Search Results (28)

Background: Chronic non-communicable diseases—chiefly chronic obstructive pulmonary disease (COPD), type 2 diabetes mellitus (T2DM), and cardiovascular diseases (CVDs)—remain the leading causes of morbidity and mortality worldwide. Despite the proliferation of telehealth programs, few longitudinal studies have rigorously evaluated theory-based, nurse-led digital education across multiple chronic conditions within a unified self-care framework. PROSELF (Promotion of Self-Care through Educational Interventions in Chronic Patients) addresses this gap. Methods: Promotion of Self-Care (PROSELF) is a prospective, longitudinal, multicenter, non-interventional study in community and primary-care settings in Southern Italy. A 12-month nurse-led digital educational intervention—grounded in the Middle-Range Theory of Self-Care of Chronic Illness—targets the three core self-care dimensions (maintenance, monitoring, and management) through individualized tele-education, asynchronous reinforcement, and structured follow-up at baseline, 3, 6, and 12 months. Validated self-care, quality-of-life, and social-support measures will be used. Data will be analyzed using repeated-measures and multivariate models to evaluate longitudinal changes in self-care, adherence, and related outcomes. Participation requires digitally informed consent. Results: The PROSELF study is expected to demonstrate the effectiveness of a 12-month, nurse-led digital educational program in improving adherence and self-care behaviors among patients with chronic diseases (COPD, diabetes, and cardiovascular disease). The intervention will leverage validated self-care assessment tools and tele-educational follow-up sessions. Conclusions: Findings from this study will inform the design of scalable, evidence-based, behaviorally informed models for digital chronic care delivery and nursing education. Full article

Background/Objectives: Family caregivers of individuals with schizophrenia often face considerable psychological and physical strain due to the complexity of caregiving. Although psychoeducation has demonstrated benefits in alleviating this burden, its provision via telenursing remains underexplored in Saudi Arabia. This study evaluated the effect of a psychoeducational program delivered via telenursing on reducing caregiver burden. Methods: A quasi-experimental design was used with 60 caregivers from a tertiary mental health hospital in northern Saudi Arabia, who were divided equally into intervention and control groups. The intervention group participated in a structured four-week psychoeducational program via Zoom, while the control group received routine care. Caregiver burden was assessed using the Family Burden Interview Schedule (FBIS), a validated tool designed to measure the objective and subjective burden experienced by family members caring for individuals with mental illness. The FBIS was administered before and three months after the intervention. The statistical analysis included independent and paired t-tests and ANOVA. Results: The pre-intervention scores showed no significant differences, confirming baseline equivalence. The post-intervention scores showed a significant reduction in burden among the intervention group (p < 0.001), while no meaningful change occurred in the control group. Additionally, a lower burden was associated with higher education, sufficient income (i.e., the caregiver’s perception of being able to meet essential household expenses without financial strain), strong family support, and absence of caregiver illness. Conclusions: These findings suggest that psychoeducation through telenursing is an effective strategy for reducing caregiver burden and improving support accessibility, particularly for those in remote areas. Full article

Background and Objectives: Specialized nurses play an essential role in managing pulmonary fibrosis. While tele-nursing has the potential to optimize disease management, current evidence regarding its impact remains limited. This study aimed to evaluate a tele-nursing intervention that provided unscheduled access to a specialized nurse via phone or email for both patients and caregivers. Materials and Methods: This was a prospective, single-center, open-label, and pre–post pilot study. Participants and their caregivers were provided with direct access to a specialized nurse, by phone and email, for unscheduled consultations. Patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) were collected at baseline and after three months of tele-nursing access. PREMs were assessed using a 10-point Likert scale questionnaire, and PROMs were evaluated using the King’s Brief Interstitial Lung Disease (K-BILD) and the Living with Pulmonary Fibrosis (L-PF) questionnaires. Results: A total of 47 patients with pulmonary fibrosis receiving antifibrotic drugs were enrolled. At three months, 44 patients and 34 caregivers completed the questionnaires. Four patients did not complete the study due to death, lung transplantation, or transition to end-of-life care. No significant changes were observed in PROMs. However, PREMs showed significant improvements, with most scores exceeding 9/10. Patient satisfaction increased by 28% (p < 0.001), and caregiver satisfaction by 30% (p < 0.001). Caregivers of patients who did not complete the study also reported high satisfaction, comparable to that of other caregivers. Conclusions: A pragmatic and affordable tele-nursing program, based on direct phone and email consultations, may enhance patient and caregiver satisfaction in the management of pulmonary fibrosis. Full article

Nutritional health is essential for older people with dementia. Their feeding is a challenge for which caregivers are not always ready, and an intervention that supports them may have a significant social impact. The aim of this project is to design and evaluate the impact of systematic nursing intervention with formal caregivers to promote nutritional health for older people with dementia. This is a “Nursing Methodology Research” study conducted with formal caregivers of older people with dementia in four Colombian nursing homes. It includes three consecutive phases: (1) systematic intervention design under Whittemore and Grey’s parameters, (2) intervention validation with seven international experts, and (3) measurement of intervention impact, which included a quasi-experimental pre-test–post-test design. The “Nurturing Neurons—Formal Caregivers” intervention met the criteria of systematic health interventions. In response to the work and personal requirements of formal caregivers, the intervention used a tele-support modality. Its content validity ratio (CVR) ranged from 0.88 to 0.92; its content validity index (CVI) was 0.90. The experience was positive for the participant caregivers (94.9%) and professional providers (92.5%). The overall caregivers’ caring competence changed from the medium, 78.1, to the high category, 91.5 (p < 0.001). Their perceived burden of care changed from 70.4 to 63.6 (p < 0.001). In conclusion, “Nurturing Neurons—Formal Caregivers” achieved a positive impact, with changes in the structure, processes, and outputs to promote the nutritional health of older people with dementia. It led to a significant improvement in formal caregivers’ caring competence and decreased their perceived care burden. Its cost–benefit was favorable; it generated health equity for a vulnerable population and achieved unexpected benefits in the context. 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

Background: Telenursing comprises a set of tools and interventions enabling nurses to provide remote care. This study aims to assess the impact of telenursing interventions on the supportive care needs of patients with melanoma and lung cancer who are receiving targeted therapies. Methods: This six-month monocentric, double-arm, randomised, controlled trial study protocol will assess the effect of telenursing on the supportive care needs (primary outcome) in 40 patients (20 in each group) after one month. The secondary outcomes will be monitored at baseline, one, three and six months: supportive care needs (at three and six months), therapeutic adherence, quality of life, usability and satisfaction, performance status, patient-reported outcomes and main adverse events. The SPIRIT guidelines will be used for the reporting. Results: The results from this trial will assess the impact of a telenursing intervention on cancer care. Conclusions: This trial could be a starting point for more extensive studies on telenursing interventions to promote nurses’ skills, as well as the quality and safety of care in patients with cancer, highlighting the impact of more outstanding nursing contributions on cancer care. Trial and Protocol Registration: The study protocol was approved by the relevant Italian Ethics Committee Lazio Area 5 (RS1851/23, 2773; 6 September 2023) and was registered on ClinicalTrials.gov (trial registry number NCT06254196). Full article

Background: Telenursing could improve continuity of care in patients with cancer. This study aims to explore the expectations and perceptions of patients with lung cancer and melanoma toward telenursing. Methods: A descriptive qualitative study using a phenomenological approach was conducted on a convenience sampling of twenty patients aged 18 years or over from a Cancer Center. With the consent of patients and the relevant Ethics Committee, in-depth open-ended face-to-face interviews were conducted until data saturation. The phenomenon’s essence was achieved through themes emerging from the qualitative data analysis. Results: Patients’ perceptions and expectations were related to areas explored by a general theme on the nurse–patient relationship’s importance. Four themes and eleven sub-themes were focused on misconceptions about lack of use, patients’ potential and fears, the home as a place of care, and the caring relationship. Fifteen patients perceived the internet as a chaotic “bubble”. Conclusions: Despite the lack of previous use, patients consider telenursing positively as “a bridge between home and care”, especially in the advanced stages of the disease. They highlighted strengths and weaknesses of telenursing, such as having “someone for you”, connection, fear of psychological addiction, loss of privacy, and lack of empathy. This study was not registered. Full article

Background: Management of PICC dressing can be performed at home by the patient through adequate training and telenursing. This trial verifies that the incidence of catheter-related complications in home patients, assisted by telenursing, is not greater than that observed in outpatients. Methods: This clinical trial is composed of 72 patients with malignant tumors who underwent long-term chemotherapy with PICC insertion. They were randomly divided into an experimental group (33 cases) and a calibration group (39 cases). The control group received outpatient dressing for the PICC at the hospital, while the experimental group received a telenursing intervention about the management of the PICC. The incidence of catheter-related infections, the ability of self-management, and a rough cost/benefit estimation were compared between the two groups. This trial was performed according to the CONSORT 2010 checklist. Results: The two groups do not significantly differ in relation to age, sex, and PICCs in terms of the body side insertion, the type of dressing, and the agents used for cleaning. The analysis of the results showed that in the home-managed group, the clinical events reported during the connection were higher when compared with the outpatient group (p < 0.001). The patients in the homecare group developed frequent complications resulting from skin redness (p < 0.001). Conclusion: The use of telenursing for patient education in cancer centers can reduce nurses’ working time, improving the self-management capacity of patients with a long-term PICC. This trial was retrospectively registered with the Clinical Trial Gov on the 18 May 2023 with registration number NCT05880420. Full article

Background: The outbreak of the COVID-19 pandemic has increased telemedicine and telenursing services worldwide, developed this innovative treatment’s potential, and emphasized its importance. The constraints imposed by the pandemic breached regulatory, psychological, and organizational obstructions among both patients and caretakers. Community and hospital nursing services were forced to deal with a new reality, to provide remote care solutions for bedridden chronic patients, as the need for this grew exponentially. Despite the increase of telemedicine in recent years, so far no research in Israel has investigated the nursing staff’s perceptions of the quality of the care provided through telenursing. Objective: To assess nurses’ perceptions of the quality of the care provided through telenursing compared to face-to-face nursing. Method: A quantitative cross-sectional study among 227 male and female nurses in Israel. The questionnaire included demographic questions, and the five measures of quality of care: concern and empathy for the patient, professional treatment, response to treatment, educated use of resources, and patients’ sense of security. Results: Significant differences were found between nurses’ perceptions of telenursing and face-to-face nursing. The quality of face-to-face nursing was perceived as more positive than that of telenursing, in general, as were the individual measures of care quality such as providing professional treatment, response to treatment, and patients’ sense of security. Conclusions: Although telemedicine has increased significantly in recent years, nursing staff still perceived the quality of care and follow-up of face-to-face nursing as more positive. It is important to continue to monitor nurses’ perceptions and attitudes towards the strengths of these two treatment methods, not only in crisis situations, but among wider populations, and to investigate the factors that could influence these perceptions. Full article

Robotic manipulators can interact with large, heavy objects through whole-arm manipulation. Combined with direct physical interaction between humans and robots, the patient can be anchored in care. However, the complexity of this scenario requires control by a caregiver. We are investigating how such a complex form of manipulation can be controlled by nurses and whether the use of such a system creates physical relief. The use case chosen was washing the back of a patient in the lateral position. The operability of the remote control from the tele-nurse’s point of view, the change in the posture of the nurse on site, the execution times, the evaluation of the cooperation between human and robot, and the evaluation of the system from the nurse’s point of view and from the patient’s point of view were evaluated. The results show that the posture of the worker improved by 11.93% on average, and by a maximum of 26.13%. Ease of use is rated as marginally high. The manipulator is considered helpful. The study shows that remote whole-arm manipulation can anchor bedridden patients in the lateral position and that this system can be operated by nurses and leads to an improvement in working posture. Full article

During the first wave of the COVID-19 pandemic, there was a significant increase in the use of telenursing to provide care for patients at home. However, the quality of the patient experience when nurses rely on technology instead of personal contact has not been thoroughly investigated. This study aimed to understand the perspectives of COVID-19 patients in home isolation who received telenursing from primary care nurses during the initial phase of the pandemic. A qualitative study was conducted that employed purposive sampling and involved semi-structured interviews via videoconference with fourteen COVID-19 patients from two primary health centers in Catalonia (Spain). Thematic analysis was used, and the study adhered to the COREQ checklist. The findings revealed three themes related to the challenges faced by COVID-19 patients in home isolation: physical symptoms, emotional and social difficulties, and a lack of information. Three themes emerged regarding the strategies patients employed to overcome these challenges and the role of nurses: self-care, emotional support, and personal commitment. The patients reported having achieved strategies to improve their physical, psychological, and situational well-being despite the unprecedented situation. The study highlights that telenursing is a valuable resource for delivering patient-centered care, which could lead to changes in organisational policies and the development of best clinical practices. Full article

Considering the increasing need for oral and dental care in the elderly, teledentistry has been proposed to improve the education of elderly patients in oral health maintenance and risk factor control, identify patients’ concerns in advance, facilitate monitoring, and save time and money. The present cross-sectional analysis of Google search data through real-time surveillance with Google Trends aimed to determine Google users’ interest in oral and dental needs and teledentistry applications in the elderly, and to compare search volumes before and after the COVID-19 outbreak. Extracted CVS data were qualitatively analyzed. Pearson and Spearman correlation analyses were performed between searches for “elderly” and “teledentistry”, and all the oral and dental needs and teledentistry applications. The Mann–Whitney U test compared search volumes in the 36 months before and after the beginning of the COVID-19 pandemic. Google users’ interest in the elderly and related oral and dental needs was diffusely medium–high, while teledentistry and its applications were of lower interest. Interest in teledentistry and its applications was strongly related to interest in the older population, which is consistent with the assumption that older adults represent the population segment that could benefit most from these tools. A positive correlation was also found between searches for “Elderly” and searches for almost all oral and dental needs typical of the geriatric population. Search volumes increased significantly after the outbreak of the COVID-19 pandemic. More information about teledentistry should be disseminated to increase knowledge and awareness, especially among older patients, about its indications, applications, and advantages. Full article

(1) Background: Primary health care institutions (PHCI) play an important role in reducing health inequities and achieving universal health coverage. However, despite the increasing inputs of healthcare resources in China, the proportion of patient visits in PHCI keeps declining. In 2020, the advent of the COVID-19 pandemic further exerted a severe stress on the operation of PHCI due to administrative orders. This study aims to evaluate the efficiency change in PHCI and provide policy recommendations for the transformation of PHCI in the post-pandemic era. (2) Methods: Data envelope analysis (DEA) and the Malmquist index model were applied to estimate the technical efficiency of PHCI in Shenzhen, China, from 2016 to 2020. The Tobit regression model was then used to analyze the influencing factors of efficiency of PHCI. (3) Results: The results of our analysis reflect considerable low levels of technical efficiency, pure technical efficiency, and scale efficiency of PHCI in Shenzhen, China, in 2017 and 2020. Compared to years before the epidemic, the productivity of PHCI decreased by 24.6% in 2020, which reached the nadir, during the COVID-19 pandemic along with the considerable reduction of technological efficiency, despite the significant inputs of health personnel and volume of health services. The growth of technical efficiency of PHCI is significantly affected by the revenue from operation, percentage of doctors and nurses in health technicians, ratio of doctors and nurses, service population, proportion of children in the service population, and numbers of PHCI within one kilometer. (4) Conclusion: The technical efficiency significantly declines along with the COVID-19 outbreak in Shenzhen, China, with the deterioration of underlying technical efficiency change and technological efficiency change, regardless of the immense inputs of health resources. Transformation of PHCI such as adopting tele-health technologies to maximize primary care delivery is needed to optimize utilization of health resource inputs. This study brings insights to improve the performances of PHCI in China in response to the current epidemiologic transition and future epidemic outbreaks more effectively, and to promote the national strategy of Healthy China 2030. Full article

Introduction: This study aims to assess the palliative care nursing (PCN) knowledge and attitude of nursing students toward end-of-life care (EoLC) after completing the multi-methods PCN courses. Methods: A quasi-experimental study with a pre-and post-palliative survey was conducted. One hundred and sixty five nursing students from a faculty of nursing in Indonesia were enrolled, and knowledge and attitude were assessed using the palliative care quiz for nurses (PCQN) and the Frommelt Attitude Toward Care of the Dying and Death (FATCOD). Paired t-test and ANOVA were applied in this study. Results: After being involved in the PCN course, the mean score of PCN knowledge of the students increased significantly (p < 0.001). According to sub-domain analysis, the knowledge increased significantly in pain and symptom management (p < 0.001) and not significantly in the domains of theory and principle of the palliative, psychosocial, and spiritual care (p = 0.053; p = 0.080). Moreover, students’ attitude toward EoLC also increased significantly (p < 0.001), and positive attitudes increased from 75.6% to 91.5%. According to the ANOVA test, knowledge in two different groups (witnessed dying people and GPA) is not statistically meaningful (FWDP (1158) = 0.817, p = 0.367; FGPA (2.158) = 1.143, p = 0.322). Similarly, attitudes toward EoLC in two different groups are not statistically meaningful (FWD (1158) = 0.971. p = 0.326, FGPA (1157) = 1.278, p = 0.281). Conclusion: PCN courses with multi-method learning and teaching are effective to increase PCN knowledge, particularly in pain and symptom management knowledge, and also effective in increasing the positive attitudes toward EoLC. Full article

Clinical depression is associated with poorer adherence to hypoglycaemic medication in patients with diabetes mellitus, leading to poorer glycaemic control, diabetes management, and increased complications. The main aim of the TELE-DD trial was to demonstrate the efficacy of a proactive and psychoeducational telephonic intervention based on motivational interviewing and collaborative care to reduce nonadherence and improve prognosis in individuals with diabetes mellitus and concurrent depression. Design: The TELE-DD project is a three-phased prospective study including a nested randomised controlled trial. Methods: The baseline cohort included the entire population of adult patients diagnosed with type 2 diabetes and concurrent depression. A randomised controlled trial was conducted in a selection of patients from the baseline cohort, distributed into a control group (n = 192) and an intervention group (n = 192). Monthly telephonic interventions delivered by specifically trained research nurses were centred on a psychoeducational individualised monitoring protocol including motivational interviewing and collaborative care strategies. Clinical and patient-centred data were systematically collected during an 18-month follow-up including HbA1c, Patient Health Questionnaire, and the Diabetes Distress Scale. Results: During the trial, 18-month follow-up HbA1C levels significantly (p < 0.001) decreased in the intervention group at every follow-up from an average of 8.72 (SD:1.49) to 7.03 (SD:1.09), but slightly increased in the control group from 8.65 (SD:1.40) to 8.84 (SD:1.38). Similar positive results were obtained in depression severity and diabetes distress, LDL-cholesterol, and systolic and diastolic blood pressure, but only at the 18-month follow-up in body mass index reduction. Conclusions: This is the first trial to concurrently decrease biological and psychological outcomes with a monthly brief telephonic intervention, pointing out that a combined biopsychosocial intervention and collaborative care strategy is essential for current world health challenges. ClinicalTrials.gov Identifier: NCT04097483. Patient or Public Contribution: Diabetic patients not belonging to the TELE-DD population or trial sample were consulted during the study design to review and guarantee the clarity and understanding of the trial psychoeducational materials. Full article