scholarly journals Understanding Drivers of Resistance Toward Implementation of Web-Based Self-Management Tools in Routine Cancer Care Among Oncology Nurses: Cross-Sectional Survey Study

10.2196/14985 ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. e14985 ◽  
Author(s):  
Matthijs de Wit ◽  
Mirella Kleijnen ◽  
Birgit Lissenberg-Witte ◽  
Cornelia van Uden-Kraan ◽  
Kobe Millet ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Social Pressure ◽  
Oncology Nurses ◽  
Self Management ◽  
Management Tools ◽  
Cross Sectional ◽  
Active Resistance ◽  
Web Based ◽  
Managerial Support ◽  
Rti Model

Background Supporting patients to engage in (Web-based) self-management tools is increasingly gaining importance, but the engagement of health care professionals is lagging behind. This can partly be explained by resistance among health care professionals. Objective The aim of this study was to investigate drivers of resistance among oncology nurses toward Web-based self-management tools in cancer care. Methods Drawing from previous research, combining clinical and marketing perspectives, and several variables and instruments, we developed the Resistance to Innovation model (RTI-model). The RTI-model distinguishes between passive and active resistance, which can be enhanced or reduced by functional drivers (incompatibility, complexity, lack of value, and risk) and psychological drivers (role ambiguity, social pressure from the institute, peers, and patients). Both types of drivers can be moderated by staff-, organization-, patient-, and environment-related factors. We executed a survey covering all components of the RTI-model on a cross-sectional sample of nurses working in oncology in the Netherlands. Structural equation modeling was used to test the full model, using a hierarchical approach. In total, 2500 nurses were approached, out of which 285 (11.40%) nurses responded. Results The goodness of fit statistic of the uncorrected base model of the RTI-model (n=239) was acceptable (χ21=9.2; Comparative Fit Index=0.95; Tucker Lewis index=0.21; Root Mean Square Error of Approximation=0.19; Standardized Root Mean Square=0.016). In line with the RTI-model, we found that both passive and active resistance among oncology nurses toward (Web-based) self-management tools were driven by both functional and psychological drivers. Passive resistance toward Web-based self-management tools was enhanced by complexity, lack of value, and role ambiguity, and it was reduced by institutional social pressure. Active resistance was enhanced by complexity, lack of value, and social pressure from peers, and it was reduced by social pressure from the institute and patients. In contrast to what we expected, incompatibility with current routines was not a significant driver of either passive or active resistance. This study further showed that these drivers of resistance were moderated by expertise (P=.03), managerial support (P=.004), and influence from external stakeholders (government; P=.04). Conclusions Both passive and active resistance in oncology nurses toward Web-based self-management tools for patients with cancer are driven by functional and psychological drivers, which may be more or less strong, depending on expertise, managerial support, and governmental influence.

scholarly journals Understanding Drivers of Resistance Toward Implementation of Web-Based Self-Management Tools in Routine Cancer Care Among Oncology Nurses: Cross-Sectional Survey Study (Preprint)

2019 ◽  
Author(s):  
Matthijs de Wit ◽  
Mirella Kleijnen ◽  
Birgit Lissenberg-Witte ◽  
Cornelia van Uden-Kraan ◽  
Kobe Millet ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Social Pressure ◽  
Oncology Nurses ◽  
Self Management ◽  
Management Tools ◽  
Cross Sectional ◽  
Active Resistance ◽  
Web Based ◽  
Managerial Support ◽  
Rti Model

BACKGROUND Supporting patients to engage in (Web-based) self-management tools is increasingly gaining importance, but the engagement of health care professionals is lagging behind. This can partly be explained by resistance among health care professionals. OBJECTIVE The aim of this study was to investigate drivers of resistance among oncology nurses toward Web-based self-management tools in cancer care. METHODS Drawing from previous research, combining clinical and marketing perspectives, and several variables and instruments, we developed the Resistance to Innovation model (RTI-model). The RTI-model distinguishes between passive and active resistance, which can be enhanced or reduced by functional drivers (incompatibility, complexity, lack of value, and risk) and psychological drivers (role ambiguity, social pressure from the institute, peers, and patients). Both types of drivers can be moderated by staff-, organization-, patient-, and environment-related factors. We executed a survey covering all components of the RTI-model on a cross-sectional sample of nurses working in oncology in the Netherlands. Structural equation modeling was used to test the full model, using a hierarchical approach. In total, 2500 nurses were approached, out of which 285 (11.40%) nurses responded. RESULTS The goodness of fit statistic of the uncorrected base model of the RTI-model (n=239) was acceptable (χ<sup>2</sup><sub>1</sub>=9.2; Comparative Fit Index=0.95; Tucker Lewis index=0.21; Root Mean Square Error of Approximation=0.19; Standardized Root Mean Square=0.016). In line with the RTI-model, we found that both passive and active resistance among oncology nurses toward (Web-based) self-management tools were driven by both functional and psychological drivers. Passive resistance toward Web-based self-management tools was enhanced by complexity, lack of value, and role ambiguity, and it was reduced by institutional social pressure. Active resistance was enhanced by complexity, lack of value, and social pressure from peers, and it was reduced by social pressure from the institute and patients. In contrast to what we expected, incompatibility with current routines was not a significant driver of either passive or active resistance. This study further showed that these drivers of resistance were moderated by expertise (<italic>P</italic>=.03), managerial support (<italic>P</italic>=.004), and influence from external stakeholders (government; <italic>P</italic>=.04). CONCLUSIONS Both passive and active resistance in oncology nurses toward Web-based self-management tools for patients with cancer are driven by functional and psychological drivers, which may be more or less strong, depending on expertise, managerial support, and governmental influence.

scholarly journals AWARENESS OF COVID-19 AMONG GENERAL POPULATION OF NORTHEAST INDIA: A WEB BASED CROSS-SECTIONAL STUDY

2021 ◽  
Vol 9 (02) ◽  
pp. 170-177
Author(s):  
Nirmali Gogoi ◽  
Anusuya Goswami
Keyword(s):  
General Population ◽  
Health Care Professionals ◽  
Close Contact ◽  
Northeast India ◽  
General Information ◽  
Cross Sectional ◽  
Web Based ◽  
Validated Questionnaire ◽  
Community Transmission ◽  
Mode Of Transmission

Introduction: The emerging infection of COVID-19 was initiated from Wuhan, China, have been spread to more than 210 countries around the globe including India. Now India is 4th position in the world scenario of COVID-19 with 426910 infected cases and 13,703 deaths by 22 June 2020. In the northeast, Assam is in highest position with 5,586 cases and 9 deaths till now. Awareness is the key factor for prevention of spread of COVID-19 among general people. In view of these contexts, the present study was undertaken to assess awareness of COVID-19 among general population of Northeast India. The aim of the study was to assess the level of awareness among general population of Northeast India regarding COVID-19. Materials and Methods: A web based survey was conducted among 185 people of deferent states of northeast during the period of April and May 2020. A self-structured validated questionnaire used for collecting information. Descriptive analysis was performed to represent the study characteristics. Awareness among the study population was categories into 3 Levels i.e Adequate, Moderately Adequate and Inadequate. Level of Adequate awareness considered as > (Mean + SD, Moderately Adequate as (Mean-SD)-(Mean + SD) and Inadequate as < (Mean-SD. Results & Discussion: Overall awareness on COVID-19, majority of respondents, 97(52.4%) have moderately adequate awareness. 49(26.5%) of respondents have adequate awareness and 39(21.1%) have inadequate awareness. It reveals that overall level of awareness is not satisfactory. Less than half of people were aware adequately about the COVID-19. Highest percentage of adequate, 36(44.4%) and inadequate, 21(25%) awareness reported from Manipur, Highest percentage of moderately adequate awareness reported from Nagaland, 17 (85%). Slightly more than half of respondents were aware about the general information, 102 (67.45%) and risk factors, 119 (64.3%) of COVID-19. Most of the respondents were aware about the mode of transmission, 176(95.1%), meaning of community transmission, 135 (72.9%), common sign and symptoms, 154(83.2%), and incubation periods 164(88.6%) of COVID-19. Regarding prevention of COVID-19, average awareness of total respondents was 154 (83.24%). Similar percentage of all levels of awareness have seen in male and female both. Conclusion: The virus is primarily spread between people during close contact, most often via small droplets produced by coughing, sneezing, and talking. Lack of awareness and negligence of general people regarding mode of transmission of COVID-19 which created community transmission. General people of Northeast still required awareness regarding COVID-19. There is a need of regular awareness programme among the general population by the health care professionals.

scholarly journals Social Networking App Use Among Primary Health Care Professionals: Web-Based Cross-Sectional Survey

10.2196/11147 ◽  
2018 ◽  
Vol 6 (12) ◽  
pp. e11147 ◽  
Author(s):  
Francesc X Marin-Gomez ◽  
Francesc Garcia Cuyas ◽  
Ramon Reig-Bolano ◽  
Jacobo Mendioroz ◽  
Pere Roura-Poch ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Social Networking ◽  
Health Care Professionals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Web Based ◽  
Primary Health

e-Learning competency for practice nurses: an evaluation report

2013 ◽  
Vol 19 (4) ◽  
pp. 287 ◽  
Author(s):  
Marie Heartfield ◽  
Andrea Morello ◽  
Melanie Harris ◽  
Sharon Lawn ◽  
Vincenza Pols ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Chronic Disease Management ◽  
Learning Experience ◽  
Self Management ◽  
Policy Outcomes ◽  
Management Support ◽  
Web Based ◽  
Practice Nurses ◽  
Web Based Learning ◽  
E Learning

Practice nurses in Australia are now funded to facilitate chronic condition management, including self-management support. Chronic disease management requires an established rapport, support and proactivity between general practitioners, patients and the practice nurses. To achieve this, training in shared decision making is needed. e-Learning supports delivery and achievement of such policy outcomes, service improvements and skill development. However, e-learning effectiveness for health care professionals’ is determined by several organisational, economic, pedagogical and individual factors, with positive e-learning experience linked closely to various supports. This paper reinforces previous studies showing nurses’ expanding role across general practice teams and reports on some of the challenges of e-learning. Merely providing practice nurses with necessary information via web-based learning systems does not ensure successful learning or progress toward improving health outcomes for patients.

scholarly journals Factors Associated With Intention to Adopt mHealth Apps Among Dementia Caregivers With a Chronic Condition: Cross-sectional, Correlational Study (Preprint)

2021 ◽  
Author(s):  
Kyra Jennifer Waligora Mendez ◽  
Chakra Budhathoki ◽  
Alain Bernard Labrique ◽  
Tatiana Sadak ◽  
Elizabeth K Tanner ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Chronic Disease ◽  
Chronic Condition ◽  
Self Management ◽  
Dementia Caregivers ◽  
Cross Sectional ◽  
Web Based ◽  
Factors Associated ◽  
Intention To Adopt ◽  
Mhealth Apps

BACKGROUND In the United States, nearly 80% of family caregivers of people with dementia have at least one chronic condition. Dementia caregivers experience high stress and burden that adversely affect their health and self-management. mHealth apps can improve health and self-management among dementia caregivers with a chronic condition. However, mHealth app adoption by dementia caregivers is low, and reasons for this are not well understood. OBJECTIVE The purpose of this study is to explore factors associated with dementia caregivers’ intention to adopt mHealth apps for chronic disease self-management. METHODS We conducted a cross-sectional, correlational study and recruited a convenience sample of dementia caregivers. We created a survey using validated instruments and collected data through computer-assisted telephone interviews and web-based surveys. Before the COVID-19 pandemic, we recruited dementia caregivers through community-based strategies, such as attending community events. After nationwide closures due to the pandemic, the team focused on web-based recruitment. Multiple logistic regression analyses were used to test the relationships between the independent and dependent variables. RESULTS Our sample of 117 caregivers had an average age of 53 (SD 17.4) years, 16 (SD 3.3) years of education, and 4 (SD 2.5) chronic conditions. The caregivers were predominantly women (92/117, 78.6%) and minorities (63/117, 53.8%), experienced some to extreme income difficulties (64/117, 54.7%), and were the child or child-in-law (53/117, 45.3%) of the person with dementia. In logistic regression models adjusting for the control variables, caregiver burden (odds ratio [OR] 1.3, 95% CI 0.57-2.8; <i>P</i>=.57), time spent caregiving per week (OR 1.7, 95% CI 0.77-3.9; <i>P</i>=.18), and burden of chronic disease and treatment (OR 2.3, 95% CI 0.91-5.7; <i>P</i>=.08) were not significantly associated with the intention to adopt mHealth apps. In the final multiple logistic regression model, only perceived usefulness (OR 23, 95% CI 5.6-97; <i>P</i>&lt;.001) and the interaction term for caregivers’ education and burden of chronic disease and treatment (OR 31, 95% CI 2.2-430; <i>P</i>=.01) were significantly associated with their intention to adopt mHealth apps. Perceived ease of use (OR 2.4, 95% CI 0.67-8.7; <i>P</i>=.18) and social influence (OR 1.8, 95% CI 0.58-5.7; <i>P</i>=.31) were not significantly associated with the intention to adopt mHealth apps. CONCLUSIONS When designing mHealth app interventions for dementia caregivers with a chronic condition, it is important to consider caregivers’ perceptions about how well mHealth apps can help their self-management and which app features would be most useful for self-management. Caregiving factors may not be relevant to caregivers’ intention to adopt mHealth apps. This is promising because mHealth strategies may overcome barriers to caregivers’ self-management. Future research should investigate reasons why caregivers with a low education level and low burden of chronic disease and treatment have significantly lower intention to adopt mHealth apps for self-management. CLINICALTRIAL

scholarly journals COVID-19 Fear Among Health Care Workers (HCW) and Non-HCW in IGMC, Shimla: An Online Questionnaire-Based Prospective Study

2021 ◽  
Vol 7 (4) ◽  
pp. 1-7
Author(s):  
Girish K Sharma ◽  
Pamposh Raina ◽  
Kailash C Barwal ◽  
Manjeet Kumar ◽  
Vineet Kumar ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Web Based ◽  
Care Workers ◽  
Fear And Anxiety

The unremitting COVID-19 pandemic is evoking anxiety, fear, panic, and socio-occupational stress among human population all around the globe. This cross-sectional study was planned to assess the fear and anxiety because of COVID-19 pandemic among health care professionals, patients, and general public in IGMC, Shimla. A cross-sectional, web-based survey was conducted in month of December 2020. COVID-19 fear questionnaire was used to assess fear among participants. A total of 162 responses were received. Ninety-five (41.35%) respondents were males and 67(58.64%) were females. Average total score of COVID-19 fear based on questionnaire was 17.71 among the participants. The majority of respondents 67(41.4%) were afraid of COVID-19, 53(32.7%) were neutral, whereas 42 (25.9%) were not afraid of COVID-19. Sixty-two (38.3%) responders were uncomfortable thinking about COVID-19, whereas, 67(41.4%) were not uncomfortable. Only 22 (13.6%) participants felt their hands clammy when they thought of COVID-19, 78 (48.15%) respondents were afraid of losing their life, 78 (48.15%) respondents disagreed with the question of being nervous or anxious to hear news and stories of COVID-19. Thirteen (8%) participants were informed of sleeplessness, and 22 (13.5%) reported palpitations due to COVID-19 fear. COVID-19 fear was evident in 65.15% of all males and 55.8% of all females’ respondents, respectively. Seventy percent of participants of age more than 40 years were afraid of COVID-19, whereas only 54.83% participants of less than 40 years had COVID-19 fear. COVID-19 fear was more evident among non-HCW (74.42%) as compared to HCW in whom it was seen in 53.03% participants. Rampaging Pandemic has ingrained fear and anxiety among non-HCW as well as health care workers. But undeterred by COVID-19 fear, majority of participants didn’t fear death and didn’t have other effects of fear. Despite (can be used) surging pandemic when fear of COVID-19 is soaring, HCW and non-HCW could work, think, and live.

scholarly journals Factors Associated With Intention to Adopt mHealth Apps Among Dementia Caregivers With a Chronic Condition: Cross-sectional, Correlational Study

10.2196/27926 ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. e27926
Author(s):  
Kyra Jennifer Waligora Mendez ◽  
Chakra Budhathoki ◽  
Alain Bernard Labrique ◽  
Tatiana Sadak ◽  
Elizabeth K Tanner ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Chronic Disease ◽  
Chronic Condition ◽  
Self Management ◽  
Dementia Caregivers ◽  
Cross Sectional ◽  
Web Based ◽  
Factors Associated ◽  
Intention To Adopt ◽  
Mhealth Apps

Background In the United States, nearly 80% of family caregivers of people with dementia have at least one chronic condition. Dementia caregivers experience high stress and burden that adversely affect their health and self-management. mHealth apps can improve health and self-management among dementia caregivers with a chronic condition. However, mHealth app adoption by dementia caregivers is low, and reasons for this are not well understood. Objective The purpose of this study is to explore factors associated with dementia caregivers’ intention to adopt mHealth apps for chronic disease self-management. Methods We conducted a cross-sectional, correlational study and recruited a convenience sample of dementia caregivers. We created a survey using validated instruments and collected data through computer-assisted telephone interviews and web-based surveys. Before the COVID-19 pandemic, we recruited dementia caregivers through community-based strategies, such as attending community events. After nationwide closures due to the pandemic, the team focused on web-based recruitment. Multiple logistic regression analyses were used to test the relationships between the independent and dependent variables. Results Our sample of 117 caregivers had an average age of 53 (SD 17.4) years, 16 (SD 3.3) years of education, and 4 (SD 2.5) chronic conditions. The caregivers were predominantly women (92/117, 78.6%) and minorities (63/117, 53.8%), experienced some to extreme income difficulties (64/117, 54.7%), and were the child or child-in-law (53/117, 45.3%) of the person with dementia. In logistic regression models adjusting for the control variables, caregiver burden (odds ratio [OR] 1.3, 95% CI 0.57-2.8; P=.57), time spent caregiving per week (OR 1.7, 95% CI 0.77-3.9; P=.18), and burden of chronic disease and treatment (OR 2.3, 95% CI 0.91-5.7; P=.08) were not significantly associated with the intention to adopt mHealth apps. In the final multiple logistic regression model, only perceived usefulness (OR 23, 95% CI 5.6-97; P<.001) and the interaction term for caregivers’ education and burden of chronic disease and treatment (OR 31, 95% CI 2.2-430; P=.01) were significantly associated with their intention to adopt mHealth apps. Perceived ease of use (OR 2.4, 95% CI 0.67-8.7; P=.18) and social influence (OR 1.8, 95% CI 0.58-5.7; P=.31) were not significantly associated with the intention to adopt mHealth apps. Conclusions When designing mHealth app interventions for dementia caregivers with a chronic condition, it is important to consider caregivers’ perceptions about how well mHealth apps can help their self-management and which app features would be most useful for self-management. Caregiving factors may not be relevant to caregivers’ intention to adopt mHealth apps. This is promising because mHealth strategies may overcome barriers to caregivers’ self-management. Future research should investigate reasons why caregivers with a low education level and low burden of chronic disease and treatment have significantly lower intention to adopt mHealth apps for self-management.

scholarly journals Experiences of Using Web-Based and Mobile Technologies to Support Self-Management of Type 2 Diabetes: Qualitative Study (Preprint)

2017 ◽  
Author(s):  
Laura Kelly ◽  
Crispin Jenkinson ◽  
David Morley
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Health Care Professionals ◽  
Well Being ◽  
Mobile Technologies ◽  
Self Management ◽  
Coordinated Care ◽  
Web Based ◽  
The Impact

BACKGROUND The prevalence of type 2 diabetes is rising, placing increasing strain on health care services. Web-based and mobile technologies can be an important source of information and support for people with type 2 diabetes and may prove beneficial with respect to reducing complications due to mismanagement. To date, little research has been performed to gain an insight into people’s perspectives of using such technologies in their daily management. OBJECTIVE The purpose of this study was to understand the impact of using Web-based and mobile technologies to support the management of type 2 diabetes. METHODS In-depth interviews were conducted with 15 people with type 2 diabetes to explore experiences of using Web-based and mobile technologies to manage their diabetes. Transcripts were analyzed using the framework method. RESULTS Technology supported the users to maintain individualized and tailored goals when managing their health. A total of 7 themes were identified as important to participants when using technology to support self-management: (1) information, (2) understanding individual health and personal data, (3) reaching and sustaining goals, (4) minimizing disruption to daily life, (5) reassurance, (6) communicating with health care professionals, and (7) coordinated care. CONCLUSIONS Patients need to be supported to manage their condition to improve well-being and prevent diabetes-related complications from arising. Technologies enabled the users to get an in-depth sense of how their body reacted to both lifestyle and medication factors—something that was much more difficult with the use of traditional standardized information alone. It is intended that the results of this study will inform a new questionnaire designed to assess self-management in people using Web-based and mobile technology to manage their health.

scholarly journals A Web-Based Physical Activity Portal for Individuals Living With a Spinal Cord Injury: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Max Pancer ◽  
Melissa Manganaro ◽  
Isabella Pace ◽  
Patrick Marion ◽  
Dany H Gagnon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Behavior Change ◽  
Health Care Professionals ◽  
Self Regulation ◽  
Self Management ◽  
Web Based ◽  
Management Platform ◽  
Cord Injury

BACKGROUND The population with a spinal cord injury (SCI) largely remains inactive following discharge from rehabilitation despite evidence on the benefits of physical activity. These individuals need to develop skills to self-manage their condition in order to prevent secondary comorbidities and rehospitalization. A Web-based physical activity portal can address this need. Few Web-based interventions incorporate theoretical frameworks, behavior change techniques, and modes of delivery into their design. CONCLUSIONS This study highlights features of an online self-management platform that can provide individuals with an SCI the motivation and volition to engage in physical activity. These findings will inform the design of a Web-based self-management physical activity portal to increase physical activity adherence and behavior change. METHODS An interpretative phenomenology methodology and participatory design, along with an integrated knowledge translation approach, were used to conduct this study. Convenience sampling was used to recruit individuals with an SCI living in the community, who were either interested or already engaging in physical activity, and HCPs working with individuals with an SCI, from three city-based rehabilitation sites. Individual 1-hour sessions involving navigation of an existing website and a semistructured interview were conducted with all participants. Individuals with an SCI completed a demographics questionnaire prior to the individual sessions, while demographic information of the HCPs was collected during their interviews. Additionally, all participants were asked a question on their intention to use or recommend a portal. An in-depth thematic analysis was used to derive themes from participants’ responses. OBJECTIVE This study aimed to identify the preferred features of a Web-based self-management physical activity portal through stakeholder engagement with individuals with a spinal cord injury and health care professionals (HCPs). RESULTS Thirteen individuals with an SCI and nine HCPs participated in the study. Five core themes emerged: (1) knowledge: guidance and barrier management; (2) possibility of achievement: the risks and benefits of physical activity and modelling; (3) self-regulation strategies: action planning, goal setting, tracking, rewards, and reminders; (4) interactivity: peers and professionals; and (5) format: appearance, language, and ease of use. The mean (median) ratings of the likelihood of promoting and using a Web-based portal tailored to individuals’ needs were 9.00 (8.78) and 7.75 (7.88) for HCPs and individuals with an SCI, respectively.

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