Search Results (42)

Objectives: This study aimed to prospectively investigate the associations among obesity, physical activity, and short-term high medical expenditures in Japanese employees and their dependents. Methods: Participants were 245,044 employees and their dependents aged 40–74 years who underwent the Specific Health Checkup in fiscal year 2008. Health checkup and medical expenditure data for 2008–2010 were provided by health insurers. They were divided into 12 groups according to the combination of body mass index categories (normal, overweight, and obesity) and engagement in exercise and/or daily physical activity (inactive, daily physical activity only, exercise only, and active). The multivariable-adjusted odds ratios of the groups for high total medical expenditures in the next year compared to the inactive normal body mass index group were estimated. High medical expenditures were defined as the top 5% of total annual expenditures, consistent with prior literature identifying high-cost users. Similar analyses were performed by sex and age (<65 years, ≥65 years). Results: Of the participants, 61.8% were men (mean age, 52.1 years). Multivariable-adjusted odds ratios were significantly high only in the inactive groups with overweight or obesity in men and younger individuals. In women and older individuals, the odds ratios were significantly high only in inactive women with obesity; however, the odds ratios were high in women who exercised only and in active older individuals, both with obesity. Conclusions: Exercise or daily physical activity might attenuate the possibility of incurring high short-term medical expenditures in men and younger individuals with overweight or obesity. These findings suggest that physical activity recommendations may need to be tailored for women and older individuals with obesity, and further longitudinal research is warranted. Full article

Objectives: With the rapid growth of artificial intelligence (AI) research across journals and conferences, traditional literature reviews face challenges in capturing broad patterns. This bibliometric analysis maps publication trends, geographic and institutional distributions, research themes, and collaboration patterns in AI applications within nursing literature. Using tools such as Bibliometrix, it provides a systematic visualization of these bibliometric features to inform future research directions. Methods: Data were retrieved from the Web of Science database (1956–May 2025), yielding 1194 full-text articles. Analyses were performed using CiteSpace, VOSviewer, OriginPro, Pajek, Bibliometrix, and Excel across four domains: (1) publication productivity (yearly output and citations), (2) distribution by country and institution, (3) research hotspots via keyword analysis, and (4) collaborative networks. Results: Publications have increased notably since 2012, with 90% of authors contributing only one article. The analysis identifies the 15 most-cited papers, leading journals by output, prominent countries and institutions, and major keyword clusters: (1) AI in nursing education, (2) clinical decision-making and patient care, (3) health informatics and telehealth, and (4) ageing care with robotics. Regression trends indicate rising publication volumes, while network visualizations reveal collaboration patterns. Conclusions: This bibliometric analysis maps publication trends, key contributors, and thematic foci in AI applications for nursing. Rising output and collaborations signal growing interest across patient care, education, and informatics. Findings offer a foundation for future interpretive studies on AI integration in nursing practice. Full article

Background: Electronic Medical Records improve decision-making but add administrative burdens for healthcare providers, such as physicians and nurses. While the rate of adoption is high in Saudi Arabia, the concrete temporary impact and reasoning behind their adoption are understudied. Objectives: This study is a Mixed-Methods Study designed to ascertain the number of hours of EMR use among physicians and nurses, the predictors of using EMRs for extended periods, perceived barriers and clinical impacts. Methods: A sequential mixed-methods study was performed in three hospitals in Riyadh, Dammam, and Makkah. Quantitative data from 503 clinicians were analyzed using inferential statistics, followed by thematic analysis of 10 semi-structured interviews. Results: A total of 503 professionals (162 physicians, 341 nurses) participated. The majority were females (67.2%), aged 30 to 40 years (44.9%), and non-Saudi (62%). Nurses reported a significantly higher daily EMR workload than physicians with 5.43 h (45.25%) versus 4.34 h (36.17%), with a mean difference of 1.09 h (t = −5.76, p = 0.001). Ordinal logistic regression identified female gender, non-Saudi nationality, nursing position, and lack of advanced education (Masters/Doctorate) as high-significance predictors of prolonged usage (all p < 0.005). Additionally, years of experience (p = 0.001) and EMR training (p = 0.003) were significant factors. Perceived barriers were moderate but significantly predicted by professional position (p = 0.004), work region (p = 0.017), and training duration (p = 0.001). Qualitatively, thematic analysis revealed four major barrier categories: system performance, infrastructure issues, lack of IT support, and increased workflow burdens. While EMRs improved professional practice and patient safety by solving handwriting issues and structuring data, they forced work routine adjustments that significantly reduced bedside patient interaction and assessment time. Full article

Introduction: Nursing informatics aims to improve patient care through rapid access to patient data, systematic assessment, a reduction in clinical errors, evidence-based practice, cost-effectiveness, and improved patient outcomes and safety. Background: Despite being the largest workforce in healthcare, nurses are not being adequately prepared to use nursing informatics, and this has been attributed to poor digital literacy, limited professional development, and a lack of undergraduate informatics education. Objectives: This scoping review aims to review contemporary published literature on the benefits, barriers, and enablers for embedding nursing informatics into undergraduate nursing education with a focus on the Australian healthcare context. Methods: A scoping review was conducted using the PRISMA-ScR checklist and the JBI Manual for evidence synthesis in adherence with an a priori scoping review protocol. A comprehensive search of JBI, Cochrane, CINAHL, Ovid, ProQuest, PubMed, and Scopus databases was performed. Two reviewers independently screened the results via Covidence, with discrepancies resolved via a third reviewer. Results: Two searches were conducted for this scoping review. In the first search, a total of 3227 articles were identified through database searches, with an additional 76 articles identified through bibliographic and grey literature searches. Following duplicate removal and screening, 46 articles met the inclusion criteria. In the second search, a total of 1555 articles were identified, and after duplicate removal and screening, 16 articles met the inclusion criteria. Duplicate removal during the second search round included those articles identified in the first search. The combined searches resulted in a total of 62 sources for this review. Conclusions: Despite the early adoption of nursing informatics in Australia in the 1980s, barriers remain to effective nursing informatics engagement and proficiency, including a lack of understanding of nursing informatics, limited infrastructure and resources, inadequate digital literacy of students and faculty, and the evolving nature of nursing informatics. Definitions of nursing informatics and associated fields, development of university faculty competency, access to digital health technologies, competency standards, digital literacy of the student cohort, faculty digital proficiency, and leadership from professional nursing bodies are all viewed as integral foundations for the development of student competency in nursing informatics. Full article

Background: Treatment nonadherence in oncology is common. Surveys often miss why patients do not follow recommendations. We synthesised Natural Language Processing (NLP) studies, mainly sentiment analysis, of patient-generated content (social media, forums, blogs, review sites, and survey free text) to identify communication and relationship factors linked to nonadherence and concordance. Methods: We conducted a scoping review (PRISMA-ScR). Searches of PubMed, CINAHL, and Scopus from 2013 to 15 June 2024 identified eligible studies. We included 25 studies. Data were charted by source, cancer type, NLP technique, and adherence/concordance indicators, then synthesised via discourse analysis and narrative synthesis. Results: Four themes emerged: (1) unmet emotional needs; (2) suboptimal information and communication; (3) unclear concordance within person-centred care; and (4) misinformation dynamics and perceived clinician bias. Sentiment analysis helped identify emotions and information gaps that surveys often miss. Conclusions: Patient-voice data suggest practical actions for nursing, including routine distress screening, teach-back, misinformation countermeasures, and explicit concordance checks to improve adherence and shared decision making. Registration: Not registered. Full article

Background/Objectives: Reducing sodium (Na) and increasing potassium (K) intake are important for lowering blood pressure (BP). Practical measures to decrease the dietary Na/K ratio are needed. A crossover design intervention study serving lunches prepared using K-enriched (low-Na/K) seasonings and dairy at an employee cafeteria was conducted. Methods: Participants consumed lunches containing low-Na/K seasonings and dairy as intervention meals and regular lunches as control meals for four weeks each, and we examined the changes in BP and urinary Na/K ratios. The Na and K contents of the meals were also measured. Results: A total of 166 employees (17.5% of whom were hypertensive, while 42.2% were women; mean age of 44.3 years) who regularly use the cafeteria completed the whole survey. The intervention meals contained less Na (66.4 vs. 74.2 mmol/serving) and more K (15.1 vs. 9.9 mmol/serving) than the control meals, and the average Na/K ratio was significantly lower (4.6 vs. 8.2, p < 0.001). The average urinary Na/K ratio was significantly lower in the intervention period than in the control (3.69 vs. 4.10, p = 0.008), but there was no difference in the average BP. Participants rated both the intervention and the control meals to be similarly good; 69.5% and 73.7% reported that the taste was fine, respectively, with no significant difference. Conclusions: Employing low-Na/K seasonings and habitual dairy consumption at lunchtime were effective in reducing urinary Na/K in a healthy working population. This may be a practical measure for sustainably decreasing dietary Na/K and controlling age-related increases in BP. UMIN-CTR registration: UMIN000050876 Full article

Background/Objective: Clinical handover of patient information is a key component of patient care in hospitals. Nurses use a structured framework to minimise communication errors. Electronic Medical Record (EMR) systems can support patient safety and clinical handover with contemporaneous documentation. The aim of this study was to evaluate nurses’ adoption, perceived usability, and satisfaction with an updated handover page within the EMR. Methods: A pre-post mixed-methods study across a large Australian tertiary healthcare organisation examined handover page adoption using data from the EMR, and perceived usability and satisfaction were measured using a survey (handover page updated in EMR on 23 September 2024). Descriptive and inferential statistical analyses were conducted for quantitative data, and content analysis was used for qualitative data. Results: Adoption of the handover page was not statistically significant post-update (Wilcoxon signed-rank test z = −1.376, p = 0.169). Improved usability of the updated handover page post-update was demonstrated by a statistically significant decrease in the need to navigate away from the page to find relevant clinical information during handover (Fisher’s Exact Test p = 0.042). Nurses’ satisfaction increased, indicated by statistically significant increases in two items of the End User Computing Satisfaction Scale (precise information (Mann–Whitney U = 963.50, p = 0.040); and sufficient information (Mann–Whitney U = 927.50, p = 0.034)). Free-text comments indicated adoption and acceptability of the updated handover page by nurses, although a gap remains in the practice process. Conclusions: A co-designed solution to update the handover page within the EMR had good usability and satisfaction among nurses. Updates or implementations to digital health technologies must be continuously evaluated by specialist informatics teams to ensure appropriate adoption, usability and satisfaction by nurses, and positive repercussions for patient safety. Full article

Background: Nursing decision-making is pivotal for patient safety and care quality. While artificial intelligence (AI) offers transformative potential in this field, a comprehensive analysis of global research trends is lacking. Methods: We conducted a bibliometric analysis of 238 publications (197 research papers, 41 reviews) from the Web of Science Core Collection (2003–2025) using CiteSpace and VOSviewer. Results: The results reveal growing interest (7.59% annually) in the field of AI in nursing decision-making, with contributions from 54 countries/regions. The USA leads in the number of publications, followed by China and Canada, while the United Kingdom stands out in terms of citation impact. Institutions such as Columbia University and Harvard Medical School dominate in both the publication volume and citation frequency. Journal analysis shows that the top three journals in terms of publication volume in this field are Cin-Computers Informatics Nursing, Journal of Nursing Management, and Applied Clinical Informatics. Keyword analysis highlights the significant potential of natural language processing technologies, particularly those based on large language models (e.g., ChatGPT), in nursing decision-making. Furthermore, emerging trends are evident, with the sudden appearance and rapid growth of keywords such as “patient safety” and “user acceptance”, indicating a shift in research focus from purely technology-driven studies to a greater emphasis on the practical impact of AI technologies on nursing systems and their clinical applications. Conclusions: This study delineates the current landscape and evolving trends of AI in nursing decision-making, emphasizing its progression from theoretical frameworks to clinical integration, thereby providing valuable references for future research. Full article

Oncology nurses have long been at the forefront of virtual care, transitioning from telenursing to technology-driven delivery methods that address the evolving needs of cancer patients. Initially developed to overcome barriers to care for rural and underserved populations, virtual care has grown into a critical component of oncology practice. Oncology nurses play a central role in providing timely, personalized, and holistic care, leveraging tools such as remote monitoring, patient-reported outcomes, and mHealth platforms. However, the rapid adoption of virtual care demands a broader focus to sustain its impact. This commentary explores the need to clearly define the role of oncology nurses in virtual care, emphasizing leadership in digital health, the integration of hybrid care models, and workforce training. By addressing these priorities, virtual care can continue to enhance patient outcomes, strengthen nursing-led interventions, and expand the scope of oncology nursing, positioning it as an essential and enduring facet of cancer care delivery. Full article

Gamification and game-based learning provide the opportunity to acquire knowledge and skills on a given subject in a practical and interactive way. They are an innovative teaching methodology that could be used for competence acquisition in a variety of fields. This study focuses on two domains: technology (including robotics) and care. This study evaluates the usability of RobotCareMaker^®, a board game designed to teach care robotics, a branch of robotics oriented towards the study of human care. RobotCareMaker^® consists of 106 elements. The playing cards are the engine of the game and the element of interaction between players. A convenience sample was selected. Usability was evaluated by the System Usability Scale (SUS) questionnaire modified for the game, and three questions about the game experience were used. Using a modified SUS questionnaire, 21 participants rated it with an excellent score of 80.36. Over 90% found the instructions clear and error-free. RobotCareMaker^® allows teachers, professionals, and nursing students to integrate curricular competencies in novel topics such as care robotics. The result suggests that RobotCareMaker^® enhances learning in assistive robotics, improving competencies in education and healthcare. Full article

Background: Health-related programs frequently integrate interprofessional education (IPE) into their training. The COVID-19 pandemic transitioned many IPE programs online, making it essential to assess student expectations and perceived learning outcomes across virtual simulations and in-person settings. Methods: This qualitative study compared student expectations and self-reported outcomes across in-person and virtual case scenarios at a Texas health science center. Responses to open-ended questions from two data collection periods were analyzed using inductive coding and thematic analysis. Results: Students from nursing, medicine, dentistry, public health, and informatics participated in each group. Three major themes emerged from this study: communication, teamwork, and role identification, with self-development and professionalism as major subthemes. For communication, students often described a desire for increased simulations to “practice with interprofessional communication”. Teamwork was the second theme identified, with students discussing the significance of effective teamwork, such as, “It is a good practice to work together, listen to each other, and achieve a common goal of patients getting better”. Additionally, students expressed a desire to better understand the roles of other healthcare professionals across different settings. Conclusions: Realistic IPE simulations may help students build confidence in their team roles while understanding other health professions. To strengthen curriculum design, faculty should include student expectations and perceived outcomes from IPE activities. A limitation of this study is the reliance on self-reported data, which may introduce response bias and the potential variability in student experiences. Full article

Purpose: To investigate community-acquired pressure injuries (CAPIs) in older people by utilizing big data. Design: Retrospective data curation and analysis of inpatient data from two general medical centers between 1 January 2016 and 31 December 2018. Methods: Nursing assessments from 44,449 electronic medical records of patients admitted to internal medicine departments were retrieved, organized, coded by data engineers, and analyzed by data scientists. Potential explanatory patient characteristics tested were gender, age, admission indices, nursing assessments including CAPIs, CAPI type and location, vital signs, and the results of lab tests within the first 36 h of admission. Findings: Most CAPIs were located in the buttocks (56.9%), followed by the sacrum (11.8%), ankle (10.8%), trochanter (5.1%), and leg (3.9%). Tissue associated with CAPIs was described as necrotic, serotic, bloody, granolithic, epithelial, and infected. There were 31% of first-degree CAPIs, 41% second-degree, and 18% third-degree. Previously unacknowledged patient characteristics associated with CAPIs are as follows: age, oxygen use, intestinal function, the touch senses of heat and pain, albumin, RDW (red cell distribution width), and systolic blood pressure. Conclusions: The novel indicators for CAPIs underscore the importance of data-driven approaches in detecting and preventing CAPIs in community care. These markers can detect and prevent pressure ulcers in the community, particularly among the elderly. Relevance for Clinical Practice: Nursing management is called upon to integrate information about novel patient characteristics associated with CAPI into clinical practice. Assimilating the insights from this hospital nursing-led study into community nursing will enhance the safety and quality of care for the elderly. Full article

Background/Objectives: This study addresses the complex challenge of Nurse Rostering (NR) in oncology departments, a critical component of healthcare management affecting operational efficiency and patient care quality. Given the intricate dynamics of healthcare settings, particularly in oncology clinics, where patient needs are acute and unpredictable, optimizing nurse schedules is paramount for enhancing care delivery and staff satisfaction. Methods: Employing advanced Integer Programming (IP) techniques, this research develops a comprehensive model to optimise NR. The methodology integrates a variety of constraints, including legal work hours, staff qualifications, and personal preferences, to generate equitable and efficient schedules. Through a case study approach, the model’s implementation is explored within a clinical setting, demonstrating its practical application and adaptability to real-world challenges. Results: The implementation of the IP model in a clinical setting revealed significant improvements in scheduling efficiency and staff satisfaction. The model successfully balanced workload distribution among nurses, accommodated individual preferences to a high degree, and ensured compliance with work-hour regulations, leading to optimised shift schedules that support both staff well-being and patient care standards. Conclusions: The findings underscore the effectiveness of IP in addressing the complexities of NR in oncology clinics. By facilitating a strategic allocation of nursing resources, the proposed model contributes to operational excellence in healthcare settings, underscoring the potential of Operations Research in enhancing healthcare delivery and management practices. Full article

Background: The biomedical and health informatics (BMHI) fields have been advancing rapidly, a trend particularly emphasised during the recent COVID-19 pandemic, introducing innovations in BMHI. Over nearly 50 years since its establishment as a scientific discipline, BMHI has encountered several challenges, such as mishaps, delays, failures, and moments of enthusiastic expectations and notable successes. This paper focuses on reviewing the progress made in the BMHI discipline, evaluating key milestones, and discussing future challenges. Methods: To, Structured, step-by-step qualitative methodology was developed and applied, centred on gathering expert opinions and analysing trends from the literature to provide a comprehensive assessment. Experts and pioneers in the BMHI field were assigned thematic tasks based on the research question, providing critical inputs for the thematic analysis. This led to the identification of five key dimensions used to present the findings in the paper: informatics in biomedicine and healthcare, health data in Informatics, nurses in informatics, education and accreditation in health informatics, and ethical, legal, social, and security issues. Results: Each dimension is examined through recently emerging innovations, linking them directly to the future of healthcare, like the role of artificial intelligence, innovative digital health tools, the expansion of telemedicine, and the use of mobile health apps and wearable devices. The new approach of BMHI covers newly introduced clinical needs and approaches like patient-centric, remote monitoring, and precision medicine clinical approaches. Conclusions: These insights offer clear recommendations for improving education and developing experts to advance future innovations. Notably, this narrative review presents a body of knowledge essential for a deep understanding of the BMHI field from a human-centric perspective and, as such, could serve as a reference point for prospective analysis and innovation development. Full article

Background: Postoperative gastrointestinal dysfunction (POGD) remains a common morbidity after gastrointestinal surgery. POGD is associated with delayed hospital recovery, increased length of stay, poor patient satisfaction and experience, and increased economic hardship. The I-FEED scoring system was created by a group of experts to address the lack of a consistent objective definition of POGD. However, the I-FEED tool needs clinical validation before it can be adopted into clinical practice. The scope of this phase 1 Quality Improvement initiative involves the feasibility of implementing percussion into the nursing workflow without additional burden. Methods: All gastrointestinal/colorectal surgical unit registered nurses underwent comprehensive training in abdominal percussion. This involved understanding the technique, its application in postoperative gastrointestinal dysfunction assessment, and its integration into the existing nursing documentation in the Electronic Health Record (EHR). After six months of education and practice, a six-question survey was sent to all inpatient GI surgical unit nurses about incorporating the percussion assessment into their routine workflow and documentation. Results: Responses were received from 91% of day-shift nurses and 76% of night-shift registered nurses. Overall, 95% of the nurses were confident in completing the abdominal percussion during their daily assessment. Conclusion: Nurses’ effective use of the I-FEED tool may help improve patient outcomes after surgery. The tool could also be an effective instrument for the early identification of postoperative gastrointestinal dysfunction (POGD) in surgical patients. Full article