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Mixed methods research is essential to development of patient-reported outcome measures, digital technology, and endpoint selection for clinical drug trials and to advance clinical care when complex health-related experiences cannot be fully understood by quantitative or qualitative approaches alone. New technology and opportunities for remote data collection have changed the ways in which qualitative and quantitative data can be collected, enabling researchers to capture human experiences in ways not previously possible. This paper describes Perspective Mapping, a new online interviewing technique that uses mind mapping software to capture in-depth qualitative data inside a quantitative measurement framework to understand and measure individual experiences. The objective of this tutorial is to review the theoretical underpinnings, present instructions for study design and implementation, and address strengths, limitations, and potential applications of this technique in health and behavioral sciences. During videoconferencing interviews, mind-mapping software is used to visually depict experiences. Structured concept maps are cocreated in real time with participants, focusing on building detailed narrative descriptions about experiences and categorizing these within a predefined quantitative framework, such as the relative importance of different experiences relevant to a phenomenon. The approach combines semistructured interviewing with technology-enhanced card-sorting techniques, allowing participants to define and prioritize what matters most. This method ensures narrative richness alongside structured data collection, facilitating deeper understanding of phenomena. Perspective Mapping emphasizes participant engagement in data generation and analysis and enables the simultaneous collection of qualitative narratives and quantitative assessment of key concepts. The variations of the technique have been successfully applied in research on chronic illness, symptom burden, and digital health technology. Advantages of the approach include systematic collection of qualitative data, transparent and structured data outputs, real-time data validation, and the ability to return maps to participants as a form of reciprocity. Feasibility factors, such as interviewer capabilities, participant literacy, interview duration, and technology resources must be considered. Perspective Mapping offers an innovative and engaging way to gather complementary qualitative and quantitative data remotely. By blending qualitative depth with quantitative structure, the technique supports richer, more actionable insights for health research, policy, and beyond. This technique holds promise for applications in health, psychology, education, and other social sciences where comprehensive understanding of experiences is essential.

Family caregivers have primary responsibility for providing care in the home for people with neuromuscular diseases (NMDs). This may negatively affect caregiver health. Peer support may enhance quality of life and reduce stress among family caregivers, but few trials have been conducted in NMD caregivers. Therefore, we conducted a randomized controlled trial with a nested qualitative evaluation (this report) of a 12-week digital peer support intervention for family caregivers of children and adults with NMD. The aim of the study is to gain insights into the perspectives of intervention participants and peer mentors regarding their experiences with the trial's digital peer support program. We conducted a nested exploratory qualitative study (August 2022 to March 2024), recruiting participants who were randomized to the intervention arm of the randomized controlled trial and study mentors. We conducted semistructured interviews via videoconferencing. Homophily theory and the theoretical framework of acceptability informed our analyses. We interviewed 21 participants and 10 mentors, identifying four themes: (1) program participation motivators, (2) program expectations and appreciation, (3) program appropriateness, and (4) the peer mentor-mentee dyad. We found that participants were motivated to join the program due to existing caregiver burden and social isolation. Participants and mentors appreciated the program's sense of community and flexible digital format, with participants valuing emotional and informational support. However, challenges in relating to each other's situations due to participant and mentor heterogeneity in the extent of the care recipient's needs were perceived to limit benefit. Peer support was perceived as potentially beneficial in relieving caregiver burden and social isolation, creating a sense of community that provides emotional and informational support. The digital and flexible format was an important facilitator. An important barrier was participant-mentor heterogeneity resulting in reduced perception of homophily. These findings can inform the development of other digital peer support programs to alleviate caregiver burden and isolation and provide emotional relief and informational guidance.

With the rapid development and iteration of generative artificial intelligence, the growing popularity of such groundbreaking tools among nurse researchers, represented by ChatGPT (OpenAI), is receiving passionate debate and intrigue. Although there has been qualitative research on generative artificial intelligence in other fields, little is known about the experiences and perceptions of nurse researchers; this study seeks to report on the topic. This study aimed to describe the experiences and perceptions of generative artificial intelligence among Chinese nurse researchers, as well as provide a reference for the application of generative artificial intelligence in nursing research in the future. Semistructured interviews were used to collect data in this qualitative study. Researchers mainly conducted interviews on the cognition, experience, and future expectations of nurse researchers regarding the use of generative artificial intelligence. Twenty-seven nurse researchers were included in the study. Through purposive sampling and snowball sampling, there were 7 nursing faculty researchers, 10 nursing graduate students, and 10 clinical nurse researchers. Data were analyzed using inductive content analysis. Five themes and 12 subthemes were categorized from 27 original interview documents as follows: (1) diverse reflections on human-machine symbiosis, which includes the interplay between substitution and assistance, researchers shaping the potential of generative artificial intelligence, and acceptance of generative artificial intelligence with alacrity; (2) multiple factors of the usage experience, including individual characteristics and various usage scenarios; (3) research paradigm reshaping in the infancy stage, which involves full-process groundbreaking assistive tools and emergence of new research paths; (4) application risks of generative artificial intelligence, including intrinsic limitations of generative artificial intelligence and academic integrity and medical ethics; and (5) the co-improvement of technology and literacy, which concerns reinforcement needs for generative artificial intelligence literacy, development of nursing research generative artificial intelligence and urgent need for artificial intelligence-generated content detection tools. In this context, the first 4 themes form the rocket of the human-machine symbiosis journey. Only when humans fully leverage the advantages of machines (generative artificial intelligence) and overcome their shortcomings can this human-machine symbiosis journey reach the correct future direction (fifth theme). This study explored the experiences and perceptions of nurse researchers interacting with generative artificial intelligence, which was a \"symbiotic journey\" full of twists and turns, and provides a reference and basis for achieving harmonious coexistence between nurse researchers and generative artificial intelligence in the future. Nurse researchers, policy makers, and application developers can use the conclusions of this study to further promote the application of generative artificial intelligence in nursing research, policy making, and product development.

Hypertension is a significant public health concern in low- and middle-income countries, where access to care is crucial for effective treatment and control. Web-based health modalities provide a promising solution to overcome barriers to care, particularly in underresourced communities, if those communities engage with the technology. This study aims to examine the past experiences, perceptions, and preferences of using web-based health modalities for health care access among community members with or at high risk for hypertension. Semistructured interviews were completed with individuals randomly selected from a sample of community members in Soweto, South Africa, previously screened as having either elevated (systolic blood pressure [BP]≥120-139 mm Hg or diastolic BP≥80-89 mm Hg) or high (systolic BP≥140 mm Hg or diastolic BP≥90 mm Hg) BP to determine their past experiences using web-based services and what their perceptions were on using such services. An interview script, grounded in the Extended Unified Theory of Acceptance and Use of Technology (UTAUT2) model, was used to guide the interviews. Deductive thematic analysis was used to code the interviews and identify common themes. A total of 178 community members (including 104 with elevated BP and 74 with high BP) were randomly selected and invited to participate in the study. Forty interviews were conducted with individuals from the elevated (n=20) and high (n=20) BP groups. Four major themes emerged from the interviews regarding using technology to receive health care services: (1) trust and credibility of health professionals in a web-based environment, (2) comfort level using technology to receive health care, (3) experience using technology to receive health care, and (4) preference for in-person versus web-based interactions. Despite being open and receptive toward the use of web-based health modalities to receive health care, participants preferred in-person interactions due to both a lack of experience using web-based health care and familiarity with traditional in-person health services. Further research is needed to understand how technology may aid future hypertension management efforts in urban African communities.

Despite improvements in early cancer diagnosis worldwide, morbidity and mortality in Southern Africa continue to rise owing to challenges with funding, sociocultural beliefs, and health care access. Digital health (\"eHealth\") has the potential to expand access to health care, particularly to remote communities. However, few studies explored the use of eHealth to support symptomatic cancer diagnosis in Southern Africa. This study explored the barriers and facilitators to eHealth use by health care workers (HCWs) to support the management of people with symptoms of possible breast, cervical, or colorectal cancer in South Africa and Zimbabwe. We conducted semistructured in-depth interviews with HCWs (n=56) who managed people with symptoms of possible cancer. Interviews explored the barriers and facilitators to eHealth use and attitudes toward further adoption of eHealth. Interview schedules were guided by the sociotechnical theory, a model \"designed to address the socio-technical challenges involved in design, development, implementation, use, and evaluation of eHealth.\" The interviews were audio-recorded and transcribed. We used the framework method to analyze the data and developed themes that encompassed patterns and meaning in the data to answer the research question. The median age of participants was 44 (IQR 34-53) years, 38 (68%) were female, and most were nurses (n=34, 61%) or doctors (n=18, 32%). Four core themes were developed: (1) \"the lack of reliable infrastructure hindered eHealth use among HCWs\"; (2) \"the use of personal mobile devices increased eHealth access at the expense of patient privacy and personal cost\"; (3) \"information, workflow integration, and access\"; while eHealth improved access to information, many tools were already in use, were poorly integrated into workflow, and disrupted consultations; and (4) \"digital health is expanding whether we like it or not,\" which describes a spectrum of attitudes toward digital health, ranging from enthusiasm to resistance but willingness to adapt to those completely against its use. Themes from the workshops were concordant with the in-depth interview findings. To capitalize on the potential benefits of eHealth use among HCWs, such as to support early cancer diagnosis, infrastructural challenges must be addressed, and tools designed to meet user needs and be integrated into clinical workflow. As in many other resource-constrained settings, significant improvements in development are required for the value of eHealth to be realized in Southern Africa. Additionally, where resources such as electricity are limited, their use for eHealth needs to be weighed against use for other priorities such as operating ventilators. Furthermore, energy production in these regions is largely reliant on burning fossil fuels, and thus, the use of eHealth tools risks contributing negatively to climate change. The findings of this study can be used to guide future eHealth design or implementation strategies that are more contextually suitable.

Retriage is the emergent interhospital transfer of severely injured patients from nontrauma and low-level trauma centers to high-level trauma centers. An estimated 17%-34% of patients with traumatic injury are undertriaged to nontrauma or low-level trauma centers in the United States each year. These patients see 30% increased odds of mortality at 48 hours and nearly 4-fold increased odds of overall mortality. However, 30%-50% of undertriaged patients are never retriaged to a high-level trauma center. Informatics-driven solutions facilitate time-sensitive exchange of patient information in other health care contexts. Few studies have explored how informatics-driven solutions can be tailored to address obstacles to timely, effective retriage. We applied user-centered design to develop a robust, acceptable, and feasible digital health solution to improve the retriage process. This was a mixed methods, observational, cross-sectional study. Potential frontline users of an intervention and hospital leadership were recruited to participate. Individuals in these roles included trauma medical directors, emergency department directors, trauma surgeons, emergency medicine physicians, emergency department nurse managers, emergency department nurses, trauma coordinators, emergency department bed managers, and health unit coordinators at nontrauma or low-level trauma centers and high-level trauma centers. We applied the 5-phase user-centered design approach, including phase 1: understanding the design needs, through site visit observations and focus groups; phase 2: ideation of potential solutions through a second round of virtual focus groups; phase 3: rank ordering solutions to identify the most robust, acceptable, and potentially feasible solutions; phase 4: prototyping by creating low-fidelity prototypes for the highest-ranked solutions; and phase 5: validation of the robustness of the prototypes through virtual focus groups. Validation approaches included asking frontline end users to assess the feasibility of each prototype and whether prototypes would address the identified retriage failures and barriers. In addition, leaders were asked to assess the feasibility of implementing the proposed solutions in their trauma center. All virtual sessions were recorded, transcribed, and inductively coded to generate themes of robustness, acceptability, and feasibility of the retriage solution. Thematic analysis was anchored on the desirability, viability, and feasibility design thinking methodology. Nineteen sessions were conducted across all 5 phases with 49 participants from 12 trauma centers across Illinois. Participants included frontline users and leadership. The key design requirement was resource transparency between centers. The ideation phase produced 70 solutions. A systemwide bed tracker was ranked the highest by participants. Prototyping and validation resulted in a centralized, systemwide, bed tracker with hourly updated bed availability being the final solution to improve the retriage of patients with traumatic injury from non- or low-level trauma centers and high-level trauma centers. A 5-phase user-centered design approach resulted in a single solution consisting of a digital bed-tracker with frequently updated data on beds at high-level trauma centers to improve retriage.

This paper explores the perception and application of artificial intelligence (AI) for personalized medicine within the trans community, an often-overlooked demographic in the broader scope of precision medicine. Despite growing advancements in AI-driven health care solutions, little research has been dedicated to understanding how these technologies can be tailored to meet the unique health care needs of trans individuals. Addressing this gap is crucial for ensuring that precision medicine is genuinely inclusive and effective for all populations. This study aimed to identify the specific challenges, obstacles, and potential solutions associated with the deployment of AI technologies in the development of personalized medicine for trans people. This research emphasizes a trans-inclusive and multidisciplinary perspective, highlighting the importance of cultural competence and community engagement in the design and implementation of AI-driven health care solutions. A communicative methodology was applied in this study, prioritizing the active involvement of end-users and stakeholders through egalitarian dialogue that recognizes and values cultural intelligence. The methodological design included iterative consultations with trans community representatives to cocreate the research workflow and adapt data collection instruments accordingly. This participatory approach ensured that the perspectives and lived experiences of trans individuals were integral to the research process. Data collection was conducted through 3 focus groups with 16 trans adults, aimed at discussing the challenges, risks, and transformative potential of AI in precision medicine. Analysis of the focus group discussions revealed several critical barriers impacting the integration of AI in personalized medicine for trans people, including concerns around data privacy, biases in algorithmic decision-making, and the lack of tailored health care data reflective of trans experiences. Participants expressed apprehensions about potential misdiagnoses or inappropriate treatments due to cisnormative data models. However, they also identified opportunities for AI to enhance health care outcomes, advocating for community-led data collection initiatives and improved algorithmic transparency. Proposed solutions included enhancing datasets with trans-specific health markers, incorporating community voices in AI development processes, and prioritizing ethical frameworks that respect gender diversity. This study underscores the necessity for a trans-inclusive approach to precision medicine, facilitated by AI technologies that are sensitive to the health care needs and lived realities of trans people. By addressing the identified challenges and adopting community-driven solutions, AI has the potential to bridge existing health care gaps and improve the quality of life for trans individuals. This research contributes to the growing discourse on equitable health care innovation, calling for more inclusive AI design practices that extend the benefits of precision medicine to marginalized communities.

With China's aging population and increasing prevalence of chronic diseases, the Internet+Nursing Service has emerged as a new care model, enabling registered nurses from medical institutions to provide home-based care through a web-based application and offline service model. This care model is particularly beneficial for vulnerable populations, such as patients with dysphagia, who face significant risks like malnutrition and aspiration pneumonia. Nurses play a critical role in delivering these services, yet their experiences, challenges, and support needs remain underexplored. Understanding these factors is essential for improving service quality and establishing standardized care guidelines. This study aims to explore the experiences and challenges of nurses providing the dysphagia-related Internet+Nursing Service, offering insights to guide the standardization and sustainable development of this innovative care model. A qualitative study was conducted with 18 nurses who had been providing the Internet+Nursing Service for patients with dysphagia for over 6 months. Purposive sampling ensured the selection of participants with relevant expertise. Semistructured interviews were used for data collection, focusing on nurses' experiences, challenges, and recommendations. Data were analyzed using conventional content analysis, following an inductive approach to identify recurring themes and patterns. The analysis revealed 3 key themes: value representation and social impact; nursing resources and staffing; and safety and management support. Nurses emphasized that patient-centered nursing services enhanced their sense of professional fulfillment and helped alleviate pressure on hospital nursing resources. However, challenges such as insufficient time and energy, inadequate manpower, and underexploitation of service potential limited service effectiveness. To ensure sustainability, nurses highlighted the need for standardized service processes, regular experience exchange, and stronger hospital involvement in managing and supporting the Internet+Nursing Service. This study highlights both the opportunities and challenges of delivering the dysphagia-related Internet+Nursing Service. While nurses acknowledge the value of this care model, addressing staffing shortages, improving training programs, and strengthening regulatory frameworks are essential for optimizing service delivery. Policy makers and health care institutions should develop standardized guidelines and supportive policies to enhance service sustainability and accessibility.

Surgical ward rounds (SWRs) are typically led by doctors, with limited involvement from key participants, including patients, family members, and bedside nurses. Despite the potential benefits of a more collaborative and person-centered approach, efforts to engage these stakeholders remain rare. This qualitative exploratory study examined the experiences and needs of doctors, nurses, patients, and their relatives during SWRs as part of a Participatory Design process. Data were collected through ethnographic field studies, focus groups with the healthcare providers, patients and relatives, and dyadic interviews conducted as part of home visits to patients and their partners after discharge. Field notes and interview data were analyzed using systematic text condensation. Lack of organization, traditional roles, and cultural norms compromised the quality, efficiency, and user experience of SWRs in multiple ways. SWRs were routine-driven, treatment-focused, and received lower priority than surgical tasks. Unpredictability resulted in unprepared participants and limited access for nurses, patients, and relatives to partake. The study identified a gap between the organizational and cultural frameworks governing the SWRs and the experiences and needs of key participants. Digital technologies were perceived as a potential solution to address some of these challenges.

Virtually delivered health care services can offer numerous benefits, and the demand for virtual care continues to grow among subgroups facing mobility challenges. The experience of compassion in health care is linked to patient satisfaction and clinical outcomes; however, this link in virtual rehabilitation settings is underexplored. The objectives of this study were to explore what compassionate care means to rehabilitation patients in a virtual rehabilitation context and explore patients' experiences of how the technology associated with virtual rehabilitation impacted their experience of care. We conducted one-on-one semistructured qualitative interviews with patients with limb loss and chronic obstructive pulmonary disease. A reflexive thematic analysis approach was used to generate domain summaries and initial themes across the sample. Themes were generated following analytic work over a series of discussions within the research team. Sixteen interviews were conducted. Four themes illustrating participants' perceptions of compassionate care were generated: (1) features of compassionate care include feeling valued, connected, and cared for by the health care provider; (2) threats to compassionate care in virtual rehabilitation; (3) facilitating compassion in virtual rehabilitation through preparation; and (4) benefits of virtual care. Patient perceptions of compassionate care in a virtual rehabilitation setting may be impacted by the behaviors and communication of providers. Provider training and preparation and the personal connections formed with their patients may impact compassionate care experiences.