Informatics Competencies of Students in a Doctor of Nursing Practice Program: A Descriptive Study.

OBJECTIVES: Health systems that apply artificial intelligence (AI) are transforming the roles of healthcare providers, including those of Doctor of Nursing Practice (DNP) providers. These professionals are required to utilize informatics knowledge and skills to deliver quality care, necessitating a high level of informatics competencies, which should be developed through well-structured courses. The purpose of this study is to assess the informatics competency scale scores of DNP students and to provide recommendations for enhancing the informatics curriculum. METHODS: An online informatics course was offered to students enrolled in a Bachelor of Science in Nursing to DNP program, and their informatics competency, which includes three subscales, was evaluated. Online survey data were collected from Fall 2021 to Fall 2022 using the "Self-Assessment of Informatics Competency Scale for Health Professionals." RESULTS: An analysis of 127 student responses revealed that students demonstrated competence in overall informatics competency and in one subscale: "applied computer skills (clinical informatics)." They showed proficiency in the "basic computer skills" and the "role" subscales. However, they reported lower competency in managing data and integrating standard terminology into their practice. CONCLUSIONS: The findings offer detailed insights into the current informatics competencies of DNP students and can inform informatics educators on how to enhance their courses. As healthcare institutions increasingly depend on AI applications, it is imperative for informatics educators to include AI-related content in their curricula.

Objectively Measured Physical Activity and Sedentary Behaviors Among Older Adults in Assisted Living Facilities: A Scoping Review.

Older adults in assisted living facilities (ALF) are at risk for low physical activity (PA) and high sedentary behavior (SB), both of which place them at risk for negative health outcomes. The purpose of this scoping review was to synthesize evidence describing the volume of device-measured PA/SB, factors associated with PA/SB, and interventions designed to change PA/SB in older adults living in ALF. Twenty articles representing 15 unique studies were identified from eight electronic databases and grey literature. Residents in ALF spent 96-201 min/day in light PA (n = 2 studies), 1-9.74 min/day in moderate to vigorous PA (n = 2 studies), and 8.5-11.01 hr/day of SB during waking hours (n = 3 studies). Factors associated with PA included 16 personal factors (n = 6 articles), one social factor (n = 2 articles), and two environmental factors (n = 2 articles). Factors associated with SB included 14 personal factors (n = 4 articles) and one social factor (n = 1 article). No intervention successfully changed PA/SB.

Prolonged bouts of sedentary behavior in people with chronic obstructive pulmonary disease and associated factors.

BACKGROUND: Increased sedentary behavior (SB), especially in prolonged bouts, is associated with adverse health outcomes, but little is known about patterns of SB in people with chronic obstructive pulmonary disease (COPD). OBJECTIVES: The purpose of this study was to describe SB and patterns of SB and to examine factors associated with prolonged bouts of SB in inactive community-dwelling adults with COPD. METHODS: This cross-sectional analysis used data from inactive adults with COPD who were enrolled in an exercise program but had not started exercising. Participants were ≥ 50 years old with a diagnosis of COPD, had a forced expiratory volume in one second < 80% predicted, and were inactive. Participants wore an activPAL device for seven days to measure their SB and completed surveys and physical measures. Data were analyzed with multiple regression. RESULTS: The sample included 160 participants with a mean age (± SD) of 69 ± 8, and a mean total sedentary time of 742 ± 150 min/day, with 254 ± 146 min/day in SB bouts ≥ 60 min. DURATION: Time spent in bouts of SB ≥ 60-min. was negatively associated with self-efficacy for overcoming barriers to light physical activity (P<0.05), balance (P<0.05), chair stand test (P<0.05), FEV1% predicted (P<0.05) and positively associated with BMI (P<0.001). CONCLUSIONS: Inactive people with COPD engage in extensive SB, much of it in prolonged bouts. Self-efficacy, balance, and lower body strength are modifiable variables associated with SB and potential targets for future interventions to reduce time in prolonged sedentary behavior.

Development and preliminary psychometric evaluation of the COPD-related Stigma Scale.

BACKGROUND: Stigma experiences contribute to psychological distress and negatively affect healthcare-seeking behavior in people with chronic obstructive pulmonary disease (COPD). Most evidence comes from qualitative research, and no well-established measure of COPD-related stigma exists. Prior research yielded a preliminary measure of COPD-related stigma, but it required item reduction and validation. OBJECTIVES: The purpose of this study was to revise the preliminary measure, reduce the number of items, identify underlying constructs, and evaluate the reliability and validity of the shortened version. METHODS: A descriptive, cross-sectional study was conducted. Participants (N = 148; mean = 64 ± 7.27 years) completed the 51-item preliminary COPD-related Stigma Scale (COPDSS). Item-level analysis was conducted before running exploratory factor analysis (EFA). Reliability was assessed using Cronbach's alpha. Convergent validity and known-groups validity were evaluated. RESULTS: In the item-level analysis, eight items were deleted, leaving 43 items for factor analysis. A four-factor model with 24 items (α = 0.93) was derived from EFA: social stigma (α = 0.95), felt stigma (α = 0.95), anticipated stigma-oxygen (α = 0.80), and smoking-related stigma (α = 0.81). The 24-item COPDSS was significantly correlated with the 8-item Stigma Scale for Chronic Illness (r = 0.83), the Hospital Anxiety and Depression Scale (r = 0.57), and the PROMIS Physical Function (r = -0.48). The 24-item COPDSS discriminated between known groups based on age (p = .03), use of inhalers (p = .002) and use of supplemental oxygen (p < .001), and psychological distress levels (ps < .001). CONCLUSION: Findings support the reliability and validity of the 24-item COPDSS. This instrument can be used to understand underlying stigma processes in people with COPD.

Artificial intelligence assisted telehealth for nursing: A scoping review.

BACKGROUND: Due to the COVID-19 pandemic, telehealth resurfaced as a convenient efficient healthcare delivery method. Researchers indicate that Artificial Intelligence (AI) could further facilitate delivering quality care in telehealth. It is essential to find supporting evidence to use AI-assisted telehealth interventions in nursing. OBJECTIVES: This scoping review focuses on finding users' satisfaction and perception of AI-assisted telehealth intervention, performances of AI algorithms, and the types of AI technology used. METHODS: A structured search was performed in six databases, PubMed, CINAHL, Web of Science, OVID, PsycINFO, and ProQuest, following the guidance of the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews. The quality of the final reviewed studies was assessed using the Medical Education Research Study Quality Instrument. RESULTS: Eight of the 41 studies published between 2017 and 2022 were included in the final review. Six studies were conducted in the United States, one in Japan, and one in South Korea. Four studies collected data from participants (n = 3014). Two studies used image data (n = 1986), and two used sensor data from smart homes to detect patients' health events for nurses (n = 35). The quality of studies implied moderate to high-quality study (mean = 10.1, range = 7.7-13.7). Two studies reported high user satisfaction, three assessed user perception of AI in telehealth, and only one showed high AI acceptability. Two studies revealed the high performance of AI algorithms. Five studies used machine learning algorithms. CONCLUSIONS: AI-assisted telehealth interventions were efficient and promising and could be an effective care delivery method in nursing.

Stigma Experiences in People with Chronic Obstructive Pulmonary Disease: An Integrative Review.

Background: People with chronic obstructive pulmonary disease (COPD) are stigmatized by smoking history. Although little is known about COPD-related stigma, it can adversely affect self-management and quality of life. Objective: To synthesize relevant scientific literature exploring stigma experiences and their impacts on people with COPD. Methods: CINAHL/PsycINFO/PubMed/Scopus were searched for relevant studies. Findings were organized using Major et al's conceptual model. Results: Fifteen studies documented COPD-related stigma processes: enacted, felt, internalized, and anticipated. Moderating factors included visibility, origin, and illness perception. Individual-level stigma responses included emotional distress, limited social interactions, and negative effects on medication adherence and help-seeking. Social/community-level stigma experiences included healthcare provider and employer behaviors. Smoking is interwoven throughout all domains of stigma processes and responses to stigma. Conclusion: Substantial evidence documents processes, moderating factors, and individual and social/community responses to the complex phenomenon of COPD-related stigma; however, prevalence of COPD-related stigma and its health effects are unclear.

Machine Learning-Based Nicotine Addiction Prediction Models for Youth E-Cigarette and Waterpipe (Hookah) Users.

Despite the harmful effect on health, e-cigarette and hookah smoking in youth in the U.S. has increased. Developing tailored e-cigarette and hookah cessation programs for youth is imperative. The aim of this study was to identify predictor variables such as social, mental, and environmental determinants that cause nicotine addiction in youth e-cigarette or hookah users and build nicotine addiction prediction models using machine learning algorithms. A total of 6511 participants were identified as ever having used e-cigarettes or hookah from the National Youth Tobacco Survey (2019) datasets. Prediction models were built by Random Forest with ReliefF and Least Absolute Shrinkage and Selection Operator (LASSO). ReliefF identified important predictor variables, and the Davies-Bouldin clustering evaluation index selected the optimal number of predictors for Random Forest. A total of 193 predictor variables were included in the final analysis. Performance of prediction models was measured by Root Mean Square Error (RMSE) and Confusion Matrix. The results suggested high performance of prediction. Identified predictor variables were aligned with previous research. The noble predictors found, such as 'witnessed e-cigarette use in their household' and 'perception of their tobacco use', could be used in public awareness or targeted e-cigarette and hookah youth education and for policymakers.

Effects of perioperative exercise interventions on lung cancer patients: An overview of systematic reviews.

AIMS AND OBJECTIVES: To identify, appraise and summarise systematic reviews of exercise interventions for surgical lung cancer patients. BACKGROUND: Low exercise capacity, reduced pulmonary function, impaired health-related quality of life and postoperative pulmonary complications are common in surgical lung cancer patients. Numerous systematic reviews address these health problems and examine the effects of exercise intervention. However, differences in the quality and scope of the systematic reviews and discordant findings from the reviews make it difficult for decisions-makers to interpret the evidence and establish best practices in the clinical settings. DESIGN: Overview of systematic reviews. METHODS: This overview was conducted following the PRISMA guideline. A literature search of PubMed, CINAHL, EMBASE, Cochrane Library, SPORTDiscus and PEDro was conducted (October 2019). Peer-reviewed systematic reviews of randomised controlled trials focusing on the effects of exercise interventions for lung cancer patients who underwent surgery were included. The methodological quality of included reviews was assessed using AMSTAR 2. The results of reviews with meta-analysis were synthesised and presented by each health outcome. RESULTS: Seven systematic reviews published between 2013 and 2019 were included. High/moderate-quality evidence showed that postoperative exercise interventions could increase the exercise capacity and muscle strength, and low/very-low-quality evidence showed that postoperative exercise interventions may increase the physical component of health-related quality of life and decease dyspnoea. Low-quality evidence showed that preoperative exercise interventions may increase exercise capacity and pulmonary function, decrease the risk of postoperative pulmonary complications and reduce the length of hospital stay. CONCLUSIONS: Postoperative and preoperative exercises have the potential to improve health outcomes in surgical lung cancer patients. Further research is needed to evaluate the effects of different types of exercise and varying amounts of exercise. RELEVANCE TO CLINICAL PRACTICE: This study provides evidence to support the implementation of exercise interventions for surgical lung cancer patients.

Testing the influence of cultural determinants on help-seeking theory.

Despite increased risks for mental health problems, East Asian immigrant women have the lowest overall service-utilization rates of any cultural group in the United States. Although the influence of cultural processes as the cause of low service use is widely speculated, no empirical study has tested cultural determinants (including culturally specific idioms of distress, culture-based illness interpretations, or concerns about social consequences), social contextual factors, perceived need (PN), and help-seeking (HS) behaviors. In the present study, we examined how cultural determinants, such as symptom experience, beliefs and interpretations, and perceptions about the social environment, affect PN and HS type for Japanese women living in the United States. Increasing physical symptom severity increased the predicted probability of endorsing PN. For those participants with PN, 48.6% of them used medical HS (χ2 = 11.27, p = .00), and 12.5% of them used the psychological HS (χ2 = 7.43, p = .01). Multivariate logistic regression revealed that, when PN is considered with the other cultural variables while controlling for structural variables, PN increases the odds of medical HS (OR = 2.78, 95% CI [1.0-5.8], p < .01). The odds of medical HS are also increased with higher social support (OR = 1.07, 95% CI [1.0-1.1], p < .01). Finally, the presence of interpersonal stigma beliefs decreased the odds of medical HS (OR = 2.4, 95% CI [1.1-5.3], p < .03). Clinical and research implications are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Factors Influencing on Mental Health Help-seeking Behavior Among Korean Women: A Path Analysis.

PURPOSE: The purpose of the study was to identify factors influencing mental health help-seeking behavior among women in the community. METHODS: A cross-sectional design was used. Participants were 402 women in South Korea. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, and a path analysis by IBM SPSS 21.0 and AMOS 21.0. RESULTS: There was a significant, but weak positive correlation between perceived need and help-seeking intentions for formal mental health help (r=0.09, p<0.05). In the path analysis, significant the factors influencing help-seeking intentions were perceived need, attitude, and belief toward mental illness, and the attitude of them had the greatest effect. These factors accounted for 12.2% of the total variance, and the model fit was acceptable. CONCLUSION: The findings of the study reveal that positive mental illness interpretation and consequence can predict mental health help-seeking behavior of women as well as the perceived need for mental health help.

Construct Validity and Reliability of the Beliefs Toward Mental Illness Scale for American, Japanese, and Korean Women.

PURPOSE: The aim of this study was to evaluate the psychometric properties of the Beliefs Toward Mental Illness Scale (BMI) across women from the United States, Japan, and South Korea. METHODS: A cross-sectional study design was employed. The sample was 564 women aged 21-64 years old who were recruited in the United States and Korea (American = 127, Japanese immigrants in the United States = 204, and Korean = 233). We carried out item analysis, construct validity by confirmatory factor analysis (CFA), and internal consistency using SPSS Version 22 and AMOS Version 22. RESULTS: An acceptable model fit for a 20-item BMI (Beliefs Toward Mental Illness Scale-Revised [BMI-R]) with 3 factors was confirmed using CFA. Construct validity of the BMI-R showed to be all acceptable; convergent validity (average variance extracted [AVE] ≥0.5, construct reliability [CR] ≥0.7) and discriminant validity (r = .65-.89, AVE >.79). The Cronbach's alpha of the BMI-R was .92. CONCLUSION: These results showed that the BMI was a reliable tool to study beliefs about mental illness across cultures. Our findings also suggested that continued efforts to reduce stigma in culturally specific contexts within and between countries are necessary to promote help-seeking for those suffering from psychological distress.