Gerontological educational interventions for student nurses: a systematic review of qualitative findings.

OBJECTIVES: This systematic review of qualitative studies explored interventions to improve student nurses' knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing. METHODS: Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses' knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies. CONCLUSIONS: Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students' negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses' knowledge, attitudes, and willingness to work with older people, so that they can be replicated.

May Measure Month 2022 in Italy: A Focus on Fixed-dose Combination, Therapeutic Adherence, and Medical Inertia in a Nationwide Survey.

INTRODUCTION: Hypertension is the main risk factor for cardiovascular diseases (CVD). Notably, only about half of hypertensive patients manage to achieve the recommended blood pressure (BP) control. Main reasons for the persistence of uncontrolled BP during treatment are lack of compliance on the patients' side, and therapeutic inertia on physicians' side. METHODS: During the global BP screening campaign "May Measure Month" (MMM) (May 1st to July 31st, 2022), a nationwide, cross-sectional, opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of the health issues surrounding high BP. A questionnaire on demographic/clinical features and questions on the use of fixed-dose single-pills for the treatment of hypertension was administered. BP was measured with standard procedures. RESULTS: A total of 1612 participants (mean age 60.0±15.41 years; 44.7% women) were enrolled. Their mean BP was 128.5±18.1/77.1±10.4 mmHg. About half of participants were sedentary, or overweight/obese, or hypertensive. 55.5% individuals with complete BP assessment had uncontrolled hypertension. Most were not on a fixed-dose combination of antihypertensive drugs and did not regularly measure BP at home. Self-reported adherence to BP medications was similar between individuals with controlled and uncontrolled BP (95% vs 95.5%). CONCLUSIONS: This survey identified a remarkable degree of therapeutic inertia and poor patients' involvement in the therapeutic process and its monitoring in the examined population, underlining the importance of prevention campaigns to identify areas of unsatisfactory management of hypertension, to increase risk factors' awareness in the population with the final purpose of reducing cardiovascular risk.

Gastroenterologist and surgeon perceptions of recommendations for optimal endoscopic localization of colorectal neoplasms.

National consensus recommendations have recently been developed to standardize colorectal tumour localization and documentation during colonoscopy. In this qualitative semi-structured interview study, we identified and contrast the perceived barriers and facilitators to using these new recommendations according to gastroenterologists and surgeons in a large central Canadian city. Interviews were analyzed according to the Consolidated Framework for Implementation Research (CFIR) through directed content analysis. Solutions were categorized using the Expert Recommendations for Implementing Change (ERIC) framework. Eleven gastroenterologists and ten surgeons participated. Both specialty groups felt that the new recommendations were clearly written, adequately addressed current care practice tensions, and offered a relative advantage versus existing practices. The new recommendations appeared appropriately complex, applicable to most participants, and could be trialed and adapted prior to full implementation. Major barriers included a lack of relevant external or internal organizational incentives, non-existing formal feedback processes, and a lack of individual familiarity with the evidence behind some recommendations. With application of the ERIC framework, common barriers could be addressed through accessing new funding, altering incentive structures, changing record systems, educational interventions, identifying champions, promoting adaptability, and employing audit/feedback processes. Future research is needed to test strategies for feasibility and effectiveness.

Patient and nursing staff perspectives on automated scalp cooling (ASC) for chemotherapy-induced alopecia in breast cancer.

PURPOSE: Automated scalp cooling (ASC) is available to patients undergoing chemotherapy for breast cancer to decrease chemotherapy-induced alopecia. This study sought to elucidate patient and chemotherapy nursing perspectives on the ASC experience. METHODS: This is a survey-based study of chemotherapy nursing staff and patients with breast cancer regarding perceived efficacy, side effects, administration, support, and overall opinions of ASC. Chemotherapy nurses across a large, multi-regional tertiary healthcare system completed a one-time survey regarding their experiences in administering ASC. Breast cancer patients who utilized ASC were surveyed along with a control group who underwent alopecia-inducing chemotherapy without ASC use for comparison. RESULTS: The majority of nursing responses reported inadequate technical support, an increased burden of administering ASC compared to other clinical duties, and that they would not recommend ASC to a family member or friend. Patients who underwent ASC reported significantly less hair loss and were significantly less likely to shave their heads or wear a wig, but this did not translate into significant differences in body image or psychosocial wellbeing responses. Time investment was the most significant burden related to ASC. CONCLUSION: Patients using ASC reported significantly less hair loss compared to those not using ASC during alopecia-inducing breast cancer chemotherapy, but this did not translate to improved body image. The majority of chemotherapy nurses reported they lacked adequate support in administering ASC and would not recommend it. Enhanced nursing support may provide a means for improving the ASC experience for both nursing staff and patients.

Interprofessional Collaboration amongst Healthcare Workers of a Tertiary Hospital in North-Eastern Nigeria.

BACKGROUND: Interprofessional collaboration in healthcare is important to optimise healthcare delivery. However, relatively few studies have been conducted on the topic in Nigeria, especially in the North. OBJECTIVE: The objective of this study was to determine the levels of interprofessional collaboration, enablers and barriers amongst healthcare workers. MATERIALS AND METHODS: Data were collected using a five-domain modified Assessment of Interprofessional Team Collaboration Scale questionnaire, with a Likert scale of 1-5. The ideal mean score was ≤2 for the barriers domain and ≥4 for the other domains. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 23. RESULTS: Two hundred and sixty-six participants responded to the questionnaire. Male and female respondents were 131 (49.2%) each. Half of the respondents were 31 to 40 years old. One hundred and thirty-six (51.1%) of the respondents were nurses, and 48 (18.0%) were doctors. The modal working experience was 6-11 years (41.4%), and 117 (44.0%) respondents had at least a bachelor's degree. The mean scores for the domains were 4.1032 for partnership, 3.2383 for cooperation, 3.6309 for coordination, 4.2844 for enablers and 3.7902 for barriers. CONCLUSION: There was adequate level of partnership and enablers amongst the healthcare workers but insufficient cooperation and coordination and high level of barriers. Staff training on cooperation, coordination and identified barriers is necessary to improve interprofessional collaboration in the hospital.

Patients' and professionals' experiences with remote care during COVID-19: a qualitative study in general practices in low-income neighborhoods.

AIM: To explore how patients and general practice professionals in low-income neighborhoods experienced the increase of remote care during COVID-19. BACKGROUND: As the GP (general practitioner) is the first point of contact in Dutch health care, there are concerns about access to remote care for patients from low-income neighborhoods. Now that general practice professionals have returned to the pre-pandemic ways of healthcare delivery, this paper looks back at experiences with remote care during COVID-19. It investigates experiences of both patients and general practice professionals with the approachability and appropriateness of remote care and their satisfaction. METHODS: In this qualitative study, 78 patients and 18 GPs, 7 nurse practitioners and 6 mental health professionals were interviewed. Interviews were held on the phone and face-to-face in the native language of the participants. FINDINGS: Remote care, especially telephone consultation, was generally well-approachable for patients from low-income neighborhoods. Contrarily, video calling was rarely used. This was partly because patients did not know how to use it. The majority of patients thought remote care was possible for minor ailments but would also still like to see the doctor face-to-face regularly. Patients were generally satisfied with remote care at the time, but this did not necessarily reflect their willingness to continue using it in the future. Moreover, there was lack in consensus among general practice professionals on the appropriateness of remote care for certain physical and mental complaints. Nurse practitioners and mental health professionals had a negative attitude toward remote care. In conclusion, it is important to take the opinions and barriers of patients and care providers into account and to increase patient-centered care elements and care provider satisfaction in remote care. Integrating remote care is not only important in times of crisis but also for future care that is becoming increasingly digitalized.

The Effect of Patient-Physician Concordance on Perinatal Care: The Family Physicians' Perspective.

Demographic concordance between patients and clinicians has been associated with better outcomes. The current perinatal care workforce is not adequately diverse to allow for patient-clinician concordance. In this mixed-methods study, we aimed to understand family physicians' perception of the impact of patient-clinician concordance on perinatal care. The predominantly (91%) non-Hispanic White sample of 1,505 family physicians (FPs) perceived gender and language concordance to affect perinatal care more than racial or ethnic concordance. Religious concordance is not perceived to greatly affect perinatal care. Nearly half (721) of the respondents chose to leave a free-text comment on the impact of concordance on perinatal care. Four categories emerged (patients, physicians, the patient-physician relationship, and potential ways to mitigate the impact of discordance). Based on the perceptions of FPs experienced in perinatal care, intentionally supporting continuity of care between patients and clinicians may help to mitigate the negative impact of discordance on perinatal outcomes.

Evaluation of Procedure Doses and Staff Attitudes in Interventional Cardiology in Terms of Radiation Safety.

OBJECTIVE: Ionizing radiation has long been used in the medical field. Catheter laboratories (cath labs) are recognized as areas where radiation exposure is notably high. This study aims to examine the levels of radiation exposure during various interventional procedures to raise awareness of this issue in Türkiye. METHODS: This study evaluated the procedure radiation doses (n = 2804) in the cath labs of four public hospitals with distinct characteristics. Radiation dose evaluation was conducted using Cumulative Air Kerma (CAK). The Kolmogorov-Smirnov test, Kruskal-Wallis H test, independent T-test, and Pearson correlation coefficient were utilized to analyze the data. A p-value of < 0.05 was considered statistically significant. Data were analyzed using IBM® Statistical Package for the Social Sciences (SPSS®) STATISTICS Version 26.0.0.0 (IBM Corporation, Armonk, New York, USA). RESULTS: The procedure radiation doses in the cath labs were documented. The findings are largely consistent with the literature. Notably, several outlier cases with extremely high radiation doses were identified [CAK (min-max) = 0.12 - 9.9 Gy]. Procedures such as chronic total occlusion (CTO) [Mean CAK: 3.8 (± 1.5) Gy] and percutaneous coronary interventions (PCI) [Mean CAK: 1.5 (± 1.4) Gy] were associated with high doses. Additionally, personnel attitudes toward radiation optimization in cath labs were found to be inadequate. CONCLUSION: The incidence of high radiation exposure during interventional procedures may be higher than expected in Türkiye. Further research is necessary to identify predictors and implement preventive measures to reduce these rates. For this purpose, establishing diagnostic radiation reference levels (DRLs) could help monitor national radiation levels.

Understanding Nurse Perceptions of Caring for Patients With Alcohol Use Disorder: A Cross-Sectional Study.

BACKGROUND: Alcohol use disorder (AUD), the problematic consumption of alcohol, affects 107 million people worldwide. Individuals with AUD experience high morbidity and increased mortality. Nurses practicing in acute care are ideally positioned to deliver quality interventions to patients with AUD, including screening and brief intervention; formal training and assessment of baseline knowledge, attitudes, and perceptions are necessary. AIMS AND OBJECTIVES: The aim of this study was to explore the knowledge, attitudes, and perceptions of acute care nurses caring for patients with AUD. DESIGN: This study used a cross-sectional survey design. METHODS: The Survey of Attitudes and Perceptions was completed by 93 nurses working in six acute care centers (seven medicine units) across Alberta. Data were analyzed using descriptive and inferential statistics. RESULTS: Few participants reported receiving any prior structured training on AUD, with the majority reporting limited knowledge of alcohol and the effects of alcohol consumption. Although most participants said that caring for patients with AUD was a part of their professional role, few felt satisfied or motivated to work with this group of patients. Responses to individual questions or subdomains of the survey did not significantly differ by length of time in professional role, employment status, or sex. CONCLUSION: Our results indicate that nurses need to learn more about caring for patients with AUD. Developing tailored educational interventions that are mindful of the importance of knowledge, support, satisfaction, and motivation is necessary to improve the quality of care for patients with AUD.

Effectiveness of Clinical Practicum Experience in Drug Addiction Treatment Facilities in Nursing Students' Attitudes Toward Alcohol, Alcohol Use Disorders, and Alcoholics: Systematic Review and Meta-Analysis.

ABSTRACT: The aim of this study was to identify, analyze, and synthesize the best evidence on the effectiveness of clinical practicum experience in drug addiction treatment facilities on nursing students' attitudes toward alcohol, alcohol use disorder (AUD), and persons with AUD. This systematic review followed the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and used the System for the Unified Management of the Assessment and Review of Information to assess methodological quality and extract data for meta-analysis. A comprehensive literature search of the EBSCO databases, Embase, PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde, PsycINFO, Scopus, Web of Science, Mednar, Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior, and ProQuest Dissertations & Theses catalog was conducted. The System for the Unified Management of the Assessment and Review of Information tool was used for the extraction and critical evaluation of the selected articles followed by a meta-analysis. After removing duplicates, 2,831 publications were identified, and eight met the inclusion criteria. More positive attitudes were observed after performing practicum experience in specialized services (-1.27, 95% confidence interval [-2.85, -0.30]), and an increase in the motivation and satisfaction among the students to care for patients with AUD was also noted. In conclusion, the review suggests that clinical practicum experience in a drug addiction treatment facility has the potential to change the attitudes of nursing students toward AUD and persons with AUD.

Experiences and perceptions of critical care nurses on the use of point-of-care ultrasound (POCUS) to establish peripheral venous access in patients with difficult intravenous access: a qualitative study.

OBJECTIVES: This study aims to explore and describe critical care nurses' (CCNs') experiences and perceptions of using point-of-care ultrasound (POCUS) to establish peripheral intravenous access in patients with difficult intravenous access (DIVA). DESIGN: A qualitative design with a hermeneutic approach was chosen for this study. From May to August 2022, data were collected using individual, face-to-face, and digital semistructured interviews and analysed using Braun and Clarke's reflexive thematic analysis. SETTING: The study were conducted in six intensive care units in both Norway and Sweden. PARTICIPANTS: Nine CCNs experienced in using point-of-care ultrasound (POCUS) to establish peripheral intravenous access in patients with DIVA were recruited. RESULTS: Data analysis led to the construction of the overarching theme: 'POCUS simplifies a complicated procedure' based on the following five subthemes: 'Sharing the experience', 'Seeing inside the body', 'Independent in establishing difficult intravenous access', 'Using POCUS to increase action readiness', and 'Appreciating an expanded role as critical care nurses'. CONCLUSION: Ultrasound-guided peripheral intravenous access can become a valuable skill for CCN's caring for patients with DIVA in the intensive care unit. This practice can potentially reduce patient suffering, improve patient outcomes, enable the CCN to provide high-quality care, improve action readiness, time management and job satisfaction for the nurses.

Using Photovoice to Stimulate Reflection and Collaboration in Health Professions Students Through an Interprofessional Education Activity.

OBJECTIVE: Today's healthcare system requires interprofessional collaborative practice (IPCP) to improve health outcomes. IPCP often begins with interprofessional education (IPE), which should stimulate meaningful idea exchange. This study's purpose was to assess the impact of a photovoice-based IPE experience on the attitudes and beliefs of students in two health professions programs. METHODS: Forty-two Doctor of Physical Therapy students and 13 Radiation Therapy students created photovoice slides representing the most significant "thing" in their professional education. Students discussed their slides in small groups followed by a large-group discussion. A pretest-posttest survey containing researcher-generated questions and the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R2) and a post-activity evaluation were administered. RESULTS: Forty-two students completed the pretest survey; 35 completed the posttest survey. A statistically significant difference was found between pretest (M=4.07, SD=0.91) and posttest (M=4.45, SD=0.70) SPICE-R2 total scores, t(928)=7.22, p<0.001. Statistically significant differences were found for all SPICE-R2 factor scores. Thematic analysis revealed three themes: 1) students learned about the other profession, 2) the IPE experience was meaningful, and 3) the IPE experience could be improved. CONCLUSIONS: The photovoice IPE experience stimulated student reflection, interprofessional collaboration, and new perceptions about the other health profession. Future studies should focus on similar activities offered earlier in the education program.

Digital Lifestyle Interventions for Young People With Mental Illness: A Qualitative Study Among Mental Health Care Professionals.

BACKGROUND: Given the physical health disparities associated with mental illness, targeted lifestyle interventions are required to reduce the risk of cardiometabolic disease. Integrating physical health early in mental health treatment among young people is essential for preventing physical comorbidities, reducing health disparities, managing medication side effects, and improving overall health outcomes. Digital technology is increasingly used to promote fitness, lifestyle, and physical health among the general population. However, using these interventions to promote physical health within mental health care requires a nuanced understanding of the factors that affect their adoption and implementation. OBJECTIVE: Using a qualitative design, we explored the attitudes of mental health care professionals (MHCPs) toward digital technologies for physical health with the goal of illuminating the opportunities, development, and implementation of the effective use of digital tools for promoting healthier lifestyles in mental health care. METHODS: Semistructured interviews were conducted with MHCPs (N=13) using reflexive thematic analysis to explore their experiences and perspectives on using digital health to promote physical health in youth mental health care settings. RESULTS: Three overarching themes from the qualitative analysis are reported: (1) motivation will affect implementation, (2) patients' readiness and capability, and (3) reallocation of staff roles and responsibilities. The subthemes within, and supporting quotes, are described. CONCLUSIONS: The use of digital means presents many opportunities for improving the provision of physical health interventions in mental health care settings. However, given the limited experience of many MHCPs with these technologies, formal training and additional support may improve the likelihood of implementation. Factors such as patient symptomatology, safety, and access to technology, as well as the readiness, acceptability, and capability of both MHCPs and patients to engage with digital tools, must also be considered. In addition, the potential benefits of data integration must be carefully weighed against the associated risks.

[Withdrawal of life sustaining treatment in the ICU - different doctors act differently]. / Hur livsuppehållande behandling avbryts på Iva ­ läkare gör olika.

Decisions to withdraw life sustaining treatment in the ICU are common, but there is little information about how treatment should be withdrawn. A pilot study showed that doctors withdraw life sustaining treatment in different ways even in identical cases. This variation can cause stress for ICU staff and relatives.  Our study investigated the decisions of doctors working in ICUs in Sweden regarding the withdrawal of life sustaining treatment for two fictitious patients. There was variation in if and how drug treatments should be withdrawn, as well as how ventilatory support should be withdrawn. Less experienced doctors tended to choose to prolong the dying process by weaning, even if it is unclear if that is preferable for the staff or for relatives.  Our study could be used in discussions in ICUs to try to understand how individual doctors make decisions about withdrawing life sustaining treatment.

Healthcare professional perspectives following implementation of an infection management care pathway for pediatric patients with cancer: a qualitative study.

PURPOSE: The Pediatric Oncology Group of Ontario (POGO) supported an effort to implement infection management care pathways based on clinical practice guidelines, to improve the consistency of infection management in pediatric cancer patients. The objective of this qualitative study was to describe the perspective of healthcare professionals (HCPs) following implementation. METHODS: Four tertiary pediatric oncology centers in Ontario, Canada, implemented the pathways. We randomly identified three HCPs per group (clinical pharmacists; nurse case managers, educators or practitioners and physician assistants; pediatric oncology fellows; or pediatric oncology staff physicians) per site and invited them to participate in a qualitative interview. One-on-one interviews were conducted remotely, followed by thematic analysis of interview transcripts. RESULTS: A total of 66 invitations were extended and 42 HCPs participated. Identified themes were: (1) implementation approach, (2) access and navigation, (3) engagement, (4) concerns, (5) workplace benefits, (6) reception, and (7) provincial harmonization. HCPs preferred in-person implementation strategies over e-mail communication. They identified teaching/educational utility and benefits to non-oncology departments and non-tertiary centers participating in shared care of patients. Other positive aspects related to evidence-based practice, safety, supporting oncology HCPs, and benefits to patients and families. Concerns included need to ensure users applied clinical judgement and loss of autonomy. Provincial harmonization of practice was viewed positively, although potential logistical and institutional cultural barriers were raised. CONCLUSIONS: Following infection management care pathway implementation, HCPs described educational utility and benefits to non-oncology departments, oncology HCPs, patients, and families. Our findings may facilitate future infection management care pathway provincial harmonization.

Offering extended use of the contraceptive implant via an implementation science framework: a qualitative study of clinicians' perceived barriers and facilitators.

BACKGROUND: The etonogestrel contraceptive implant is currently approved by the United States Food and Drug Administration (FDA) for the prevention of pregnancy up to 3 years. However, studies that suggest efficacy up to 5 years. There is little information on the prevalence of extended use and the factors that influence clinicians in offering extended use. We investigated clinician perspectives on the barriers and facilitators to offering extended use of the contraceptive implant. METHODS: Using the Consolidated Framework for Implementation Research (CFIR), we conducted semi-structured qualitative interviews. Participants were recruited from a nationwide survey study of reproductive health clinicians on their knowledge and perspective of extended use of the contraceptive implant. To optimize the diversity of perspectives, we purposefully sampled participants from this study. We used content analysis and consensual qualitative research methods to inform our coding and data analysis. Themes arose deductively and inductively. RESULTS: We interviewed 20 clinicians including advance practice clinicians, family medicine physicians, obstetrician/gynecologist and complex family planning sub-specialists. Themes regarding barriers and facilitators to extended use of the contraceptive implant emerged. Barriers included the FDA approval for 3 years and clinician concern about liability in the context of off-label use of the contraceptive implant. Educational materials and a champion of extended use were facilitators. CONCLUSIONS: There is opportunity to expand access to extended use of the contraceptive implant by developing educational materials for clinicians and patients, identifying a champion of extended use, and providing information on extended use prior to replacement appointments at 3 years.

Predictive Factors of Physicians' Satisfaction and Quality of Work Under Teleconsultation Conditions: Structural Equation Analysis.

BACKGROUND: The COVID-19 pandemic contributed to an increase in teleconsultation adoption in the Polish primary health care system. It is expected that in the long run, teleconsultations will successfully replace a significant part of face-to-face visits. Therefore, a significant challenge facing primary health care facilities (PHCs) is the acceptance of teleconsultations by their users, especially physicians. OBJECTIVE: This study aimed to explore physicians' acceptance of teleconsultations during the COVID-19 pandemic in Poland. METHODS: A representative survey was conducted among 361 physicians of PHCs across Poland in 2021. For the purposes of the study, we developed a modified Technology Acceptance Model (TAM) model. Based on the modified TAM, we analyzed the impact of perceived usefulness (PU), perceived ease of use (PEU), and intention to use teleconsultation (INT) on physicians' satisfaction (SAT) and quality of work (Q). The psychometric properties of the research instrument were examined using exploratory factor analysis. Finally, structural equation modeling was used for data analysis. RESULTS: The results indicated a generally high level of PU (mean 3.85-4.36, SD 0.87-1.18), PEU (mean 3.81-4.60, SD 0.60-1.42), INT (mean 3.87-4.22, SD 0.89-1.12), and SAT (mean 3.55-4.13, SD 0.88-1.16); the lowest rated dimension in TAM was Q (mean 3.28-3.73, SD 1.06-1.26). The most important independent variable was PU. The influence of PU on INT (estimate=0.63, critical ratio [CR]=15.84, P<.001) and of PU on SAT (estimate=0.44, CR= 9.53, P<.001) was strong. INT was also a key factor influencing SAT (estimate=0.4, CR=8.57, P<.001). A weaker relationship was noted in the effect of PEU on INT (estimate=0.17, CR=4.31, P<.001). In turn, Q was positively influenced by INT (estimate=0.179, CR=3.64, P<.001), PU (estimate=0.246, CR=4.79, P<.001), PEU (estimate=0.18, CR=4.93, P<.001), and SAT (estimate=0.357, CR=6.97, P<.001). All paths between the constructs (PU, PEU, INT, SAT, and Q) were statistically significant, which highlights the multifaceted nature of the adoption of teleconsultations among physicians. CONCLUSIONS: Our findings provide strong empirical support for the hypothesized relationships in TAM. The findings suggest that the PU and PEU of teleconsultation have a significant impact on the intention of physicians to adopt teleconsultation. This results in an improvement in the satisfaction of Polish physicians with the use of teleconsultation and an increase in Q. The study contributes to both theory and practice by identifying important prognostic factors affecting physicians' acceptance of teleconsultation systems.

Examining evidence of lung cancer stigma among health-care trainees.

BACKGROUND: Innovations in lung cancer control and care have started to transform the landscape of lung cancer outcomes, but lung cancer stigma and biases have been implicated as a deterrent to realizing the promise of these innovations. Research has documented lung cancer stigma among the general public and lung cancer survivors (self-blame), as well as clinicians across many disciplines. However, studies have not explored lung cancer stigma in health-care trainees. These data seek to address that gap and inform efforts to prevent the emergence or mitigate the presence of lung cancer stigma among future clinicians. METHODS: Using clinical vignettes and a 2x2 factorial design, this investigation evaluated the impact of a history of smoking (yes vs no) and cancer diagnosis (lung vs colorectal) on perceptions of the described patient among 2 groups of preclinical health-care trainees (medical = 94 and nursing = 138). A charitable giving paradigm also asked participants to donate provided funds to 1 of 2 cancer advocacy organizations: one serving the lung cancer community and one serving the colorectal cancer community. RESULTS: In study 1, results revealed a consistent pattern of statistically significant and medium to large effect size differences regarding stigmatized perceptions (eg, higher stigmatizing behavior, increased pity, greater anger, and less helping) for individuals with a history of smoking but no reliable differences regarding cancer diagnosis. Analysis of data from nursing trainees in study 2 showed a similar pattern of statistically significant and medium to large effects pertaining to stigma behavior and perceptions of individuals who had a history of smoking depicted in the vignettes. The charitable giving paradigm did not identify any reliable difference between the groups in either study. CONCLUSIONS: Findings revealed a consistent pattern of health-care trainee perceptions that varied by smoking status but much less evidence that the cancer diagnosis contributed to different perceptions. This suggests that efforts to integrate consideration of stigma and biases in health-care training needs to adopt an approach that seeks to mitigate or eliminate stigmatizing perceptions and behaviors toward individuals with a history of smoking.

A survey of knowledge, attitudes, and practices among paediatric intensive care unit nurses for preventing pressure injuries: An analysis of influencing factors.

To explore the knowledge, attitudes and practice (KAP) status of preventing pressure injury among clinical nurses working in paediatric ICU, and to examine factors affecting nurses' KAP. A questionnaire survey was conducted among 1906 paediatric ICU nurses in 18 children's hospitals by convenience sampling method. The survey tools were self-designed general data questionnaire, KAP questionnaire for the prevention of pressure injury and the influencing factors were analysed. A total of 1906 valid questionnaires were collected. The scores of overall KPA, knowledge, attitudes, and practice were 101.24 ± 17.22, 20.62 ± 9.63, 54.93 ± 5.81and 25.67 ± 6.76, respectively. The results of multiple linear regression analysis showed that education background, professional title, age and specialist nurse were the main influencing factor of nurses' knowledge of preventing PI; education background and specialist nurse were the main influencing factors of nurses' attitudes of preventing PI; knowledge, attitudes and education background were the main influencing factors of nurses' practice of preventing PI. Paediatric ICU nurses have a positive attitude towards the prevention of PI, but their knowledge and practice need to be improved. According to different characteristics of nurses, nursing managers should carry out training on the knowledge of prevention of PI to establish a positive attitude, so as to drive the change of nursing practice and improve the nursing practice level of ICU nurses to prevent of PI.