013689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
mHealth interventions in cancer care are being increasingly applied in various settings. Nevertheless, there is a phenomenon wherein individuals show different usage patterns, which could affect the effectiveness of the intervention. In general, it is important to know the predictors of app adherence and usage patterns to improve the design and content (i.e., tailoring). The aim of this scoping review was to provide an overview of predictors of adherence to cancer-related mHealth apps in cancer patients. A systematic literature search was conducted in March 2021 in the electronic databases PubMed, CINAHL, and PsychINFO without limitation in year, focusing on cancer patients undergoing oncological or follow-up treatment using mHealth apps. The initial database search yielded a total of N = 8035 records. After title, abstract, and full-text screening, 10 articles met inclusion criteria. Studies were published between 2013 and 2020. Studies focused on children and adolescents (2/10) as well as adults (8/10). The predictors identified could be categorized into sociodemographic variables, cancer-related factors and others. This study provides an initial insight into relevant predictors of app adherence in cancer patients. However, no clear predictor of increased app adherence was found. Further research of usage patterns is therefore needed so that mHealth interventions can be tailored during development.
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Fenton A, Cooper-Ryan AM, Hardey M(M, Ahmed W. Football Fandom as a Platform for Digital Health Promotion and Behaviour Change: A Mobile App Case Study. Int J Environ Res Public Health 2022; 19:ijerph19148417. [PMID: 35886270 PMCID: PMC9317557 DOI: 10.3390/ijerph19148417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 02/07/2023]
Abstract
Background: The last decade has seen a dramatic shift toward the study of fitness surveillance, thanks in part to the emergence of mobile health (mHealth) apps that allow users to track their health through a variety of data-driven insights. This study examines the adoption trends and community mediation of the mobile fitness application ‘FanFit’, a platform aimed at promoting physical activity among sports fans by creating a fitness app branded to their favourite team for health promotion. Objective: Our study looked at the impact of a specially designed mobile app (FanFit) as a digital health intervention for initiating and maintaining physical activity as part of football club membership. Our analysis indicates that app users will adopt healthier behaviours as a result of the app’s sense of fan community and behaviour change. Methods: The findings reported here are based on an implementation of the FanFit app and, in particular, on those who participated in a more in-depth study (n = 30). These participants were Rangers FC supporters with a mix of genders (n = 19 males and n = 11 females). Focus groups and interviews were conducted with participants to ascertain users’ perspectives on the most effective methods for nudging users toward adopting and maintaining a pattern of fitness behaviours. Results: The findings show that the user community was interested in fitness and wanted to live a ‘healthy lifestyle,’ which was augmented and fuelled by the app’s competitive architecture design. Furthermore, the data reveal a new fan-health discourse about a person’s developing wants, talents, and identities as embodied beings. Conclusions: We have developed and presented valid links between the use of sports club apps and health programmes. The app could be useful for sports programmes and club providers looking for mHealth applications that provide community support through fan discourse with opportunities for both male and female fans.
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Affiliation(s)
- Alex Fenton
- Business School, University of Chester, Chester CH1 4BJ, UK;
| | | | | | - Wasim Ahmed
- Stirling Management School, University of Stirling, Stirling FK9 4LA, UK
- Correspondence: ; Tel.: +44-(0)1786-467333
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