Collective empowerment of an online patient community: conceptualizing process dynamics using a multi-method qualitative approach

Reassembling nursing in the digital age: An actor-network theory perspective

This article explores the application of actor-network theory (ANT) to the nursing profession, proposing a novel perspective in understanding nursing in the context of modern digital healthcare. Traditional grand nursing theories, while foundational, often fail to encapsulate the dynamic and complex nature of nursing, particularly in an era of rapid technological advancements and shifting societal dynamics. ANT, with its emphasis on the relationships between human and nonhuman actors, offers a framework to understand nursing beyond traditional paradigms. This article makes two key arguments: first, that nursing can be viewed as a highly organised social assemblage, where both human (nurses, patients and policymakers) and nonhuman actors (technologies, medical equipment, institutional policies) play a crucial role, and second, that ANT can be used to enhance existing nursing theory to better understand the role of technology in nursing practice. The article considers how ANT can provide a more holistic and adaptable model for describing the nursing profession, particularly in an era where technology plays an integral role in healthcare delivery. It discusses the implications of viewing nursing through ANT, highlighting the need for nursing education and practice to adapt to the interconnected and technologically advanced nature of modern healthcare. The article also acknowledges the limitations of ANT, particularly its potential oversimplification of the complex ethical dimensions inherent in nursing and its focus on observable phenomena.

Lessons Learned From Clinical Studies in Centronuclear Myopathies: The Patient Perspective-A Qualitative Study

BACKGROUND

Since 2014, several clinical studies focusing on centronuclear myopathies have been conducted, including a prospective natural history study, a gene transfer clinical trial and a clinical trial using an antisense oligonucleotide. Dedicated patient organizations have played an important role in this process. The experience of members of these organizations, either as a study participant, parent or as a patient organization member communicating with the sponsors are potentially very informative for future trial design.

METHODS

We investigated the burden of and the lessons learned from the first natural history studies and clinical trials from a patient perspective using a qualitative approach. We arranged 4 focus groups with a total of 37 participants from 3 large international patient organizations: ZNM-ZusammenStark!, the Myotubular Trust, and the MTM-CNM Family Connection. 4 themes, based on a systematic literature search were discussed: Expectations and preparation, Clinical study participation, Communication and Recommendations for future clinical trials. The focus group recordings were transcribed, anonymized, and uploaded to Atlas-ti version 8.1 software. The data were analyzed using a thematic content analysis.

RESULTS

Overall, participants were realistic in their expectations, hoping for small improvements of function and quality of life. The realization that trial participation does not equate to a treatment was challenging. Participating in a clinical study had a huge impact on many aspects of daily life, both for patients and their immediate families. First-hand insights into the burden of the design and its possible effect on performance were provided, resulting in numerous compelling recommendations for future clinical studies. Furthermore, participants stressed the importance of clear communication, which was considered to be especially vital in cases of severe adverse events. Finally, while patients were understanding of the importance of adhering to the regulations of good clinical practice, they indicated that they would strongly appreciate a greater understanding and/or acknowledgment of the patient perspective and a reflection of this perspective in future clinical trial design.

CONCLUSION

The acknowledgment and inclusion of patients' perspectives and efficient and effective communication is expected to improve patient recruitment and retention in future clinical studies, as well as more accurate assessment of the patient performance related to suitable planning of the study visits.

A Mapping Review of Netnography in Nursing

People use the Web to seek health-related information and to discuss health issues with peers. Netnography, a qualitative research methodology, has gained the attention of researchers interested in people's health and health issues. However, no previous reviews have accounted for how netnography is used in nursing research. The purpose of this mapping review was to generate a map of netnographic research in nursing. The search was conducted in PubMed, Academic Search Elite, the Cumulative Index to Nursing and Allied Health Literature, Medline, PsycINFO, Scopus, and Web of Science. Data were extracted from 53 original articles. The results show an increasing trend in published netnographies over time; 34% of the total sample was published in 2021. Of the total, 28% originated from Sweden, and 81% had used a covert approach. In studies in which the researchers used more participatory designs, the time spent on online forums ranged between 4 weeks and 20 months. Informed consent is found to be an issue in netnographic studies. We discuss the fact that nursing researchers have used netnography to address a wide range of research topics of concern and interest, from self-care support in an online forum for older adults to nursing students' perspectives on effective pedagogy. In line with the digital transformation in society in general, we discuss the fact that netnography as a research methodology offers great opportunities for nurse researchers to monitor new spaces and places that presuppose online methodological knowledge.

The work of Chinese chronic conditions: adaptation and validation of the Distribution of Co-Care Activities Scale

Purpose

The Distribution of Co-Care Activities Scale was adapted into Chinese for the purposes of this study, and then the psychometric characteristics of the Chinese version of the DoCCA scale were confirmed in chronic conditions.

Methods

A total of 434 patients with chronic diseases were recruited from three Chinese cities. A cross-cultural adaptation procedure was used to translate the Distribution of Co-Care Activities Scale into Chinese. Cronbach's alpha coefficient, split-half reliability, and test-retest reliability were used to verify the scale's reliability. Content validity indices, exploratory factor analysis, and confirmatory factor analysis were used to confirm the scale's validity.

Results

The Chinese DoCCA scale includes five domains: demands, unnecessary tasks, role clarity, needs support, and goal orientation. The S-CVI was 0.964. Exploratory factor analysis yielded a five-factor structure that explained 74.952% of the total variance. According to the confirmatory factor analysis results, the fit indices were within the range of the reference values. Convergent and discriminant validity both met the criteria. Also, the scale's Cronbach's alpha coefficient is 0.936, and the five dimensions' values range from 0.818 to 0.909. The split-half reliability was 0.848, and the test-retest reliability was 0.832.

Conclusions

The Chinese version of the Distribution of Co-Care Activities Scale had high levels of validity and reliability for chronic conditions. The scale can assess how patients with chronic diseases feel about their service of care and provide data to optimize their personalized chronic disease self-management strategies.

Online social support and collective empowerment: Serial mediation effect on self-efficacy among mothers of children with type 1 diabetes

AIM

To identify a serial multiple mediation effect of social support in online health communities and collective empowerment on the relationship between diabetes-related burden (DRB) and self-efficacy, among mothers using a continuous glucose monitoring device for children with type 1 diabetes (T1D).

DESIGN

A secondary analysis, cross-sectional, descriptive study.

METHODS

Data were obtained from 198 mothers of children with T1D via a web survey, from August to September 2020. Measures used were the Collective Empowerment in the Online Health Community Scale, a modified version of the Multidimensional Scale of Perceived Social Support, Problem Areas in Diabetes Survey-Parent Revised version and a modified version of the Maternal Self-efficacy for Diabetes Management Scale. Data were analysed using SPSS 25.0, and PROCESS MACRO for SPSS v3.5.

RESULTS

A serial multiple mediation model was used. The indirect effects of both social support in online health communities and collective empowerment were identified in the relationship between DRB and diabetes self-efficacy (DSE). However, there was no indirect effect of social support in online health communities on these relationships.

CONCLUSION

These findings suggest that online social support alone has a limited role in chronic disease management self-efficacy. Collective empowerment should be a strategic component in intervention development using online health communities to strengthen DSE in mothers of children with T1D.

IMPACT

This study provides novel insights into the functional mechanism of online health communities for T1D. Peer mentor coaching by parents of children with T1D effectively helps other children's parents with its recent diagnosis. The findings recognize a need for strategies enhancing collective empowerment among parents of children with T1D. Along with peer coaching, these strategies should strengthen knowledge of resources and methods to impact social change as well as resource mobilization for collective actions.