1
|
Wu X, Kuang Y, Guo Y, Wei N, Fan Z, Ling J. Analyzing the barriers and enablers to internet hospital implementation: a qualitative study of a tertiary hospital using TDF and COM-B framework. Front Digit Health 2024; 6:1362395. [PMID: 39175961 PMCID: PMC11340510 DOI: 10.3389/fdgth.2024.1362395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/28/2024] [Indexed: 08/24/2024] Open
Abstract
Background Internet hospitals have become an important way to improve the accessibility of medical services and promote medical equity in China. However, there is still lack of research on the behavior of medical personnel during the process of using Internet medical services, and the elements of behavior that motivate doctors to actively use or resist the use of Internet hospitals are still not fully analyzed. The study applied the Theoretical Domains Framework to examine the factors affecting the engagement of medical personnel in Internet hospitals, with the aim of guiding the design of intervention to enhance Internet hospital participation. Methods This study utilized qualitative analysis. Semi-structured questionnaires based on the Theoretical Domains Framework (TDF) and Capability-Opportunity-Motivation-Behavior (COM-B) model was developed and administered to 40 doctors and nurses at a Grade A tertiary hospital in Guangdong Province. Data was coded and analyzed using qualitative methods including Nvivo software. Results The research displayed 19 barriers and 7 enablers for the implementation of Internet hospitals, all 14 TDF domains impacted participation with motivation cited most frequently. Despite challenges, medical personnel exhibited a generally optimistic stance towards utilization of the Internet hospital. Major barriers include the higher requirement of diagnostic ability, objective difficulties brought by online consultation to the decision-making process, limitation of time and other resources, not ideal technological and institutional environment, lack of self-efficacy and negative expectation of results in online consultation. Key enablers include patient needs and the positive impact of online care on the medical process and patient experience. Discussion This qualitative study identified a range of barriers and enablers to Internet hospital participation according to medical personnel, providing an conceptual framework to guide further research evaluating implementation strategies. Expanded research and targeted interventions design can help optimize participation in this evolving healthcare delivery model.
Collapse
Affiliation(s)
- Xiaolong Wu
- Business School, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yulin Kuang
- Business School, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Yonglin Guo
- School of Government, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Ning Wei
- Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Zichun Fan
- Business School, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Jingru Ling
- Business School, Sun Yat-sen University, Shenzhen, Guangdong, China
| |
Collapse
|
2
|
Miao C, Liu C, Zhou Y, Zou X, Song L, Chung JWY, Tan W, Li X, Li D. Nurses' perspectives on professional self-concept and its influencing factors: A qualitative study. BMC Nurs 2024; 23:237. [PMID: 38594667 PMCID: PMC11003037 DOI: 10.1186/s12912-024-01834-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/01/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Nurses with a strong professional self-concept tend to exhibit a positive mindset and strong work engagement, delivering high-quality patient care. Although numerous quantitative studies have examined the factors impacting professional self-concept, there remains a limited exploration of these factors from the perspective of nurses themselves. METHODS This qualitative descriptive study uses the PERMA theory and Social Cognitive Theory as the theoretical framework. Semi-structured interviews were conducted with 15 nurses from six public hospitals in China. The data were analyzed thematically using a combination of inductive and deductive approaches. RESULTS Nurses' understanding of professional self-concept could be divided into four categories: professional identity, competence, care, and knowledge. Factors influencing nurses' professional self-concept were categorized into eight subthemes in three domains: (1) personal factors, including psychological qualities and attitude towards the nursing profession; (2) occupational-related behavioral factors, including role-oriented behavior and knowledge-oriented behavior; and (3) work environment and external factors, including external evaluation and perceptions of nurses, time allocation, nursing work tasks, work atmosphere, school education, and perceived supports. CONCLUSIONS This study found that, although nurses had different personal experiences, their perceptions of professional self-concept were similar. Nurses' professional self-concept is a multidimensional concept and involves various factors, such as personality, work-related characteristics, environment, and family. To thrive in a nursing career, nurses must discern the factors that can enhance or hinder their professional self-concept. By identifying and adjusting these factors, personalized support and positive interventions can be tailored to meet nurses' specific needs, which ultimately nurtures their professional development. TRIAL REGISTRATION This study was registered on December 14, 2022, in the Chinese Clinical Trial Registry (ChiCTR2200066699) as part of our ongoing study.
Collapse
Affiliation(s)
- Chuyuan Miao
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, 510182, China
| | - Chunqin Liu
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, 510182, China
| | - Ying Zhou
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, 510182, China.
| | - Xiaofang Zou
- Department of Nursing, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, 510150, China
| | - Liqin Song
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, 510182, China
| | - Joanne W Y Chung
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, 510182, China.
- Kiang Wu Nursing College of Macau, Macao, Macao SAR, 999078, China.
| | - Wenying Tan
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, 510182, China
| | - Xiaohua Li
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, 510182, China
| | - Dong Li
- Department of International Culture Education, Chodang University, Muan, 58530, Republic of Korea
| |
Collapse
|
3
|
Tong LK, Zhu MX, Wang SC, Cheong PL, Van IK. Gender similarities and differences in the perception of caring among nurses during the COVID-19 pandemic: a mixed-methods study. BMC Nurs 2023; 22:115. [PMID: 37046318 PMCID: PMC10091316 DOI: 10.1186/s12912-023-01267-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Caring is the essence and core of nursing. Current studies on the effect of gender on nurses' perception of caring have been inconsistent. Most of these studies were quantitative and conducted before the COVID-19 pandemic. The study aimed to explore the gender similarities and differences in nurses' perception of caring during the COVID-19 pandemic. METHODS In 2020, a cross-sectional mixed-method study was conducted in 11 cities in China using structured online questionnaire (n = 8030) and face-to-face individual interview (n = 42). Data collection tools included the Caring Dimensions Inventory and semi-structured interview. RESULTS In stepwise multivariable linear regression analysis, female nurses scored 1.93 points higher on caring than male nurses, after completely controlling for the other factors. The interview results showed that both male and female nurses agreed that caring was to deal with three kinds of relationships, namely nurses and people, nurses and themselves, nurses and society. There were gender differences in the connotation of caring between nurses and themselves, but not in the connotations of caring between other relationships. The ranking of the importance of caring connotations among these relationships showed no gender difference except between nurses and themselves. CONCLUSION The quantitative findings suggest that gender influences nurses' perception of caring. The qualitative findings demonstrate that nurses regard themselves as both recipients and implementers of caring. The qualitative results indicate nurses of different genders have similarities and differences in their perception of caring, and the biggest difference lies in the relationship between nurses and themselves.
Collapse
Affiliation(s)
| | | | | | | | - Iat Kio Van
- Kiang Wu Nursing College of Macau, Macao, China.
| |
Collapse
|
4
|
Tong LK, Au ML, Li YY, Ng WI, Wang SC. The mediating effect of critical thinking between interest in learning and caring among nursing students: a cross-sectional study. BMC Nurs 2023; 22:30. [PMID: 36737747 PMCID: PMC9895970 DOI: 10.1186/s12912-023-01181-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Previous studies have explored the influence of interest in learning on caring and critical thinking, as well as the relationship between caring and critical thinking. However, the mediating effect of critical thinking in interest learning and caring among nursing students has not been clarified. METHODS Nursing students who enrolled for the 2021/2022 academic year in diploma, undergraduate, or graduate programs in five provinces of China (Guangdong, Sichuan, Jiangsu, Hunan and Macao). An online survey with a convenience sampling method was employed to collect data. The questionnaires were administered to 692 participants between January 20 and 26, 2022. Amos 26.0 was employed to establish the structural equation modelling and analyze the mediating effect of critical thinking on interest in learning and caring. RESULTS The first regression equation showed that interest in learning significantly influenced caring (β = 0.339, p < 0.001). The third regression equation showed that critical thinking significantly influenced caring (β = 0.494, p < 0.001). The effect of interest in learning on caring was less in the third equation than in the first equation (β = 0.154 vs β = 0.339), which indicates partial mediation. Furthermore, interest in learning had an indirect positive effect (β = 0.186, p < 0.001) on caring mediated by critical thinking, with 95% confidence interval of 0.142 to 0.233. CONCLUSIONS Critical thinking was a significant mediator of the relationship between interest in learning and caring. It is suggested that nursing colleges and instructors should take into account students' interest in learning and critical thinking as potential intervention elements to enhance caring.
Collapse
Affiliation(s)
- Lai Kun Tong
- grid.445015.10000 0000 8755 5076Kiang Wu Nursing College of Macau, Macau, China
| | - Mio Leng Au
- grid.445015.10000 0000 8755 5076Kiang Wu Nursing College of Macau, Macau, China
| | - Yue Yi Li
- grid.445015.10000 0000 8755 5076Kiang Wu Nursing College of Macau, Macau, China
| | - Wai I. Ng
- grid.445015.10000 0000 8755 5076Kiang Wu Nursing College of Macau, Macau, China
| | - Si Chen Wang
- grid.445015.10000 0000 8755 5076Kiang Wu Nursing College of Macau, Macau, China
| |
Collapse
|
5
|
Tong LK, Zhu MX, Wang SC, Cheong PL, Van IK. The impact of caring for COVID-19 patients on nurse professional identity: A cross-sectional study using propensity score analysis. Front Public Health 2022; 10:1066667. [PMID: 36523574 PMCID: PMC9745049 DOI: 10.3389/fpubh.2022.1066667] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To examine the impact of caring for COVID-19 patients on the professional identity of nurses. Methods An online survey was conducted between 19 May and 7 August 2020 in 11 Chinese cities, including Dongguan, Foshan, Guangzhou, Hong Kong, Huizhou, Jiangmen, Macao, Shenzhen, Zhaoqing, Zhongshan, and Zhuhai. Propensity score matching was used to adjust for confounding variables between nurses with and without experience caring for COVID-19 patients. To analyze the impact of caring for COVID-19 patients on nurses' professional identity, a nominal logistic regression model was used rather than an ordinal regression model because the parallel regression assumption was violated. Results After propensity score matching, the final sample contained 1,268 participants, including 634 nurses who cared for COVID-19 patients. During the COVID-19 outbreak, 88.6% of nurses had high levels of professional identity. Nurses who cared for COVID-19 patients had the lowest percentage of high score level on the professional identity subscale for "sense of organizational influence," as did nurses who did not care for COVID-19 patients. The findings indicated that nurses who cared for COVID-19 patients were 17.95 times more likely to have a high professional identity than a low professional identity (95% CI 2.38-135.39, p = 0.005), after completely controlling for the other factors. There were significant differences between nurses who cared for COVID-19 patients and those who did not in scores on the subscales of professional identity, except for the subscales "sense of self-decision-making" (χ2 = 4.85, p = 0.089) and "sense of organizational influence" (χ2 = 4.71, p = 0.095). Conclusion Nurses' professional identity is positively impacted by their experience caring for COVID-19 patients. Caring for COVID-19 patients should be highlighted as an opportunity to enhance nurses' professional identity. To further enhance the professional identity of nurses, we call for visible nursing leadership during the COVID-19 pandemic and improve their working environment.
Collapse
Affiliation(s)
- Lai Kun Tong
- Research Management and Development Department, Kiang Wu Nursing College of Macau, Macao SAR, China
| | - Ming Xia Zhu
- Education Department, Kiang Wu Nursing College of Macau, Macao SAR, China
| | - Si Chen Wang
- Education Department, Kiang Wu Nursing College of Macau, Macao SAR, China
| | - Pak Leng Cheong
- Education Department, Kiang Wu Nursing College of Macau, Macao SAR, China
| | - Iat Kio Van
- Education Department, Kiang Wu Nursing College of Macau, Macao SAR, China,*Correspondence: Iat Kio Van
| |
Collapse
|