Transformation of care delivery requires rethinking the relationship between the person and clinician. The model described provides a process to more fully engage patients in their care. Five encounters include assessing capacity for engagement, exchanging information and choices, planning, determining interventions, and evaluating the effectiveness of engagement interventions. Created by researchers and validated by experts, implications for practice, education, and policy are explored.
With the growing prevalence of diabetes in teens and frequent concomitant problems with adherence, adolescents are a frequent target for diabetes self-management support and education. Due to widespread use of technology among teens in general, the use of serious games, games used for purposes beyond entertainment with the intention to educate and support health behavior for teens with diabetes self-management, is an emerging and promising practice. This report explores games intended for teens with diabetes, how the use of games may enhance clinical practice, and provides suggestions for future research and better utilization of these technologies. Current research on the use of gaming for promoting diabetes management in teens is fairly limited, with some initial support for improvements in both behavioral and clinical outcomes among teens. More research is clearly needed in order to further determine how gaming can best be utilized to impact health outcomes in these teens, as well as potential mechanisms of change.
Patient engagement is an important element in transitioning care delivery to achieve population health management goals. Providers are challenged to develop care delivery processes that better engage patients in their life journey across the healthcare continuum. Nurse leaders are central to this process. Building upon the American Organization of Nurse Executives competencies for nurse executives, the nurse manager role requires specific skills to translate the vision of patient engagement into practice.
As the impact of the COVID-19 pandemic became clear, it was evident that higher education schools and Universities, including schools of nursing were facing enormous challenges to create a safe environment for educational instruction to continue. Clinical education in particular was affected as clinical sites were increasingly unable to accommodate student clinical rotations due to crushing volumes and overwhelming care needs of COVID patients. This article outlines the innovative efforts of one university that set up a robust surveillance testing program that required and provided weekly COVID-19 testing of all students, faculty and staff that were on-campus. The testing center is nurse led and nurse managed, providing a clinical experience for over 50 nursing students each semester, allowing them to accrue community clinical hours so that they can progress through their nursing program. Clinical quality and patient experience outcomes are shared, and lessons learned described.
As the US health care system moves rapidly toward a population health management focus in communities and care settings, the chief nursing officer has an opportunity to lead innovation efforts for patient care. One innovative strategy for use to influence patient behavior change, ongoing clinical education, and prelicensure education is the application of gaming theory into learning strategies. With the ever-increasing emphasis the general public is placing on social media and online gaming, there has been a significant push by the health sector in recent years to harness this medium for use in health management, education, and behavior change. A number of organizations and insurers have dedicated significant resources to researching and developing games and apps to help patients manage diseases, track self-management activities, and motivate behavior change for healthy lifestyles. This article shares information about gaming theory and its application to health care including a review of the science behind the theory, the use of technology, and gaming education strategies for both patients and clinicians.
Purpose The purpose of the study was to explore facilitators and barriers to self-management behaviors in adolescents with type 1 diabetes (T1D) to inform the development of an mHealth platform. Methods Eight adolescents with T1D, 9 parents, and 13 health care providers participated in separate focus groups that explored teen self-management behaviors. Results Adolescents and their parents have distinct preferences for handling diabetes management and use of mHealth technologies. Health care providers support the use of new technologies yet acknowledge concern meeting the potential increased volume of communication requests from teens and families. Conclusion Stakeholders agreed that an ideal mHealth platform would facilitate open communication between teens and their care network and easily integrate with other diabetes technologies. Future directions include incorporating additional feedback from stakeholders to build and modify the mHealth platform. The use of mHealth platforms could be integrated into clinical practice to optimize self-management and support communication between educators, providers, and families in between clinic visits.
Purpose This study aims to investigate individual motivations for participating in collaborative health knowledge producing teams (KPTs), as well as satisfaction gained by participation in science teams. The authors focus on understanding motivators across team types, levels of engagement and alignment within and across teams and need satisfaction in a total of six science teams. Areas of strong congruence and divergence of motivating factors can be aligned across (i) learning and professional growth satisfaction, (ii) respect, collegiality and enjoyment satisfaction and (iii) accomplishment and discovery satisfaction. Levels of satisfaction are hierarchically mapped showing their relation to more external and communal foci to motivations that seek satisfaction of individual needs. Design/methodology/approach This mixed method comparative study uses data from the motivation assessment for team readiness integration and collaboration (MATRICx) tool and themes generated from semi-structured interviews. This methodology provided a means to compare a hierarchy of motivations against levels of collaborative engagement, as well as individual needs satisfaction and ultimately the identification of higher and lower-level motivations related to self and external foci. Findings The findings indicate that there are both similarities and differences in motivations in different health science teams when one compares biomedical, education and policy teams. A comparison of MATRICx data from across team types and teams suggests areas of strong congruence as well as areas of divergence in motivation factors. Originality/value The paper and its findings use a novel tool along with qualitative research techniques to identify motivation in KPTs and uses these data to understand what type of needs satisfaction are important across three areas of health science teaming. Our research informs team leaders, facilitators and consultants about the important motivations team members have entering teams and has the potential to provide a blueprint to ensure peak performance as individual team members seek to address their ever-growing professional needs.
Background and PurposeEngagement in one’s health care is paramount to improving health outcomes. As adolescents begin their journey into adulthood and increase involvement in their health-care decision-making, it is critical to understand their ability to be involved in their health care. The purpose of this instrumentation study was to develop and evaluate the psychometric properties and underlying factors of the Adolescent Capacity to Engage Index (ACEI) tool which measures the construct of an adolescent’s capacity to engage in their health care.MethodsThis study had a two-phase approach. Phase 1 consisted of the pilot and cognitive testing of the items developed based on the literature and content expertise. Phase 2 was the testing of the final 21 item revised instrument among 15–17-year-old online teen panel, (n = 226).ResultsPsychometric testing revealed a valid and reliable 21 item scale with a four-factor solution. The Cronbach’s alpha for the total scale was .901. The four subscales and each subscale Cronbach’s alpha were: 1) Active Participation In Healthcare with Psychosocial Support to Aid/Foster Good Healthcare Choices, (.826). 2) Transition Readiness to Self-Management with Family Support to Guide/Foster Health/Healthcare Decisions, (.825). 3) Proactivity and Empowerment to Have a Say in Health/Healthcare, (.747) and 4) Technology Use to Seek Health/Healthcare Information, (.648).ConclusionsThis study demonstrated the ACEI is a psychometrically sound instrument with good internal consistency for the overall scale and subscales. The ACEI can be implemented in clinical practice to measure adolescents’ engagement capacity in their healthcare and identify appropriate interventions based on ACEI score. Further research to determine engagement capacity among teens of various populations is warranted.
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