Telenursing: How do caregivers treat and prevent pressure injury in bedridden patients during the COVID-19 pandemic in Thailand? Using an embedded approach

Intervention effects of telenursing based on M-O-A model in empty-nest older adult individuals with chronic diseases: a randomized controlled trial

Aim

This study aims to verify the effectiveness of M-O-A telenursing intervention model in improving the health status and quality of life of the empty-nest older adult individuals with chronic diseases by a randomized comparative trial.

Methods

M-O-A telenursing intervention model was constructed based on the needs of the participants. The control group (N = 39) received routine nursing, the experimental group (N = 39) received M-O-A telenursing intervention in addition to routine nursing. After 12 weeks of intervention, the intervention effects of being a participant in the two groups were evaluated. SPSS 26.0 was used for data analysis.

Results

After 12 weeks of intervention, for the experimental group, each dimension of quality of life based on EQ-5D-3L became better, especially for "pain/discomfort," "anxiety/depression," "HRQoL" and "EQ-VAS" (all p < 0.05) and each dimension of quality of life based on SF-36 became better too, especially for "GH," "BP," "RE," "MH," "VT," "SF," "PCS," "MCS," "SF-36" (all p < 0.05). In addition, there was a statistical downward trend in blood pressure, blood glucose, weight, BMI, fat rate, nap duration, number of nocturnal awakenings, light sleep rate and a statistical upward trend in water rate, basal metabolic rate, nighttime sleep duration, deep sleep rate, rapid eye movement sleep rate, especially at the end of intervention (all p < 0.05). While for the control group, there was no statistical improvement in all these aspects.

Conclusion

The M-O-A telenursing model could effectively regulate quality of life and health condition of the empty-nest older adult individuals with chronic diseases, making it worthy of further promotion and application.

Mapping trends and hotspots regarding the use of telenursing for elderly individuals with chronic diseases: A bibliometric analysis

BACKGROUND

Telenursing is receiving extensive attention from scholars and medical staff. However, there are few studies on the knowledge structure of telenursing for elderly individuals with chronic diseases. This study aims to demonstrate current research status and development trend of telenursing for elderly individuals with chronic diseases through a visual analysis of CiteSpace, so as to provide a more comprehensive perspective for future researches.

METHODS

Literature about telenursing for elderly patients with chronic diseases from 2002 to 2022 was retrieved from the Web of Science Core Collection using CiteSpace 6.1.R3.

RESULTS

A total of 375 records were obtained. Annual publication and citation frequency gradually increased over the investigated period, reaching a peak in 2022. Journal of Telemedicine and Telecare was the most prolific and the most cited journal. The United States was the most productive country, the University of Melbourne was the most productive institution, and the author CHEN C ranked the highest in the number of publications. The most popular keywords were "care," "telemedicine," "management," "older adult," "chronic disease," "health," and "heart failure," which had a high frequency and centrality. The keywords "telehealth," "randomized controlled trail," "chronic obstructive pulmonary disease," "implementation" and "time" showed the strongest citation burst. The keywords were clustered to form 10 labels. The article published in 2010 by Chaudhry SI was cited the most. The top 3 cited journals were all special journal of telemedicine.

CONCLUSION

This study revealed current research status and development trend of telenursing for elderly individuals with chronic diseases. The bibliometric analysis of telenursing expands the knowledge field of telemedicine and provides new insights into the management of elderly patients with chronic diseases.

Perceptions of pre-licensure nursing students toward telecare and telenursing

Telehealth transforms the healthcare system and provides the population with equal access to healthcare services at distance. This study aimed to investigate nursing students' perceptions toward telenursing. Students' knowledge, attitudes, advantages, disadvantages, barriers, and factors that affect the intention toward telenursing implementation were addressed. This study was conducted using a descriptive design. The study participants were 313 undergraduate nursing students. Data were gathered through a web-based survey from June to August 2022 and analyzed using SPSS version 22. Fifty-four-point-six percent (54.6%) of the students were male and 45.4% were female. Around one-fourth were internship students. Most students had access to the internet 97.4%. The results revealed that nursing students have positive perceptions toward telenursing. Their overall competencies in terms of knowledge, proficiency, awareness, and familiarity were moderate. Students raised some disadvantages and difficulties regarding telenursing; meanwhile, more advantages and suggestions to overcome the disadvantages were reported. It is of utmost importance that nursing education integrates telenursing content and practice to prepare future nurses for the successful implementation of telenursing. More research is still needed to examine the impact of telenursing on nursing practice. Nursing administrators must develop appropriate and prompt interventions to respond to the dramatically changing healthcare environment.

Telepalliative Care in Home-Based Nursing Care for Older Adults With Metastatic Cancer Post COVID-19: An Ethnoscientific Study

Introduction

The post-COVID-19 pandemic caused the whole world to make several changes to the nursing healthcare system. This sudden shift raised questions about telepalliative care in home-based nursing care in the context of healthcare utilization, including meeting the needs of older adults with metastatic cancer. The evidence suggests that telepalliative care in home-based nursing care is acceptable to most advanced practice nurses, but the extent of their use for metastatic cancer patients has not been defined.

Objectives

To explore the use of telepalliative care in home-based nursing care for older adults with metastatic cancer in central Thailand following the post-COVID-19 pandemic.

Methods

A qualitative approach with an ethnoscientific design was used to collect data from a purposive sample of 15 advanced practice nurses from May to September 2023. The interview transcripts were analyzed using componential analysis (core coding, categorizing, theme, and emerging theory).

Results

The componential analysis revealed two themes of telepalliative care in home-based nursing care for older adults with metastatic cancer in the post COVID-19 pandemic. The first theme is telepalliative care delivery, with subthemes of delivering practice, nurse-mediated feedback and supportive care, remote monitoring of real-time emergencies, and transferring medical data. The second theme is advanced practice nurses' (APN) role in telepalliative nursing care, including the subthemes of virtual monitoring, life-threatening cancer, side effects, caregiving capacity, continuity of care, and long-term care services. The study found that caregiving capacity, continuity of care, and long-term care services were formed of telepalliative care in home-based nursing care for cancer patients following the COVID-19 pandemic.

Conclusion

Telepalliative care in home-based nursing care is effective in delivering services to older adults with metastatic cancer during the post-COVID-19 pandemic. The findings suggested that remote monitoring of real-time emergencies, life-threatening cancer, and long-term care services are part of telepalliative care in home-based nursing care. Adapting the telepalliative competency standards of advanced practice nurses is needed to ensure high-quality healthcare access for older adults with metastatic cancer during the post-COVID-19 pandemic.

“Even though we are elders living alone”: has social support reshaped the care of older adults during the COVID-19 pandemic?

Purpose

This study aims to explore how social support has reshaped the care of older adults living alone in northeast Thailand during the COVID-19 pandemic.

Design/methodology/approach

This study used a qualitative method using a narrative gerontological perspective with a descriptive design. Purposive sampling was conducted from 20 in-depth narrative interviews between November 2021 and February 2022 in Maha Sarakham province, northeast Thailand. Data transcriptions were performed using a narrative analytical process.

Findings

The in-depth narrative interviews indicated that older adults living alone during the coronavirus pandemic valued a comfortable life, a sense of place, favourable living arrangements, self-reliance, life goals and meaningful life. The gerontological analysis showed that social support for older adults living alone included a social safety net, networking, supporting needs, physical care and mental health responses to the COVID-19 pandemic.

Originality/value

To the best of the authors’ knowledge, this is the first qualitative narrative gerontological study to explore how social support reshaped the care of older adults living alone during the COVID-19 pandemic in northeast Thailand.

Electronic Alert Signal for Early Detection of Tissue Injuries in Patients: An Innovative Pressure Sensor Mattress

Monitoring the early stage of developing tissue injuries requires intact skin for surface detection of cell damage. However, electronic alert signal for early detection is limited due to the lack of accurate pressure sensors for lightly pigmented skin injuries in patients. We developed an innovative pressure sensor mattress that produces an electronic alert signal for the early detection of tissue injuries. The electronic alert signal is developed using a web and mobile application for pressure sensor mattress reporting. The mattress is based on body distributions with reference points, temperature, and a humidity sensor to detect lightly pigmented skin injuries. Early detection of the pressure sensor is linked to an electronic alert signal at 32 mm Hg, a temperature of 37 °C, a relative humidity of 33.5%, a response time of 10 s, a loading time of 30 g, a density area of 1 mA, and a resistance of 7.05 MPa (54 N) at 0.87 m³/min. The development of the innovative pressure sensor mattress using an electronic alert signal is in line with its enhanced pressure detection, temperature, and humidity sensors.

Demand analysis of telenursing among empty-nest elderly individuals with chronic diseases based on the Kano model

Aim

The increase in empty-nest elderly individuals with chronic diseases poses a major challenge to the provision of public health services in China. Telenursing can effectively relieve the pressure of public health services to a certain extent. This study aims to explore the telenursing needs of empty-nest elderly individuals with chronic diseases based on the Kano model to provide references for improving the quality of telenursing.

Methods

Participants were selected from five rural communities and five urban communities in Yangzhou and Nantong, Jiangsu Province, China. A total of 348 empty-nest elderly individuals with chronic diseases were included. The participants received a sociodemographic characteristics questionnaire, and their telenursing needs were surveyed and analyzed based on the Kano model.

Results

Of the 15 quality attributes evaluated by the participants, 3 telenursing services were categorized as "must-be quality", 5 were categorized as "one-dimensional quality", 5 were categorized as "attractive quality", and 2 were categorized as "indifferent quality". The proportion of individuals who desired telenursing services ranged from 47.41 to 83.62%, the better values (satisfaction) ranged from 35.29-83.98%, and the worse values (dissatisfaction) ranged from 10.91 to 63.27%. There were no significant differences in any items of telenursing needs for between participants in Yangzhou and Nantong (all P > 0.05), and there were also no significant differences in all items between rural and urban communities (all P > 0.05).

Conclusion

Based on the Kano model, it was found that empty-nest elderly individuals with chronic diseases had a positive attitude toward telenursing and that they had different levels of need for different telenursing services. These findings provided a theoretical basis for medical decision-makers to formulate medical policies and provided a scientific foundation for nursing managers to improve telenursing services to meet the needs of the empty-nest elderly individuals with chronic diseases.

Determinants of the Mobile Health Continuance Intention of Elders with Chronic Diseases: An Integrated Framework of ECM-ISC and UTAUT

With the deepening of population aging in China, chronic diseases are a major public health concern that threatens the life and health of nationals. Mobile health or mHealth can effectively monitor chronic diseases, which holds vital significance to the alleviation of social pressure caused by aging. To patients with chronic diseases, mHealth cannot give full play to its value, only when it is used in the long term. However, there is not yet research exploring mHealth continuance intention from the perspective of elders with chronic diseases. So, this research represents the first attempt to empirically analyze mHealth continuance intention from the perspective of elders with chronic diseases. The purpose of this research is to make up the research gap of the mHealth field and to put forward theoretical and practical implications based on research results. To obtain research data, a questionnaire was conducted. A total of 926 copies were collected online and 527 copies were collected offline. The structural equation model (SEM) was used for data analysis. Research results suggest that confirmation can significantly influence satisfaction, performance expectancy and effort expectancy. Meanwhile, confirmation and performance expectancy can significantly influence satisfaction. Additionally, effort expectancy, performance expectancy, social influence and facilitating conditions can directly and significantly influence continuance intention. Among them, performance expectancy can directly influence continuance intention in the most significant way. This research provides solid evidence for the validity of the integrated model of ECM-ISC and UTAUT in the mHealth field, which can be a theoretical basis for mHealth operators' product R&D.