Prehospital delay after acute ischemic stroke among Thai older adults: A cross-sectional study.

Acute ischemic stroke is a common medical emergency among older adults and requires immediate treatment. Prehospital delay limits the use of critical treatments, such as intravenous recombinant tissue plasminogen activators, leading to serious complications and often death. Using Andersen's Behavioral Model, this cross-sectional study aimed to investigate and determine factors influencing prehospital delay among older persons with acute ischemic stroke. The participants consisted of 120 older persons with first-time acute ischemic stroke diagnoses who received treatments at two hospitals in northern Thailand between November 2021 and February 2022. The results revealed that 70% of older persons experienced delays of over 3 hours following the onset of stroke symptoms. It was found that increased perceived severity of ischemic stroke and a shorter distance from home to the hospital were both associated with a reduced probability of prehospital delay. These findings highlight the significant factors influencing prehospital delay and suggest possible interventions to reduce prehospital delay among older patients with acute ischemic stroke.

Technological machines and artificial intelligence in nursing practice.

This article is a theoretical discourse about technological machines and artificial intelligence, highlighting their effective interactive outcomes in nursing. One significant influence is technological efficiency which positively affects nursing care time, enabling nurses to focus more on their patients as the core of nursing. The article examines the impact of technology and artificial intelligence on nursing practice in this era of rapid technological advancements and technological dependence. Strategic opportunities in nursing are advanced, exemplified by robotics technology and artificial intelligence. A survey of recent literature focused on what is known about the influence of technology, healthcare robotics, and artificial intelligence on nursing in the contexts of industrialization, societal milieu, and human living environments. Efficient, precision-driven machines with artificial intelligence support a technology-centered society in which hospitals and healthcare systems become increasingly technology-dependent, impacting healthcare quality and patient care satisfaction. As a result, higher levels of knowledge, intelligence, and recognition of technologies and artificial intelligence are required for nurses to render quality nursing care. Designers of health facilities should be particularly aware of nursing's increasing dependence on technological advancements in their practice.

Psychometric Properties of Grief Traits and State Scale for Nurses to Measure Levels of Grief.

Frequent exposure to patient deaths prompts nurses to experience grief. Unresolved grief leads to harmful consequences of nurses' mental health and quality of nursing care. A cross-sectional study using an online survey was conducted to determine the psychometric properties of the Grief traits and State Scale for Nurses. Exploratory factor analysis revealed two factors measuring the level of nurses' grief traits (Cronbach's alpha: 0.84) and two factors in grief state (Cronbach's alpha: 0.86). Nurses' feelings of unable to provide good care were associated with a higher risk of grief (odds ratio (OR): 4.30, 95% confidence interval (CI): 1.45-12.75), uncomfortable feeling toward deaths (OR: 11.29, 95%CI: 1.48-85.91), and emotional exhaustion (OR: 7.12, 95%CI: 1.63-30.99). Results indicated that the scale was reliable in determining the levels of their grief. Nurse managers can use the scale to identify their nurses' levels of grief, creating opportunities to influence the resolution of the grief experiences.

Living alone and using social media technologies: The experience of Filipino older adults during the COVID-19 pandemic.

Prolonged implementation of lockdowns during the coronavirus disease 2019 (COVID-19) pandemic has resulted in older adults living alone in social isolation. The purpose of the study was to describe the meaning of the experience of Filipino older adults, who are living alone and using social media technologies during the COVID-19 pandemic. Eight participants who met the inclusion criteria were interviewed using the snowball selection technique. Transcribed interviews were read while also listening to the recorded interviews and highlighting significant words, phrases, and statements. An iterative process of analysis using van Manen's phenomenological approach identified thematic structures and categories revealing life-worlds of corporeality, relationality, temporality, spatiality, and materiality. The five general essences of flourishing, communicating, struggling, journeying and empowering, described the meaning of living alone and using social media technologies among older adults during the pandemic. The experience was expressed as "flourishing despite struggling to communicate, while journeying and empowering oneself and others." Older adults in isolation struggled to communicate with others however, with social technologies opportunities were opened for them in securing needed food, safety and security, maintaining their health, and their social connectedness. Despite the physical isolation and living arrangements during the pandemic, the use of social media technologies sustained older persons' well-being.

Reimagining quarantine: Assuring hopefulness in nursing and healthcare.

This article aimed to explore issues of concern related to quarantine, its social consequences and influences, challenging its effects on human behavioral expressions during social isolation. The advent of the coronavirus disease 2019 (COVID-19) pandemic impacted human lives in multifarious ways, threatening the meaning of normalcy. Quarantine, lockdown, isolation, and other terms reflecting conditions limiting human freedoms have become synonymous in importance to safety, security, and survival. To understand human defiance in the face of maintaining limited mobility during the COVID-19 pandemic, reimagining situations of "unfreedoms" is explained as thinking of changes to inspire and improve the meaning of living lives meaningfully. During the pandemic, issues regarding healthcare practices and social behaviors focused much attention on interactive challenges that enhance ways to mitigate the spread of contagious diseases. Illuminating these issues, discussing concerns and highlighting recommendations to engage in alternative approaches and practices, heightens the declaration of efficiency of quarantine outcomes and effectiveness. Implications are proposed with the hope that they may lead the way forward in exercising contemporary healthcare practices.

Transcending human frailties with technological enhancements and replacements: Transhumanist perspective in nursing and healthcare.

As human beings age, they become weak, fragile, and feeble. It is a slowly progressing yet complex syndrome in which old age or some disabilities are not prerequisites; neither does loss of human parts lead to frailty among the physically fit older persons. This paper aims to describe the influences of transhumanist perspectives on human-technology enhancements and replacements in the transcendence of human frailties, including those of older persons, in which technology is projected to deliver solutions toward transcending these frailties. Through technologies including genetic screening and other technological manipulations, intelligent machines and augmented humans improve, maintain, and remedy human-linked susceptibilities. Furthermore, other technologies replace parts fabricated through inorganic-mechanical processes such as 3D-printing. Advancing technologies are reaching the summit of technological sophistication contributing to the transhumanist views of being human in a technological world. Technologies enhance the transcendence of human frailties as essential expressions of the symbiosis between human beings and technology in a transcendental world.

Treatise on the influence of theism, transhumanism, and posthumanism on nursing and rehabilitation healthcare practice.

Reservations concerning the ontologies of theism, transhumanism and posthumanism compel an explicatory discourse on their influences on Nursing and rehabilitation healthcare. Key journals in Nursing and health sciences have recently devoted themed issues on intelligent machine technologies such as humanoid healthcare robots and other highly technological healthcare devices and practice initiatives. While the technological advance witnessed has been a cause for celebration, questions still remain that are focused on the epistemological concerns. The purpose of this article is to discuss theistic ontologies such as the Judeo-Christian, Shinto-Buddhist and Islamic religious belief systems on transhumanism and posthumanism in the assimilation of symbiotic technological beings in Nursing and rehabilitation healthcare practice. In view of the approaching technological singularity dominating arguments regarding the future of human beings, a treatise on Nursing and rehabilitation health care is positioned well within the realms of human care. Theism, transhumanism and posthumanism are directing discussions regarding human beings and healthcare processes. It is imperative that the beneficial effects of these discussions be acknowledged within the highly technological world of Nursing and rehabilitative healthcare.

Relating Mori's Uncanny Valley in generating conversations with artificial affective communication and natural language processing.

Human beings express affinity (Shinwa-kan in Japanese language) in communicating transactive engagements among healthcare providers, patients and healthcare robots. The appearance of healthcare robots and their language capabilities often feature characteristic and appropriate compassionate dialogical functions in human-robot interactions. Elements of healthcare robot configurations comprising its physiognomy and communication properties are founded on the positivist philosophical perspective of being the summation of composite parts, thereby mimicking human persons. This article reviews Mori's theory of the Uncanny Valley and its consequent debates, and examines "Uncanny" relations with generating healthcare robot conversational content with artificial affective communication (AAC) using natural language processing. With healthcare robots provoking influential physical composition and sensory expressions, the relations in human-healthcare robot transactive engagements are argued as supportive of the design and development in natural language processing. This implies that maintaining human-healthcare robot interaction and assessing the eeriness situations explained in the Uncanny Valley theory are crucial positions for healthcare robot functioning as a valuable commodity in health care. As such, physical features, language capabilities and mobility of healthcare robots establish the primacy of the AAC with natural language processing as integral to healthcare robot-human healthcare practice.

Social transformation and social isolation of older adults: Digital technologies, nursing, healthcare.

BACKGROUND: The incidence of social isolation among older adults is on the rise in today's health care climate. Consequently, preventing or ameliorating social isolation through technology in this age group is now being discussed as a significant social and health issue. AIM: The purpose of the opinion paper is to clarify social transformation through technology and shed light on a new reality for older adults in situations of social isolation. Our goal is to persuade the reader that our position on this topic is a valid one. We support our claims with practice-based evidence and published research studies. METHODS: To do so, we checked the most recent literature, most of which came from the last decade. Our literature survey focused primarily on what is known about technology and how technology can affect social transformation and perceptions of social isolation. FINDINGS: Two dominant transformative realities became the focal points: the precarious implications of loneliness for older adults and the emerging reality of social change through digital technology central to eHealth and mHealth. DISCUSSION: To benefit from new technologies and reduce the detrimental effects of social isolation, we must engage older adults in a meaningful way and adapt the system of smart devices to reflect the specific physiological and psychological characteristics of the ageing population. CONCLUSION: Older adults need to comprehend the meanings of their social experiences to preserve their active lifestyle. Human interactions may be desirable, but technological dominance may also minimize the adverse effects of social isolation.

Intelligent humanoid robots expressing artificial humanlike empathy in nursing situations.

Intelligent humanoid robots (IHRs) are becoming likely to be integrated into nursing practice. However, a proper integration of IHRs requires a detailed description and explanation of their essential capabilities, particularly regarding their competencies in replicating and portraying emotive functions such as empathy. Existing humanoid robots can exhibit rudimentary forms of empathy; as these machines slowly become commonplace in healthcare settings, they will be expected to express empathy as a natural function, rather than merely to portray artificial empathy as a replication of human empathy. This article works with a twofold purpose: firstly, to consider the impact of artificial empathy in nursing and, secondly, to describe the influence of Affective Developmental Robotics (ADR) in anticipation of the empathic behaviour presented by artificial humanoid robots. The ADR has demonstrated that it can be one means by which humanoid nurse robots can achieve expressions of more relatable artificial empathy. This will be one of the vital models for intelligent humanoid robots currently in nurse robot development for the healthcare industry. A discussion of IHRs demonstrating artificial empathy is critical to nursing practice today, particularly in healthcare settings dense with technology.

The implementation of the Japanese Dental English core curriculum: active learning based on peer-teaching and learning activities.

BACKGROUND: Education in Japan and other Asian countries advocates the stereotypical passive learning style where students are limited in their breadth of knowledge dismissing anything not imparted by their teachers. With globalized education, professions are becoming very competitive, embracing student-centeredness compelling them to introduce active learning activities. A study funded by Japan's Ministry of Education conducted a needs analysis, proposed a solution, and implemented an active learning approach. Since the latter is still new in the Japanese teaching-learning environment, this current study aimed at assessing the willingness of undergraduate students of dental medicine to participate in active learning activities rather than the typical passive-style teaching-learning educational process. METHODS: Three active implementation-learning activities, namely International Group Discussions (IGD), Student-Teacher Experience (STE) and Role Play Activities (RPA) were included in the Dental English course in a classroom setting at a dental school in Japan. Students had to choose between participating in the activity or taking the final examination. Two hundred and three third-year undergraduate dental students participated over a 5-year period from October 2013 to March 2017. For IGD, the researchers assigned students to a topic and grouped them with visiting international exchange students. For STE, researchers gave students teacher-prepared presentation slides on basic dental topics, which they presented in front of their classmates. For RPA, students had to do prepared role-play and impromptu role play. Peer and teacher feedbacks of the activities were given to all students. At the end of the course, the students evaluated the active learning activities and wrote their comments in a free entry survey. RESULTS: All 203 students participated in the active learning activities confirming the changing learning needs of Japanese students in this dental school. The most common comment was that the class was interesting, fun, an easy-to-understand way to learn dental terms, and a safe way to express themselves in the English language. CONCLUSION: The majority of Japanese students preferred the active learning style. The study revealed that students reported greater engagement and better learning with proper guidance and time to prepare for the activities.

Disruptive Engagements With Technologies, Robotics, and Caring: Advancing the Transactive Relationship Theory of Nursing.

Human caring, founded on a Japanese caring perspective and nursing theory, fosters innovative and creative ideas for an aging society. The growing reality of health care dependency on technology presents a temptation to give robots utility as partners in nursing practice. Human caring expressed in human-to-human relationships, and also between humans and nonhumans, is a futuristic model for health care, with humanoid robots as major supporters. The purpose of this article is to explore this disruptive technology, along with its functions and characteristics. Tanioka's Transactive Relationship Theory of Nursing is shared along with its relevance for addressing technological disruptions in health care.

Lived experience of caring for dying patients in emergency room.

BACKGROUND: Dying often occurs in hospitals and frequently in emergency rooms. Understanding caring for critical and dying patients is necessary for quality nursing. PURPOSE: This study described the meaning of nurses' lived experience of caring for critical and dying patients in the emergency rooms. METHODS: This study was conducted in three emergency rooms of tertiary hospitals in southern Thailand. Twelve nurses met the inclusion criteria: nurses working in emergency room for at least 2 years, and experienced caring for critical and dying patients in an emergency department. Data were collected using in-depth individual interviews. Data transcription and analysis used van Manen's hermeneutic phenomenological approach. Trustworthiness was established following Lincoln and Guba's criteria. FINDINGS: Experiences of caring for critical and dying patients revealed four thematic categories: defying death; no time for palliative care; lacking support for family; and privacy for peaceful deaths. These thematic categories reflected van Manen's four lived worlds of body, time, relations and space. CONCLUSIONS: The study described the meaning of the experience of caring for critical and dying patients while supporting the development of nursing knowledge for palliative and end-of-life care in emergent settings. IMPLICATIONS FOR NURSING POLICY: Findings of the study influence nursing policies toward enhancing education of nurses regarding palliative and end-of-life care in emergency settings. These findings can also influence the value of caring-healing environments for critical and dying patients and their families. Policies can focus on practice and education of families particularly about end-of-life care for critical and dying patients.

Lived experience of patients being cared for in ICUs in Southern Thailand.

BACKGROUND: Technologies in ICUs are increasingly saving human lives. The challenge for nursing in ICUs is to use technologies competently in order to know patients more fully within the harmonized view of technology, nursing and human care. PURPOSE: The purpose of this study was to describe the meaning of the experiences of patients who were dependent on technologies while being cared for in ICUs. METHOD: A hermeneutic phenomenological approach was used to describe the experiences of 10 participants who were discharged from adult ICU units in Southern Thailand. Lincoln and Guba's criteria for trustworthiness was used to establish the rigour of the study. FINDINGS: Four thematic categories structured the meaning of the participants' experiences: Living suffering; Harmonizing living; Being in trust and security; and Transitioning to a better life. These thematic categories were reflective of the four lived worlds of corporeality, relationality, spatiality and temporality. CONCLUSION: The description of being cared for was based on the narratives of patients who were discharged from ICUs in Southern Thailand. In conclusion, the lived experience of being cared for with technologies in ICU was described as living suffering within trust and security, and harmonizing living while transitioning to a better life. RELEVANCE TO CLINICAL PRACTICE: The findings of the study could be used to design innovative nursing strategies and interventions to enhance understanding of human health and well-being while maintaining and advancing competencies in the use of technologies for human care.

Effects of Healthcare Technologies on the Promotion of Physical Activities in Older Persons: A Systematic Review.

This study aimed to explore the effects of health technologies on the promotion of health through physical activities of older persons. Following PRISMA guidelines, a systematic review of relevant articles published prior to 2020 was conducted from selected indices such as COCHRANE, PubMed, Science Direct, Proquest, including the use of hand search procedure. Twenty-seven articles were analyzed with significant findings influential to older people nursing: types of health technologies used for promoting physical activity; effects of technology use in promoting physical activity of older person care; and aspects that need to be considered in technology use among older persons. Characteristics of technologies were accuracy, usefulness, reliability, comfort, safety, and relevancy. Most technologies promoting physical activities for older people were wearable technologies that use artificial intelligence. Altogether, these technologies influenced overall healthcare behaviors of older persons. With healthcare technology efficiencies, proficiencies, and dependencies, technology-based healthcare have served older people well. Most technologies for older people care, such as wearables, reliably produce characteristics enhancing dependency and accuracy of bio-behavioral information influencing physical activities of older persons. Health technologies foster the values of physical activities among older persons thereby promoting healthy living.

Development and psychometric testing of the Professional Interpersonal Competency Assessment Scale for Novice nurses (PICASN).

Background: Assessing the professional interpersonal competency of novice nurses is crucial for preventing staff turnover and promoting effective work. However, none of the instruments identified in the literature specifically target novice nurses. Objective: This study aimed to develop and psychometrically test the perception dimension of the Professional Interpersonal Competency Assessment Scale for Novice nurses (PICASN) in Japan. Methods: The study comprised four steps: 1) concept identification, 2) item construction, 3) validity measure, and 4) reliability measure. A cross-sectional web-based questionnaire was administered from February to April 2023 and was completed by 203 novice nurses. Data quality was assessed using mean, item response, missing values, floor and ceiling effects, internal consistency, and item-rest correlations. Content validity index (CVI) was used to determine the instrument's validity, while exploratory factor analysis (EFA) using maximum likelihood estimation with Promax rotation was employed to assess the factor structure. Cronbach's alpha was used to evaluate reliability. Results: The 27-item PICASN demonstrated an Item-CVI of 0.94 and a Scale-CVI of 0.88. EFA revealed two factors: 1) Basic competencies as a novice nurse (15 items) and 2) Relationship building skills within the healthcare team (12 items), which explained 80% of the variance. Internal consistency reliability was excellent at 0.94 and 0.91 for the factors, and the overall scale reliability was 0.95. The item-rest (I-R) correlation values exceeding 0.6 were considered acceptable. Conclusion: The PICASN demonstrates satisfactory psychometric properties, making it an effective tool for measuring professional interpersonal competency among novice nurses in Japan. This instrument serves to assist novice nurses by promoting self-awareness and offering targeted insights into specific areas requiring improvement. Additionally, it provides experienced nurses and nurse managers with valuable insights into team dynamics, guiding interventions for continuous quality improvement.

Variations on a theme: Labeling patients as persons, the nursed, or client in nursing.

The debate regarding the variation of names used for labeling the patient in a nursing care situation has always existed in nursing. Names such as patient, client, person, and nursed have been used widely among healthcare disciplines, including nursing. However, does the use of any of these identifying terms establish the appropriate identification of the nurse and the persons being nursed in a nursing care situation participating in a mutual relationship? This editorial aims to address the varieties and rationales of identifying persons participating in or receiving nursing care. Among these terms, "person" describing human beings underscores personhood, allowing nurse-nursed relations to foster, support, celebrate, and affirm living the meaning of what matters most to one's life. Therefore, it will be advantageous to nursing practice if the term "person being nursed" is the relevant descriptor to be considered as the primary label.