iBDecide: A web-based tool to promote engagement in shared decision-making among adolescents with ulcerative colitis.

BACKGROUND: Adolescents and young adults (AYAs) seek increased autonomy and self-efficacy. AYAs must learn to manage their medical care in preparation for transition to adult healthcare. Our team's research found that AYAs need more information about their disease and treatment OBJECTIVE: To develop and test the usability of a decision tool "iBDecide" to promote shared decision-making among AYAs with ulcerative colitis (UC) who are beginning to manage their treatment and medications METHODS: Using design thinking, 14 AYAs, 6 healthcare providers, 4 designers, a social worker, and a human factors researcher developed a shared decision-making tool. The System Usability Scale (SUS) assessed usability RESULTS: AYAs preferred an application with information on treatment, medication, nutrition, and symptom tracking. A web-based application, 'iBDecide', was developed to include these options. SUS results indicated that participants on average "agree" that: 'they would use iBDecide' and that 'it was easy to use and streamlined'. The mean SUS score was 78.25 (+/-12.91), range 70-90 DISCUSSION: Including AYAs in tool development helps ensure usability and improves engagement in shared decision-making. Co-designed tools may remove barriers for engagement and skill-building needed for the transition to adult care. CONCLUSION: iBDecide can stimulate AYA engagement in shared decision-making in treating UC.

Musculoskeletal outcomes in multiple body regions and work effects among nurses: the effects of stressful and stimulating working conditions.

This study investigated the various stressors encountered by the nursing profession. In particular, the following hypotheses were tested: (1) working conditions of nurses significantly affect perceived risk of injury and illness, work dissatisfaction, work satisfaction, energy state at the end of workday, the effort exerted by the registered nurse (RN), psychosomatic outcomes, and musculoskeletal symptoms (in multiple body regions); (2) both intermediate work effects (i.e., effort, perceived risk of injury/illness, work satisfaction/dissatisfaction, energy state at end of workday) and psychosomatic outcomes significantly affect musculoskeletal outcomes (in multiple body regions); (3) both working conditions and effects significantly affect musculoskeletal outcomes. In a preliminary study conducted on 34 registered nurses, results show that: (1) stressful working conditions affect musculoskeletal outcomes in multiple body regions, and (2) physical maladies such as lower back problems are not only associated with physical factors but also with a complex interaction of working conditions. Further research is warranted to obtain a better understanding of the complex interaction and the synergistic effects of the various nursing working conditions.