Caring behavior perceived by nurses, patients and nursing students in Indonesia.

Caring as a term in nursing, represents all factors used by nurses to provide health services to patients. The aim of this study was to compare the differences of caring behaviors as perceived by nurses, patients and nursing students and to explore the relationship between sociodemographic variables and the perception of caring. This was a descriptive comparative research study. Data were collected from August to September 2015 in Indonesia by using Caring Behavior Inventory-42 composed of five domains: respect, assurance, connectedness, knowledge and skills, and attentiveness. A total of 158 respondents were sought for three study groups and each group had 53 respondents. Results indicated that nurses, patients and nursing students have the same perception regarding caring behaviors. Patients' age was positively correlated with respect (r=0.282, p<0.05) and connectedness (r=0.307, p<0.05) domains. Male students had a higher mean score than female students in assurance (t=2.230, p<0.05), knowledge and skills (t=3.885, p<0.001), and attentiveness (t=3.267, p<0.01), Students with 8-week clinical experiences scored higher in the caring behavior domain of connectedness (t=3.504, p<0.05) than students with 4-week experiences. This study can be used as an additional resource to enhance knowledge about caring behavior and for application in the fields of nursing practice and nursing education.

Experience of Home Telehealth Technology in Older Patients With Diabetes.

The incidence of diabetes, a common chronic disease among older adults, is increasing annually. The lack of blood glucose regulation can result in severe diabetes-related complications and substantial healthcare costs, making self-care programs specific to this population especially important. Combined with reduced numbers of healthcare professionals, the integration of healthcare and information technology and the older adults' adoption of telehealth services have become increasingly important. This study used a qualitative method to interview 18 older study participants who used a telehealth service. Subject perceptions and suggestions regarding using such a service for diabetes management were investigated. Content analysis was used to examine the interview data and determine the older patients' acceptance and perceived benefits of telehealth service. Four main themes emerged: (1) initial trial encouragement from the doctors, nurses, and financial incentives; (2) enhanced self-management capability through continuous device use for better outcomes; (3) ambivalent feelings regarding dependence on others for problem solving; and (4) consideration for continual technology use for an uncertain future. These results serve as a reference for promoting, assessing, and verifying telehealth models for older patients with diabetes.

Technology acceptance and quality of life of the elderly in a telecare program.

As information and communication technology applied to telecare has become a trend in elder care services, evaluation of the program is vital for further program design and development. This study evaluated the variables influencing the use of a telecare service program by the elderly. A questionnaire survey was used to explore the relationship between quality of life and technology acceptance of a telecare program in Taiwan. In addition, open-ended questions were used to elicit qualitative information regarding the experience of technology use. The results revealed that elderly persons with better social welfare status and health condition, who used the device frequently, had higher quality of life and accepted technology use. The correlation results also indicated that elderly persons who perceived telecare as useful in solving health problems, had the intention to use the program, and were willing to continue use, also had a better perception toward quality of life regarding their interpersonal relationships and living environment. Nonetheless, cost may be an issue that will impede their willingness to use the technology in care service.

The evaluation of a web-based incident reporting system.

A Web-based reporting system is essential to report incident events anonymously and confidentially. The purpose of this study was to evaluate a Web-based reporting system in Taiwan. User satisfaction and impact of system use were evaluated through a survey answered by 249 nurses. Incident events reported in paper and electronic systems were collected for comparison purposes. Study variables included system user satisfaction, willingness to report, number of reports, severity of the events, and efficiency of the reporting process. Results revealed that senior nurses were less willing to report events, nurses on internal medicine units had higher satisfaction than others, and lowest satisfaction was related to the time it took to file a report. In addition, the Web-based reporting system was used more often than the paper system. The percentages of events reported were significantly higher in the Web-based system in laboratory, environment/device, and incidents occurring in other units, whereas the proportions of reports involving bedsores and dislocation of endotracheal tubes were decreased. Finally, moderate injury event reporting decreased, whereas minor or minimal injury event reporting increased. The study recommends that the data entry process be simplified and the network system be improved to increase user satisfaction and reporting rates.

Application of data mining to the identification of critical factors in patient falls using a web-based reporting system.

PURPOSE: The implementation of an information system has become a trend in healthcare institutions. How to identify variables related to patient safety among accumulated data has been viewed as a main issue. The purpose of this study was to identify critical factors related to patient falls through the application of data mining to available data through a hospital information system. METHOD: Data on a total of 725 patient falls were obtained from a web-based nursing incident reporting system at a medical center in Taiwan. In the process of data mining, feature selection was applied as the first step, after which 10 critical factors were selected to predict the dependent variables (injury versus non-injury). An artificial neural network (ANN) analysis was applied to develop a predictive model and a multivariate stepwise logistic regression was performed for comparison purposes. RESULTS: The ANN model produced the following results: a Receiver-Operating-Character (ROC) curve indicated 77% accuracy, the positive predictive value (PPV) was 68%, and the negative predictive value (NPV) was 72%; while the multivariate stepwise logistic regression only identified 3 variables (fall assessment, anti-psychosis medication and diuretics) as significant predictors with ROC curve of 42%, PPV of 26.24%, and NPV of 87.12%. CONCLUSION: In addition to medication use such as anti-psychotic and diuretics, nursing intervention where a fall assessment is conducted could represent a critical factor related to outcomes of fall incidence.

The application of data mining skill on identifying critical factors in the web-based incident reporting system.

The purpose of this is study was to apply data mining skill to explore the fall critical factors. Feature selection and variable screening were applied on the total of 725 incidents as the first two screening steps. The neuronetwork model was - MLP (multilayer perceptron) 19-7-2 with sensitivity and specificity as 50.00% and 84.42, respectively. The result could be utilized for further intervention studies to validate the findings.

A pilot study of a case management program for patients with chronic obstructive pulmonary disease (COPD).

The purpose of this study was to develop a case management program for patients with chronic obstructive pulmonary disease (COPD) and to test the effects of the developed program on patient length of stay in the hospital, medical costs, disease knowledge and level of satisfaction with nursing care received. This quasi-experimental study focused on a group of 50 COPD patients (24 in the control group and 26 in the experimental one), all treated in one hospital medical ward in northern Taiwan. The control group received routine care, while those in the experimental group received a COPD case management protocol. Data for the control group was collected between September of 2003 and January 2004. Data for the experimental group was collected between April and December 2004. Data collection instruments included medical records, the COPD Knowledge Measurement scale, and the Patient Satisfaction with Nursing Care Questionnaire. Descriptive and inferential statistical analyses were applied to describe demographics, length of stay, medical cost, patient disease-related knowledge, and patient satisfaction with nursing care. Results indicated that, while the study found no significant difference in length of stay and medical cost between the two groups, the use of case management procedures improved patient disease-related knowledge and satisfaction with nursing care. This conclusion supports the premise that case management improves patient care in these two dimensions and is, thus, an effective approach in the management of patients diagnosed with secondary COPD infections.

Nurses' adoption of technology: application of Rogers' innovation-diffusion model.

This qualitative study applied Everett Rogers' innovation-diffusion model to analyze nurses' perceptions toward using a computerized care plan system. Twelve nurses from three respiratory intensive care units in Taiwan voluntarily participated in a one-on-one, in-depth interview. Data were analyzed by constant comparative analysis. The content that emerged was compared with the model's five innovation characteristics (relative advantage, compatibility, complexity, trialability, and observability), as perceived by new users. Results indicate that Rogers' model can accurately describe nurses' behavior during the process of adopting workplace innovations. Related issues that emerged deserve further attention to help nurses make the best use of technology.