Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care: Pilot Study

Patients' experience of telehealth clinics during the COVID-19 pandemic: Cross-sectional study

Globally, the Coronavirus disease (COVID-19) pandemic in 2019 has accelerated the adoption of telehealth technologies. The implementation of the Saudi Telemedicine Network (STN) and other digital health initiatives, such as the telehealth clinic (THC) at King Abdullah bin Abdulaziz University Hospital (KAAUH), exemplifies this trend in Saudi Arabia. The aim of this study was to explore the patients' experience of THC in KAAUH during the COVID-19 pandemic and their' beliefs about their readiness to replace the traditional onsite clinical visits with THC from March to September 2020. A cross-sectional study targeted all 1398 patients who utilized THC at KAAUH. A self-administrated, validated survey collected the data. The survey used a Likert scale and included questions on satisfaction with THC services and the perceived effectiveness of telehealth as a substitute for in-person visits. The collected data was analyzed using frequency and percentage. A total of 252 patients responded to the THC postvisit survey. Overall, 217 patients (86%) were satisfied, 32 patients (13%) were dissatisfied, and only 3 patients (1%) were neutral about THC. Most patients (65.5%) agree that THC provided enough information about their health conditions, which can substitute for clinical visits. About 18.3% of patients were neutral, while 16.3% disagreed with the effectiveness of THC services and believed that they could not replace onsite visits. During the COVID-19 pandemic, most patients were satisfied at KAAUH-THC in Saudi Arabia and believed that it could replace the onsite visit to a physician's clinic. The 2 main causes of the patient's belief that THC could not replace an onsite clinical visit were: First, nonadherence to appointments led to missed calls and a complete medical service. Second, the patient's perception is that a physical examination and lab investigation cannot be completed through THC.

Communication and empathy of nursing students in patient care through telenursing: A comparative cross-sectional study

BACKGROUND

Phone calls and videoconferences are the most widely used systems to interact with patients in real time. Patient care through phone calls or videoconferences is different from an in-person meeting. Interpersonal communication skills, self-confidence communication skills and empathy with the patient may be affected during phone calls or videoconferences.

AIM

The objective of this study was to describe the interpersonal communication skills, self-confidence communication skills and empathy of nursing students during patient care through phone calls or videoconferences.

DESIGN

A cross-sectional study.

PARTICIPANTS

A total of 170 nursing students participated from the University of Almeria. The subjects were randomly assigned to the phone call group or videoconference group.

METHODS

The students contacted standardised patients through phone calls or videoconferences. Questionnaires were used to assess interpersonal communication skills with patient, empathy, and self-confidence in communication skills. Data collection was carried out between March and May 2022.

RESULTS

No statistically significant differences were found between self-confidence in communication skills with the patient and the type of consultation, nor were statistically significant differences found between the empathy of the nursing students and the type of consultation. The students who used videoconference reported higher patient interpersonal communication skills than the students who made phone calls. Finally, the participants who made videoconferences obtained a higher score in dimension therapeutic use of self than those who made phone calls.

CONCLUSIONS

Nursing students have shown a high level of empathy and interpersonal communication skills with patients and a moderate level of self-confidence in communication skills, both when interacting with patients through phone calls and videoconferences. Finally, differences were found in interpersonal communication skills with patient and type of consultation. In particular, interpersonal communication skills with the patient are greater when the nursing students make a videoconference.

Telenursing implications for future education and practice: Nursing students' perspectives and knowledge from a course on child health

BACKGROUND

Technology advancements have altered the standard of nursing care, and education. This suggests the necessity to equip prospective nurses to provide competent care in a highly technical and digital environment via telenursing.

AIMS

The aim of this study was to assess the perceptions and knowledge of nursing students about telenursing.

METHODS

Using a descriptive cross-sectional design. A self-reported questionnaire was used. The distribution of 110 questionnaires to nursing students attending two private colleges in Jordan resulted in an 83.6% (n = 92) response rate. Descriptive and inferential statistics were applied.

RESULTS

The results showed a positive perception toward telenursing practice, as well as the difficulty in precisely defining telenursing. Age, internet usage patterns, and knowledge were all factors considered telenursing predictors. 32% of the variance was explained by the model. Telenursing would be beneficial for future nursing professionals by incorporating telenursing into the curriculum.

CONCLUSIONS

The learning environment is extends somewhat beyond the classroom, making it is necessary to integrate telenursing into education in order to redefine the future of the nursing practice.

The Quality of Telenursing-Israeli Nursing Staff's Perceptions

BACKGROUND

The outbreak of the COVID-19 pandemic has increased telemedicine and telenursing services worldwide, developed this innovative treatment's potential, and emphasized its importance. The constraints imposed by the pandemic breached regulatory, psychological, and organizational obstructions among both patients and caretakers. Community and hospital nursing services were forced to deal with a new reality, to provide remote care solutions for bedridden chronic patients, as the need for this grew exponentially. Despite the increase of telemedicine in recent years, so far no research in Israel has investigated the nursing staff's perceptions of the quality of the care provided through telenursing.

OBJECTIVE

To assess nurses' perceptions of the quality of the care provided through telenursing compared to face-to-face nursing.

METHOD

A quantitative cross-sectional study among 227 male and female nurses in Israel. The questionnaire included demographic questions, and the five measures of quality of care: concern and empathy for the patient, professional treatment, response to treatment, educated use of resources, and patients' sense of security.

RESULTS

Significant differences were found between nurses' perceptions of telenursing and face-to-face nursing. The quality of face-to-face nursing was perceived as more positive than that of telenursing, in general, as were the individual measures of care quality such as providing professional treatment, response to treatment, and patients' sense of security.

CONCLUSIONS

Although telemedicine has increased significantly in recent years, nursing staff still perceived the quality of care and follow-up of face-to-face nursing as more positive. It is important to continue to monitor nurses' perceptions and attitudes towards the strengths of these two treatment methods, not only in crisis situations, but among wider populations, and to investigate the factors that could influence these perceptions.

Health Information Technology Adoption at U.S. Home Health Care Agencies: Results from a Multi-Methods Study

Health information technology (HIT) holds potential to transform Home Health Care (HHC), yet, little is known about its adoption in this setting. In the context of infection prevention and control, we aimed to: (1) describe challenges associated with the adoption of HIT, for example, electronic health records (EHR) and telehealth and (2) examine HHC agency characteristics associated with HIT adoption. We conducted in-depth interviews with 41 staff from 13 U.S. HHC agencies (May-October 2018), then surveyed a stratified random sample of 1506 agencies (November 2018-December 2019), of which 35.6% participated (N = 536 HHC agencies). We applied analytic weights, generating nationally-representative estimates, and computed descriptive statistics, bivariate and multivariable analyses. Four themes were identified: (1) Reflections on providing HHC without EHR; (2) Benefits of EHR; (3) Benefits of other HIT; (4) Challenges with HIT and EHR. Overall, 10% of the agencies did not have an EHR; an additional 2% were in the process of acquiring one. Sixteen percent offered telehealth, and another 4% were in the process of acquiring telehealth services. In multivariable analysis, EHR use varied significantly by geographic location and ownership, and telehealth use varied by geographic location, ownership, and size. Although HIT use has increased, our results indicate that many HHC agencies still lack the HIT needed to implement technological solutions to improve workflow and quality of care. Future research should examine the impact of HIT on patient outcomes and the impact of the COVID-19 pandemic on HIT use in HHC.

Although in shortage, nursing workforce is still a significant contributor to life expectancy at birth

OBJECTIVES

Previous studies have not fully reported the strength and independency of the correlation of nursing workforce to life expectancy. This study advances that nursing workforce is a major independent contributor to life expectancy at birth (LEB) globally and regionally.

DESIGN

A cross-sectional study was conducted at population level.

SAMPLE

Ecological data were extracted from the United Nations agencies for 215 populations. Each population is considered a research subject.

MEASUREMENTS

The correlation between nursing workforce and LEB was analyzed with scatter plots, bivariate correlation, partial correlation, and multiple linear regression analyses, Analysis of Variance post hoc and independent T-test. Economic affluence, urban lifestyle and obesity were included as the potential confounders in this study.

INTERVENTION

Not applicable RESULTS: Nursing workforce correlated to LEB and this relationship remained regardless of the competition of economic affluence, urbanization, and obesity. Second to economic affluence, nursing workforce showed the greatest influence on LEB. In total, 64.50% of LEB was explained in this study. Nursing workforce was a determinant of regional variations of LEB.

CONCLUSIONS

Nursing workforce may be a significant contributor to LEB globally and regionally. This contribution was independent of the potential confounding effects of economic affluence, urbanization, and obesity.

Perceptions and Use of Telehealth among diverse communities: A Multisite Community Engaged Mixed Methods Study

BACKGROUND

Telehealth has been increasingly adopted by healthcare systems since the start of the COVID-19 pandemic. Although telehealth may provide convenience for patients and clinicians, there are several barriers to accessing it and using it effectively to provide high quality patient care.

OBJECTIVE

This study, was part of a larger multisite community engaged study conducted to understand the impact of COVID-19 on diverse communities. The work described here explored the perceptions of and experience with telehealth use among diverse and underserved community members during COVID-19.

METHODS

We used mixed methods across three regions in the US (Midwest, Arizona, and Florida) from January 2021-November 2021. We promoted our study through social media and community partnerships, disseminating flyers in English and Spanish. We developed a moderator guide and conducted focus groups in English and Spanish mostly using a videoconferencing platform. Participants were placed in focus groups with others who shared similar demographic attributes and geographic location. Focus groups were audio-recorded and transcribed. We analyzed our qualitative data using the framework analytic approach. We developed our broader survey using validated scales and with input from community and scientific leaders and distributed it through social media in English and Spanish. We included a previously published questionnaire which had been used to assess perceptions about telehealth among patients with HIV. We analyzed our quantitative data using SAS software and standard statistical approaches. We examined the effect of region, age, ethnicity/race and education on use and perceptions of telehealth.

RESULTS

We included data from 47 focus groups. Due to our mode of dissemination, we cannot calculate a response rate for the survey. However, we received 3447 English language and 146 Spanish language responses. Over 90% of participants had internet access and 94% had used telehealth. About half of all participants agreed or strongly agreed that telehealth would be beneficial in the future because it better fit their schedules and they would not need to travel. However, about half also agreed or strongly agreed they would not be able to express themselves well and could not be examined when using telehealth. Indigenous participants were especially concerned about these issues when compared to other racial groups.

CONCLUSIONS

This work describes findings from a mixed methods community engaged research study about telehealth including perceived benefits and concerns. Although participants enjoyed the benefits of telehealth (not having to travel and easier scheduling) they also had concerns (not being able to express themselves well and not having a physical exam) about telehealth.. These sentiments were especially notable among the Indigenous population. Our work highlights the importance of fully understanding the impact of these novel health delivery modalities on the patient experience and actual or perceived quality of care received.

CLINICALTRIAL

Telehealth in long-term care facilities during the Covid-19 pandemic - Lessons learned from patients, physicians, nurses and healthcare workers

Background

Telehealth and telecare are particularly important and beneficial to long-term care facilities due to care demands, workforce, and the unique environment. Stemming from the recent findings on telehealth utilisation in residential aged-care facilities in Australia, this commentary seeks to identify lessons and perspectives learned during the Covid-19 pandemic from multiple users, including patients, physicians, nurses, and healthcare workers in long-term care (LTC) settings.

Main body

From patients' perspectives, older adults residing in LTC settings often opt not to use virtual care, with the majority preferring in-person visits. This is despite residents expressing their willingness to use telehealth, and virtual care has advantages in LTC settings or in remote areas. Additionally, hearing, vision, or cognitive impairment can limit residents' ability to use information technology to access care, so their preferences for phone or video consultations depend on the health conditions or care requirement. From physicians' perspectives, most healthcare practitioners have a positive attitude toward using telehealth. However, telephone consultations tended to be the dominant mode during the early period of the Covid-19 pandemic. Physicians also raised several major concerns, including technical and equipment-related issues, expanded roles, or additional workloads of LTC staff that could negatively affect clinical decision-making and unequal access in rural, older, and cognitively impaired patients. Most nurses and healthcare workers perceived telehealth positively as a way to enhance patients' care access. However, the majority had concerns about acquiring appropriate knowledge of using the technology for themselves and their patients. In remote areas, nurses expressed higher efficiency and higher care quality when utilising telehealth in caring for older patients than in the regular in-person care mode.

Conclusion

Since the beginning of the Covid-19 pandemic, telehealth has continued as an alternative platform in clinical services. However, as a healthcare platform that offers flexibilities of time, location, and improved efficiency, changing the traditional mindset is essential to shift the paradigm to use telehealth when appropriate. Importantly, telehealth needs substantial support in rural or remote long-term care facilities. Doing so will contribute to the reduction of healthcare inequity in long-term care facilities in remote settings and those with social disparities.

Maximizing Pharmacological Treatment Adherence of Children and Adolescents: A Randomized Controlled Study

The aim of the current randomized controlled study was to evaluate treatment adherence of children and adolescents who visited an outpatient psychiatry clinic and started medication for the first time, with telehealth application. This study was performed with parents of patients who visited the clinic from October 1, 2020, to March 31, 2021. Data were collected using a personal information form, Medication Control Form, and Morisky Medication Adherence Scale via telephone after verbal and written consent were obtained. It was found that 96.7% of participants in the experimental group had high medication adherence, whereas 93.3% of participants in the control group had low medication adherence. Results show that telehealth application is effective in maximizing adherence to treatment among children and adolescents. [Journal of Psychosocial Nursing and Mental Health Services, 61(1), 16-24.].

Health information technology: Ethical concerns in nursing practice and research

Health information technology (HIT) has become essential for nursing practice. However, the lack of digital literacy leaves some nurses unaware of serious ethical issues that may occur when using it. This article describes the ethical issues that arise with the use of HIT in everyday nursing practice as well as in research activities, and outlines options for mitigation.

Telehealth and Transformation of Nursing Care in Saudi Arabia: A Systematic Review

Introduction

Technological advancements have transformed nursing care, quality, and education across the globe. In the Kingdom of Saudi Arabia (KSA), the inventions and adoption of mobile technologies such as an e-health application (app) called SEHA continue to revolutionize the healthcare system in the country.

Purpose

The present systematic review is aimed at examining the technological impact on nursing in Saudi Arabia. The study provides a comprehensive analysis of telehealth and its role in nursing quality, nursing practice, and education.

Methods

The present study adopted a literature review methodology by deriving data from journal articles from different databases, for example, Web Science, Google Scholar, CINAHL, MEDLINE, and PubMed databases. Inclusive years for the search ranged from 2016 to 2022. A total of eight articles were found dovetailing to meet the research objectives and answer research questions.

Result

After appraising and analyzing the research, the present review found that (Abolfotouh et al., 2019) telehealth in nursing is loosely researched; (Ahmed et al., 2021) telehealth impacts nursing practice and quality by fostering nurse-patient communication promoting positive outcomes, seamless nursing care, and positive experiences; and (Albahri et al., 2021) telehealth and telemedicine is a central tenet of contemporary nursing education and practice.

Conclusion

From these findings, this analysis informed three key recommendations: the need to integrate telehealth into the nursing curriculum, telehealth training, and reskilling among healthcare workers (HCWs) in KSA and further primary studies focusing predominantly on telenursing. Overall, telehealth remains a fundamental transformation of nursing practice that forms a central ideology in the contemporary nursing process.

Effects of telehealth-assisted interventions for secondary prevention of cardiovascular disease: A systematic review and meta-analysis

BACKGROUND

Telehealth-assisted interventions have been used as secondary prevention measures in cardiac rehabilitation, especially for the delivery of information between healthcare service providers and patients. However, as the application of this intervention modality broadens, investigation of its effects in secondary prevention of cardiovascular disease (CVD) is necessary.

AIMS

To identify the effectiveness of telehealth-assisted interventions for secondary prevention of CVD.

DESIGN

Systematic review and meta-analysis.

METHODS

The PRISMA protocol was used to conduct a systematic review and meta-analysis of randomised controlled trials. The full text of articles was obtained from six databases for the period from database establishment to 25 November 2021. To assess the methodological quality of the studies reviewed, the updated Cochrane risk-of-bias checklist for randomised trials was employed. A meta-analysis was performed using a random-effects model to calculate the pooled effects of telehealth-assisted interventions for secondary CVD prevention.

RESULTS

The final analysis included 4012 individuals from 18 different trials. Telehealth-assisted interventions were shown to improve medication adherence (standardised mean difference [SMD]: 0.31; 95% confidence interval [CI]: 0.33-0.59) and reduce depression (SMD: -0.28; 95% CI: -0.46 to -0.10).

CONCLUSIONS

Telehealth-assisted interventions appear to improve adherence to medication and reduce depression of individuals with CVD. These intervention strategies could be offered to both healthcare providers and individuals with CVD as an option in delivering and facilitating the use of health services to improve health behaviours and overall outcomes. Furthermore, this study may be used as guidance for future research to provide an appropriate plan of care for this population.

RELEVANCE TO CLINICAL PRACTICE

The findings imply that the delivery of care remotely via telehealth-assisted interventions for secondary prevention of CVD is beneficial in improving CVD survivors' health and access to healthcare services.

TRIAL REGISTRATION

The International Prospective Register of Systematic Review: (PROSPERO): CRD 42021290111.

Healthcare Professional Perspectives on the Use of Remote Patient-Monitoring Platforms during the COVID-19 Pandemic: A Cross-Sectional Study

The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion in healthcare services, protect health professionals, and help them maintain satisfactory quality and safety of care. Remote monitoring platforms (RPM) emerged as potential solutions. In this study, we evaluate, from health professionals’ perspectives, the capacity and contribution of two different digital platforms to maintain quality, safety, and patient engagement in care. A cross-sectional study was conducted using a survey in which a total of 491 health professionals participated. The results show that, in general, user perceptions of the quality and safety of care provided through the platforms were positive. The ease of access to health professionals’ services in general and shorter waiting times for patients were the two main features that were highly appreciated by most participants. However, some problems were encountered during the use of these two platforms, such as a lack of training and/or direct support for users. To improve the two platforms and maximize their use, the areas for improvement and the issues identified should be addressed as part of a collaborative process involving health professionals and patients as well as health system leaders, decision-makers, and digital platform providers.

Factors affecting telepractice use in COVID-19

Background

The use of telepractice as an alternate method of delivering healthcare to people increased significantly after COVID-19 became a global pandemic.

Objectives

This study aimed to identify factors contributing to the accelerated adoption of telepractice during COVID-19 in Singapore. It also sought to examine whether there are differences in the perspectives of staff in nursing facilities and caregivers in personal homes towards telepractice.

Methods

A cross-sectional mixed method design was used. A survey with 20 items was adapted from the Telehealth Usability Questionnaire and translated into Mandarin. Anonymous responses were obtained from 70 patients and caregivers who had received speech therapy services via telepractice from a restructured hospital before and/or during Singapore’s Circuit Breaker period. Analyses were conducted using descriptive statistics and content analysis.

Results

Sociodemographic variables of age, gender, education level and language preference did not impact user satisfaction and the likelihood of using telepractice again. Service-related factors were more influential. Participants chose to use telepractice as it saved travelling time (24.0%), was easy to use (19.3%), improved healthcare access (17.5%) and reduced waiting time (17.5%). Although all respondents expressed satisfaction in telepractice, 35.5% from personal homes and 37.5% from nursing facilities were not keen to use it again. Amongst caregivers, 26.7% from personal homes and 37.5% from nursing facilities preferred not to continue telepractice use. Technical and logistical disruptions and the lack of ‘personal touch’ were contributing factors.

Conclusion

Improving technological infrastructure, providing training for users and developing guidelines would help sustain telepractice as a form of service delivery beyond COVID-19.

The essential role of nurses in supporting physical examination in telemedicine: Insights from an interaction analysis of postsurgical consultations in orthopedics

Telemedicine changes clinical practice and introduces new ways of distributing tasks between physicians and nurses, and particularly the delegation of sensory assessments during remote physical examinations. As nurses become more involved in patient assessment and clinical decision-making, the quality of physician-nurse collaboration has been recognized as essential to ensure quality patient care. However, few studies have examined physician-nurse interactions during teleconsultations. This article presents the results of an empirical study of nurse-physician communication during remote physical examinations. In partnership with a university-affiliated hospital in Ontario, Canada, we observed and recorded 10 simulated postsurgical consultations in orthopedics (involving a physician, a patient, and an on-site nurse) and conducted auto-confrontation interviews with physicians. The results of the thematic analysis of the interviews informed the selection of consultation sequences for in-depth interaction analysis. The findings demonstrate the nurse's essential role during remote physical examinations and reveal specific practices accomplished by the nurse to ensure successful nurse-physician collaboration. The interview data shows how physicians view the nurse's role and contributions. The findings contribute to our understanding of the collaborative nature of sensory assessments during remote physical examinations in telemedicine and can inform the development of training programs for professionals focusing on communication skills. Implications for clinical practice are discussed.

Home healthcare patient, caregiver and provider perspectives on use of unscheduled acute care and the usability and acceptability of on-demand telehealth solutions

BACKGROUND/OBJECTIVES

Home health care (HHC) agencies provide an important role in helping to transition patients from acute care to independent residential living. Telehealth has the potential to transform care delivery in HHC, however the majority of studies in HHC have focused on the use of telemonitoring for patients with specific chronic conditions. The objective of this study was to examine reasons HHC patients use acute care services and assess the acceptability of on-demand telehealth services among HHC patients, caregivers and personnel to help alleviate the need for seeking in-person acute care. Design/Setting/Participants/Measures: This study was a secondary analysis of qualitative data from in-depth interviews of 30 HHC personnel, patients and caregivers from a Medicare-certified HHC agency affiliated with a large healthcare system from January through May 2020. A conventional content analysis approach was used to identify themes.

RESULTS

Themes associated with reasons for seeking acute care included: sense of urgency, behavioral and psychosocial factors, and access to care. Participants described their perceptions of the benefits, usability and acceptability and barriers to using telehealth. Patients and HHC personnel agreed that on-demand telehealth should not replace in-person visits but all identified roles that on-demand telehealth services could play in improving communication and access to care. The biggest barriers to use of telehealth identified by HHC personnel were cost, access and ability to use technology by HHC patients.

CONCLUSION

This study identified reasons HHC patients seek unscheduled acute care and the usability and acceptability of on-demand telehealth services to increase access to care among HHC patients. These findings underscore the need to improve communication and coordination between patients, HHC personnel, and primary care providers and the role that on-demand telehealth services can have in transforming HHC.

The Home Healthcare Nurse: A Concept Analysis

The home healthcare nurse is a concept that has grown rapidly in the past two centuries, however, the role and meaning remain ambiguous. Continuous changes in the healthcare system have sparked confusion with patients and healthcare providers as to the essence of the home healthcare nurse. With the popularity and demand for home healthcare-based care on the rise, it is necessary to differentiate the concept of the home healthcare nurse from other related terms through a concept analysis. Using Walker and Avant's methodology, a literature search using Cumulative Index to Nursing and Allied Health Literature (CINAHL) along with dictionaries, encyclopedias, and professional organizations was performed to identify all the uses, attributes, and characteristics of the concept. Five defining attributes emerged during the analysis: autonomy, adaptability, person-centered holistic care, care coordination, and self-efficacy. Antecedents, consequences and empirical referents were identified. As a first step, this concept analysis brings clarity to the meaning and role of the home healthcare nurse from which arose an operational definition and proposed conceptual model. With the number of patients admitted to home healthcare accelerating, healthcare organizations and clinicians must distinctly understand the concept of the home healthcare nurse. Future research should include testing theoretical relationships between the home healthcare nurse and patient outcome variables to enhance nursing science and promote population health.

The Intention and Influence Factors of Nurses’ Participation in Telenursing

This study aimed to identify factors that significantly affect the behavioral intention of nursing staff to practice telenursing, applying the decomposed theory of planned behavior (DTPB) as the research framework. This cross-sectional survey study collected data from a valid sample of 203 responses from nurses from a regional hospital in Taipei City, Taiwan. The results of data analysis showed that nursing staff’s attitude, subjective norms, and perceived behavioral control toward telenursing correlated positively with behavioral intention to participate in telenursing. Decomposing the main concepts identified two significant predictive determinants that influence nurses’ behavioral intentions: (a) facilitating conditions (β = 0.394, t = 5.817, p = 0.000 < 0.001) and (b) supervisor influence (β= 0.232, t = 3.431, p = 0.001 < 0.01), which together explain 28.6% of the variance for behavioral intention. The results of this study indicated that support and encouragement from nursing supervisors are important factors affecting nurses’ intention to practice telenursing. Education and training, health policies advocacy and the provision of adequate facilitating technologies and recourses are important factors for improving intention to practice telenursing.

Stroke and Telerehabilitation: A Brief Communication

This rapid communication highlights stroke telerehabilitation, a health care service that provides daily monitoring of the care of patients recovering from stroke, delivering convenient and immediate feedback for patients, family, and caregivers. The delivery, management, and coordination of nursing care services, provided via telecommunications technology, is a convenient method of delivering health care to patients recovering from stroke. It is important to assess the service quality of the telehealth process and to establish the role of telehealth nursing and related technologies in the care of patients recovering from stroke. Studies show that even though both health professionals and participants have reported high levels of satisfaction and acceptance of telerehabilitation interventions, the quality of the evidence on telerehabilitation in poststroke care remains low. Conducting a quality study of telehealth rehabilitation for patients recovering from stroke will help assess if home health agencies with telehealth capabilities caring for patients recovering from stroke and patients with chronic diseases can provide quality care to patients in their home and fill this health care gap. Patients that are severely handicapped and impaired and unable to reside in their home environment are not included in telerehabilitation services provided by the home care agency. It would be informative to study the benefits of telerehabilitation and the care provided to patients recovering from stroke within nursing homes, given the need for social distancing to reduce disease transmission during the current coronavirus disease (COVID-19) global health pandemic. Using telerehabilitation would mean that patients have a lower risk of exposure to infectious agents. Further research into telehealth interventions and stroke management in home care is crucial.

Analyzing Nursing Students' Relation to Electronic Health and Technology as Individuals and Students and in Their Future Career (the eNursEd Study): Protocol for a Longitudinal Study

Background

The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students’ internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study.

Objective

The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students’ knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge?

Methods

The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study.

Results

The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019.

Conclusions

This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students’ attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students’ knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology.

International Registered Report Identifier (IRRID)

DERR1-10.2196/14643

Commentary and Reflection Related to the Perspectives of Nurses Toward Telehealth Efficacy and Quality of Health Care

Telehealth nursing enabling communication with chronic disease patients has shown to improve medical outcomes for patients suffering from diabetes mellitus, chronic obstructive pulmonary disease (COPD), and chronic heart disease. Studies have been conducted to examine whether telehealth technology impacts the perceived level of internal service quality (SQ) delivered by nurses within a telehealth organization. Overall, the perspectives toward telehealth SQ researched through case studies showed positive results. The innovative role of telehealth nursing and related technology toward patient care was highlighted. Literature establishes how telehealth provides daily monitoring of patient health, which has the benefits of peace of mind, immediate feedback for patients, family, and caregivers, as well as the convenience of scheduling. This commentary not only reflects but also aims to analyze the effectiveness of the telehealth nursing interventions and reasons for the delayed implementation across United States. Improving and implementing telehealth methods in the case of chronic patients suffering from diabetes, COPD, and heart disease can lead to reductions in health-care errors and readmissions. Telehealth nursing has the potential of decreasing the length of hospital stay, at the same time improving satisfaction of care teams, while the patient management continues at home.