Family adaptation in families of individuals with Down syndrome from 12 countries.

Our current understanding of adaptation in families of individuals with Down syndrome (DS) is based primarily on findings from studies focused on participants from a single country. Guided by the Resiliency Model of Family Stress, Adjustment, and Adaptation, the purpose of this cross-country investigation, which is part of a larger, mixed methods study, was twofold: (1) to compare family adaptation in 12 countries, and (2) to examine the relationships between family variables and family adaptation. The focus of this study is data collected in the 12 countries where at least 30 parents completed the survey. Descriptive statistics were generated, and mean family adaptation was modeled in terms of each predictor independently, controlling for an effect on covariates. A parsimonious composite model for mean family adaptation was adaptively generated. While there were cross-country differences, standardized family adaptation mean scores fell within the average range for all 12 countries. Key components of the guiding framework (i.e., family demands, family appraisal, family resources, and family problem-solving communication) were important predictors of family adaptation. More cross-country studies, as well as longitudinal studies, are needed to fully understand how culture and social determinants of health influence family adaptation in families of individuals with DS.

ACCESS: an empirically-based framework developed by the International Nursing CASCADE Consortium to address genomic disparities through the nursing workforce.

Introduction: Efforts are needed across disciplines to close disparities in genomic healthcare. Nurses are the most numerous trained healthcare professionals worldwide and can play a key role in addressing disparities across the continuum of care. ACCESS is an empirically-based theoretical framework to guide clinical practice in order to ameliorate genomic disparities. Methods: The framework was developed by the International Nursing CASCADE Consortium based on evidence collected between 2005 and 2023 from individuals and families of various ethnic backgrounds, with diverse hereditary conditions, and in different healthcare systems, i.e., Israel, Korea, Switzerland, and several U.S. States. The components of the framework were validated against published scientific literature. Results: ACCESS stands for Advocating, Coping, Communication, cascadE Screening, and Surveillance. Each component is demonstrated in concrete examples of clinical practice within the scope of the nursing profession related to genomic healthcare. Key outcomes include advocacy, active coping, intrafamilial communication, cascade screening, and lifelong surveillance. Advocacy entails timely identification of at-risk individuals, facilitating referrals to specialized services, and informed decision-making for testing. Active coping enhances lifelong adaptation and management of disease risk. Effective intrafamilial communication of predisposition to hereditary disease supports cascade testing of unaffected at-risk relatives. Lifelong surveillance is essential for identifying recurrence, changes in health status, and disease trajectory for life-threatening and for life-altering conditions. Discussion: ACCESS provides a standardized, systematic, situational, and unifying guide to practice and is applicable for nursing and for other healthcare professions. When appropriately enacted it will contribute towards equitable access to genomic resources and services.

Assessment of the Intention to Use Mobile Health Applications Using a Technology Acceptance Model in an Israeli Adult Population.

Background: Mobile health applications (mHealth apps) have now gained global popularity. However, evaluating the level of their use over time still remains a pertinent challenge. According to the Technology Acceptance Model (TAM), perceived ease of use and usefulness predict attitudes toward technology utilization. Together, these factors serve as determinants of behavioral intention to use the technology, which in turn predicts actual use. Purpose: We sought to elucidate factors affecting behavioral intention to use mHealth apps in an Israeli adult population sample. Methods: A modified TAM Likert Scale questionnaire-based survey was offered to 200 participants, with 168 respondents. Results: Sixty one percent of participants reported using mHealth apps on their smartphones, 81% of whom used mHealth apps from health maintenance organization providers. Generation Y participants displayed more confidence with the use of mHealth apps, and were less concerned about compromising the confidentiality of their health records. Furthermore, answers to TAM-related questions among mHealth apps users were significantly more positive, compared with nonuser TAM components that accounted for 51% of the total variance in the intention to use mHealth apps. Discussion: TAM constructs were related to the behavioral intention to continue to use mHealth apps. Health organizations as providers of mHealth apps were strong determinants of their acceptance and utilization. Generational differences in user competence were observed; however, whether user experience or interface design represents the underlying differentials remains to be elucidated, and developers of health care-related mobile technologies will need to address this question.

Family Health Clinics as a Source of Social Capital.

PURPOSE: To examine the extent to which Family Health Clinics (FHCs) contribute to the formation of social capital among mothers, and determine whether it is influenced by socioeconomic factors. In FHCs, social capital can be gained by relationships between mothers (bonding social capital), by relationships between mothers and FHCs team, or between mothers of different origins/culture (bridging social capital) and health services institutional bodies (linking social capital). DESIGN: This is a mixed method study. For the quantitative part, data were collected from 673 mothers using a questionnaire. The qualitative part was conducted with six focus groups. RESULTS: The FHC constitutes a source of social capital in all dimensions. Bridging social capital was most prominent and is formed by interactions between mothers and FHC nurses. The factors that explain the formation of social capital were: mothers' spoken language being Arabic, participation in group training, and lower level of education. The focus groups revealed that participation in group training increased the social capital. Mothers noted that FHC nurses supplied updated information about their children's care. Regarding linking social capital, mothers perceive FHC nurses as mediators between them and the local and national health services. CONCLUSIONS: FHC clinics are a source for gaining social capital. The FHC services should be adapted to mother's needs. IMPLICATIONS: FHC nurses should try to create conditions for mothers to meet to create bonding social capital, relate to mother's needs for the creation of bridging social capital, and provide culturally adapted care for the formation of linking social capital.

The quality and safety culture in general hospitals: patients', physicians' and nurses' evaluation of its effect on patient satisfaction.

OBJECTIVE: To explore the disparities between patients' and health care workers' perception of the quality and safety culture and to explore the relationship between patient perceptions, and engagement in, and satisfaction with their care and treatment. DESIGN: A cross-sectional study was conducted in medical-surgical wards of four Israeli general hospitals. Data were collected using a self-administered questionnaire. SETTING: Fourteen medical-surgical wards of the four hospitals where data were collected. PARTICIPANTS: The sample comprised of 390 physicians and nurses and 726 inpatients admitted for at least 3 days. MAIN OUTCOME MEASURES: A self-administered questionnaire that covered the following topics: (i) quality and safety culture, (ii) patient engagement, (iii) patient satisfaction, (iv) an assessment of the care quality and safety in the ward and (v) sociodemographic data. The questionnaire was translated into Arabic and Russian. Sixty nine items were directed to the staff and 71 to patients. RESULTS: Patients evaluated the quality and safety culture significantly higher than did the health care workers. Significant correlations were found between patients' engagement in and satisfaction with their care and their quality and safety assessments. Their evaluation of this culture was the only predictor of their satisfaction and engagement. Arabic-speaking patients rated four variables, including patients' satisfaction with their care, lower than did Hebrew and Russian speakers. CONCLUSIONS: Patients have sufficient experience and understanding to form an opinion of the quality and safety of their care. The lower evaluation of the quality and safety culture expressed by health care workers might stem from their more realistic expectations.

Professional, generational, and gender differences in perception of organisational values among Israeli physicians and nurses: Implications for retention.

The global health workforce today is more age diverse than ever before and spans three generations: baby boomers, X and Y generations. Each generation has a distinct set of characteristics, values, and beliefs. This diversity can lead to increased creativity and a greater richness of values and skills, but at the same time it can also lead to value clashes, disrespect, and conflicts. This study aimed to examine professional, generational, and gender differences in the perception of the importance of organisational values among nurses and physicians working in both hospitals and outpatient clinics in Israel. Data were collected from a large sample of nurses and physicians (N = 603) from 11 hospitals and community services across Israel. The participants completed a self-administered questionnaire rating the perceived importance of 20 organisational values, such as leadership, risk-taking, competition, power, and collaboration. The five values ranked most important were performance quality, cooperation, commitment, effectiveness, and efficiency. The five values ranked least important were competition, marketing, power, risk-taking, and assertiveness. Significant value differences were found by profession, generation, and gender. Nurses scored efficiency, assertiveness, risk-taking, power, and marketing higher than physicians did. The Y generation scored power higher and marketing lower than the two older generations. Women ranked the values of cooperation, commitment, innovativeness, vision, and marketing significantly higher than men did. Understanding differences between professions, generations, and gender is a useful first step in improving employees' job satisfaction, productivity, and retention.

Patients' Attitudes Towards Disclosure of Genetic Test Results to Family Members: The Impact of Patients' Sociodemographic Background and Counseling Experience.

Many factors predict the intention to disclose genetic information to relatives. The article examines the impact of patients' socio-demographic factors on their intention to disclose genetic testing results to their relatives. Data were collected in eight genetic clinics in Israel. Patients were requested to fill in a questionnaire after counseling. A convenience sample of 564 participants who visited these clinics was collected for a response rate of 85 %. Of them, 282 participants came for susceptibility testing for hereditary cancers (cancer group), and 282 for genetic screening tests (prenatal group). In the cancer group, being secular and having more years of education correlated positively with the intention to disclose test results to relatives. In the prenatal group, being married and female correlated positively with the intention to disclose. In the cancer group, being religious and with less years of education correlated positively with the view that the clinician should deliver the results to the family. In the prenatal group, being male and unmarried correlated positively with this belief. In both groups, being of young age correlated with the perception that genetic information is private. Varied sociodemographic factors affect the intention to inform family members. Thus, knowing the social background of patients will shed light on people's attitudes to genetic information and will help clinicians provide effective counseling in discussions with patients about the implications of test results for relatives.

Factors associated with reporting of medication errors by Israeli nurses.

This study investigated medication error reporting among Israeli nurses, the relationship between nurses' personal views about error reporting, and the impact of the safety culture of the ward and hospital on this reporting. Nurses (n = 201) completed a questionnaire related to different aspects of error reporting (frequency, organizational norms of dealing with errors, and personal views on reporting). The higher the error frequency, the more errors went unreported. If the ward nurse manager corrected errors on the ward, error self-reporting decreased significantly. Ward nurse managers have to provide good role models.

Genetic testing, genetic information, and the role of maternal-child health nurses in Israel.

PURPOSE: To examine the rate of genetic testing, the characteristics of those who had these tests, and to examine the public's openness to the possibility of expanding nurses' roles in maternal-child health (MCH) clinics to include providing genetic information. DESIGN: The study was conducted in nine MCH clinics in the central district of Israel. All women attending the clinics during 1 week were requested to complete the questionnaire. The sample consisted of 361 participants. FINDINGS: A high rate of genetic testing (80.4%) was shown. Higher education, being secular, and native-born Israeli predicted testing performance. Half of the tested participants reported that they did not understand the test results and were interested in receiving explanations regarding these results. Forty-four percent of respondents were interested in receiving genetic information from an MCH nurse. CONCLUSIONS: A high rate of genetic testing performance was reported. The public reported lack of information regarding genetic tests and their results. An appropriate setting for providing this information is the maternal-child health clinics.