Older and fearing new technologies? The relationship between older adults' technophobia and subjective age.

OBJECTIVE: This article aimed to identify different technophobia subgroups of older adults and examine the associations between these distinct subgroups and the subjective age. METHODS: A sample of 728 retired older adults over the age of 55 was recruited in China. Latent profile analysis was conducted to identify technophobia subgroups using three indicators: techno-anxiety, techno-paranoia and privacy concerns. Analysis of Variance was applied to determine whether a relationship exists between the identified technophobic subgroups and subjective ages (Feel-age, Look-age, Do-age and Interests-age). RESULT: Four technophobia types were identified: 'low-technophobia' (24.59%), 'high-privacy concerns' (26.48%), 'medium-technophobia' (28.38%), and 'high-technophobia' (20.55%). Privacy concerns play a major role in the profiles of older adults who belong to the profiles of 'high-privacy concerns' and 'high-technophobia' (47.03%). A series of ANOVAs showed that older adults in the 'low-technophobia' were more likely to be younger subjective ages of the feel-age and interest-age. CONCLUSION: The majority of Chinese older adults do not suffer from high levels of technophobia, but do concerns about privacy issues. It also pointed out the younger subjective age might have a protective effect on older adults with technophobia. Future technophobia interventions should better focus on breaking the age stereotype of technology on older adults.

The mental workload of ICU nurses performing human-machine tasks and associated factors: A cross-sectional questionnaire survey.

AIMS: To assess the level of mental workload (MWL) of intensive care unit (ICU) nurses in performing different human-machine tasks and examine the predictors of the MWL. DESIGN: A cross-sectional questionnaire study. METHODS: Between January and February 2021, data were collected from ICU nurses (n = 427) at nine tertiary hospitals selected from five (east, west, south, north, central) regions in China through an electronic questionnaire, including sociodemographic questions, the National Aeronautics and Space Administration Task Load Index, General Self-Efficacy Scale, Difficulty-assessing Index System of Nursing Operation Technique, and System Usability Scale. Descriptive statistics, t-tests, one-way ANOVA and multiple linear regression models were used. RESULTS: ICU nurses experienced a medium level of MWL (score 52.04 on a scale of 0-100) while performing human-machine tasks. ICU nurses' MWL was notably higher in conducting first aid and life support tasks (using defibrillators or ventilators). Predictors of MWL were task difficulty, system usability, professional title, age, self-efficacy, ICU category, and willingness to study emerging technology actively. Task difficulty and system usability were the strongest predictors of nearly all typical tasks. CONCLUSION: ICU nurses experience a medium MWL while performing human-machine tasks, but higher mental, temporal, and effort are perceived compared to physical demands. The MWL varied significantly across different human-machine tasks, among which are significantly higher: first aid and life support and information-based human-machine tasks. Task difficulty and system availability are decisive predictors of MWL. IMPACT: This is the first study to investigate the level of MWL of ICU nurses performing different representative human-machine tasks and to explore its predictors, which provides a reference for future research. These findings suggest that healthcare organizations should pay attention to the MWL of ICU nurses and develop customized management strategies based on task characteristics to maintain a moderate level of MWL, thus enabling ICU nurses to perform human-machine tasks better. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Workflow interruption and nurses' mental workload in electronic health record tasks: An observational study.

BACKGROUND: Workflow interruptions are common in modern work systems. Electronic health record (EHR) tasks are typical tasks involving human-machine interactions in nursing care, but few studies have examined interruptions and nurses' mental workload in the tasks. Therefore, this study aims to investigate how frequent interruptions and multilevel factors affect nurses' mental workload and performance in EHR tasks. METHODS: A prospective observational study was conducted in a tertiary hospital providing specialist and sub-specialist care from June 1st to October 31st, 2021. An observer documented nurses' EHR task interruptions, reactions and performance (errors and near errors) during one-shift observation sessions. Questionnaires were administered at the end of the electronic health record task observation to measure nurses' mental workload for the electronic health record tasks, task difficulty, system usability, professional experience, professional competency, and self-efficacy. Path analysis was used to test a hypothetical model. RESULTS: In 145 shift observations, 2871 interruptions occurred, and the mean task duration was 84.69 (SD 56.68) minutes per shift. The incidence of error or near error was 158, while 68.35% of errors were self-corrected. The total mean mental workload level was 44.57 (SD 14.08). A path analysis model with adequate fit indices is presented. There was a relationship among concurrent multitasking, task switching and task time. Task time, task difficulty and system usability had direct effects on mental workload. Task performance was influenced by mental workload and professional title. Negative affect mediated the path from task performance to mental workload. CONCLUSIONS: Nursing interruptions occur frequently in EHR tasks, come from different sources and may lead to elevated mental workload and negative outcomes. By exploring the variables related to mental workload and performance, we offer a new perspective on quality improvement strategies. Reducing harmful interruptions to decrease task time can avoid negative outcomes. Training nurses to cope with interruptions and improve competency in EHR implementation and task operation has the potential to decrease nurses' mental workload and improve task performance. Moreover, improving system usability is beneficial to nurses to mitigate mental workload.

Mental workload of frontline nurses aiding in the COVID-19 pandemic: A latent profile analysis.

AIMS: To investigate the mental workload level of nurses aiding the most affected area during the Coronavirus disease 2019 (COVID-19) pandemic and explore the subtypes of nurses regarding their mental workload. DESIGN: Cross-sectional study. METHODS: A sample of 446 frontline nurses participated from March 8 to 19, 2020. A latent profile analysis was performed to identify clusters based on the six subscales of the Chinese version of the National Aeronautics and Space Administration Task Load Index. The differences among the classes and the variables including sociodemographic characteristics, psychological capital and coping style were explored. RESULTS: The level of mental workload indicates that the nurses had high self-evaluations of their performance while under extremely intensive task loads. The following three latent subtypes were identified: 'low workload & low self-evaluation' (8.6%); 'medium workload & medium self-evaluation' (35.3%) and 'high workload & high self-evaluation' (56.1%) (Classes 1, 2, and 3, respectively). Nurses with shared accommodations, fewer years of practice, junior professional titles, lower incomes, nonmanagement working positions, lower psychological capital levels and negative coping styles had a higher likelihood of belonging to Class 1. In contrast, senior nurses with higher psychological capital and positive coping styles were more likely to belong to Classes 2 and 3. CONCLUSION: The characteristics of the 'low workload & low self-evaluation' subtype suggest that attention should be paid to the work pressure and psychological well-being of junior nurses. Further research on regular training program of public health emergency especially for novices is needed. Personnel management during public health events should be focused on the allocation between novice and senior frontline nurses. IMPACT: This study addresses the level of mental workload of frontline nurses who aid in the most severe area of the COVID-19 pandemic in China and delineates the characteristics of the subtypes of these nurses.

Differences in practice and preferences associated with truth-telling to cancer patients.

BACKGROUND: Doctors should disclose the diagnosis to patients according to the principle of autonomy. However, not disclosing the diagnosis and prognosis to cancer patients remains common in mainland China. OBJECTIVE: The study explored the experiences and attitudes of patients with cancer, family members, and the medical staff in truth-telling. RESEARCH DESIGN: A quantitative survey with three closed-ended questionnaires was conducted. PARTICIPANTS: In all, 137 patients with cancer, 134 family members caring for cancer cases, and 54 medical staff were surveyed. Descriptive statistics were used to summarize all characteristics, and the chi-square test was performed to analyze group differences in attitudes toward cancer disclosure. ETHICAL CONSIDERATIONS: This study was approved by the Committee on Ethics of Biomedicine Research, at the Second Military Medical University (HJEC-2018-YF-001). Informed consent was obtained from all participants prior to study commencement. FINDINGS: A total of 59.8% of patients were informed about their diagnosis within 1 week, and 19.7% inferred theirs. The medical staff preferred to prioritize family members in informing about patient diagnosis while 77.4% of patients preferred to be told the whole truth at the time of initial diagnosis. More patients than family members and medical staff wanted the patients to be informed about the diagnosis (p < 0.001). A significant difference was found between the patients and family members regarding who should tell the patients. DISCUSSION: The willingness of patients in knowing the truth was underestimated by their family members as well as the medical staff. Guessing the truth indirectly may exert negative effects on the patients, and not telling the truth is inappropriate in patients who want to be informed. CONCLUSION: Disclosure of a cancer diagnosis is a complex process involving medical practice, as well as a range of cultural, ethical, and legal factors. The medical staff should first assess each patient's willingness in truth-telling and inform about disease diagnosis with respect. Emotional support and comfort from family members are encouraged. Anyone in the patient's care team, especially nurses, could be integrated in the process of truth-telling.

Development and Psychometric Evaluation of the Patient Engagement in Health Care Questionnaire.

BACKGROUND: Patient engagement in health care can contribute to improving care quality and safety. A valid measurement is essential for promoting it. PURPOSE: The purpose was to develop the Patient Engagement in Health Care Questionnaire and test its psychometric properties. METHODS: An item pool was generated based on a literature review and qualitative research, and was reviewed by 2 expert panels. Two rounds of survey, with 364 and 433 patients, respectively, were conducted to evaluate psychometric properties of the questionnaire. RESULTS: The questionnaire consists of 33 items. Exploratory factor analysis revealed a 6-factor model, explaining 67.16% of the variance, which included communication and information exchange, engaging in treatment and care, engaging in decision-making, giving feedback about care quality, monitoring care safety, and choosing health care providers. Confirmatory factor analysis indicated that the 6-factor model fit the data well. The scale-level content validity index, Cronbach α, and test-retest reliability were 0.935, 0.928, 0.882, respectively. CONCLUSIONS: The Patient Engagement in Health Care Questionnaire is a reliable and valid tool to assess patient engagement.

The relationships between clinical teaching behaviour and transition shock in newly graduated nurses.

AIM: To explore the relationships between clinical teaching behaviour and transition shock in newly graduated nurses and significant differences in the northwest and northeast China. DESIGN: A cross-sectional design. METHODS: A total of 211 (nurses) and 925 (preceptors) were recruited in six Third-class different hospitals from July to August 2019. RESULTS: The transition shock is negatively correlated with the clinical teaching behaviour in northwest and northeast China, while the transition shock in the northwest is higher than that in the northeast for the behindhand economy and natural limit. CONCLUSION: The transition process of newly graduated nurses in northeast China with ethnic minorities and the behindhand economy is more difficult. For newly graduated nurses, personal health and a supportive environment need further improvement. Teaching strategies for preceptors need to be enhanced. Two-way feedback is more useful for both the newly graduated nurses and preceptors to improve quality care, and holistic care.

Rumination's Role in Second Victim Nurses' Recovery From Psychological Trauma: A Cross-Sectional Study in China.

Background: Nurses can experience psychological trauma after adverse nursing events, making it likely for them to become second victims (SVs). This negatively impacts patient safety and nurses' development. This study aims to understand the status of psychological trauma and recovery of nurses as SVs in domestic China and examine the influencing mechanism of cognitive rumination during their recovery from psychological damage. Methods: This was a cross-sectional survey. An online questionnaire was completed by 233 nurses from across China. Data were collected using Chinese versions of the Second Victim Experience and Support Evaluation Scale, the Incident-related Rumination Meditation Questionnaire, and the post-traumatic growth (PTG) Rating Scale. Descriptive statistics, correlation, and regression, as well as mediation analysis, were used for different analyses in this study. Results: Participants experienced apparent psychological traumas (4.65 ± 0.5583) with a certain degree of PTG (76.18 ± 16.0040); they reported a strong need for psychological support (95.7%). Psychological trauma was positively and negatively correlated with rumination and PTG (r = 0.465, p < 0.001; r = -0.155, p < 0.05) respectively. Both psychologically impaired experience and rumination had significant predictive effects on participants' PTG (both, p < 0.001). Nurses' active rumination significantly mediated their psychological recovery from trauma to PTG (p < 0.05), but the effect of invasive rumination was not significant (p > 0.05). Limitation: The specific manifestations of the mechanism of invasive rumination are not clarified in this study. Conclusion: The present study investigated the psychological trauma of SV nurses as well as their support needs, and explored the role of cognitive rumination in the psychological repair and PTG of SV nurses. Results showed that SV nurses' active rumination on adverse nursing events could promote their recovery from psychological trauma, but invasive rumination could not. This study provides a trauma-informed approach to care at the clinical level for nurses who experience psychological trauma caused by adverse events.

Heterogeneity of Attitudes toward Robots in Healthcare among the Chinese Public: A Latent Profile Analysis.

Attitudes are deemed critical psychological variables that can determine end users' acceptance and adoption of robots. This study explored the heterogeneity of the Chinese public's attitudes toward robots in healthcare and examined demographic characteristics associated with the derived profile membership. The data were collected from a sample of 428 Chinese who participated in an online survey. Latent profile analysis identified three distinct subgroups regarding attitudes toward robots-optimistic (36.9%), neutral (47.2%), and ambivalent (15.9%). Interestingly, although participants in the ambivalent attitude profile held more negative attitudes toward interaction with or social influence of healthcare robots, their attitudes tended to be positive when it came to emotional interactions with healthcare robots. All the respondents reported negative attitudes toward the social influence of healthcare robots. Multivariable regression analysis results showed that there were significant differences in age, education level, monthly income, experience with computers, experience with wearable devices, and whether to follow robot-related news or not. This study confirmed the heterogeneity of the Chinese public's attitudes toward robots in healthcare and highlighted the importance of emotional interaction with and social influence of healthcare robots, which might facilitate a better understanding of the needs and expectations of potential end users for robots in healthcare to make them more acceptable in different situations.

Practice and effectiveness of "nursing case-based learning" course on nursing student's critical thinking ability: A comparative study.

BACKGROUND: Case-based Learning was an effective and highly efficient teaching approach that was extensively applied in education systems across a variety of countries. Critical thinking ability is an important indicator for access the study ability for baccalaureate nursing education. OBJECTIVES: The study aimed to explore the effect of "nursing case-based learning" course on the critical thinking ability of nursing student. PARTICIPANTS: A total of 80 students who were in Junior were included in this study. The experimental group included 40 students who selected "nursing case-based learning" course. The control group included 40 students who selected the traditional teaching course. METHODS: The critical thinking disposition inventory (CTDI-CV) was used to evaluate the effects of the critical thinking abilities during the 1st week (pre-test), the 9th week (mid-test), and the 18th week (post-test). RESULTS: There are no statistically significant differences between two groups in the pre-test thinking abilities (P > 0.05). After nine weeks, the critical thinking abilities of experimental group were significantly higher than control group (P < 0.05). Three obtained time-points had statistically significant differences of control and experimental group (P < 0.05). CONCLUSION: The "nursing case-based learning" was an effective course to develop the critical thinking abilities of nursing students. Strict instructional design was the guarantee for the smooth implementation of "nursing case-based learning" course.

Net primary productivity dynamics and associated hydrological driving factors in the floodplain wetland of China's largest freshwater lake.

Wetlands are thought to be the most unique ecosystem in the world which plays an important role in water and material circulation. However, investigation of ecosystem dynamics in those lake floodplain wetlands that suffering rapid and significant short-term water level fluctuation is quite a challenge. In this study, the short- and long-term characteristics of vegetation NPP (net primary productivity) and their driving mechanism were investigated in the Poyang Lake floodplain wetland, an important international wetland that listed in the Global Eco-region by the World Wildlife Fund (WWF). Attempts were achieved through validating the Carnegie-Ames-Stanford Approach (CASA) model based on observed biomasses of different vegetation types and reconstructed continuous high spatiotemporal resolution (30 m and 16 days) of NDVI data during 2000-2015 according to the fused Landsat and MODIS data. Major result indicates that the intra-annual variation of NPP of most vegetation types shows two peaks in a year due to combined effects of vegetation growth rhythm and seasonal exposure of the lake floodplain. Annual NPP of the lake floodplain ranges in 360.09-735.94 gC/m2 and shows an increasing trend during the study period. The change of NPP in space indicates that the distribution elevation of the major vegetation types decreased and evoluted toward the center lake floodplain. Different from the terrestrial ecosystem, inundation duration is the dominant factor that controls NPP dynamics in the lake floodplain, while the influences of other meteorological factors are much weakened. Recent decline of lake water level was the major reason for the spatio-temporal evolution of annual and seasonal vegetation NPP in the lake floodplain.

The design and testing of a caring teaching model based on the theoretical framework of caring in the Chinese Context: a mixed-method study.

AIM: This paper aims to report the design and test the effectiveness of an innovative caring teaching model based on the theoretical framework of caring in the Chinese context. BACKGROUND: Since the 1970's, caring has been a core value in nursing education. In a previous study, a theoretical framework of caring in the Chinese context is explored employing a grounded theory study, considered beneficial for caring education. METHODS: A caring teaching model was designed theoretically and a one group pre- and post-test quasi-experimental study was administered to test its effectiveness. From Oct, 2009 to Jul, 2010, a cohort of grade-2 undergraduate nursing students (n=64) in a Chinese medical school was recruited to participate in the study. Data were gathered through quantitative and qualitative methods to evaluate the effectiveness of the caring teaching model. RESULTS: The caring teaching model created an esthetic situation and experiential learning style for teaching caring that was integrated within the curricula. Quantitative data from the quasi-experimental study showed that the post-test scores of each item were higher than those on the pre-test (p<0.01). Thematic analysis of 1220 narratives from students' caring journals and reports of participant class observation revealed two main thematic categories, which reflected, from the students' points of view, the development of student caring character and the impact that the caring teaching model had on this regard. CONCLUSIONS: The model could be used as an integrated approach to teach caring in nursing curricula. It would also be beneficial for nursing administrators in cultivating caring nurse practitioners.