%0 Journal Article %@ 1438-8871 %I JMIR Publications %V 27 %N %P e67538 %T Environmental Impact of Physical Visits and Telemedicine in Nursing Care at Home: Comparative Life Cycle Assessment %A van Bree,Egid M %A Snijder,Lynn E %A Ossebaard,Hans C %A Brakema,Evelyn A %+ , Department of Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, Leiden, 2300 RC, The Netherlands, 31 0715268444, egid_van_bree@live.nl %K carbon footprint %K eHealth %K telemedicine %K telehealth %K sustainable health care %K digital health care %K environmental impact %K environment %K physical visits %K telemedicine %K nursing %K life cycle assessment %K life cycle %K ecology %K sustainability %K footprint %K planetary health %D 2025 %7 4.4.2025 %9 Original Paper %J J Med Internet Res %G English %X Background: The health care sector contributes notably to environmental harms, impacting human and ecosystem health. Hence, countries increasingly set ambitions to transition to environmentally sustainable health care, focusing on resource use, energy consumption, and patient travel. Telemedicine is often considered a promising solution to reduce travel-related carbon emissions. However, underlying environmental impact assessments lack important components such as staff travel and fail to adhere to standardized conduct and reporting. Moreover, assessments of telemedicine use in primary care are scarce. Objective: This study aims to quantify and compare the environmental impact of physical visits and telemedicine visits in the context of domiciliary care and home nursing. Methods: We conducted a life cycle assessment following international ISO-14040/44 standards of all resources required per individual patient visit, either in person at the patient’s home or via video calling with a dedicated user-friendly tablet. We collected anonymous user data in collaboration with a telemedicine service company, complemented by consulting staff members of four nursing organizations. Telemedicine visits were elementary in nature, such as supporting patients in taking their medication or structuring their daily agenda. We quantified average environmental impacts from cradle to grave, using the Environmental Footprint method, and verified the robustness of the comparison via uncertainty analysis. The variability of environmental impacts in different settings was explored using scenario analyses for the available minimum to maximum ranges. Results: Compared to a single physical visit in the studied setting, a telemedicine visit contributed less to global warming (0.1 vs 0.3 kg of carbon dioxide equivalents [kgCO2eq]; –60%), particulate matter formation (6.2 * 10–9 vs 1.8 * 10–8 disease incidence; –60%), and fossil resource use (1.8 vs 4.4 megajoules; –60%). Mineral/metal resource use was higher for telemedicine than for physical visits (1.1 * 10–5 vs 4.0 * 10–6 kg antimony equivalent; +180%). Only water use was not consistently different in the uncertainty analysis. Scenario analyses indicated that telemedicine’s environmental impact could become similar to physical visits only in urban settings (1-3 km of travel distance) with 50%-100% car commuting (0.1-0.4 vs 0.2-0.7 kgCO2eq). In rural settings (5-15 km of travel distance, 80%-100% car commute), physical visits’ environmental impact was higher (1.0-3.5 kgCO2eq), mostly even for mineral/metal resource use. Conclusions: Using telemedicine for domiciliary care and home nursing mostly reduces its environmental impact compared to physical visits. Benefits are larger in rural settings, where travel distances between patients are larger, and apply to multiple environmental impacts but not always to mineral/metal resource use. In urban settings, factors that influence the degree to which telemedicine is environmentally beneficial are whether staff are working from home versus at the office, commuting to the office by bicycle versus by car, and reusing video-calling devices. Accordingly, considerate application of telemedicine is important to support care for both human and planetary health. %M 40184167 %R 10.2196/67538 %U https://www.jmir.org/2025/1/e67538 %U https://doi.org/10.2196/67538 %U http://www.ncbi.nlm.nih.gov/pubmed/40184167 %0 Journal Article %@ 2562-7600 %I JMIR Publications %V 7 %N %P e44580 %T Remote Patient Monitoring at Home in Patients With COVID-19: Narrative Review %A Cornelis,Justien %A Christiaens,Wendy %A de Meester,Christophe %A Mistiaen,Patriek %+ Belgian Health Care Knowledge Centre, Kruidtuinlaan 55, Brussels, 1000, Belgium, 32 475834741, justien.cornelis@kce.fgov.be %K COVID-19 %K coronavirus disease %K telemonitoring %K remote patient monitoring %K review %K pandemic %K at-home monitoring %K implementation %K health care %K patient care %D 2024 %7 19.11.2024 %9 Review %J JMIR Nursing %G English %X Background: During the pandemic, health care providers implemented remote patient monitoring (RPM) for patients experiencing COVID-19. RPM is an interaction between health care professionals and patients who are in different locations, in which certain patient functioning parameters are assessed and followed up for a certain duration of time. The implementation of RPM in these patients aimed to reduce the strain on hospitals and primary care. Objective: With this literature review, we aim to describe the characteristics of RPM interventions, report on patients with COVID-19 receiving RPM, and provide an overview of outcome variables such as length of stay (LOS), hospital readmission, and mortality. Methods: A combination of different searches in several database types (traditional databases, trial registers, daily [Google] searches, and daily PubMed alerts) was run daily from March 2020 to December 2021. A search update for randomized controlled trials (RCTs) was performed in April 2022. Results: The initial search yielded more than 4448 articles (not including daily searches). After deduplication and assessment for eligibility, 241 articles were retained describing 164 telemonitoring studies from 160 centers. None of the 164 studies covering 248,431 patients reported on the presence of a randomized control group. Studies described a “prehosp” group (96 studies) with patients who had a suspected or confirmed COVID-19 diagnosis and who were not hospitalized but closely monitored at home or a “posthosp” group (32 studies) with patients who were monitored at home after hospitalization for COVID-19. Moreover, 34 studies described both groups, and in 2 studies, the description was unclear. In the prehosp and posthosp groups, there were large variations in the number of emergency department (ED) visits (0%-36% and 0%-16%, respectively) and no convincing evidence that RPM leads to less or more ED visits or hospital readmissions (0%-30% and 0%-22%, respectively). Mortality was generally low, and there was weak to no evidence that RPM is associated with lower mortality. Moreover, there was no evidence that RPM shortens previous LOS. A literature update identified 3 small-scale RCTs, which could not demonstrate statistically significant differences in these outcomes. Most papers claimed savings; however, the scientific base for these claims was doubtful. The overall patient experiences with RPM were positive, as patients felt more reassured, although many patients declined RPM for several reasons (eg, technological embarrassment, digital literacy). Conclusions: Based on these results, there is no convincing evidence that RPM in COVID-19 patients avoids ED visits or hospital readmissions and shortens LOS or reduces mortality. On the other hand, there is no evidence that RPM has adverse outcomes. Further research should focus on developing, implementing, and evaluating an RPM framework. %M 39287362 %R 10.2196/44580 %U https://nursing.jmir.org/2024/1/e44580 %U https://doi.org/10.2196/44580 %U http://www.ncbi.nlm.nih.gov/pubmed/39287362 %0 Journal Article %@ 2369-2960 %I JMIR Publications %V 10 %N %P e62887 %T Competence and Training Needs in Infectious Disease Emergency Response Among Chinese Nurses: Cross-Sectional Study %A Zhang,Dandan %A Chen,Yong-Jun %A Cui,Tianxin %A Zhang,Jianzhong %A Chen,Si-Ying %A Zhang,Yin-Ping %K competence %K preparedness %K infectious disease emergency %K Chinese %K nurse %K cross-sectional study %K COVID-19 %K pandemic %K public health %K health crises %K emergency response %K emergency preparedness %K medical institution %K health care worker %K linear regression %D 2024 %7 18.11.2024 %9 %J JMIR Public Health Surveill %G English %X Background: In recent years, the frequent outbreaks of infectious diseases and insufficient emergency response capabilities, particularly issues exposed during the COVID-19 pandemic, have underscored the critical role of nurses in addressing public health crises. It is currently necessary to investigate the emergency preparedness of nursing personnel following the COVID-19 pandemic completely liberalized, aiming to identify weaknesses and optimize response strategies. Objective: This study aimed to assess the emergency response competence of nurses, identify their specific training needs, and explore the various elements that impact their emergency response competence. Methods: Using a multistage stratified sampling method, 5 provinces from different geographical locations nationwide were initially randomly selected using random number tables. Subsequently, within each province, 2 tertiary hospitals, 4 secondary hospitals, and 10 primary hospitals were randomly selected for the survey. The random selection and stratification of the hospitals took into account various aspects such as geographical locations, different levels, scale, and number of nurses. This study involved 80 hospitals (including 10 tertiary hospitals, 20 secondary hospitals, and 50 primary hospitals), where nurses from different departments, specialties, and age groups anonymously completed a questionnaire on infectious disease emergency response capabilities. Results: This study involved 2055 participants representing various health care institutions. The nurses’ mean score in infectious disease emergency response competence was 141.75 (SD 20.09), indicating a moderate to above-average level. Nearly one-fifth (n=397, 19.32%) of nurses have experience in responding to infectious disease emergencies; however, they acknowledge a lack of insufficient drills (n=615,29.93%) and training (n=502,24.43%). Notably, 1874 (91.19%) nurses expressed a willingness to undergo further training. Multiple linear regression analysis indicated that significant factors affecting infectious disease emergency response competence included the highest degree, frequency of drills and training, and the willingness to undertake further training (B=−11.455, 7.344, 11.639, 14.432, 10.255, 7.364, and −11.216; all P<.05). Notably, a higher frequency of participation in drills and training sessions correlated with better outcomes (P<.001 or P<.05). Nurses holding a master degree or higher demonstrated significantly lower competence scores in responding to infectious diseases compared with nurses with a diploma or associate degree (P=.001). Approximately 1644 (80%) of the nurses preferred training lasting from 3 days to 1 week, with scenario simulations and emergency drills considered the most popular training methods. Conclusions: These findings highlight the potential and need for nurses with infectious disease emergency response competence. Frequent drills and training will significantly enhance response competence; however, a lack of practical experience in higher education may have a negative impact on emergency performance. The study emphasizes the critical need for personalized training to boost nurses’ abilities, especially through short-term, intensive methods and simulation drills. Further training and tailored plans are essential to improve nurses’ overall proficiency and ensure effective responses to infectious disease emergencies. %R 10.2196/62887 %U https://publichealth.jmir.org/2024/1/e62887 %U https://doi.org/10.2196/62887 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 13 %N %P e59975 %T Ameliorating Racial Disparities in HIV Prevention via a Nurse-Led, AI-Enhanced Program for Pre-Exposure Prophylaxis Utilization Among Black Cisgender Women: Protocol for a Mixed Methods Study %A Zhang,Chen %A Wharton,Mitchell %A Liu,Yu %+ School of Nursing, University of Rochester, 255 Crittenden Boulevard, Hellen Wood Hall, Room 2w-218, Rochester, NY, 14622, United States, 1 5852766495, chen_zhang@urmc.rochester.edu %K artificial intelligence %K PrEP care %K PrEP %K pre-exposure prophylaxis %K nurse-led %K AI %K HIV prevention %K HIV %K prevention %K AIDS %K nurse %K Black cisgender women %K Black %K cisgender %K women %K HIV pre-exposure prophylaxis %K prophylaxis %K biomedical %K effectiveness %K medical mistrust %K Black women %K nurse practitioners %K chatbot %K socioeconomic %K HumanX technology %K health care interventions %D 2024 %7 13.8.2024 %9 Protocol %J JMIR Res Protoc %G English %X Background: HIV pre-exposure prophylaxis (PrEP) is a critical biomedical strategy to prevent HIV transmission among cisgender women. Despite its proven effectiveness, Black cisgender women remain significantly underrepresented throughout the PrEP care continuum, facing barriers such as limited access to care, medical mistrust, and intersectional racial or HIV stigma. Addressing these disparities is vital to improving HIV prevention outcomes within this community. On the other hand, nurse practitioners (NPs) play a pivotal role in PrEP utilization but are underrepresented due to a lack of awareness, a lack of human resources, and insufficient support. Equipped with the rapid evolution of artificial intelligence (AI) and advanced large language models, chatbots effectively facilitate health care communication and linkage to care in various domains, including HIV prevention and PrEP care. Objective: Our study harnesses NPs’ holistic care capabilities and the power of AI through natural language processing algorithms, providing targeted, patient-centered facilitation for PrEP care. Our overarching goal is to create a nurse-led, stakeholder-inclusive, and AI-powered program to facilitate PrEP utilization among Black cisgender women, ultimately enhancing HIV prevention efforts in this vulnerable group in 3 phases. This project aims to mitigate health disparities and advance innovative, technology-based solutions. Methods: The study uses a mixed methods design involving semistructured interviews with key stakeholders, including 50 PrEP-eligible Black women, 10 NPs, and a community advisory board representing various socioeconomic backgrounds. The AI-powered chatbot is developed using HumanX technology and SmartBot360’s Health Insurance Portability and Accountability Act–compliant framework to ensure data privacy and security. The study spans 18 months and consists of 3 phases: exploration, development, and evaluation. Results: As of May 2024, the institutional review board protocol for phase 1 has been approved. We plan to start recruitment for Black cisgender women and NPs in September 2024, with the aim to collect information to understand their preferences regarding chatbot development. While institutional review board approval for phases 2 and 3 is still in progress, we have made significant strides in networking for participant recruitment. We plan to conduct data collection soon, and further updates on the recruitment and data collection progress will be provided as the study advances. Conclusions: The AI-powered chatbot offers a novel approach to improving PrEP care utilization among Black cisgender women, with opportunities to reduce barriers to care and facilitate a stigma-free environment. However, challenges remain regarding health equity and the digital divide, emphasizing the need for culturally competent design and robust data privacy protocols. The implications of this study extend beyond PrEP care, presenting a scalable model that can address broader health disparities. International Registered Report Identifier (IRRID): PRR1-10.2196/59975 %M 39137028 %R 10.2196/59975 %U https://www.researchprotocols.org/2024/1/e59975 %U https://doi.org/10.2196/59975 %U http://www.ncbi.nlm.nih.gov/pubmed/39137028 %0 Journal Article %@ 2562-7600 %I JMIR Publications %V 7 %N %P e56616 %T Evaluation of Autonomic Nervous System Function During Sleep by Mindful Breathing Using a Tablet Device: Randomized Controlled Trial %A Togo,Eiichi %A Takami,Miki %A Ishigaki,Kyoko %+ Department of Nursing, Faculty of Nursing, Hyogo University, 2301, Hiraoka-cho Shinzaike, Kakogawa City, 675-0195, Japan, 81 794279516, tougo@hyogo-dai.ac.jp %K mindfulness %K sleep %K cardiac potential %K low frequency %K high frequency %K mobile phone %D 2024 %7 12.6.2024 %9 Original Paper %J JMIR Nursing %G English %X Background: One issue to be considered in universities is the need for interventions to improve sleep quality and educational systems for university students. However, sleep problems remain unresolved. As a clinical practice technique, a mindfulness-based stress reduction method can help students develop mindfulness skills to cope with stress, self-healing skills, and sleep. Objective: We aim to verify the effectiveness of mindful breathing exercises using a tablet device. Methods: In total, 18 nursing students, aged 18-22 years, were randomly assigned and divided equally into mindfulness (Mi) and nonmindfulness (nMi) implementation groups using tablet devices. During the 9-day experimental period, cardiac potentials were measured on days 1, 5, and 9. In each sleep stage (sleep with sympathetic nerve dominance, shallow sleep with parasympathetic nerve dominance, and deep sleep with parasympathetic nerve dominance), low frequency (LF) value, high frequency (HF) value, and LF/HF ratios obtained from the cardiac potentials were evaluated. Results: On day 5, a significant correlation was observed between sleep duration and each sleep stage in both groups. In comparison to each experimental day, the LF and LF/HF ratios of the Mi group were significantly higher on day 1 than on days 5 and 10. LF and HF values in the nMi group were significantly higher on day 1 than on day 5. Conclusions: The correlation between sleep duration and each sleep stage on day 5 suggested that sleep homeostasis in both groups was activated on day 5, resulting in similar changes in sleep stages. During the experimental period, the cardiac potentials in the nMi group showed a wide range of fluctuations, whereas the LF values and LF/HF ratio in the Mi group showed a decreasing trend over time. This finding suggests that implementing mindful breathing exercises using a tablet device may suppress sympathetic activity during sleep. Trial Registration: UMIN-CTR Clinical Trials Registry UMIN000054639; https://tinyurl.com/mu2vdrks %M 38865177 %R 10.2196/56616 %U https://nursing.jmir.org/2024/1/e56616 %U https://doi.org/10.2196/56616 %U http://www.ncbi.nlm.nih.gov/pubmed/38865177 %0 Journal Article %@ 1929-0748 %I JMIR Publications %V 13 %N %P e52250 %T Designing Implementation Strategies for the Inclusion of Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, and Allied and Key Populations’ Content in Undergraduate Nursing Curricula in KwaZulu-Natal, South Africa: Protocol for a Multimethods Research Project %A Nxumalo,Celenkosini Thembelenkosini %A Luvuno,Zamasomi %A Chiya,Wilbroda Hlolisile %A Ngcobo,Silingene Joyce %A Naidoo,Deshini %A Zamudio-Haas,Sophia %A Harris,Orlando %+ Research Development and Postgraduate Support, Office of the DVC Research and Innovation, University of the Western Cape, Private Bag X17, Robert Sobukwe Road, Bellville, Cape Town, 7535, South Africa, 27 219594140 ext 4140, cnxumalo@uwc.ac.za %K lesbian, gay, bisexual, transgender, intersex, queer, and allied %K LGBTQIA+ %K key populations %K nursing curricula %K health science education %K South Africa %K undergraduate %K nursing %K lesbian, gay, bisexual, and transgender %K LGBT %K legislation %K health care %K unmet %K barrier %K stigma %K discrimination %K threats %K co-design %D 2024 %7 31.5.2024 %9 Protocol %J JMIR Res Protoc %G English %X Background: Lesbian, gay, bisexual, transgender, intersex, queer, and allied (LGBTQIA+) individuals encounter challenges with access and engagement with health services. Studies have reported that LGBTQIA+ individuals experience stigma, discrimination, and health workers’ microaggression when accessing health care. Compelling evidence suggests that the LGBTQIA+ community faces disproportionate rates of HIV infection, mental health disorders, substance abuse, and other noncommunicable diseases. The South African National Strategic Plan for HIV or AIDS, tuberculosis, and sexually transmitted infections, 2023-2028 recognizes the need for providing affirming LGBTQIA+ health care as part of the country’s HIV or AIDS response strategy. However, current anecdotal evidence suggests paucity of LGBTQIA+ and key populations’ health content in the undergraduate health science curricula in South Africa. Moreover, literature reveals a general lack of health worker training regarding the health needs of LGBTQIA+ persons and other key populations such as sex workers, people who inject drugs, and men who have sex with men. Objective: This study aimed to describe the design of a project that aims at facilitating the inclusion of health content related to the LGBTQIA+ community and other key populations in the undergraduate nursing curricula of KwaZulu-Natal, South Africa. Methods: A multimethods design encompassing collection of primary and secondary data using multiple qualitative designs and quantitative approaches will be used to generate evidence that will inform the co-design, testing, and scale-up of strategies to facilitate the inclusion of LGBTQIA+ and key populations content in the undergraduate nursing curricula in KwaZulu-Natal, South Africa. Data will be collected using a combination of convenience, purposive, and snowball sampling techniques from LGBTQIA+ persons; academic staff; undergraduate nursing students; and other key populations. Primary data will be collected through individual in-depth interviews, focus groups discussions, and surveys guided by semistructured and structured data collection tools. Data collection and analysis will be an iterative process guided by the respective research design to be adopted. The continuous quality improvement process to be adopted during data gathering and analysis will ensure contextual relevance and sustainability of the resultant co-designed strategies that are to be scaled up as part of the overarching objective of this study. Results: The proposed study is designed in response to recent contextual empirical evidence highlighting the multiplicity of health challenges experienced by LGBTQIA+ individuals and key populations in relation to health service delivery and access to health care. The potential findings of the study may be appropriate for contributing to the education of nurses as one of the means to ameliorate these problems. Data collection is anticipated to commence in June 2024. Conclusions: This research has potential implications for nursing education in South Africa and worldwide as it addresses up-to-date problems in the nursing discipline as it pertains to undergraduate students’ preparedness for addressing the unique needs and challenges of the LGBTQIA+ community and other key populations. International Registered Report Identifier (IRRID): PRR1-10.2196/52250 %M 38598816 %R 10.2196/52250 %U https://www.researchprotocols.org/2024/1/e52250 %U https://doi.org/10.2196/52250 %U http://www.ncbi.nlm.nih.gov/pubmed/38598816 %0 Journal Article %@ 1438-8871 %I JMIR Publications %V 26 %N %P e50518 %T Agendas on Nursing in South Korea Media: Natural Language Processing and Network Analysis of News From 2005 to 2022 %A Park,Daemin %A Kim,Dasom %A Park,Ah-hyun %+ Home Visit Healthcare Team, Expert Group on Health Promotion for Seoul Metropolitan Government, #410, Life Science Building.Annex, 120, Neungdong-ro, Gwangjin-gu, Seoul, 05029, Republic of Korea, 82 1072040418, dudurdaram@naver.com %K nurses %K news %K South Korea %K natural language processing %K NLP %K network analysis %K politicization %D 2024 %7 19.3.2024 %9 Original Paper %J J Med Internet Res %G English %X Background: In recent years, Korean society has increasingly recognized the importance of nurses in the context of population aging and infectious disease control. However, nurses still face difficulties with regard to policy activities that are aimed at improving the nursing workforce structure and working environment. Media coverage plays an important role in public awareness of a particular issue and can be an important strategy in policy activities. Objective: This study analyzed data from 18 years of news coverage on nursing-related issues. The focus of this study was to examine the drivers of the social, local, economic, and political agendas that were emphasized in the media by the analysis of main sources and their quotes. This analysis revealed which nursing media agendas were emphasized (eg, social aspects), neglected (eg, policy aspects), and negotiated. Methods: Descriptive analysis, natural language processing, and semantic network analysis were applied to analyze data collected from 2005 to 2022. BigKinds were used for the collection of data, automatic multi-categorization of news, named entity recognition of news sources, and extraction and topic modeling of quotes. The main news sources were identified by conducting a 1-mode network analysis with SNAnalyzer. The main agendas of nursing-related news coverage were examined through the qualitative analysis of major sources’ quotes by section. The common and individual interests of the top-ranked sources were analyzed through a 2-mode network analysis using UCINET. Results: In total, 128,339 articles from 54 media outlets on nursing-related issues were analyzed. Descriptive analysis showed that nursing-related news was mainly covered in social (99,868/128,339, 77.82%) and local (48,056/128,339, 48.56%) sections, whereas it was rarely covered in economic (9439/128,339, 7.35%) and political (7301/128,339, 5.69%) sections. Furthermore, 445 sources that had made the top 20 list at least once by year and section were analyzed. Other than “nurse,” the main sources for each section were “labor union,” “local resident,” “government,” and “Moon Jae-in.” “Nursing Bill” emerged as a common interest among nurses and doctors, although the topic did not garner considerable attention from the Ministry of Health and Welfare. Analyzing quotes showed that nurses were portrayed as heroes, laborers, survivors of abuse, and perpetrators. The economic section focused on employment of youth and women in nursing. In the political section, conflicts between nurses and doctors, which may have caused policy confusion, were highlighted. Policy formulation processes were not adequately reported. Media coverage of the enactment of nursing laws tended to relate to confrontations between political parties. Conclusions: The media plays a crucial role in highlighting various aspects of nursing practice. However, policy formulation processes to solve nursing issues were not adequately reported in South Korea. This study suggests that nurses should secure policy compliance by persuading the public to understand their professional perspectives. %M 38393293 %R 10.2196/50518 %U https://www.jmir.org/2024/1/e50518 %U https://doi.org/10.2196/50518 %U http://www.ncbi.nlm.nih.gov/pubmed/38393293 %0 Journal Article %@ 2561-326X %I JMIR Publications %V 7 %N %P e46476 %T Determinants of Inadequate Health Literacy Among Faculty of Medical Technical Sciences Students in Albania: Cross-Sectional Survey %A Rustami,Etleva %A Toçi,Dorina %A Poshi,Klodiana %A Peka,Elida %A Pano,Irida %A Pula,Alma %+ Department of Clinical Subject, University of Medicine Tirane, Rr Rexhep Jella Selite, RR Dibres Tirane, Tirane, 1005, Albania, 355 692217426, etleva.rustami@umed.edu.al %K Albania %K health literacy %K nursing %K prevalence %K sociodemographic factors %K students %K Faculty of Medical Technical Sciences %K FMTS %D 2023 %7 18.7.2023 %9 Original Paper %J JMIR Form Res %G English %X Background: Health literacy (HL) refers to people’s ability to find, understand, and use health information in order to make appropriate health decisions. Health literacy among students is important so that tomorrow’s health professionals can deliver high-quality health care and enhance patient education and communication. Objective: In this context, the aim of this study was to assess the HL level of Faculty of Medical Technical Sciences (FMTS) students in order to shed light on this underresearched topic in Albanian settings. Methods: A cross-sectional study involving 193 FMTS students of various study branches (nursing, midwifery, physiotherapy, and laboratory technician) was carried out during June 22-29, 2022, on the premises of the FMTS Faculty in Tirana, Albania. The international European Health Literacy Survey Questionnaire (HLS-EU-Q) standardized questionnaire, validated in Albanian, was used to collect information about FMTS students’ general HL through a face-to-face interview. Basic sociodemographic information was collected as well. Binary logistic regression was used to assess the factors associated with inadequate, problematic, or limited HL. Results: The mean level of general HL was 37.2 (on a scale from 0 [minimum HL] to 50 [maximal HL]). About one-quarter of FMTS students had inadequate (9/193, 4.7%) or problematic (38/193, 19.7%) HL, 51.3% (99/193) had sufficient HL, and 24.4% (47/193) had excellent HL. The prevalence of limited HL (inadequate and problematic HL) was higher among male than female students (6/12, 50% vs 41/181, 22.6%, respectively) and those with lower social and economic status. Upon adjusting for confounding effects, the only factor significantly increasing the likelihood of limited HL was male gender (odds ratio 8.13, 95% CI 1.68-39.39). Findings suggested that low social and economic status also increased the likelihood of limited HL, but such associations did not reach statistical significance. Conclusions: To our knowledge, this is the first study exploring the level of HL and its associated factors among FMTS students in Albania. The prevalence of limited HL was relatively high among FMTS students. There is a need for targeted interventions to increase the HL of nursing and midwifery students, such as the inclusion of HL subjects in the nursing curriculum. %M 37463034 %R 10.2196/46476 %U https://formative.jmir.org/2023/1/e46476 %U https://doi.org/10.2196/46476 %U http://www.ncbi.nlm.nih.gov/pubmed/37463034 %0 Journal Article %@ 2291-9279 %I JMIR Publications %V 10 %N 1 %P e30738 %T A Serious Game (Immunitates) About Immunization: Development and Validation Study %A Lima,Isabela Dantas de Araujo %A Ponce de Leon,Casandra Genoveva Rosales Martins %A Ribeiro,Laiane Medeiros %A Silva,Izabel Cristina Rodrigues da %A Vilela,Danielle Monteiro %A Fonseca,Luciana Mara Monti %A Góes,Fernanda dos Santos Nogueira de %A Funghetto,Silvana Schwerz %+ Graduate Program in Health Sciences and Technologies, Ceilândia College, University of Brasília, Campus Universitário - Centro Metropolitano, Ceilândia Sul, Brasília, 72220-275, Brazil, 55 61 3107 8418, isabeladantas.al@gmail.com %K educational technology %K immunization %K nursing education %K validation %K methodological study %K vaccination %K public health %K nursing students %K teaching %K education %K support tool %K continuing education %D 2022 %7 18.2.2022 %9 Original Paper %J JMIR Serious Games %G English %X Background: Vaccination is a fundamental part of all levels—local to worldwide—of public health, and it can be considered one of humanity's greatest achievements in the control and elimination of infectious diseases. Teaching immunization and vaccination can be monotonous and tiring. It is necessary to develop new approaches for teaching these themes in nursing school. Objective: We aimed to develop and validate a serious game about immunization and vaccination for Brazilian nursing students. Methods: We developed a quiz-type game, Immunitates, using design and educational theoretical models and Brazilian National Health Guidelines. The game’s heuristics and content were evaluated with 2 different instruments by a team of experts. A sample of nursing students evaluated the validity of the game’s heuristics only. We calculated the content validity index (CVI) for each evaluation. Results: The study included 49 experts and 15 nursing students. All evaluations demonstrated high internal consistency (Cronbach α≥.86). The game’s heuristics (experts: CVI 0.75-1.0; students: CVI 0.67-1.0) and the game’s contents demonstrated validity (experts: CVI 0.73-1.0). Participants identified some specific areas for improvement in the next version. Conclusions: The serious game appears to be valid. It is intended as a support tool for nursing students in the teaching–learning process and as a tool for continuing education for nurses. %M 35179496 %R 10.2196/30738 %U https://games.jmir.org/2022/1/e30738 %U https://doi.org/10.2196/30738 %U http://www.ncbi.nlm.nih.gov/pubmed/35179496 %0 Journal Article %@ 2369-2960 %I JMIR Publications %V 6 %N 4 %P e18878 %T Antivaccine Messages on Facebook: Preliminary Audit %A Dhaliwal,Dhamanpreet %A Mannion,Cynthia %+ University of Calgary, 2500 University Dr NW, Calgary, AB, , Canada, 1 403 210 3848, cmannion@ucalgary.ca %K antivaccine %K vaccines %K vaccination %K immunization %K communicable disease %D 2020 %7 20.10.2020 %9 Original Paper %J JMIR Public Health Surveill %G English %X Background: The World Health Organization lists vaccine hesitancy as one of 10 threats to global health. The antivaccine movement uses Facebook to promote messages on the alleged dangers and consequences of vaccinating, leading to a reluctance to immunize against preventable communicable diseases. Objective: We would like to know more about the messages these websites are sharing via social media that can influence readers and consumers. What messages is the public receiving on Facebook about immunization? What content (news articles, testimonials, videos, scientific studies) is being promoted? Methods: We proposed using a social media audit tool and 3 categorical lists to capture information on websites and posts, respectively. The keywords “vaccine,” “vaccine truth,” and “anti-vax” were entered in the Facebook search bar. A Facebook page was examined if it had between 2500 and 150,000 likes. Data about beliefs, calls to action, and testimonials were recorded from posts and listed under the categories Myths, Truths, and Consequences. Website data were entered in a social media audit template. Results: Users’ posts reflected fear and vaccine hesitancy resulting from the alleged dangers of immunization featured on the website links. Vaccines were blamed for afflictions such as autism, cancer, and infertility. Mothers shared testimonies on alleged consequences their children suffered due to immunization, which have influenced other parents to not vaccinate their children. Users denied the current measles outbreaks in the United States to be true, retaliating against the government in protests for fabricating news. Conclusions: Some Facebook messages encourage prevailing myths about the safety and consequences of vaccines and likely contribute to parents’ vaccine hesitancy. Deeply concerning is the mistrust social media has the potential to cast upon the relationship between health care providers and the public. A grasp of common misconceptions can help support health care provider practice. %M 33079072 %R 10.2196/18878 %U http://publichealth.jmir.org/2020/4/e18878/ %U https://doi.org/10.2196/18878 %U http://www.ncbi.nlm.nih.gov/pubmed/33079072 %0 Journal Article %@ 2291-5222 %I JMIR Publications %V 7 %N 2 %P e11644 %T The MomConnect Nurses and Midwives Support Platform (NurseConnect): A Qualitative Process Evaluation %A Fischer,Alex Emilio %A Sebidi,Jane %A Barron,Peter %A Lalla-Edward,Samanta Tresha %+ Wits Reproductive Health and HIV Institute, University of Witwatersrand, Hillbrow Health Precinct, 22 Esselen Street, HIllbrow, Johannesburg, 2001, South Africa, 27 073 776 2705, afischer@wrhi.ac.za %K evaluation %K mHealth %K mobile phone %K MomConnect %K NurseConnect %K South Africa %D 2019 %7 13.02.2019 %9 Original Paper %J JMIR Mhealth Uhealth %G English %X Background: Over the past decade, mobile health has steadily increased in low-income and middle-income countries. However, few platforms have been able to sustainably scale up like the MomConnect program in South Africa. NurseConnect was created as a capacity building component of MomConnect, aimed at supporting nurses and midwives in maternal and child health. The National Department of Health has committed to expanding NurseConnect to all nurses across the country, and an evaluation of the current user experience was conducted to inform a successful scale up. Objective: This study aims to evaluate the perception and use of NurseConnect by nurses and midwives to produce feedback that can be used to optimize the user experience as the platform continues to scale up. Methods: We conducted focus group discussions and in-depth interviews with 110 nurses and midwives from 18 randomly selected health care facilities across South Africa. Questions focused on mobile phone use, access to medical information and their experience with NurseConnect registration, as well as the content and different platforms. Results: All participants had mobile phones and communication through calls and messaging was the main use in both personal and work settings. Of 110 participants, 108 (98.2%) had data-enabled phones, and the internet, Google, and apps (South African National Department of Health Guidelines, iTriage, Drugs.com) were commonly used, especially to find information in the work setting. Of 110 participants, 62 (56.4%) were registered NurseConnect users and liked the message content, especially listeriosis and motivational messages, which created behavioral change in some instances. The mobisite and helpdesk, however, were underutilized because of a lack of information surrounding these platforms. Some participants did not trust medical information from websites and had more confidence in apps, while others associated a “helpdesk” with a call-in service, not a messaging one. Many of the unregistered participants had not heard of NurseConnect, and some cited data and time constraints as barriers to both registration and uptake. Conclusions: Mobile and smartphone penetration was very high, and participants often used their phone to find medical information. The NurseConnect messages were well-liked by all registered participants; however, the mobisite and helpdesk were underutilized owing to a lack of information and training around these platforms. Enhanced marketing and training initiatives that optimize existing social networks, as well as the provision of data and Wi-Fi, should be explored to ensure that registration improves, and that users are active across all platforms. %M 30758298 %R 10.2196/11644 %U http://mhealth.jmir.org/2019/2/e11644/ %U https://doi.org/10.2196/11644 %U http://www.ncbi.nlm.nih.gov/pubmed/30758298 %0 Journal Article %@ 2562-7600 %I JMIR Publications %V 1 %N 1 %P e11425 %T Nursing Unit Communication During a US Public Health Emergency: Natural Experiment %A Benham-Hutchins,Marge %A Carley,Kathleen M %A Brewer,Barbara B %A Effken,Judith A %A Reminga,Jeffrey %+ School of Nursing, University of Texas at Austin, 1710 Red River, Mail code: D0100, Austin, TX, 78712, United States, 1 512 475 6351, mbenhamhutchins@austin.utexas.edu %K social network analysis %K nursing unit communication %K Ebola virus disease %K public health emergency %K natural experiment %K nursing %D 2018 %7 06.12.2018 %9 Original Paper %J JMIR Nursing %G English %X Background: In the second half of 2014, the first case of Ebola virus disease (EVD) was diagnosed in the United States. During this time period, we were collecting data for the Measuring Network Stability and Fit (NetFIT) longitudinal study, which used social network analysis (SNA) to study relationships between nursing staff communication patterns and patient outcomes. One of the data collection sites was a few blocks away from where the initial EVD diagnosis was made. The EVD public health emergency during the NetFIT data collection time period resulted in the occurrence of a natural experiment. Objective: The objectives of the NetFIT study were to examine the structure of nursing unit decision-making and information-sharing networks, identify a parsimonious set of network metrics that can be used to measure the longitudinal stability of these networks, examine the relationship between the contextual features of a unit and network metrics, and identify relationships between key network measures and nursing-sensitive patient-safety and quality outcomes. This paper reports on unit communication and outcome changes that occurred during the EVD natural disaster time period on the 10 hospital units that had data collected before, during, and after the crisis period. Methods: For the NetFIT study, data were collected from nursing staff working on 25 patient care units, in three hospitals, and at four data collection points over a 7-month period: Baseline, Month 1, Month 4, and Month 7. Data collection was staggered by hospital and unit. To evaluate the influence of this public health emergency on nursing unit outcomes and communication characteristics, this paper focuses on a subsample of 10 units from two hospitals where data were collected before, during, and after the EVD crisis period. No data were collected from Hospital B during the crisis period. Network data from individual staff were aggregated to the nursing unit level to create 24-hour networks and three unit-level safety outcome measures—fall rate, medication errors, and hospital-acquired pressure ulcers—were collected. Results: This analysis includes 40 data collection points and 608 staff members who completed questionnaires. Participants (N=608) included registered nurses (431, 70.9%), licensed vocational nurses (3, 0.5%), patient care technicians (133, 21.9%), unit clerks (28, 4.6%), and monitor watchers (13, 2.1%). Changes in SNA metrics associated with communication (ie, average distance, diffusion, and density) were noted in units that had changes in patient safety outcome measures. Conclusions: Units in the hospital site in the same city as the EVD case exhibited multiple changes in patient outcomes, network communication metrics, and response rates. Future research using SNA to examine the influence of public health emergencies on hospital communication networks and relationships to patient outcomes is warranted. %M 34345768 %R 10.2196/11425 %U https://nursing.jmir.org/2018/1/e11425/ %U https://doi.org/10.2196/11425 %U http://www.ncbi.nlm.nih.gov/pubmed/34345768