Cue-responding is a valuable concept which can contribute to our understanding of optimal ways of communicating. Cue-responding behaviour facilitates the disclosure of worries and concerns of patients. Further research is needed to assess the clinical relevancy of cue-responding.
Background
The introduction of health information technology (HIT) has drastically changed health care organizations and the way health care professionals work. Some health care professionals have trouble coping efficiently with the demands of HIT and the personal and professional changes it requires. Lagging in digital knowledge and skills hampers health care professionals from adhering to professional standards regarding the use of HIT and may cause professional performance problems, especially in the older professional population. It is important to gain more insight into the reasons and motivations behind the technology issues experienced by these professionals, as well as to explore what could be done to solve them.
Objective
Our primary research objective was to identify factors that influence the adoption of HIT in a sample of nurses who describe themselves as digitally lagging behind the majority of their colleagues in their workplaces. Furthermore, we aimed to formulate recommendations for practice and leadership on how to help and guide these nurses through ongoing digital transformations in their health care work settings.
Methods
In a Dutch university medical center, 10 face-to-face semi-structured interviews were performed with registered nurses (RN). Ammenwerth’s FITT-framework (fit between the Individual, Task, and Technology) was used to guide the interview topic list and to formulate themes to explore. Thematic analysis was used to analyze the interview data. The FITT-framework was also used to further interpret and clarify the interview findings.
Results
Analyses of the interview data uncovered 5 main categories and 12 subthemes. The main categories were: (1) experience with digital working, (2) perception and meaning, (3) barriers, (4) facilitators, and (5) future perspectives. All participants used electronic devices and digital systems, including the electronic health record. The latter was experienced by some as user-unfriendly, time-consuming, and not supportive in daily professional practice. Most of the interviewees described digital working as “no fun at all,” “working in a fake world,” “stressful,” and “annoying.” There was a lack of general digital knowledge and little or no formal basic digital training or education. A negative attitude toward computer use and a lack of digital skills contributed to feelings of increased incompetency and postponement or avoidance of the use of HIT, both privately and professionally. Learning conditions of digital training and education did not meet personal learning needs and learning styles. A positive impact was seen in the work environment when colleagues and nurse managers were aware and sensitive to the difficulties participants experienced in developing digital skills, and when there was continuous training on the job and peer support from digitally savvy colleagues. The availability of a digital play environment combined with learning on the job and support of knowledgeable peers was experienced as helpful and motivating by participants.
Conclusions
Nurses who are digitally lagging often have had insufficient and ineffective digital education. This leads to stress, frustration, feelings of incompetency, and postponement or avoidance of HIT use. A digital training approach tailored to the learning needs and styles of these nurses is needed, as well as an on-the-job training structure and adequate peer support. Hospital management and nurse leadership should be informed about the importance of the fit between technology, task, and the individual for adequate adoption of HIT.
These results suggest that nurse-led consultations for patients with head and neck cancer have a positive effect, primarily with respect to HRQOL. Nurse-led follow-up leads to a similar psychosocial adjustment as conventional follow-up, even among patients who showed worse performance at the start of follow-up. Thus, nurse-led follow-up may be a cost-effective way to improve follow-up care for this patient group.
Traditionally, cancer patient follow-up has focused on disease surveillance and detecting recurrence. However, an increasing number of patients who have survived cancer acknowledge the importance of cancer rehabilitation issues and the need for more patient-oriented models of care by reporting their unmet physical, emotional, and social needs. Nurse-led follow-up care for cancer patients fulfills this need and has been developing gradually for various cancer diagnoses and prognoses. A growing body of evidence suggests that these services provide high-quality care that is both safe and efficient. Furthermore, patients benefit from the continuity of care and easy access to support for their multitude of needs, provided by such organized care. In this paper, we review the literature published in the past 5 years regarding nurse-led follow-up care for cancer patients in order to provide input and opinion for future research, clinical practice development, and nursing leadership. We pay special attention to head and neck cancer patients, a group that has been largely understudied and hence underreported in the literature. These patients have specific needs with respect to information and education regarding their cancer and potential treatment side-effects as well as a particular need for long-term psychosocial support and practical advice.
Nurses' awareness of the importance of adequate cue responding is vital, as is the choice to "unlearn" the predominant distancing behaviors. The needs and the role of the patients' partner in consultations and managing consultations require further attention in training and professional practice.
Health-related quality of life differs between RT, SRT, and CRT patients 1 month posttreatment. The RT- and CRT-treated patients reported higher impairment than the patients who were treated with SRT. Nutritional intake and oral function emphasize the importance of providing supportive care to radiated advanced-stage HNC patients throughout the treatment trajectory and the need for continuation during the first few posttreatment months.
There seems to be an excellent opportunity for health professionals to support cancer patients by further tailoring of follow-up care. Knowledge and insight into the challenges patients face posttreatment will benefit both professionals and patients.
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