Virtual care in the health care system: A concept analysis.

BACKGROUND: Health care providers need a better understanding of virtual care to recognise and use it for service delivery. AIM: To provide a more comprehensive definition of the concept of virtual care. METHOD: This study was conducted based on Walker and Avant's concept analysis method. A comprehensive review of the published texts in English from 2012 to 2022 was performed using the PubMed, Web of Science, Scopus, ProQuest, Science Direct, Ovid, CINAHL and Google Scholar databases. RESULTS: The main aspects and attributes of virtual care, including the use of any information and communication technology in various formats such as platforms, telephone calls, messages, email consultation, remote monitoring, secure and two-way digital communication between health care providers and patients, the possibility of providing remote care synchronously or asynchronously, more interaction between patients and caregivers, the possibility of transferring information between patients and health care providers and within the teams themselves, symptom management, sending diagnostic results in the form of video visits, and providing follow-up care, are attributes that distinguish virtual care from telehealth, telemedicine and other methods of providing remote healthcare services. CONCLUSION: Considering the positive and negative consequences of implementing virtual care, the findings of this study developed a basis for an operational definition of the concept so that providers can understand the meaning of virtual care and consider it when providing virtual care to patients. The findings of this study can be used in many international and national contexts in the health care system and in future studies on interventions to increase the use of virtual care.

The effect of virtual reminiscence therapy on depression and anxiety in patients with gastric cancer undergoing chemotherapy.

PURPOSE: To determine the effect of virtual reminiscence therapy on depression and anxiety in patients with gastric cancer (PwGC) undergoing chemotherapy. METHODS: In this quasi-experimental study, we randomly allocated 152 PwGC who met the inclusion criteria as 1:1 ratio to control (N = 76) and intervention (N = 76) groups. The patients in the control group received routine post-chemotherapy care, while those in the intervention group received reminiscence therapy over the phone in addition to routine care. The participants of both groups completed Beck's Depression Inventory and Zung's Self-rating Anxiety Scale before the study, 6 weeks after the beginning of the study, and 3 months after the intervention. RESULTS: Although the mean depression score before chemotherapy indicated moderate depression in both groups, the reminiscence therapy group showed a significant reduction in the depression score compared to the control group (P < 0.001) following intervention. The mean anxiety scores indicated mild to moderate anxiety in both groups, which was later placed within the normal range, there was a significant difference between the two groups. Intra-group comparison revealed that the mean depression and anxiety scores decreased significantly in the reminiscence therapy group (P < 0.001). CONCLUSION: This study indicated that virtual reminiscence therapy can decrease anxiety and depression in PwGC undergoing chemotherapy. Therefore, it can be a supportive psychological method for these patients.

Barriers to the implementation of virtual care programmes for patients with chronic wounds: Qualitative empirical research.

AIM: To assess the barriers to the implementation of virtual care for patients with chronic wounds from wound therapists' perspective. DESIGN: A qualitative study. METHODS: The study was conducted in two consecutive phases: (1) literature review, (2) descriptive qualitative study. In the first phase, texts published in English until 2023 were identified using international databases. The entire text of the selected studies was evaluated independently by two reviewers. Data analysis was carried out using textual content analysis. In the second phase of the study, twelve participants from Iranian wound care clinics participated. Data were collected through focus group discussion and analysed using conventional content analysis. Integration of both phases was conducted in the data analysis stage. RESULTS: The most important barriers in providing virtual care to patients with chronic wounds were identified into five categories including lack of policymaking in virtual care, ethical challenges in virtual information and communication technology, social, economic and cultural issues, IT users' insufficient knowledge and limitation of virtual care scope of practice. CONCLUSION: The findings of the present study identified different barriers in the implementation of virtual care for patients with chronic wounds. In order to successfully develop a virtual care programme, it is necessary to adopt suitable policies regarding information and communication technology, provide the necessary legal frameworks, assign an adequate budget and consider the ethical, cultural, social and social issues. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Identifying barriers to developing a virtual care programme will help manage patients with chronic wounds at home. IMPACT: This study accurately identifies barriers to providing virtual care for patients with chronic wounds and helps plan to address these barriers and facilitate the development of a virtual care programme for these patients at home. REPORTING METHOD: This research has adhered to the SRQR reporting guideline. NO PATIENT OR PUBLIC CONTRIBUTION: The involvement of patients or the public in the design, or conduct, or reporting, or dissemination plans of this research was not suitable.

Stress management protocol for nurses working in the COVID-19 wards.

Purpose: Due to necessity of immediate support strategies for nurses during COVID-19 pandemic and lack of comprehensive and applied standard guidelines, the present study was conducted to develop stress management protocol for nurses working in COVID-19 wards with an approach based on the best scientific evidences. Methods: This descriptive methodological and validation study was conducted with evidence-based approach based on Stetler model in two hospitals of Iran in 2020. In order to identify the resources of stress and the solutions provided to deal with it to design the protocol, a comprehensive literature review was performed. After extracting evidence, they were ranked based on the levels of evidence and designed as a protocol. Quality appraisal of guideline was done using AGREEII instrument by an expert panel. The applicability of the protocol was assessed by a group of nurses through focus group discussion. Results: Out of 184 studies, 28 articles related to the topic were selected. According to the expert panel, in the AGREEII domains, Scope and Purpose (87.5%) and Applicability (70.5%) were the highest and the lowest scores respectively. The "Stress Management Protocol for Nurses Working in COVID-19 Wards" was designed in six sections, which was elaborated relative to each stress resources. Members of the focus group mostly considered the evidence-based recommendations feasible by making suggestions to some items. Conclusion: This study emphasized the important role of proper planning by health care system officials according to the designed protocol to manage stress and increase the self-efficacy of nurses in critical situations.

Human dignity of patients in nursing: A concept analysis.

To understand the concept of dignity in care and use it in practice, nurses need a clear understanding of the dignity of patients, which can help them improve quality of care and provide services of a higher standard. This study aims to clarify the concept of human dignity of patients in nursing. Walker and Avant's method (2011) was used for this concept analysis. Published literature from 2010 to 2020 was identified using national and international databases. The full text of the included articles was reviewed. The main dimensions and attributes include valuing the patient, respecting patients' privacy, autonomy, and confidentiality, having a positive mental image, having a sense of altruism, respecting human equality, observing patients' beliefs and rights, adequately educating patients, and paying attention to secondary caregivers. Nurses should consider the subjective and objective aspects of dignity in their daily care activities by cultivating a deeper understanding of the concept of dignity and its attributes. In this regard, nursing tutors, managers, and policymakers in healthcare should emphasise human dignity in nursing.

A scoping review of virtual care in the health system: infrastructures, barriers, and facilitators.

For virtual care models to be able to improve the safety and quality of care, it is essential to identify the strengths and weaknesses of virtual care. In this Scoping review, literature published on virtual care was identified using international databases. The results of the included studies were summarized using a predefined taxonomy. In total, 20 studies were included in the present review. Extracting the findings of the articles showed four main topics, including "virtual care delivery models," "Video conference software platforms to provide virtual care," "virtual care delivery challenges," and "virtual care implementation facilitators." Therefore, with the development of emerging digital technologies, unique opportunities to provide virtual care and improve the provision of health services have been created in the health care system worldwide. Multifunctional video conference software platforms using specific models for each scope of care practice should be considered.

Interventions for adapting health care providers to new situations in the workplace during the COVID-19 pandemic: A scoping review for developing a policy brief.

The rapid change in the conditions of health care centers following the sudden onset of the COVID-19 pandemic led to work challenges and role changes and the transfer of staff to new and unfamiliar workplaces. This study aimed to develop policy interventions to adapt health care providers to the new situation in the workplace during the COVID-19 pandemic. A systematic literature review was carried out using international databases to identify English-language studies to identify policy interventions. The viewpoints resulting from the observations of the research team and seven health system experts were used to categorize the interventions. Three main policy interventions were identified: creating a flexible and efficient system through modifying personnel roles, adequate training of health care personnel about work conditions when treating COVID-19 patients, and creating a supportive and motivating work environment.

Determine and compare the viewpoints of nurses, patients and their relatives to workplace violence against nurses.

AIM: The present study aims to assess the perception of nurses, patients and their relatives regarding the nature of workplace violence against nurses. BACKGROUND: Workplace violence adversely affects the health, well-being and safety of nurses and the quality of nursing care. METHODS: In the present descriptive comparative study, the nature of violence was assessed using a modified and validated International Labor Office, the International Council of Nurses, World Health Organization, and Public Services International Questionnaire. RESULTS: Nurses, patients and relatives reported verbal abuse as the most common and sexual violence as the least common type of violence against nurses. Nurses mostly blamed factors associated with patients and their relatives as the cause of violence, whereas patients and their relatives blamed social factors. CONCLUSIONS: This study shows that violence is significantly prevalent in clinical settings, but its nature is differently perceived by nurses, patients and their relatives. This phenomenon requires further studies because knowledge of the causes of this difference could help to reduce and control violence. IMPLICATIONS FOR NURSING MANAGEMENT: It is necessary that nursing managers inform nurses about protocols for reporting all such cases in order to collect information, and based on a clear procedure, actively pursue reported cases and take the necessary measures to prevent violence against nurses.