Developing an Online Health Community Platform for Facilitating Empowerment in Chronic Disease Prevention and Health Promotion.

This study aimed to develop an online health community platform for facilitating the empowerment of people with chronic diseases dwelling in the community regarding disease prevention and health promotion. The user-centered design approach included four main steps: (1) identifying the health problems and needs of target users, (2) developing the content of the platform, (3) constructing the platform, and (4) pilot testing, refinement, and finalization. An online health community platform available both in a mobile application and a Web-enabled application has been launched to facilitate empowerment and self-management by people with chronic conditions. The main components of the application comprised (1) screening for chronic diseases and health problems, (2) setting personal goals for health promotion and action planning to achieve the goals themselves, (3) offering an online health community with shared group goals that help users engage with their peers to attain their goals, and (4) creating one's own online health community and inviting others to participate. The platform has the potential to encourage people with chronic conditions to proactively engage in their own health promotion. Future studies are needed to determine the impact of the application on self-management and empowerment for its users.

Decision aids for promoting shared decision-making: A review of systematic reviews.

In the context of shared decision-making (SDM), experts have advocated the use of validated decision aids (DAs) as valuable tools for facilitating SDM in various healthcare scenarios. This comprehensive review attempts to analyze a vast corpus of DA research by performing thorough searches across four prominent databases (PubMed, CINAHL, Embase, and Web of Science). Independent reviewers selected relevant reviews, extracted data, and assessed review quality using the AMSTAR II tool. A total of 34 systematic reviews were identified and evaluated in this review, encompassing a wide range of outcomes associated with using DAs. These outcomes include patient knowledge, patient involvement in SDM, decision conflict, decision regret, satisfaction, and adherence. In addition, DAs positively affect healthcare provider outcomes by increasing satisfaction, reducing decision conflicts, and lengthening clinical consultations. This review highlights the need for additional research in specific contexts such as long-term care, mental health, and reproductive health to better understand the benefits and challenges of implementing DAs in these settings. Such research can contribute to the improvement of SDM practices and patient-centered care.

Evaluating the performance of an integrated evidence-based nursing knowledge management (I-EBNKM) platform in real-world clinical environments.

BACKGROUND: For evidence-based knowledge to be applicable in clinical practice, providing support for and the management of knowledge is required to ensure the effective sharing of appropriate expertise across healthcare organizations. Knowledge management platforms can provide a wide range of benefits related to the activation and establishment of evidence-based practice (EBP) in clinical environments. OBJECTIVES: In this study, we developed an integrated evidence-based nursing knowledge management (I-EBNKM) platform and applied it in real-world clinical environments to evaluate its effectiveness. METHODS: We designed an I-EBNKM platform with three main functions: (1) clinical questioning and knowledge linkage, (2) systematic knowledge management, and (3) knowledge communication. After a two-month long application of the I-EBNKM platform in real-world clinical environments, we evaluated the changes in the levels of knowledge in EBP, attitude, practice, confidence in clinical questioning, individual innovative behavior, innovative organizational culture, and organizational knowledge management. The experimental and control groups consisted of 198 nurses, who participated in the study. RESULTS: After applying the I-EBNKM platform, the levels of EBP knowledge and skills (t = 7.16; p <.001), attitude (t = 6.30; p <.001), practice (t = 7.63; p <.001), confidence in clinical questioning (t = 4.57; p <.001), individual innovative behavior (t = 8.72; p <.001), and organizational knowledge management (t = 7.43; p <.001) differed significantly between the experimental group and the control group. CONCLUSION: The results of this study clearly indicate that the I-EBNKM platform we developed has the potential to enhance nurses' involvement in ensuring effective knowledge management in real-world clinical environments. Therefore, the provision of an innovative digital approach ensuring systematic and timely organizational support among nurses is of critical importance.

Long-Term Effects of a COMPASS Program on the Caregiving Journey: 1-Year Follow-Up in a Randomized Controlled Trial.

INTRODUCTION: The number of older adults requiring long-term care (LTC) is increasing rapidly worldwide. The primary family caregivers of LTC recipients experience ongoing burdens and various challenges in their caregiving that adversely affect their own health and also the quality of caring that they provide to their loved ones. As a country becoming a super-aged society, South Korea has been making considerable efforts to improve the long-term effects on caregivers by providing them with support intervention programs. METHODS: This study was designed to assess the long-term effects of a COMPASS program at a national level. The short-term and long-term benefits were compared for the full COMPASS program (comprising 6 individual visits, 3 group-support sessions, and 2 telephone calls) provided to 203 caregivers, as were the long-term benefits between the full COMPASS program and its short form (comprising 3 individual visits and 1 group-support session) provided to 213 caregivers. The effects of the program on the family caregivers were evaluated by measuring their levels of social support received, self-efficacy, depression, burden, and risk to health. RESULTS: The long-term effects of the COMPASS program were greater than those of its short-term effects in reducing depression and risk to health (p = 0.013 and p = 0.002, respectively), whereas there were no significant differences between the short-term and long-term effects of the full COMPASS program on social support, self-efficacy, or burden. Comparing the long-term effects between the two forms of the COMPASS program revealed that the depression of caregivers was improved more by the full program than by the short form (p = 0.022), while there were no significant differences for social support, self-efficacy, burden, or risk to health. CONCLUSION: This study supports providing COMPASS programs to obtain long-term benefits for family caregivers of LTC recipients. Potential approaches that could optimize the long-term benefits of the COMPASS program include supporting caregivers to participate in arts-related hobbies and maintaining follow-up telephone calls after program completion.

Cognitive and Emotional Motivation to Explain Infection-Prevention Behaviors with Social Support as a Mediator During the COVID-19 Pandemic: A Nationwide Cross-Sectional Study in Korea.

Purpose: To predict the performance of infection-prevention behaviors among adults in Korea based on the health belief model, using social support as a mediator. Patients and Methods: A nationwide cross-sectional survey of 700 participants from the local community was conducted using both online and offline methods from 8 metropolitan cities and 9 provinces in Korea from November 2021 to March 2022. The questionnaire was composed of 4 sections: demographic information, motivational factors for behavior change, social support, and infection-prevention behaviors. Data were analyzed using structural equation modeling with the AMOS program. The general least-squares method was applied to assess the fit of the model and the bootstrapping method was tested for indirect effect and the total effect. Results: Motivation factors that directly affected infection-prevention behaviors were self-efficacy (γ=0.58, p<0.001), perceived barriers (γ=-.08, p=0.004), perceived benefits (γ=0.10, p=0.002), perceived threats (γ=0.08, p=0.009), and social support (γ=0.13, p<0.001), after controlling for related demographic variables. Cognitive and emotional motivation factors together explained 59% of the variance in infection-prevention behaviors. Social support exerted significant mediating effects between each cognitive and emotional motivation variable and infection-prevention behaviors, along with a significant direct effect on infection-prevention behaviors (γ=0.12, p<0.001). Conclusion: The engagement of prevention behaviors among community-dwelling adults was influenced by their self-efficacy, perceived barriers, perceived benefits, and perceived threats with social support as a mediator. Prevention policy approaches could include providing specific information to improve self-efficacy and build awareness of the severity of the disease while establishing a supportive social environment for promoting health behaviors during the COVID-19 pandemic.

Factors Influencing Training Transfer Among Infection Control Professionals Participating in Infectious Disease Training.

INTRODUCTION: Infectious disease training is considered vital in health care systems to improve knowledge, skills, and work performance of infection control professionals. However, the extent to which trainees effectively transfer knowledge, skills, and attitudes that they acquire through training has received little attention. This study aimed to identify factors influencing training transfer of infection control professionals receiving infectious disease training. METHODS: This cross-sectional study selected infection control professionals who completed an infectious disease training program provided by Korea Human Resources Development Institute for Health and Welfare. A self-reported questionnaire was used to collect data on sociodemographic variables, trainee characteristics, training design, work environment, and training transfer. Data analysis was conducted using SPSS (version 26.0). RESULTS: The mean age of the 139 participants was 41.45 years, and 77% were female participants. Regression analysis indicated that the following factors significantly influenced the training transfer of infection control professionals and thereby decrease morbidity and mortality: for trainee characteristics, transfer experience (ß = 0.205, P = 0.012) and motivation to learn (ß = 0.196, P =0.016); for training design, learning objectives (ß = 0.269, P = 0.021), goals (ß = 0.356, P =0.023), and methods (ß = 0.365, P = 0.020); and for the work environment, supervisor support (ß = 0.275, P =0.024) and colleague support (ß = 0.474, P = 0.022). CONCLUSION: Future training programs for improving training transfer should focus more on strategies to improve the motivation for training transfer. Trainees should be guided on (1) how to apply training knowledge in specific clinical contexts to improve their performance and (2) potential methods to get support from their supervisors and colleagues during training.

Development of a Standardized Curriculum for Nursing Informatics in Korea.

OBJECTIVES: This study explored the current status of nursing informatics education in South Korea and developed a standardized curriculum for it. METHODS: Data were collected in two stages: first, an online survey conducted from December 2020 to February 2021 among 60 nursing schools to analyze the current status of nursing informatics education; and second, a two-round Delphi survey with 15 experts from March to April 2021 to determine the mean and standard deviation of the demand for each learning objective in nursing informatics education. A standardized curriculum proposal was developed based on the results of the two-round Delphi survey. RESULTS: Nursing informatics was most commonly taught in the fourth year (34%), with two credits. The proportion of elective major subjects was high in undergraduate and graduate programs (77.4% and 78.6%, respectively), while the proportion of nursing informatics majors was low (21.4%). The curriculum developed included topics such as nursing information system-related concepts, definitions and components of healthcare information systems, electronic medical records, clinical decision support systems, mobile technology and health management, medical information standards, personal information protection and ethics, understanding of big data, use of information technology in evidence-based practice, use of information in community nursing, genome information usage, artificial intelligence clinical information systems, administrative management systems, and information technology nursing education. CONCLUSIONS: Nursing informatics professors should receive ongoing training to obtain recent medical information. Further review and modification of the nursing informatics curriculum should be performed to ensure that it remains up-to-date with recent developments.

Simulation Education Incorporating Academic Electronic Medical Records for Undergraduate Nursing Students: A Pilot Study.

OBJECTIVES: Academic electronic medical records (AEMRs) can be utilized for a variety of educational programs that can enhance nursing students' nursing informatics and clinical reasoning competencies. This study aimed to identify the applicability and effectiveness of simulation education incorporating AEMRs. METHODS: We developed simulation education scenarios incorporating AEMRs and evaluated them with 76 third- and fourth-year nursing students from five nursing schools using a mixed-methods design. We incorporated three simulation case scenarios involving preeclampsia, diabetes mellitus, and myocardial infarction into the AEMRs. After the simulation education, participants' feedback on the usability of the AEMR system and their self-efficacy for AEMR utilization were collected via self-reported surveys. Subsequently, the simulation education incorporating AEMRs was evaluated through a focus group interview. The survey data were examined using descriptive statistics, and thematic analysis was done for the focus group interview data. RESULTS: The average mean scores for the AEMR system's usability and participants' self-efficacy for AEMR utilization were 5.36 of 7 and 3.96 of 5, respectively. According to the focus group interviews, the participants were satisfied with the simulation education incorporating AEMRs and recognized their confidence in AEMR utilization. In addition, participants addressed challenges to simulation education incorporating AEMRs, including the need for pre-education and AEMR utilization difficulties. CONCLUSIONS: Nursing students were satisfied with and recognized the value of simulation education incorporating AEMRs. Although the actual application of simulation education incorporating AEMRs remains challenging, further research can help develop and implement this approach for nursing students.

eHealth interventions for the informal caregivers of people with dementia: A systematic review of systematic reviews.

OBJECTIVES: To systematically synthesize existing evidence on the implementation and effectiveness of eHealth interventions for the informal caregivers of people with dementia. METHODS: A systematic review of systematic reviews was conducted following the Cochrane methodological recommendations. Data were searched from MEDLINE/Ovid, Embase, CINAHL, Web of Science, Cochrane Library, and PsycInfo. Methodological quality was appraised independently using the AMSTAR 2. RESULTS: Nineteen reviews were included. The methodological quality of reviews varied from high to critically low. The eHealth interventions provided multiple components covering informative, psychoeducation, communication, psychotherapeutic, and psychosocial support. Interventions were delivered via the Internet, telephones, and combined technologies. The evidence varied, but was generally positive regarding depression, anxiety, caregiver burden, stress, self-efficacy, knowledge, and skill improvements. No evidence was found on the coping competence of caregivers. CONCLUSIONS: eHealth interventions are widely applied and benefit informal caregivers, but still lacking high methodological quality. More rigorous research is necessary to produce robust evidence for this changing field.

Unmet informatics needs of nurses regarding the use of personal smartphones in the workplace.

AIMS: This study aimed to investigate the differences in practices, policies, and perceptions of nurses regarding work-related utilization of smartphones in acute-care settings. BACKGROUND: Mobile devices utilizing emerging technology are widely used in acute-care settings; however, concerns such as potential distraction, improper use, and negative impact on the nursing image in clinical practice remain valid. METHODS: Nurse managers (n = 8) and nurses (n = 181) were enrolled from eight academic tertiary hospitals that have comprehensive electronic medical record systems and mobile versions. Between October 2018 and February 2019, participants completed a questionnaire designed to explore their use of smartphones. The reporting guide for self-administered surveys of clinicians was applied. RESULTS: Approximately 80% of nurses carried personal smartphones while working, with 70% using their devices for work. The prevalence of work-related smartphone use ranged from 3% to 43% by functionality, which was lower than that estimated by managers. Frequent uses included taking pictures/videos and internet browsing. Nurses were more positive than managers about the benefits of smartphone use and less burdened by related concerns. Novice and junior nurses were more optimistic than senior nurses. Only one hospital had a policy on nurses' use of personal devices at work. CONCLUSION: Two unmet needs in the current clinical information system were identified: information supporting task-related knowledge at the bedside and security of data capture and communication. IMPLICATION FOR NURSING POLICY: The unintended perception gaps between nurses and managers regarding work-related smartphone use can be closed by nursing leadership. Unmet nursing informatics, particularly for information-seeking purposes, can be addressed in the context of quality assurance. Nurse leaders can advocate secure and proper use of smartphones in clinical practice.

Listening to patients' voices: Applying the design-thinking method for teaching person-centered care to nursing students.

BACKGROUND: Providing a person-centered care (PCC) education program to nursing students is necessary. This study aims to determine the impact of a design-thinking based education program on how nursing students perceive PCC. METHODS: Five 2-h lessons were offered to 105 fourth-year nursing students in South Korea. Each randomly assigned group of eight or nine students was instructed to develop a plan to address the problems/dissatisfaction experienced by patients during hospitalization. The Individualized Care Scale-nurse's version was used to measure student's perception of PCC before and after the education program. RESULTS: After the program the students exhibited significant improvements in how they viewed supporting patient individuality, with that score increasing by 0.44 (from 3.64 to 4.08; p < 0.0001), and maintaining patient individuality while providing care, with that score increasing by 0.34 (from 3.71 to 4.05; p < 0.0001). Among subdomains, the most notable change was in how the students viewed the personal life situation of patients, and its impact on patients' healthcare outcomes. CONCLUSION: This education program, based on the design-thinking approach, was effective in improving the perceptions of nursing students about PCC. Expanding such PCC education programs for nursing school students should therefore be considered.

Dissemination of person-centered community care for mild dementia using local cooperatives in Korea during the COVID-19 pandemic.

BACKGROUND: To promote aging in place and improve the quality of life for persons with mild dementia during COVID-19 pandemic, there is a need to support them in their community in-person approach. Therefore, person-centered community care for individual service and support in the community is an urgent priority. This study aimed to develop a person-centered community service for mild dementia patient to collaborate with local cooperatives and test its feasibility. METHODS: This study was done from March to December, 2020. The person centered community service manual was developed based on previous guidelines and studies. The manual guided person-centered assessment, tailored intervention, and outcome evaluation based on six domains; person-hood, daily life, cognitive health, physical activity, safety, and community support. The local cooperatives for community care participated to provide comprehensive needs assessment and individualized service to the community residents with mild dementia. The staff visited the patient's home and provide individual service. The feasibility study was tested with the staff and patients. RESULTS: This study found that the service was effective for initial rapport, comprehensive assessment, individualized planning, person-centered service provision, referral to community service, and outcome evaluation. However, service provider's increased workloads and the time for home visiting and completing the service were identified as barriers during pandemic period. In addition, service providers still experienced lack of knowledge and skills in enhancing safety such as precaution and social distancing. CONCLUSION: The person-centered community service can be useful to enhance the safe and sustainable community services during COVID-19 pandemics. Collaboration with local cooperatives can be the best practices through the well-designed manual.

ICT-based person-centered community care platform (IPC3P) to enhance shared decision-making for integrated health and social care services.

BACKGROUND: Community care is a care model with the aim of shifting care services from being hospital based toward community-based care. Advances in platforms based on information and communications technology (ICT) with a person-centered approach provide the potential to improve the delivery of health and social care services toward community-based settings. OBJECTIVES: The aims of this study were to describe the ICT-Based Person-Centered Community Care Platform (IPC3P) and to determine its impact on health- and social-care-related shared decision-making and quality of life among community residents. METHODS: An online platform was developed with the aim of enhancing community care. The platform had four components: (1) comprehensive health and social needs assessment system, (2) personalized community care planning, (3) needs-based health and social care services delivery, and (4) health community engagement. Community residents were invited to use and evaluate the impact of the IPC3P on their quality of life and shared decision-making regarding health and social care services. They provided feedback about the platform by completing two surveys: at baseline (before using the platform) and 6 months after using the platform. RESULTS: Data of 164 community residents were analyzed in this study. Between baseline and after using the platform, the quality of life reported by the participants increased significantly in all domains, with clear improvements also noted for shared decision-making about health and social care services. The IPC3P received positive feedback from the participants for its usability, familiarity, and ease of use. Some participants also reported their desire for the addition of more functions that support health communities. CONCLUSION: The IPC3P has the potential to enhance the involvement of community residents in their own care. The findings of this study can be used to support the wider implementation of the IPC3P to promote person-centered community care.

"Walking in the patient's shoes": An innovative training method using storytelling to promote knowledge transfer of patient-centered care in hospital: A quasi-experimental study.

OBJECTIVE: To evaluate an onsite patient-centered care (PCC) training program for nurses using a digital patient-storytelling approach. BACKGROUND: PCC is a dominant model for improving the quality of care. Effective strategies for providing PCC training to nurses can yield numerous benefits. DESIGN: A pretest-posttest design was used with a nonrandomized control group METHODS: PCC training program involved participants playing a patient role to experience their hospital journey. Nurses' perception of PCC, compassion and knowledge transfer were measured before (pretest) and after (posttest) PCC training (experimental group). Controls received PCC training only after pretest and posttest evaluations. RESULTS: Changes in PCC perception and compassion were significantly greater in the experimental group (n = 39) than in controls (n = 49; p = .001 and .006, respectively). PCC knowledge transfer was significantly correlated with PCC perception (r = 0.55) and compassion (r = 0.63). CONCLUSIONS: Through the PCC training program, the perceived improvements of the nurses' views on supporting patient individuality and compassion while providing care were revealed. This program is also potential for promoting PCC knowledge transfer into the daily activities of nurses. Therefore, such PCC training programs could be a good beginning in developing a patient-centered culture in healthcare systems.

A predictive model of the perceptions of patient-centered care among nurses in long-term care hospitals: A cross-sectional study.

This study aimed to propose and examine a predictive model of the impacts of organizational and individual factors on the perceptions of patient-centered care (PCC) among nurses working in long-term care hospitals. A cross-sectional study was conducted at six hospitals in South Korea. Data collected from 187 nurses were analyzed using structural equation modeling. Findings showed that the model explained the impacts of the factors on how nurses perceive PCC, it explaining 47% of the variation in PCC. Organizational factors had stronger influences on PCC [innovative organizational culture (ß = 0.34), teamwork (ß = 0.30)] compared to individual factors [compassion (ß = 0.15), self-leadership (ß = 0.07)]. The hypothesized model has potential for determining the factors that influence the perceptions of PCC among nurses working in long-term care hospitals. Further strategies should focus on organizational factors in strategies for improving long-term care nurses' perceptions of PCC.

Implementing Patient and Family Involvement Interventions for Promoting Patient Safety: A Systematic Review and Meta-Analysis.

OBJECTIVE: The aims of the study were to evaluate and to quantify the effects of patient and family involvement (PFI) interventions on patient safety by synthesizing the available global data. METHODS: Four databases were searched to identify relevant studies that have assessed the impact of PFI on patient safety up to March 2019. Reference lists of potential selected articles were also used to identify additional relevant studies. Effect sizes (ESs) were calculated using random and fixed effects models. Statistical heterogeneity was measured using the I2 test. RESULTS: Twenty-two studies met the review criteria. The meta-analysis showed that PFI were beneficial in significantly reducing adverse events (ES = -0.240, P < 0.001), decreasing the length of hospital stay (ES = -0.122, P < 0.001), increasing patient safety experiences (ES = 0.630, P = 0.007), and improving patient satisfaction (ES = 0.268, P = 0.004). However, the PFI interventions did not significantly enhance the perception of patient safety (ES = 0.205, P = 0.09) or the quality of life (ES = 0.057, P = 0.61). Moreover, moderate-to-high heterogeneity was found for all impacts except adverse events (I2 = 0%) and length of hospital stay (I2 = 35%). A funnel plot indicated a low degree of publication bias for the adverse event outcome. CONCLUSIONS: The synthesized evidence in this review demonstrates the benefits of PFI for promoting patient safety. However, further studies should extend the research scope to fill the existing gaps for both the type of PFI interventions and the patient safety outcomes.

Digital Story-Based Education: An Innovative Way to Learn Evidence-Based Practice.

Applying evidence-based practice (EBP) to diverse clinical situations is challenging due to the complex process of EBP. Digital story-based education helps learners to understand the complex process more easily by providing contextual information. This article shares the process of development of digital story-based education to teach the steps of EBP and its implementation. A diversity of stories in real clinical situations can be used as effective learning content and to make the learning process of EBP enjoyable. [J Contin Educ Nurs. 2020;51(11):501-503.].

Randomized Controlled Trial of the Caregiver Orientation for Mobilizing Personal Assets and Strengths for Self-Care (COMPASS) for Caregiving Journey: A National Family Caregiver Support Program in a Long-Term Care Insurance System.

OBJECTIVES: To investigate the effects of a national support program on family caregivers for long-term care (LTC) recipients. DESIGN: A single-blinded randomized controlled trial compared the 8-week Caregiver Orientation for Mobilizing Personal Assets and Strengths for Self-Care (COMPASS) program consisting of 6 individual in-home, 3 group support, and 2 telephone sessions with a multicomponent intervention, and a control group. SETTING AND PARTICIPANTS: In total, 969 caregivers who were living with LTC recipients assessed as having a high caregiving burden in 12 Korean cities. MEASURES: The primary outcomes were depression, burden, and stress levels of caregivers, the secondary outcomes were caregiver self-efficacy, positive aspects of caregiving, social support, social activities, and health risk behaviors. These outcomes were measured at baseline and after the 8-week program, analyzed using modified intention-to-treat, per-protocol (PP), and non-PP analyses. RESULTS: The modified intention-to-treat analysis revealed significant improvements in burden (effect size, = 0.010, P = .008), depression (ηp2 = 0.012, P = .003), and health risk behaviors (ηp2 = 0.010, P = .012) for the experimental group compared with the control group. However, there were no significant differences between the 2 groups in improving stress (P = .997), social support (P = .234), or social activities (P = .816). The PP analysis indicated that the COMPASS program was successful in increasing positive aspects of caregiving (ηp2 = 0.013, P = .004) and self-efficacy (ηp2 = 0.010, P = .032) compared with the control group. CONCLUSIONS AND IMPLICATIONS: The COMPASS program was effective in family caregivers of LTC recipients in critical aspects of physical and psychological outcomes, especially in demonstrating the important role of participating in group support sessions. It is feasible for the program to become a formal national support program as part of the national insurance system in Republic of Korea.

Effects of a Mobile-App-Based Self-Management Support Program For Elderly Hemodialysis Patients.

OBJECTIVES: To identify the effects of a mobile-app-based self-management program for elderly hemodialysis patients on their sick-role behavior, basic psychological needs, and self-efficacy. METHODS: A nonequivalent control group with a non-synchronized design was utilized, and 60 participants (30 in each of the experimental and control groups) were recruited from Chungnam National University Hospital from March to August 2018. The program consisted of continuous training on how to use the mobile-app, self-checking via the app, message transfer through Electronic Medical Records, and feedback. The control group received the usual care. Data were analyzed using the χ2-test, the t-test, the repeated-measures ANOVA, and the McNemar test. A formalized messaging program was developed, and the app was developed with consideration of the specific physical and cognitive limitations of the elderly. RESULTS: Comparisons were conducted between the experimental (n = 28) and control (n = 28) groups. Statistically significant increases in sick-role behavior, basic psychological needs, and self-efficacy were found in the experimental group (p < 0.001). Physiological parameters were maintained within the normal ranges in the experimental group, and the number of non-adherent patients decreased, although the change was not statistically significant. CONCLUSIONS: The mobile-app-based self-management program developed in this study increased the sick-role behavior, basic psychological needs, and self-efficacy of elderly hemodialysis patients, while physiological parameters were maintained within the normal range. Future studies are needed to develop management systems for high-risk hemodialysis patients and family-sharing apps to manage non-adherent patients.

Web-based experiential learning strategies to enhance the evidence-based-practice competence of undergraduate nursing students.

BACKGROUND: Evidence-based practice (EBP) is considered a key competence for practicing high-quality and safe nursing. However, undergraduate nursing programs continue to provide traditional classroom teaching strategies that have limitations in facilitating the development of critical competences for engaging in EBP in real clinical contexts. OBJECTIVE AND DESIGN: The purpose of this study was to develop a web-based experiential learning program aimed at improving the engagement and experience of nursing students in EBP. A quasi-experimental research with non-equivalent control-group with non-synchronized design was used to describe the process of program development and the innovative learning method, and discuss the outcomes of the program. METHODS: The experimental group was exposed to a web-based experiential learning program, while the control group received traditional learning with written material. Self-reported EBP scores (knowledge and skills, attitude, and practice) and clinical-questioning confidence were evaluated to assess the effects of the program. RESULTS: The result showed that web-based experiential learning strategies were effective in significantly improving the EBP knowledge and skills score (F = 12.29, p = .001) and the score for confidence in asking clinical questions (F = 12.14, p = .001). The attitudes toward EBP (F = 0.75, p = .389) and practice score (F = 3.22, p = .076) did not show a significant difference between the experimental group and the control group. CONCLUSION: The web-based experiential learning was found to be an effective method for enhancing the EBP competence of nursing students. Based on the study results, we suggest using web-based experiential learning to supplement the traditional learning method or as the mainstream learning method for nursing students.