3,549 research outputs found

    The Role of Parents’ Mores on Their Intentions to Enroll Their Children in a School-based Telemedicine Program

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    Hospitals providing nurse-run school telemedicine programs can improve children’s access to healthcare services by delivering such services on school premises. Despite this potential, the enrollment in such programs by parents falls short of expectations because of parents’ hesitation to allow their children to receive such telemedicine healthcare services. This study investigates some aspects of the role of parents’ perception of contributing to a good cause (i.e., personal mores), on their intentions to enroll their children in such a telemedicine program. Surveying parents about such a new telemedicine service that is being deployed in their school district shows that parents’ personal mores are associated with increased intentions over and above its expected time-flexibility advantages. Surprisingly, trust-increased intentions were fully mediated by those mores. Practical and theoretical implications are discussed, especially the idea that doing good to others may be another reason why people adopt telemedicine, suggesting another reason beyond the utilitarian, rational, and social processes that are portrayed in previous research

    Clinical and cost-effectiveness of an adapted intervention for preschoolers with moderate to severe intellectual disabilities displaying behaviours that challenge: the EPICC-ID RCT

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    Background: Stepping Stones Triple P is an adapted intervention for parents of young children with developmental disabilities who display behaviours that challenge, aiming at teaching positive parenting techniques and promoting a positive parent–child relationship. Objective: To evaluate the clinical and cost-effectiveness of level 4 Stepping Stones Triple P in reducing behaviours that challenge in children with moderate to severe intellectual disabilities. Design, setting, participants: A parallel two-arm pragmatic multisite single-blind randomised controlled trial recruited a total of 261 dyads (parent and child). The children were aged 30–59 months and had moderate to severe intellectual disabilities. Participants were randomised, using a 3 : 2 allocation ratio, into the intervention arm (Stepping Stones Triple P; n = 155) or treatment as usual arm (n = 106). Participants were recruited from four study sites in Blackpool, North and South London and Newcastle. Intervention: Level 4 Stepping Stones Triple P consists of six group sessions and three individual phone or face-to-face contacts over 9 weeks. These were changed to remote sessions after 16 March 2020 due to the coronavirus disease 2019 pandemic. Main outcome measure: The primary outcome measure was the parent-reported Child Behaviour Checklist, which assesses the severity of behaviours that challenge. Results: We found a small non-significant difference in the mean Child Behaviour Checklist scores (−4.23, 95% CI −9.98 to 1.52, p = 0.146) in the intervention arm compared to treatment as usual at 12 months. Per protocol and complier average causal effect sensitivity analyses, which took into consideration the number of sessions attended, showed the Child Behaviour Checklist mean score difference at 12 months was lower in the intervention arm by −10.77 (95% CI −19.12 to −2.42, p = 0.014) and −11.53 (95% CI −26.97 to 3.91, p = 0.143), respectively. The Child Behaviour Checklist mean score difference between participants who were recruited before and after the coronavirus disease 2019 pandemic was estimated as −7.12 (95% CI −13.44 to −0.81) and 7.61 (95% CI −5.43 to 20.64), respectively (p = 0.046), suggesting that any effect pre-pandemic may have reversed during the pandemic. There were no differences in all secondary measures. Stepping Stones Triple P is probably value for money to deliver (−£1057.88; 95% CI −£3218.6 to −£46.67), but decisions to roll this out as an alternative to existing parenting interventions or treatment as usual may be dependent on policymaker willingness to invest in early interventions to reduce behaviours that challenge. Parents reported the intervention boosted their confidence and skills, and the group format enabled them to learn from others and benefit from peer support. There were 20 serious adverse events reported during the study, but none were associated with the intervention. Limitations: There were low attendance rates in the Stepping Stones Triple P arm, as well as the coronavirus disease 2019-related challenges with recruitment and delivery of the intervention. Conclusions: Level 4 Stepping Stones Triple P did not reduce early onset behaviours that challenge in very young children with moderate to severe intellectual disabilities. However, there was an effect on child behaviours for those who received a sufficient dose of the intervention. There is a high probability of Stepping Stones Triple P being at least cost neutral and therefore worth considering as an early therapeutic option given the long-term consequences of behaviours that challenge on people and their social networks. Future work: Further research should investigate the implementation of parenting groups for behaviours that challenge in this population, as well as the optimal mode of delivery to maximise engagement and subsequent outcomes

    The role of nursing in multimorbidity care

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    Background Multimorbidity (the co-occurrence of two or more chronic conditions in the same person) affects around one in three persons, and it is strongly associated with a range of negative outcomes including worsening physical function, increased health care use, and premature death. Due to the way healthcare is provided to people with multimorbidity, treatment can become burdensome, fragmented and inefficient. In people with palliative conditions, multimorbidity is increasingly common. Better models of care are needed. Methods A mixed-methods programme of research designed to inform the development of a nurse-led intervention for people with multimorbidity and palliative conditions. A mixed-methods systematic review explored nurse-led interventions for multimorbidity and their effects on outcomes. A cross-sectional study of 63,328 emergency department attenders explored the association between multimorbidity, complex multimorbidity (≥3 conditions affecting ≥3 body systems), and disease-burden on healthcare use and inpatient mortality. A focussed ethnographic study of people with multimorbidity and life-limiting conditions and their carers (n=12) explored the concept of treatment burden. Findings Nurse-led interventions for people with multimorbidity generally focus on care coordination (i.e., case management or transitional care); patients view them positively, but they do not reliably reduce health care use or costs. Multimorbidity and complex multimorbidity were significantly associated with admission from the emergency department and reattendance within 30 and 90 days. The association was greater in those with more conditions. There was no association with inpatient mortality. People with multimorbidity and palliative conditions experienced treatment burden in a manner consistent with existing theoretical models. This thesis also noted the effect of uncertainty on the balance between capacity and workload and proposes a model of how these concepts relate to one another. Discussion This thesis addresses a gap in what is known about the role of nurses in providing care to the growing number of people with multimorbidity. A theory-based nurse-led intervention is proposed which prioritises managing treatment burden and uncertainty. Conclusions Nursing in an age of multimorbidity necessitates a perspective shift which conceptualises chronic conditions as multiple overlapping phenomena situated within an individual. The role of the nurse should be to help patients navigate the complexity of living with multiple chronic conditions

    Telenursing Future in Solving the Nursing Global Workforce Gap

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    Although there are 28 million nurses worldwide, it is not enough to meet patient needs. So we face a future with too much work, with too few workers. Telenursing can help in solving this issue by utilizing the technology in providing distance healthcare and health education to patients/clients with lower costs, effective services and proper clients’ satisfaction especially in rural areas through insufficient accessibility to local clinics or hospitals. Telenursing can use phone calls, video visits and remote monitoring devices in different nursing fields as family, pediatric, geriatric nursing and/or others. Telenursing can improve the quality of nursing care for patients by building relationships with them and improve the preferable outcomes. Telenursing also can decrease the work burden on nurses and direct contacts with patients with negative related health consequences specially after COVID 19 pandemic

    Parents' use of digital technology for social connection during the COVID-19 pandemic: a mixed-methods study

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    Introduction: The COVID-19 pandemic (2020–2021) resulted in isolation due to social distancing rules and lockdowns, during which technology was used to enable families and friends to maintain contact. Despite loneliness being high in parents, little is known about which parents are more likely to experience loneliness and strategies to support them. Method: This mixed-methods study examines which parents were lonely during the pandemic and how digital technologies were used to reduce loneliness and social isolation. Data were collected during the first UK lockdown from May to July 2020 via an online survey (N = 145) and follow-up interviews (n = 13). Results: Loneliness reported during lockdown was greater than retrospective reporting of loneliness for all respondents, but it was higher in single parents, those caring for children with specific needs, and those with lower household incomes before and during lockdown. Parents rapidly adapted to and experimented with using technology for social connection during the lockdown, which helped to reduce feelings of isolation and loneliness. Video calling was found to be useful for making connections and enhancing social presence, but parents also experienced anxieties and difficulties with its use. There were mixed views about technology use; some were keen to continue using technology for socializing after the lockdown ended, but for others, it was only a temporary measure. Conclusion: Although technology was invaluable during the pandemic, it was not a panacea, and the way parents used it was influenced by their approach to technology and existing social behaviors and networks

    The Role of TikTok in Students’ Health and Wellbeing

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    Students are exposed to various academic, financial and psychosocial stressors while studying at a university, and have increasingly turned to social media to alleviate stress and access social support. While evidence suggests that social networking sites may promote health awareness and health-protective behaviours, little research has explored TikTok, a relatively new platform with over 800 million active users. Seven university students (6 females, 1 non-binary; all White British; mean age = 20.57) were interviewed about their experiences on TikTok, their motivations behind using it and its effects on their psychological wellbeing. A thematic analysis of this data revealed that while TikTok use temporarily relieved academic stress, it also encouraged addictive behaviour and upward social comparisons. These differential effects were largely mediated by TikTok’s algorithm, which recommended content based on users’ previous interactions

    UMSL Bulletin 2023-2024

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    The 2023-2024 Bulletin and Course Catalog for the University of Missouri St. Louis.https://irl.umsl.edu/bulletin/1088/thumbnail.jp

    Impact of the Increased Use of Telehealth on Health Care Management and Administration: The Case of New Care Management Practices

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    The COVID-19 pandemic has brought unprecedented challenges to healthcare systems worldwide, forcing them to adapt and implement alternative modes of healthcare delivery quickly. Telehealth, the delivery of healthcare services through telecommunication technologies, has become crucial in providing continuous care while reducing the risk of virus transmission. This qualitative study aimed to explore healthcare managers\u27 perceptions of the use of telehealth and its impact on healthcare practices during the pandemic, particularly in terms of provision and quality control. A purposive sample of 10 healthcare managers from different healthcare settings in the United States participated in semi-structured interviews conducted via video conferencing. The interviews were transcribed and analyzed using thematic analysis. The findings revealed six overarching themes: (1) perceived benefits of telehealth, including increased accessibility, convenience, and efficiency; (2) challenges and limitations of telehealth; (3) role of telehealth in shaping healthcare practices; (4) implications for quality control, including the need for standardization, training, and evaluation measures; (5) leadership and innovation in telehealth; and (6) future of telehealth in healthcare management. This study provides insights into how healthcare managers perceive the use of telehealth and how it shapes healthcare practices during the COVID-19 pandemic. The findings suggest that telehealth can potentially improve healthcare provision and quality control, but its implementation requires addressing challenges and limitations and adapting to evolving healthcare needs. Future research can build on these findings by exploring the perspectives of other stakeholders, such as healthcare providers and patients, and examining the long-term effects of telehealth on healthcare practices

    The Student Movement Volume 107 Issue 13: We\u27ve Got the Spirit: Students Celebrate Dr. Luxton

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    HUMANS Best of Bon Appetit, Nora Martin Interview with the Dean of Lamson and Meier Halls, Interviewed by: Grace No The Joy of Japan, Interviewed by: Gloria Oh ARTS & ENTERTAINMENT A Creation Adventure, Nathaniel Reid Currently: Velma, Solana Campbell Suite Dreams for Sweet Dreams, Skylor Stark Where do I Find God? Part II, Anonymous NEWS AUSA Celebrates 100 Years of Student-Led Action, Andrew Francis Response to A House Divided Story, Christon Arthur, Provost Where\u27s the Harm in True Crime?. Abigail Kim IDEAS Redefining Free Agency in Sports, Andrew Francis Flying Cars of 2030, Rachel Ingram-Clay The Spooky Nature of Our Physical World, Alexander Navarro The State of AI, Abby Shim PULSE Debunking Myths Surrounding J.N. Andrews Honors Program, Gloria Oh Our Dear AU: A Spirit Week Tour, Lexie Dunham Romance and Reading, Gloria Oh LAST WORD An Ode to Tea, Alexander J. Hesshttps://digitalcommons.andrews.edu/sm-107/1012/thumbnail.jp

    UMSL Bulletin 2022-2023

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    The 2022-2023 Bulletin and Course Catalog for the University of Missouri St. Louis.https://irl.umsl.edu/bulletin/1087/thumbnail.jp
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