Perceptions of pre-licensure nursing students toward telecare and telenursing.

Telehealth transforms the healthcare system and provides the population with equal access to healthcare services at distance. This study aimed to investigate nursing students' perceptions toward telenursing. Students' knowledge, attitudes, advantages, disadvantages, barriers, and factors that affect the intention toward telenursing implementation were addressed. This study was conducted using a descriptive design. The study participants were 313 undergraduate nursing students. Data were gathered through a web-based survey from June to August 2022 and analyzed using SPSS version 22. Fifty-four-point-six percent (54.6%) of the students were male and 45.4% were female. Around one-fourth were internship students. Most students had access to the internet 97.4%. The results revealed that nursing students have positive perceptions toward telenursing. Their overall competencies in terms of knowledge, proficiency, awareness, and familiarity were moderate. Students raised some disadvantages and difficulties regarding telenursing; meanwhile, more advantages and suggestions to overcome the disadvantages were reported. It is of utmost importance that nursing education integrates telenursing content and practice to prepare future nurses for the successful implementation of telenursing. More research is still needed to examine the impact of telenursing on nursing practice. Nursing administrators must develop appropriate and prompt interventions to respond to the dramatically changing healthcare environment.

Patients' experiences of telenursing follow-up care after bariatric surgery.

AIM: To explore the postsurgical management experiences of bariatric patients after receiving telenursing follow-up care, using a telemonitoring platform for approximately 1 month. BACKGROUND: Obesity prevalence rates among adult Canadians are increasing, and as such the number of bariatric surgeries. Adapting to life following bariatric surgery is challenging, and patients are often experiencing difficulties to adhere to the postsurgical behavioural recommendations. The use of technology has been introduced in bariatric aftercare programmes, yet patients voiced a desire to communicate with a clinician between routine visits to improve continuity of care. To our knowledge, there is a lack of research on emerging practice of telenursing to provide monitoring, support and aftercare to bariatric patients remotely. DESIGN: A qualitative descriptive design was used. METHODS: A total of 22 semi-structured interviews were thematically analysed. The SRQR checklist was used. RESULTS: Participants embraced the idea of integrating telenursing care in bariatric aftercare programmes, as they viewed this novel approach to care as a way to overcome the current challenges of accessing bariatric services. The most salient benefit reported by participants was the timely advice and care provided by the telenurse. The provision of tailored nursing care and the accessibility to a first-line professional empowered participants to exercise greater control over their recovery process, which promotes self-management and enhances feelings of security and reassurance. Lastly, participants voiced areas of improvement to better the system and to render it most accessible and user-friendly. CONCLUSION: Despite its novelty in bariatric aftercare, our findings indicated that patients are eager to integrate telenursing in mainstream services. Discussions are needed regarding patient adherence to telemonitoring, and the need to develop clinical follow-up protocols. RELEVANCE TO CLINICAL PRACTICE: Results provide new insights into the importance of a telenurse in providing individualised care to bariatric patients.

Herramientas de telesalud para el seguimiento posoperatorio de enfermería en servicios de cirugía mayor ambulatoria / Telehealth Tool for Nursing Postoperative Follow-up in Major Ambulatory Surgery Services

Introducción: La cirugía mayor ambulatoria ha experimentado un aumento creciente en los últimos años, la cual ha ido de la mano con nuevos desafíos para los profesionales de enfermería, quienes realizan el seguimiento posoperatorio de estos usuarios con las diferentes herramientas de telesalud. Objetivo: Identificar en las bases de datos científicas las principales herramientas de telesalud utilizadas en el seguimiento de pacientes post operados vía cirugía mayor ambulatoria. Métodos: Revisión integrativa de la literatura de estudios publicados en español, inglés y portugués, desde 2013 hasta 2019 en las bases de datos MEDLINE/PubMed, CINAHL y SciELO. A partir de la metodología PRISMA, se utilizaron las palabras clave "Teleenfermería", "Procedimientos quirúrgicos ambulatorios", "Monitoreo ambulatorio", "Telemedicina", "Cuidados posoperatorios", con los operadores AND y OR. Fueron seleccionados 10 artículos, a los que se realizó análisis de contenido. Conclusiones: Se identificaron las principales herramientas de telesalud utilizadas en el paciente posoperado de cirugía mayor ambulatoria, donde cada una posee ventajas y limitantes para su uso. Se destacan las aplicaciones móviles como una herramienta a seguir innovando por el gran potencial en prestaciones que posee(AU)

Introduction: Major ambulatory surgery has experienced a growing increase in recent years. This modality has gone hand in hand with new challenges for nursing professionals, who carry out postoperative follow-up of these users by using different telehealth tools. Objective: To identify, in scientific databases, the main telehealth tools used in the follow-up of patients who received major ambulatory surgery. Methods: Integrative review of the literature about studies published in Spanish, English and Portuguese, from 2013 to 2019 in the databases MEDLINE/PubMed, CINAHL and SciELO. Using the PRISMA methodology, the keywords Teleenfermería [Tele-nursing], Procedimientos quirúrgicos ambulatorios [ambulatory surgical procedures], Monitoreo ambulatorio [ambulatory monitoring], telemedicine [telemedicine], and Cuidados posoperatorios [postoperative care] were used, with the operators AND and OR. Ten articles were selected and content analysis was carried out with them. Conclusions: The main telehealth tools used in the postoperative patient of major outpatient surgery were identified. Each has advantages and limitations for its use. Mobile applications stand out as a tool to continue innovating due to their great potential regarding benefits(AU)

Construção de um apoio online para o familiar cuidador / Construction of an online support for the family caregiver

The increase in the number of dependent individuals means that more and more families find themselves in the situation of caregivers, with all the consequences that performing this role entails. Based on this reality, we consider it to be completely relevant to systematize knowledge in this area towards the develop of an educational online support tool for caregivers. We conducted a focus group with experts in this field to identify what appropriate content an online caregiver support program should have. Our goal is to build an online tool that works as a complement to the work of professionals and is safe for carers. The main results and conclusions, after we analyze the focus group incomes indicate that the online support tool should contain topics that can be grouped into three main themes: 1) caregiver knowledge and skills, 2) potential resources for the caregiver and 3) caregiver coping strategies and well-being. It was also possible to obtain important complementary information that will be very useful in the construction of the online tool. The relevance of this study to clinical practice is that, although it is still necessary to expand and enhance the scope of research in this area, we consider this information essential for all health professionals seeking to provide effective support to family caregivers, as well as to serve as support for the development of intervention projects and health services

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Telenurses' experiences of monitoring calls to parents of children with gastroenteritis.

AIMS AND OBJECTIVE: To describe telenurses' experiences of monitoring calls in telephone advice nursing to parents of children with gastroenteritis. BACKGROUND: In previous studies, making monitoring calls is mentioned as a method used by telenurses to assess the need for care. MonitoringTHE terms 'care-seekers', 'care-seeker' and 'careseekers' are used inconsistently in the article. Please suggest which one to follow. We suggest Care-seeker calls in telephone advice nursing have been described as when telenurses call care-seekers back once or twice after an initial call. Calls from parents of children with gastroenteritis are common, and many of these calls result in telenurses providing self-care advice. METHODS: Nineteen telenurses from two healthcare call centres in Sweden were interviewed. Data were analysed using inductive qualitative content analysis. RESULTS: One main category, four generic categories and eleven sub-categories emerged. The telenurses described how working with monitoring calls aimed to provide self-care at home in a patient-safe way. Their focus on the parents aimed at increasing their feeling of security and focus on the child aimed at ensuring patient safety. Monitoring calls also provided a learning opportunity for parents and telenurses, and the possibility of relieving pressure on healthcare services. The findings indicate that the use of monitoring calls aims to provide a patient-safe form of telephone advice nursing. CONCLUSION: This study shows that many parents feel insecure when their child has gastroenteritis, and the use of monitoring calls may be an effective approach to help them feel more secure at home with their sick child.

Telenurses' experiences of interaction with patients and family members: nurse-caller interaction via telephone.

BACKGROUND: Telephone nursing is expanding worldwide, but a little is known about nurses' interactions with callers and the factors that affect these interactions. AIM: The purpose of this paper is to describe how telenurses experience caller interactions. METHODS: A qualitative study designed through open telephone interviews with call centre nurses (n = 9) in 2017. The data were analysed using inductive content analysis. Ethical guidelines were followed at all stages of the study. RESULTS: Callers both enhanced and hindered interactions. Nurses' professional skills, such as communication skills, nurse-led control over the call and the nurses' capabilities, enabled positive interactions. Disturbing background sounds, communication problems and service system failures made the telephone interactions challenging. Achieving connection with callers, callers who had supportive family members and a supportive organisational structure were features of successful interactions. STUDY LIMITATIONS: As all nine participants were recruited from one call centre, the findings are not directly transferable to another environment. CONCLUSIONS: The results reveal that nurse-caller interactions are affected by several issues concerning the callers and the nurses' skills. Communication problems were often present when telenurses were unable to provide the services callers expected due to lacking health and medical care resources. Family members could be considered important participants in telephone communication with nurses, though further research should examine the possible benefits of interacting with family members. PRACTICAL IMPLICATIONS: Based on the results of this study, telenurses could benefit from training that focuses on the communication skills that are needed for telephone nursing and the tools needed to meet individual callers' needs. Work environments could also better support caller-nurse interactions. Organisations should provide more resources for telephone nursing in order to promote positive interactions.

The influence of an eHealth intervention for adults with type 2 diabetes on the patient-nurse relationship: a qualitative study.

BACKGROUND: A constructive patient-nurse relationship is beneficial in self-management support approaches. Research indicates eHealth interventions hold a potential for self-management support for adults with type 2 diabetes. However, eHealth may change the patient-nurse relationship. No studies to date have addressed how eHealth self-management support interventions with written asynchronous communication can influence the relationship between patients and nurses. AIM: The aim of this study was to explore how an eHealth intervention based on the Guided Self-Determination program (eGSD) influences the patient-nurse relationship from the perspective of patients participating and the nurses conducting the intervention. METHODS: A qualitative approach with individual semi-structured interviews was used. Ten patients with type 2 diabetes who completed the eGSD and four nurses who delivered the intervention participated. The data were transcribed verbatim, and qualitative content analysis was used to analyse the text. RESULTS: The findings revealed two themes: 'eGSD facilitates a reciprocal understanding and a flexibility in the relationship' and 'eGSD creates a more fragile relationship', reflecting ambiguous experiences with the eGSD. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE: The findings indicate that eGSD influences the patient-nurse relationship by facilitating reciprocal understanding and flexibility. Both patients and RNs acknowledged these outcomes as beneficial. Nevertheless, familiar in-person consultations were expressed as integral for the patient-nurse relationship. As written communication in eHealth is a novelty, it demands new knowledge and expertise that RNs must master. Findings from this study may therefore be acknowledged when developing and implementing eHealth interventions. Education programs in written eHealth communication, as well as guidelines and frameworks on how to professionally and effectively conduct eHealth services while maintaining supportive patient-nurse relationships, should be a priority for institutions that educate healthcare personnel, health institutions and other stakeholders.

Effect of remote nursing monitoring on overweight in women: clinical trial.

OBJECTIVE: to evaluate the effect of remote nursing monitoring on the improvement of anthropometric measurements of overweight women. METHOD: controlled, randomized clinical trial, carried out in a reference outpatient clinic for treatment of obesity. The baseline sample was composed of 101 women randomly assigned to two groups, 51 in the intervention group (IG) and 50 in the control group (CG). The IG received remote monitoring through telephone calls and conventional monitoring, and the CG received conventional monitoring. Women were assessed at the baseline and after three months of intervention. A paired t-test and analysis of covariance were used to evaluate intragroup differences in anthropometric measurements, and the statistical significance of 5% was adopted. Eighty one women completed the study. RESULTS: in the intergroup comparison after the intervention, a reduction of 1.66 kg in the mean weight (p = 0.017) and of 0.66 kg/m2 in the mean BMI (p = 0.015) was found in the intervention group. There was a borderline statistically significant (p = 0.055) reduction of 2.5 cm in WC with in the intervention group. CONCLUSION: the remote monitoring was beneficial in reducing anthropometric measurements. RBR-3hzdgv.

The role of telenursing in the management of diabetes：A systematic review and meta-analysis.

BACKGROUND: Diabetes is a common chronic disease that requires a long-term regimen. However, the management of diabetes by telenursing is limited and inconclusive. OBJECTIVES: To determine the effectiveness of telenursing on control in diabetes. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS: We searched electronic databases, including PubMed, Embase, Web of Science and Cochrane Library. Studies comparing telenursing with usual care in diabetes patients were included. RESULTS: A total of 17 randomized controlled trials were identified. Glycated hemoglobin (HbA1c) dates were pooled using a random effects meta-analysis method, followed by subgroup analyses to examine heterogeneity. The meta-analysis showed that the use of telenursing (vs. usual care) was associated with a significant reduction in HbA1c levels compared to usual care, with a pooled 0.68% (95% CI: 0.33-1.03, p = 0.0001; I2  = 95%). For the secondary outcome, the SMD of body mass index (BMI) was -0.25% (95% CI: -0.81 to 0.32%, p = 0.39), with no statistically significant change; the fasting blood sugar (FBS) SMD was -0.19% (95% CI: 0.20 to 1.01, p = 0.003), with a statistically significant change; the total cholesterol (TC) SMD was -0.09% (95% CI: -0.03 to 0.21, p = 0.12), with no statistically significant change. CONCLUSIONS: Telenursing, as a useful tool for patient education and behavioral interventions, can help diabetes patients to improve their glycemic control. However, more studies on up-to-date and cost-effective technologies are needed.

The effect of telehealth, telephone support or usual care on quality of life, mortality and healthcare utilization in elderly high-risk patients with multiple chronic conditions. A prospective study / Telecuidados, apoyo telefónico o cuidados habituales: impacto sobre la calidad de vida, mortalidad y uso de recursos sanitarios en pacientes ancianos de alto riesgo con múltiples condiciones crónicas. Un estudio prospectivo

Background and objective: To assess the effect of home based telehealth or structured telephone support interventions with respect to usual care on quality of life, mortality and healthcare utilization in elderly high-risk multiple chronic condition patients. Patients and methods: 472 elderly high-risk patients with plurimorbidity in the region of Valencia (Spain) were recruited between June 2012 and May 2013, and followed for 12 months from recruitment. Patients were allocated to either: (a) a structured telephone intervention, a nurse-led case management program with telephone follow up every 15 days; (b) telehealth, which adds technology for remote self-management and the exchange of clinical data; or (c) usual care. Main outcome measures was quality of life measured by the EuroQol (EQ-5D) instrument, cognitive impairment, functional status, mortality and healthcare resource use. Inadequate randomization process led us to used propensity scores for adjusted analyses to control for imbalances between groups at baseline. Results: EQ-5D score was significantly higher in the telehealth group compared to usual care (diff: 0.19, 0.08-0.30), but was not different to telephone support (diff: 0.04, −0.05 to 0.14). In adjusted analyses, inclusion in the telehealth group was associated with an additional 0.18 points in the EQ-5D score compared to usual care at 12 months (p<0.001), and with a gain of 0.13 points for the telephone support group (p<0.001). No differences in mortality or utilization were found, except for a borderline significant increase in General Practitioner visits. Conclusions: Telehealth was associated with better quality of life. Important limitations of the study and similarity of effects to telephone intervention call for careful endorsement of telemedicine. Clinicaltrials.gov (identifier: NCT02447562)

Fundamento y objetivo: Evaluar el impacto de un programa de telecuidados domiciliarios o de apoyo telefónico con respecto a cuidados habituales sobre la calidad de vida, la mortalidad y el uso de recursos en ancianos de alto riesgo pluripatológicos. Pacientes y métodos: Se reclutaron 472 pacientes ancianos con plurimorbilidad en la región de Valencia entre junio de 2012 y mayo de 2013 y se les siguió durante 12 meses. Los pacientes fueron asignados a: a) una intervención de apoyo telefónico estructurado, con recordatorios y seguimiento por enfermería cada 15 días; b) telecuidados, que añade tecnología para el automanejo y la transmisión remotos de información clínica; o c) cuidados habituales. Las medidas de resultado fueron calidad de vida medida con el instrumento EuroQoL-5D (EQ-5D), afectación cognitiva, estatus funcional, mortalidad y uso de recursos sanitarios. Debido a fallos en el proceso de aleatorización, se ajustó los análisis mediante propensity scores para controlar las diferencias basales entre grupos. Resultados: La puntuación EQ-5D fue significativamente mayor en el grupo de telecuidados frente a cuidados habituales (dif. 0,19, 0,08 a 0,30), pero no frente a apoyo telefónico (dif. 0,04, −0,05 a 0,14). En análisis ajustados, la inclusión en el grupo de telecuidados se asoció con la obtención de 0,18 puntos adicionales en la escala EQ-5D comparado con cuidados habituales a 12 meses (p<0,001), y con 0,13 puntos en el caso de apoyo telefónico (p<0,001). No se hallaron diferencias en mortalidad o uso de recursos, salvo un incremento marginal en visitas al médico de AP. Conclusiones: Los telecuidados se asociaron con una mayor calidad de vida. Limitaciones importantes del estudio y la similitud de los efectos con la intervención de apoyo telefónico llaman a un apoyo ponderado de las tecnologías e-health. Clinicaltrials.gov (identifier: NCT02447562)

Detection of early-stage changes in people with chronic diseases: A telehome monitoring-based telenursing feasibility study.

Chronic diseases, such as chronic obstructive pulmonary disease, amyotrophic lateral sclerosis, and diabetes mellitus, require long-term management, which daily telenurse monitoring can provide. The aim of the present feasibility study was to determine if using a telenursing protocol with home monitoring during a 12 week implementation could also identify early signs of deterioration and factors correlated with participants' change in status, while attaining patient acceptance and satisfaction. The purposive sample of 43 participants provided 4533 combined days of monitoring. Outcome feasibility indicators were the range of triggering protocol alerts (70~100%) and diagnoses with exacerbations (20~29.3%). Highly correlated were participants' activity limitation and palpitations with chronic obstructive pulmonary disease, activity limitation and ineffective sputum clearance with amyotrophic lateral sclerosis, and fatigue with diabetes. Acceptance and adherence were high with daily monitoring, including "feelings of safety," and "understanding own condition". Telenursing with home monitoring indicated a trend to accurately detect early-stage changes. Participant acceptance was acceptable. It would be feasible to conduct a randomized, controlled trial using this model with some modifications.

Expert in nursing care but sometimes disrespected-Telenurses' reflections on their work environment and nursing care.

AIMS AND OBJECTIVES: To describe telenurses' reflections on their work environment and how it impacts on their nursing care. BACKGROUND: Telenursing is one of the largest healthcare settings in Sweden today; approximately 5.5 million care-seekers call the designated number-1177-each year. Telenursing is regarded as highly qualified nursing care, and providing care over the telephone is considered a complex form of nursing. Within other fields of nursing, the work environment has been shown to affect the outcome of care, patient safety, nurse job satisfaction and burnout. DESIGN: The study used a descriptive design and followed the COREQ checklist. METHODS: Twenty-four interviews were performed and analysed using qualitative content analysis. RESULTS: The main theme concerned "feeling like a nursing care expert but sometimes being disrespected." The telenurses reported that their work environment supported their work as nursing care experts via the telephone in some respects, but also hindered them. Appreciation and respect they received from the vast majority of callers positively impacted the work environment and contributed to work satisfaction. However, they also felt disrespected by both their employers and healthcare staff; they sometimes felt like a dumping ground. Receiving support from colleagues seemed invaluable in helping them feel like and be a nursing care expert. CONCLUSION: Work was perceived as cognitively demanding and sometimes exhausting, but appreciation from care-seekers and the feeling of being able to provide qualified nursing care made working as a telenurse worthwhile. RELEVANCE TO CLINICAL PRACTICE: If telenurses are to perform good nursing care over the telephone, managers must provide them with resources, for example, support, education and opportunities for recovery during shifts. It seems that the role of the 1177 service has not been properly implemented and accepted within the healthcare system, and politicians need to anchor its mission within the healthcare organisation.

Cost-Effectiveness Analysis in Telehealth: A Comparison between Home Telemonitoring, Nurse Telephone Support, and Usual Care in Chronic Heart Failure Management.

OBJECTIVES: To assess the cost effectiveness of home telemonitoring (HTM) and nurse telephone support (NTS) compared with usual care (UC) in the management of patients with chronic heart failure, from a third-party payer's perspective. METHODS: We developed a Markov model with a 20-year time horizon to analyze the cost effectiveness using the original study (Trans-European Network-Home-Care Management System) and various data sources. A probabilistic sensitivity analysis was performed to assess the decision uncertainty in our model. RESULTS: In the original scenario (which concerned the cost inputs at the time of the original study), HTM and NTS interventions yielded a difference in quality-adjusted life-years (QALYs) gained compared with UC: 2.93 and 3.07, respectively, versus 1.91. An incremental net monetary benefit analysis showed €7,697 and €13,589 in HTM and NTS versus UC at a willingness-to-pay (WTP) threshold of €20,000, and €69,100 and €83,100 at a WTP threshold of €80,000, respectively. The incremental cost-effectiveness ratios were €12,479 for HTM versus UC and €8,270 for NTS versus UC. The current scenario (including telenurse cost inputs in NTS) yielded results that were slightly different from those for the original scenario, when comparing all New York Heart Association (NYHA) classes of severity. NTS dominated HTM, compared with UC, in all NYHA classes except NYHA IV. CONCLUSIONS: This modeling study demonstrated that HTM and NTS are viable solutions to support patients with chronic heart failure. NTS is cost-effective in comparison with UC at a WTP of €9000/QALY or higher. Like NTS, HTM improves the survival of patients in all NYHA classes and is cost-effective in comparison with UC at a WTP of €14,000/QALY or higher.

Attaining Mutual Goals in Telehealth Encounters: Utilizing King's Framework for Telenursing Practice.

Access to essential health-promoting nursing care is increasingly facilitated through the expanding scope and capabilities provided through the utilization of telehealth technologies. Telehealth technologies facilitate the nursing process with clients at a distance in multiple ways, such as video conferencing, video conferencing with peripheral diagnostic tools, and store and forward modalities. Nursing care needs to remain the focus of care, but technology is a useful ancillary tool to help clients achieve health outcomes. The authors of this article discuss nursing practice and the use of telehealth technology and how King's concepts and theory of goal attainment can be used as a guiding framework.

Telephone Support and Telemonitoring for Low-Income Older Adults.

The objective of the current pilot study was to determine whether nurse-led telephone counseling improves health behavior, self-care, and physiological indices for low-income older adults using a telemonitoring system. The control group (n = 15) was provided with weekly health education only, and the intervention group (n = 20) was given additional telephone support by nurses. At baseline and 8 weeks, data on health and self-care behaviors were collected using a self-reported questionnaire, and blood pressure and fasting blood glucose levels were assessed. Nurse-led telephone support had a medium effect on improving health behavior (Cohen's d = 0.58, 95% confidence interval [CI] [-0.10, 1.27]), reducing systolic blood pressure (Cohen's d = -0.61, 95% CI [-1.29, 0.08]), and improving self-care behavior for hypertension (Cohen's d = 1.16, 95% CI [0.05, 2.27]). Findings support that nurse-led telephone support may be effective for improvements in health behavior, systolic blood pressure, and hypertension self-care in disadvantaged older adults under remote monitoring. Further studies are needed to obtain a powered sample size and investigate the long-term effects of personalized elements surrounding telehealth in community-based settings. [Res Gerontol Nurs. 2018; 11(4):198-206.].

Cribado de retinopatía diabética mediante retinografía no midriática: concordancia de médicos de familia, enfermeras y oftalmólogos / Retinopathy diabetic screening by non-mydriatic retinography: concordance between primary care physicians, nurses and ophthalmologists

Objetivo: Comparar la evaluación de las retinografías para el cribado de retinopatía diabética (RD) realizadas por la enfermera de teleoftalmología y los médicos de atención primaria (MAP) con un oftalmólogo del hospital de referencia (estándar de oro). Métodos: Estudio transversal en una muestra aleatoria de 337 pacientes del programa de teleoftalmología desde enero de 2010 a enero de 2015. Analizamos la valoración diagnóstica (si presentaba hallazgos de RD o no) y la valoración terapéutica (si precisaba derivación al Servicio de Oftalmología o no) que realizaron de manera independiente sobre las retinografías de la muestra los MAP, una enfermera y un oftalmólogo (patrón de oro). Se comprobó la fiabilidad y concordancia de los MAP y la enfermera con el patrón de oro, apoyando los análisis estadísticos con SPSS v.23.00 y calculadoras de fiabilidad de pruebas diagnósticas (EPIDAT 4.1). Resultados: En el diagnóstico de RD, la enfermera presentó: sensibilidad (S): 0,96; especificidad (E): 0,89; VPP: 0,58; VPN: 0,99; índice Kappa: 0,67 y el MAP: S: 0,98; E: 0,99; VPP: 0,96; VPN: 0,99; índice Kappa: 0,96. En la derivación a Oftalmología valorado por la enfermera: S: 0,83; E: 0,83; VPP: 0,51; VPN: 0,96; índice Kappa: 0,53 y el MAP: S: 0,62. E: 0,76; VPP: 0,36; VPN: 0,90; índice Kappa: 0,29. Conclusiones: La enfermera del programa de teleoftalmología podría realizar el cribado poblacional de RD con la misma calidad que los MAP. Esto permitiría incrementar la cobertura, además de proporcionar un mejor aprovechamiento de los recursos al evitar citaciones intermedias de los pacientes a través del MAP y un mayor ahorro sanitario (AU)

Aim: To compare the evaluation of retinographies by a teleophthalmology nurse and primary care physicians (PCP) with an ophthalmologist referral hospital (gold standard). Methods: Cross-sectional study on a random sample of 337 patients on the teleophthalmology programme from January 2010 to January 2015. We analyzed the diagnostic evaluation (whether or not it presented findings of RD) and the therapeutic assessment (whether or not referral to the opthalmology department was needed) which were conducted independently on the sample retinographies by the PCP, a nurse and an ophthalmologist (gold standard). Reliability and concordance between the gold standard and the PCP and the nurse were checked and the statistical analyses were supported using SPSSv.23.00 software and diagnostic test reliability calculators (EPIDAT 4.1). Results: In the diagnosis of RD, the nurse presented: sensitivity (S): 0.96; specificity (Sp): 0.89; PPV: 0.58; NPV: 0.99; Kappa index: 0.67 and PCP: S: 0.98; Sp: 0.99; PPV: 0.96; NPV: 0.99; Kappa index: 0.96. In the referral to ophthalmology assessed by the nurse: S: 0.83; Sp: 0.83; PPV: 0.51; NPV: 0.96; Kappa Index: 0.53 and PCP: S: 0.62; Sp: 0.76; PPV: 0.36; NPV: 0.90; Kappa index: 0.29. Conclusions: A nursing teleophthalmology programme could perform population screening for RD with the same quality as PCP. This would increase coverage, in addition to providing better use of resources by avoiding intermediate patient appointments through PCP and increased health savings (AU)

Telehealth and telenursing using simulation for pre-licensure USA students.

An innovative simulation was used to teach pre-licensure USA nursing students about telenursing for screening, assessment, and patient education during a home visit. The students used telepresence technology to deliver nursing care to a homebound geriatric patient. After the simulation, students (N = 73) felt increased confidence with the skills needed to deliver telenursing care and in using telepresence technology. Students reported that they modified and improved their communication in order to adapt to perceived barriers posed by the new technology. As telenursing becomes more prevalent for managing patient care at a distance, nursing programs will need to incorporate educational strategies to reflect this change.

Telenursing and Nurse-Patient Communication Within Fertility, Inc.

The purpose of this study is to examine patient perceptions of practitioner-patient communication in reproductive endocrinology and infertility (REI) practices. During this study, we uncovered the importance of telenursing for nurse-patient communication during REI treatment. Telenursing, which is defined as the use of wireless technology for out-of-office communication, is the basis for out-of-office communication. We examined participants' conceptualization of supportive and unsupportive communication, through the lens of biomedicalization theory. After conducting 23 interviews, we conclude that telenursing is integral to providing holistic nursing care during treatment at REI practices. We discuss efficient and effective uses of telenursing and patients' positive perceptions telenursing and assess telenursing as both an embrace of and form of resistance to biomedicalization within Fertility, Inc. Theoretical and practical implications are offered, including suggestions for increasing patient access to telenursing while protecting REI nurses from burnout.