Conceptualizing the Commercialization of Human Milk: A Concept Analysis.

BACKGROUND: Donor human milk is recommended when infants are unable to be fed their mother's own milk or require supplementation. For-profit companies use technologies to create human milk products for infants in the neonatal intensive care setting without consistent guidelines and regulatory frameworks in place. This commercialization of human milk is inadequately conceptualized and ill-defined. RESEARCH AIMS: The aim of this study is to conceptualize and define the commercialization of human milk and discuss the need for policy guidelines and regulations. METHOD: Using a concept analysis framework, we reviewed the literature on the commercialization of human milk, analyzed the antecedents and potential consequences of the industry, and developed a conceptual definition. The literature review resulted in 13 relevant articles. RESULTS: There has been a surge in the development and availability of human milk products for vulnerable infants developed by for-profit companies. Commercialized human milk can be defined as the packaging and sale of human milk and human milk components for financial gain. Factors contributing to the commercialization of human milk include an increased demand for human milk, and consequences include potential undermining of breastfeeding. The lack of guidelines and regulations raises concerns of equity, ethics, and safety. CONCLUSION: The industry is rapidly growing, resulting in an urgent need for consistent guidelines and regulatory frameworks. If left unaddressed, there could be potential risks for donor milk banking, the future of breastfeeding, and infant and maternal health.

Understanding Adolescents' Experiences With Menstrual Pain to Inform the User-Centered Design of a Mindfulness-Based App: Mixed Methods Investigation Study.

BACKGROUND: Digital interventions are increasingly popular for the provision of nonpharmacological pain interventions, but few exist for adolescents with menstrual pain. User-centered design involves incorporating users across phases of digital health intervention design, development, and implementation and leads to improved user engagement and outcomes. A needs assessment is the first step of this approach. OBJECTIVE: The goal of this study was to conduct a needs assessment to understand menstrual pain management needs and preferences and mindfulness experiences, preferences, and knowledge of adolescents with menstrual pain to inform the future development of an app for managing menstrual pain. METHODS: We used an explanatory sequential mixed method design that included a survey followed by focus groups. Adolescents aged 13-17 years completed a survey (n=111) and participated in focus groups (n=16). Data were analyzed using descriptive statistics and thematic content analysis and synthesized to provide specific recommendations based on adolescent responses. RESULTS: Adolescents (n=111) who completed the survey reported a moderate understanding of mindfulness and menstrual pain. Over three-quarters (n=87, 78%) of participants practiced some form of mindfulness and 87% (n=97) of survey participants used nonpharmacological pain management strategies. Teens had a moderate perception that mindfulness could help their menstrual pain (mean 4.51/10, SD 2.45, with higher scores suggesting more interest). Themes were generated related to mindfulness experiences, menstrual pain knowledge and experiences, and app functionality. These themes underscored adolescents' need for continued support and flexible access to mindfulness activities; their awareness of multiple influences to pain, with potential for further education in this area; and the need for menstrual pain-specific content, along with content relevant to typical day-to-day experiences of adolescents. CONCLUSIONS: Adolescents with menstrual pain have an interest in using a mindfulness app for pain but have unique needs that need to be addressed to ensure app engagement and relevance for this population. Concrete recommendations for future app development are provided.

Revolutionizing nursing education through Ai integration: A reflection on the disruptive impact of ChatGPT.

Artificial intelligence (AI) is driving global change. An AI language model like ChatGPT could revolutionize the delivery of nursing education in the future. ChatGPT is an AI-enabled text generator that has garnered significant attention due to its ability to engage in conversations and answer questions. Nurse educators play a crucial role in preparing nursing students for a technology-integrated healthcare system, and the emergence of ChatGPT presents both opportunities and challenges. While the technology has limitations and potential biases, it also has the potential to benefit students by facilitating learning, improving digital literacy, and encouraging critical thinking about AI integration in healthcare. Nurse educators can incorporate ChatGPT into their curriculum through formative or summative assessments and should prioritize faculty development to understand and use AI technologies effectively. Collaboration between educational institutions, regulatory bodies, and educators is crucial to establish provincial and national competencies and frameworks that reflect the increasing importance of AI in nursing education and practice. It is paramount that nurses and nurse educators be open to AI-enabled innovations as well as continue to critically think about their potential value to advance the profession so nurses are better prepared to lead the digital future.

An Exploratory Study of Health-related Quality of Life and Care Experiences in Older Adults with Inflammatory Bowel Disease.

Canada has one of the highest rates of inflammatory bowel disease (IBD), with older adults as the fastest-growing group of individuals affected. This exploratory mixed methods study aimed to understand perceived health-related quality of life and care experiences in older adults with IBD. Participants greater than 60 years of age, who were diagnosed with IBD, and who lived in Saskatchewan, Canada were invited to participate in both an online survey and telephone interview. Seventy-three respondents completed the survey, and 18 participants were interviewed. Most individuals were diagnosed before age 60, believed their IBD was well controlled, believed their current treatment was useful, and were satisfied with their care. Individuals also reported a moderate health-related quality of life. However, collaborative management of IBD care between providers and older adults with IBD was identified as an area with room for improvement. Strategies to enhance disease self-management and engaged chronic illness care are critical.

Inequities in Rural and Urban Health Care Utilization Among Individuals Diagnosed With Inflammatory Bowel Disease: A Retrospective Population-Based Cohort Study From Saskatchewan, Canada.

Background: Rural dwellers with inflammatory bowel disease (IBD) face barriers to accessing specialized health services. We aimed to contrast health care utilization between rural and urban residents diagnosed with IBD in Saskatchewan, Canada. Methods: We completed a population-based retrospective study from 1998/1999 to 2017/2018 using administrative health databases. A validated algorithm was used to identify incident IBD cases aged 18+. Rural/urban residence was assigned at IBD diagnosis. Outpatient (gastroenterology visits, lower endoscopies, and IBD medications claims) and inpatient (IBD-specific and IBD-related hospitalizations, and surgeries for IBD) outcomes were measured after IBD diagnosis. Cox proportional hazard, negative binomial, and logistic models were used to evaluate associations adjusting by sex, age, neighbourhood income quintile, and disease type. Hazard ratios (HR), incidence rate ratios (IRR), odds ratios (OR), and 95% confidence intervals (95% CI) were reported. Results: From 5,173 incident IBD cases, 1,544 (29.8%) were living in rural Saskatchewan at IBD diagnosis. Compared to urban dwellers, rural residents had fewer gastroenterology visits (HR = 0.82, 95% CI: 0.77-0.88), were less likely to have a gastroenterologist as primary IBD care provider (OR = 0.60, 95% CI: 0.51-0.70), and had lower endoscopies rates (IRR = 0.92, 95% CI: 0.87-0.98) and more 5-aminosalicylic acid claims (HR = 1.10, 95% CI: 1.02-1.18). Rural residents had a higher risk and rates of IBD-specific (HR = 1.23, 95% CI: 1.13-1.34; IRR = 1.22, 95% CI: 1.09-1.37) and IBD-related (HR = 1.20, 95% CI: 1.11-1.31; IRR = 1.23, 95% CI: 1.10-1.37) hospitalizations than their urban counterparts. Conclusion: We identified rural-urban disparities in IBD health care utilization that reflect rural-urban inequities in the access to IBD care. These inequities require attention to promote health care innovation and equitable management of patients with IBD living in rural areas.

Lessons learned developing and deploying a provincial virtual mental health support during the COVID-19 pandemic.

Significant efforts have been put into implementing virtual forms of healthcare and supports since the beginning of the pandemic. However, limited information has been shared with health leaders about how this has taken place, and what can be learned from this to move forward into the future. The purpose of this article is to describe lessons learned co-designing and developing a virtual health support during the COVID-19 pandemic in the province of Saskatchewan. In this article, we anchor these lessons learned on a specific virtual health service support, "SaskWell," which offers a digital service, and aims to connect residents of the province to digital mental health supports and resources.

Transition of Mental Health Service Delivery to Telepsychiatry in Response to COVID-19: A Literature Review.

Due to COVID-19, face-to-face mental health service delivery has been interrupted by social distancing and stay-at-home orders. To abridge physical distance between patients and healthcare providers, while limiting exposure to COVID-19, telepsychiatry has been widely adopted to provide services to patients with pre-existing mental health disorders. Though telepsychiatry has become more mainstream in delivering mental health services during COVID-19, evaluation studies of the rapid conversion of care delivery from face-to-face to telepsychiatry have been limited. The aim of this study was to review the literature on the transition of mental health service delivery to telepsychiatry during COVID-19. The findings of the current review showed that a majority of patients and healthcare providers were satisfied with telepsychiatry services, and suggest that telepsychiatry is feasible and appropriate for supporting patients and healthcare providers during COVID-19.

Optimizing the InterRAI Assessment Tool in Care Planning Processes for Long-Term Residents: A Scoping Review.

The aim of this review was to chart and report on existing literature that discusses how the interRAI assessment tool drives care-planning processes for residents in long-term-care settings. This scoping review was informed by the Joanna Briggs Institute guidelines for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guideline. Relevant studies were obtained from databases search of CINAHL (EBSCO), MEDLINE (Ovid), PsycINFO (EBSCO), Academic Search Premier (EBSCO), Embase (Elsevier), ProQuest Nursing and Allied Health Database (ProQuest), Sociological Abstracts (ProQuest), and Social Services Abstracts (ProQuest). Of the 17 included studies, five (29.4%) addressed interRAI's minimum dataset component as a clinical data-collection tool; five (29.4%) addressed interRAI's assessment scales and its clinical-assessment protocols as viable health-assessment tools; four (23.5%) considered interRAI's assessment scales in terms of whether this tool is capable of predicting residents' health risks; one (5.9%) addressed the effects of interRAI's care plans on residents' health outcomes; and the remaining two studies (11.8%) used interRAI's quality-indicator function for both the performance of and improvements in the quality of care. The scoping review finds that there is no substantial evidence that supports the implementation of interRAI care plans for consistent health outcomes.

Maximizing Opportunities for User-Centered Design in Acute-Care: Introducing the Focal Wall.

Digital health is a promising development in the pursuit of patient centered care. Technological developments, like patient portals, are providing new opportunities for patients to engage in their own healthcare journeys, increasing access to health data and practitioners in many cases. The primary objective of this research is the establishment of an in-patient portal for a new children's hospital through a collaborative design process. This paper details experiences from the first phase of this multi-year project and in particular methodological solutions that have been developed in order to meet the challenges of engaging acute care patients, families, and practitioners in user-centered design within such a demanding context.

Supporting population mental health and wellness during the COVID-19 pandemic in Canada: protocol for a sequential mixed-method study.

INTRODUCTION: The global COVID-19 pandemic has reported to have a negative impact on the mental health and well-being of individuals around the world. Mental health system infrastructure, primarily developed to support individuals through in-person care, struggled to meet rising demand for services even prior to COVID-19. With public health guidelines requiring the use of physical distancing during the pandemic, digital mental health supports may be one way to address the needs of the population. Despite this, barriers exist in promoting and supporting access to existing and emerging digital resources. Text messaging may address some of these barriers, extending the potential reach of these digital interventions across divides that may separate some vulnerable or disadvantaged groups from essential mental health supports. Building on an existing knowledge synthesis project identifying key digital resources for improved mental health, this research will establish low-tech connections to assess need and better match access to services for those who need it most. The aim of this study is to codesign a customised two-way texting service to explore need and better align access to mental health supports for Canadians located in Saskatchewan during the COVID-19 pandemic. METHODS AND ANALYSIS: This study will be completed in Saskatchewan, Canada. For this project, the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will be used to support three phases of a sequential mixed-method study. An advisory committee of Saskatchewan residents will guide this work with the study team. A 10-week service will be launched to connect individuals with appropriately suited digital mental health interventions through the use of text messaging. In phase 1, implementation and prototyping will be conducted with collaborative codesign for key elements related to features of an enrolment survey and initial messaging content. Phase 2 will focus on advancing the effectiveness of the service using quantitative user data. In phase 3, an embedding approach will be used to integrate both qualitative and quantitative data collected to understand the overall acceptability, satisfaction and perceived benefit of the text messaging service. Thematic analysis and descriptive statistics will be used as analytic methods. ETHICS AND DISSEMINATION: This study has received approval from the Research Ethics Board at the University of Saskatchewan. A knowledge dissemination plan has been developed that includes traditional academic approaches such as conference presentations, and academic publications, as well as mainstream approaches such as social media, radio and dissemination through the advisory committee.

Predicted Influences of Artificial Intelligence on Nursing Education: Scoping Review.

BACKGROUND: It is predicted that artificial intelligence (AI) will transform nursing across all domains of nursing practice, including administration, clinical care, education, policy, and research. Increasingly, researchers are exploring the potential influences of AI health technologies (AIHTs) on nursing in general and on nursing education more specifically. However, little emphasis has been placed on synthesizing this body of literature. OBJECTIVE: A scoping review was conducted to summarize the current and predicted influences of AIHTs on nursing education over the next 10 years and beyond. METHODS: This scoping review followed a previously published protocol from April 2020. Using an established scoping review methodology, the databases of MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central, Education Resources Information Centre, Scopus, Web of Science, and Proquest were searched. In addition to the use of these electronic databases, a targeted website search was performed to access relevant grey literature. Abstracts and full-text studies were independently screened by two reviewers using prespecified inclusion and exclusion criteria. Included literature focused on nursing education and digital health technologies that incorporate AI. Data were charted using a structured form and narratively summarized into categories. RESULTS: A total of 27 articles were identified (20 expository papers, six studies with quantitative or prototyping methods, and one qualitative study). The population included nurses, nurse educators, and nursing students at the entry-to-practice, undergraduate, graduate, and doctoral levels. A variety of AIHTs were discussed, including virtual avatar apps, smart homes, predictive analytics, virtual or augmented reality, and robots. The two key categories derived from the literature were (1) influences of AI on nursing education in academic institutions and (2) influences of AI on nursing education in clinical practice. CONCLUSIONS: Curricular reform is urgently needed within nursing education programs in academic institutions and clinical practice settings to prepare nurses and nursing students to practice safely and efficiently in the age of AI. Additionally, nurse educators need to adopt new and evolving pedagogies that incorporate AI to better support students at all levels of education. Finally, nursing students and practicing nurses must be equipped with the requisite knowledge and skills to effectively assess AIHTs and safely integrate those deemed appropriate to support person-centered compassionate nursing care in practice settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER IRRID: RR2-10.2196/17490.

Perspectives of health care use and access to care for individuals living with inflammatory bowel disease in rural Canada.

INTRODUCTION: Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract with no known cure. Management of IBD is complex and requires those with IBD to have lifelong interactions with the healthcare system. Individuals with IBD who live in rural areas are at risk of poorer health outcomes due to their limited access to care. This study examined healthcare utilization and access to care for rural adults with IBD. The research questions explored in this study were: What are the care experiences of healthcare providers (HCPs) and persons living with IBD in rural areas? What are the enablers and barriers to optimal IBD care in rural environments? What strategies are necessary to enhance care delivery for these individuals with IBD? METHODS: This patient-oriented research initiative involved patient and family advisors as active and equal team members in decision-making throughout the project. This article reports on the qualitative findings of a larger mixed-methods study. The setting was one western Canadian province. Fourteen individuals with IBD living in rural areas and three HCPs working in rural areas participated. Interview data were analyzed using thematic analysis. RESULTS: Three themes were identified: communication, stressors and support systems, and coordination of care. Communication with and between HCPs was challenging due to the distance to access care. Participants described challenges related to rural HCPs' lack of IBD-related knowledge. Virtual communication, such as telehealth and phone clinics, was infrequently used yet highly recommended by participants. Individuals with IBD described various stressors and feelings of isolation while living in rural environments, and both participant groups described the need for additional formal and informal support systems to ease these stressors. Coordination of care was considered essential to optimal health outcomes, but individuals frequently experienced gaps in care. Lack of local services such as outpatient clinics, hospitals, laboratory testing, infusion clinics, and pharmacies meant individuals with IBD frequently had to travel to access care. Some participants reported bypassing existing local services, instead preferring the expedited, specialist care within larger centers. CONCLUSION: Most participants described challenges associated with living in rural areas and suggested health system improvements. Access to multidisciplinary care teams, including IBD physicians and nurses, psychologists, and dieticians, for individuals in rural areas is encouraged, as is the use of virtual care delivery options such as telehealth, online clinics, telephone clinics or advice lines, web-based video-conferencing, and email communication to increase access to care. Continued efforts to recruit and retain rural HCPs with knowledge of IBD are deemed necessary to provide continuity of care within rural environments. Strengthening formal and informal support systems and enhancing psychosocial supports in rural communities are warranted to ensure optimal wellbeing. Online strategies to provide individual and group education related to IBD are strongly recommended. Facilitating access to care in rural areas can increase disease remission, decrease direct and indirect care costs, and promote quality of life in individuals with IBD.

How to Improve Information Technology to Support Healthcare to Address the COVID-19 Pandemic: an International Survey with Health Informatics Experts.

OBJECTIVES: To identify the ways in which healthcare information and communication technologies can be improved to address the challenges raised by the COVID-19 pandemic. METHODS: The study population included health informatics experts who had been involved with the planning, development and deployment of healthcare information and communication technologies in healthcare settings in response to the challenges presented by the COVID-19 pandemic. Data were collected via an online survey. A non-probability convenience sampling strategy was employed. Data were analyzed with content analysis. RESULTS: A total of 65 participants from 16 countries responded to the conducted survey. The four major themes regarding recommended improvements identified from the content analysis included: improved technology availability, improved interoperability, intuitive user interfaces and adoption of standards of care. Respondents also identified several key healthcare information and communication technologies that can help to provide better healthcare to patients during the COVID-19 pandemic, including telehealth, advanced software, electronic health records, remote work technologies (e.g., remote desktop computer access), and clinical decision support tools. CONCLUSIONS: Our results help to identify several important healthcare information and communication technologies, recommended by health informatics experts, which can help to provide better care to patients during the COVID-19 pandemic. The results also highlight the need for improved interoperability, intuitive user interfaces and advocating the adoption of standards of care.

Inflammatory Bowel Disease Nurses' Perspectives: Prioritizing Adolescent Transition Readiness Factors.

PURPOSE: Despite the wealth of knowledge and expertise that Inflammatory Bowel Disease (IBD) nurses bring to the transition process, health literature lacks nurses' perspectives on transition readiness. The purpose of study was to ask IBD nurses to prioritize care transition readiness factors for adolescents living with IBD. DESIGN AND METHODS: The cross-sectional exploratory survey was researcher-developed and distributed online to IBD nurses across Canada. The survey was divided into nine transition topic categories. RESULTS: Fifty-six female registered nurses from six Canadian provinces participated in the study. Overall, nurses rated all items within each transition topic category to be very important in facilitating adolescent transition to adult healthcare. The highest individual mean scores and the highest prioritized categories were within the Knowing IBD and Healthcare Provider Relationships categories, emphasizing the importance for adolescents to understand their disease and feel comfortable communicating their needs and questions to healthcare providers. CONCLUSIONS: The transition process needs to be individualized and comprehensive addressing a multitude of biopsychosocial factors in order to support IBD patients and families to achieve healthy adult self-care behaviours that can foster positive health outcomes. PRACTICE IMPLICATIONS: Healthcare providers, adolescents, and parents must work collaboratively to achieve identified transition goals so that the transition process is a mutually satisfying experience. A comprehensive readiness assessment tool is suggested to assist in the transition process. Transition readiness assessment must start early, be ongoing, be age-appropriate, and be individualized to the patient needs.

Nursing in the Age of Artificial Intelligence: Protocol for a Scoping Review.

BACKGROUND: It is predicted that digital health technologies that incorporate artificial intelligence will transform health care delivery in the next decade. Little research has explored how emerging trends in artificial intelligence-driven digital health technologies may influence the relationship between nurses and patients. OBJECTIVE: The purpose of this scoping review is to summarize the findings from 4 research questions regarding emerging trends in artificial intelligence-driven digital health technologies and their influence on nursing practice across the 5 domains outlined by the Canadian Nurses Association framework: administration, clinical care, education, policy, and research. Specifically, this scoping review will examine how emerging trends will transform the roles and functions of nurses over the next 10 years and beyond. METHODS: Using an established scoping review methodology, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central, Education Resources Information Centre, Scopus, Web of Science, and Proquest databases were searched. In addition to the electronic database searches, a targeted website search will be performed to access relevant grey literature. Abstracts and full-text studies will be independently screened by 2 reviewers using prespecified inclusion and exclusion criteria. Included literature will focus on nursing and digital health technologies that incorporate artificial intelligence. Data will be charted using a structured form and narratively summarized. RESULTS: Electronic database searches have retrieved 10,318 results. The scoping review and subsequent briefing paper will be completed by the fall of 2020. CONCLUSIONS: A symposium will be held to share insights gained from this scoping review with key thought leaders and a cross section of stakeholders from administration, clinical care, education, policy, and research as well as patient advocates. The symposium will provide a forum to explore opportunities for action to advance the future of nursing in a technological world and, more specifically, nurses' delivery of compassionate care in the age of artificial intelligence. Results from the symposium will be summarized in the form of a briefing paper and widely disseminated to relevant stakeholders. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/17490.

Advancing nursing participation in user-centred design.

BACKGROUND: What is the role of nursing in the digital health transformation of the 21st century? The answer to this critical question may rely on how prepared nursing is to enter into design processes associated with this evolution. AIMS: The purpose of this paper is to introduce foundational terminology and tools to support increased nursing participation in user-centred design. Situated within a six-step design process, this includes a new analytic framework combining the disciplinary expertise of computer science with the nursing methodology Interpretive Description. METHODS: The analytic framework and recommended research process were developed over the course of two projects each employing a similar collaborative mixed-methods design. Primary methodological drivers were drawn from the software development life-cycle and Interpretive Description in these digital health intervention studies. RESULTS: Using aspects of software development practice, an analytic framework was conceived as part of an interdisciplinary research process allowing nurses to integrate their disciplinary expertise in user-centred digital design. The framework allows nurses to parse collected data into a robust set of functional and non-functional requirements for software developers while still engaging in a fulsome interpretive analysis. CONCLUSION: There is a need for nursing to occupy a more significant role in the advancement of technology innovation in healthcare. However, a lack of familiarity with design-thinking and associated practical experience impedes nursing voices in this area. Tools and processes are introduced to enhance an existing nursing methodology as a means to extend our disciplinary design capacity.

Predicted Influences of Artificial Intelligence on the Domains of Nursing: Scoping Review.

BACKGROUND: Artificial intelligence (AI) is set to transform the health system, yet little research to date has explored its influence on nurses-the largest group of health professionals. Furthermore, there has been little discussion on how AI will influence the experience of person-centered compassionate care for patients, families, and caregivers. OBJECTIVE: This review aims to summarize the extant literature on the emerging trends in health technologies powered by AI and their implications on the following domains of nursing: administration, clinical practice, policy, and research. This review summarizes the findings from 3 research questions, examining how these emerging trends might influence the roles and functions of nurses and compassionate nursing care over the next 10 years and beyond. METHODS: Using an established scoping review methodology, MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central, Education Resources Information Center, Scopus, Web of Science, and ProQuest databases were searched. In addition to the electronic database searches, a targeted website search was performed to access relevant gray literature. Abstracts and full-text studies were independently screened by 2 reviewers using prespecified inclusion and exclusion criteria. Included articles focused on nursing and digital health technologies that incorporate AI. Data were charted using structured forms and narratively summarized. RESULTS: A total of 131 articles were retrieved from the scoping review for the 3 research questions that were the focus of this manuscript (118 from database sources and 13 from targeted websites). Emerging AI technologies discussed in the review included predictive analytics, smart homes, virtual health care assistants, and robots. The results indicated that AI has already begun to influence nursing roles, workflows, and the nurse-patient relationship. In general, robots are not viewed as replacements for nurses. There is a consensus that health technologies powered by AI may have the potential to enhance nursing practice. Consequently, nurses must proactively define how person-centered compassionate care will be preserved in the age of AI. CONCLUSIONS: Nurses have a shared responsibility to influence decisions related to the integration of AI into the health system and to ensure that this change is introduced in a way that is ethical and aligns with core nursing values such as compassionate care. Furthermore, nurses must advocate for patient and nursing involvement in all aspects of the design, implementation, and evaluation of these technologies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/17490.

Advocating for Safe, Quality and Just Care: What Nursing Leaders Need to Know about Artificial Intelligence in Healthcare Delivery.

The rapid integration of artificial intelligence (AI) into healthcare delivery has not only provided a glimpse into an enhanced digital future but also raised significant concerns about the social and ethical implications of this evolution. Nursing leaders have a critical role to play in advocating for the just and effective use of AI health solutions. To fulfill this responsibility, nurses need information on the widespread reach of AI and, perhaps more importantly, how the development, deployment and evaluation of these technologies can be influenced.

Defining Empowerment and Supporting Engagement Using Patient Views From the Citizen Health Information Portal: Qualitative Study.

BACKGROUND: The increasing presence of technology in health care has created new opportunities for patient engagement and with this, an intensified exploration of patient empowerment within the digital health context. While the use of technology, such as patient portals, has been positively received, a clear linkage between digital health solutions, patient empowerment, and health outcomes remains elusive. OBJECTIVE: The primary objective of this research was to explore the views of participants enrolled in an electronic health record portal access trial regarding the resultant influence of this technology on their feelings of patient empowerment. METHODS: The exploration of patient empowerment within a digital health context was done with participants in a tethered patient portal trial using interpretive description. Interpretive description is a qualitative methodology developed to pragmatically address clinical health questions. Patient demographics, self-reported health status, and self-identified technology adaptation contributed to the assessment of empowerment in this qualitative approach. RESULTS: This research produced a view of patient empowerment within the digital health context summarized in two overarching categories: (1) Being Heard and (2) Moving Forward. In each of these, two subcategories further delineate the aspects of empowerment, as viewed by these participants: Knowing More and Seeing What They See under Being Heard, and Owning Future Steps and Promoting Future Care under Moving Forward. This work also highlighted an ongoing interconnectedness between the concepts of patient empowerment, engagement, and activation and the need to further articulate the unique aspects of each of these. CONCLUSIONS: The results of this study contribute needed patient voice to the ongoing evolution of the concept of patient empowerment. In order to move toward more concrete and accurate measure of patient empowerment and engagement in digital health, there must be further consideration of what patients themselves identify as essential aspects of these complex concepts. This research has revealed relational and informational elements as two key areas of focus in the ongoing evolution of patient empowerment operationalization and measure.