The Associations of Electronic Health Record Usability and User Age With Stress and Cognitive Failures Among Finnish Registered Nurses: Cross-Sectional Study.

BACKGROUND: Electronic health records (EHRs) are expected to provide many clinical and organizational benefits. Simultaneously, the end users may face unintended consequences, such as stress and increased cognitive workload, due to poor EHR usability. However, whether the effects of usability depend on end user characteristics, such as career stage or age, remains poorly understood. OBJECTIVE: The objective of this study was to examine the associations of EHR usability and user age with stress related to information systems and cognitive failures among registered nurses. METHODS: A cross-sectional survey design was employed in Finland in 2017. A total of 3383 registered nurses responded to the nationwide electronic survey. Multiple linear regression was used to examine the associations of EHR usability (eg, how easily information can be found and a patient's care can be documented) and user age with stress related to information systems and cognitive failures. Interaction effects of EHR usability and age were also tested. Models were adjusted for gender and employment sector. RESULTS: Poor EHR usability was associated with higher levels of stress related to information systems (ß=.38; P<.001). The strength of the association did not depend on user age. Poor EHR usability was also associated with higher levels of cognitive failures (ß=.28; P<.001). There was a significant interaction effect between age and EHR usability for cognitive failures (ß=.04; P<.001). Young nurses who found the EHR difficult to use reported the most cognitive failures. CONCLUSIONS: Information system stress due to poor EHR usability afflicts younger and older nurses alike. However, younger nurses starting their careers may be more cognitively burdened if they find EHR systems difficult to use compared to older nurses. Adequate support in using the EHRs may be particularly important to young registered nurses, who have a lot to learn and adopt in their early years of practice.

Loneliness in Professional Caring Relationships, Health, and Recovery.

This study investigated patients' experiences of loneliness in professional caring relationships and their associations with perceived recovery, health, psychological distress, and general loneliness in life. The sample consisted of 406 patients who had undergone breast cancer or heart surgery 6 months earlier. The data were collected in May 2014-March 2015 using a postal survey including the Caring Loneliness Scale (CARLOS), questions concerning perceived health and recovery, 12-item General Health Questionnaire (GHQ-12), and a question concerning perceived general loneliness in life. Data analysis was done using Mann-Whitney U test and Kruskal-Wallis test. The variables showing a statistically significant association with professional caring loneliness were perceived health, recovery, psychological distress, and general loneliness in life. It is necessary for health care professionals to identify the phenomenon of this dimension of loneliness because it is bound to affect patients' experiences. Further studies with different patient groups are required.

Development and Validation of the Caring Loneliness Scale.

BACKGROUND AND PURPOSE: The Caring Loneliness Scale (CARLOS) includes 5 categories derived from earlier qualitative research. This article assesses the reliability and construct validity of a scale designed to measure patient experiences of loneliness in a professional caring relationship. METHODS: Statistical analysis with 4 different sample sizes included Cronbach's alpha and exploratory factor analysis with principal axis factoring extraction. RESULTS: The sample size of 250 gave the most useful and comprehensible structure, but all 4 samples yielded underlying content of loneliness experiences. The initial 5 categories were reduced to 4 factors with 24 items and Cronbach's alpha ranging from .77 to .90. CONCLUSION: The findings support the reliability and validity of CARLOS for the assessment of Finnish breast cancer and heart surgery patients' experiences but as all instruments, further validation is needed.

Patient Experiences of Loneliness: An Evolutionary Concept Analysis.

Loneliness is a painful experience for patients. To clarity the concept of patient loneliness, this study undertook an evolutionary concept analysis based on a literature search in the main relevant databases. We identified 7 dimensions in adult patients' experiences of loneliness. These dimensions of loneliness have different causes and theoretical foundations, which have different implications for patient care. Patients may be lonely in their different relationships, including those with nurses and doctors. Loneliness in relation to health care professionals is a new application of the concept of loneliness that provides a useful starting point for future research.

The connection between personnel resources with work loading and patient satisfaction on in-patient wards.

AIM: The aim of the study is to describe the connection between the burden of nurses' work experience and patient dissatisfaction using electronic indicators available in databases. BACKGROUND: The hospitals in this study have a lot of information stored in electronic databases, but the data is stored in different databases and there are no straight connections between them. METHODS: This study was retrospective. Inpatient rates, workload statistics, patient classification, patient satisfaction and financial statistics were collected on 39 hospital wards from electronic databases. The data were analysed statistically. RESULTS: The results showed that the higher care intensity index and number of gross treatment days are, the greater was the burden on nurses. The burden was smaller on those wards using a named nurse system. CONCLUSIONS: Nurses' workload varies according to the condition of patients and patient flow. There is a connection between high workload and patient dissatisfaction. Nurse Managers should easily be able to use significant indicators. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing management must have tools that are easy to use in every day workload measurement, burden adjustment and personnel planning in the long run. This article presents patient classification and the number of beds used including daily change percentage of wards as instruments for nursing management.