190 research outputs found

    Estime de soi et dynamique d'apprentissage chez les étudiants infirmiers : une étude phénoménologique existentielle

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    peer reviewedAim: To describe nursing student self-esteem changes over time and its impacts on learning strategies. Design: Existential phenomenology. Methods: Interviews were conducted in Spring 2018 in a purposive sample of 39 nursing students, exploring events critical to self-esteem and their impacts. Transcriptions were analysed descriptively and interpretatively to decipher the process that links self-esteem, events and learning behaviour. Results: What led to self-esteem changes were “relationships with nurses during internships” and “receiving evaluations.” The students interpreted events and drew conclusions about their aptitude for nursing, which in turn prompted proactive or defensive learning behaviours. Their interpretations both depended on their self-esteem and impacted it, in a vicious or virtuous circle. Exploring self-esteem allows a better understanding of the importance of students' relationships with nursing teams, and of some of their defensive behaviours. Understanding the role of nursing student self-esteem in the learning process could help improve student well-being and competence

    Developing evaluation capacities in integrated care projects: Lessons from a scientific support mission implemented in Belgium

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    peer reviewedThe capacity of self-assessment, to learn from experience, to make information-based decisions, and to adapt over time are essential drivers of success for any project aiming at healthcare system change. Yet, many of those projects are managed by healthcare providers' teams with little evaluation capacity. In this article, we describe the support mission delivered by an interdisciplinary scientific team to 12 integrated care pilot projects in Belgium, mobilizing a set of tools and methods: a dashboard gathering population health indicators, a significant event reporting method, an annual report, and the development of a sustainable “learning community.” The article provides a reflexive return on the design and implementation of such interventions aimed at building organizational evaluation capacity. Some lessons were drawn from our experience, in comparison with the broader evaluation literature: The provided support should be adapted to the various needs and contexts of the beneficiary organizations, and it has to foster experience-based learning and requires all stakeholders to adopt a learning posture. A long-time, secure perspective should be provided for organizations, and the availability of data and other resources is an essential precondition for successful work

    Socioeconomic and behavioural factors associated with access to and use of Personal Health Records

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    Background: Access to and use of digital technology are more common among people of higher socioeconomic status. These differences might be due to lack of interest, not having physical access or having lower intentions to use this technology. By integrating the digital divide approach and the User Acceptance of Information Technology (UTAUT) model, this study aims to further our understanding of socioeconomic factors and the mechanisms linked to different stages in the use of Personal Health Records (PHR): desire, intentions and physical access to PHR. Methods: A cross-sectional online and in-person survey was undertaken in the areas of Lorraine (France), Luxembourg, Rhineland-Palatinate and Saarland (Germany), and Wallonia (Belgium). Exploratory factor analysis was performed to group items derived from the UTAUT model. We applied linear and logistic regressions controlling for country-level heterogeneity, health and demographic factors. Results: A total of 829 individuals aged over 18 completed the questionnaire. Socioeconomic inequalities were present in the access to and use of PHR. Education and income played a significant role in individuals' desire to access their PHR. Being older than 65 years, and migrant, were negatively associated with desire to access PHR. An income gradient was found in having a physical access to PHR, while for the subgroup of respondents who expressed desire to have access, higher educational level was positively associated with intentions to regularly use PHR. In fully adjusted model testing the contribution of UTAUT-derived factors, individuals who perceived PHRs to be useful and had the necessary digital skills were more inclined to use their PHR regularly. Social influence, support and lack of anxiety in using technology were strong predictors of regular PHR use. Conclusion: The findings highlight the importance of considering all stages in PHR use: desire to access, physical access and intention to regularly use PHRs, while paying special attention to migrants and people with lower socioeconomic backgrounds who may feel financial constraints and are not able to exploit the potential of PHRs. As PHR use is expected to come with health benefits, facilitating access and regular use for those less inclined could reduce health inequalities and advance health equity
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