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BackgroundWith the aging of the population and rising rates of chronic diseases, older adults need support if they are to adopt healthy lifestyles. Web-based interventions should be considered for this purpose, since they are easily accessed and can foster healthy lifestyles among older adults. However, the literature on such interventions discusses a variety of components and effects and provides only 2 syntheses of knowledge on web-based interventions with older adults. These studies focus on populations aged 50 years and older, whereas the components and effects of interventions for a population of older adults (ie, 65 years and older) may differ. In addition, these 2 syntheses examined only quantitative studies, although other types of studies (ie, qualitative) are available and could help advance knowledge in this field. A scoping review is therefore relevant in order to explore the extent of the literature on this subject. ObjectiveThe purpose of the study described by this protocol is to explore the extent of the literature (experimental, quasi-experimental, qualitative, systematic reviews, and grey literature) on the components and effects of web-based interventions as a way to promote healthy lifestyles among older adults. MethodsThe databases MEDLINE, CINAHL, PsycInfo, Web of Science, Cochrane Database of Systematic Review and Joanna Briggs Library will be searched, in addition to the grey literature using Google Scholar and OpenGrey. Studies will be selected for the review by 2 researchers, working independently. The data will be synthesized based on the conceptualization of web-based interventions (ie, behavior change techniques, dispensation modes, and theories). A thematic analysis will be performed to summarize the components of the interventions studied. ResultsThe database search will begin in August 2020 and be completed in October 2020. ConclusionsThis scoping review should highlight web-based interventions designed to promote healthy lifestyles, as well as their components and effects, among people aged 65 years and older. These results could provide important guidance for intervention developers and designers in identifying the components of web-based interventions relevant to older adults and lead to further studies on this topic. International Registered Report Identifier (IRRID)PRR1-10.2196/23207

BackgroundBrief counseling can motivate patients to initiate health behavior change. However, increasing the provision of brief counseling by nurses is difficult due to contextual and practitioner-level factors impeding nurses’ motivation and intentions to provide brief counseling (eg, unfavorable attitude toward brief counseling, lack of perceived control linked to barriers). Theory-based implementation interventions could address these practitioner-level factors and support evidence-based practice in the context of brief counseling. Web-based, adaptive e-learning (electronic learning) programs are a novel type of implementation intervention that could address the limitations of current brief counseling training programs, such as accessibility and personalization. ObjectiveThis paper presents a study protocol for evaluating the effectiveness of the E_MOTIVA implementation intervention—a theory- and web-based adaptive e-learning program—to increase nurses’ and nursing students’ intentions to provide brief counseling for smoking, an unbalanced diet, and medication nonadherence. MethodsA two-group, single-blind, randomized controlled trial will be conducted with nurses and nursing students enrolled in a Bachelor of Science in Nursing program in Quebec, Canada. Participants in the experimental group will be allocated to the E_MOTIVA intervention—a theory- and web-based adaptive e-learning program—while participants in the active control group will be allocated to the E_MOTIVB intervention, a knowledge- and web-based standardized e-learning program. The E_MOTIVA intervention was designed to influence the constructs of the Theory of Planned Behavior (eg, attitude, subjective norms, and perceived behavioral control) in the context of brief counseling. The Cognitive Load Index and User Engagement Scale will be used to assess participants’ cognitive load and engagement related to e-learning. Participants will complete the Brief Counseling Nursing Practices Questionnaire–Abridged Version at baseline and follow-up. All study measures will be completed online. ResultsThe study is ongoing. The results of the study will provide answers to the primary hypothesis (H1) that experimental group participants will demonstrate a greater change in the score of intentions to provide brief counseling between baseline (–T1) and follow-up (T4). Secondary hypotheses include greater improvements in scores of attitude (H2), subjective norms (H3), perceived control (H4), behavioral beliefs (H5), normative beliefs (H6), and control beliefs (H7) regarding brief counseling in the experimental group between baseline and follow-up. We also anticipate lower intrinsic and extrinsic cognitive loads (H8, H9), higher germane cognitive load (H10), and higher engagement (H11, H12) in the experimental group. ConclusionsThis study will be among the first in evaluating a novel type of implementation intervention, a theory- and web-based adaptive e-learning program, in nurses and nursing students. This type of intervention has the potential to support evidence-based practice through accessible, personalized training in wide-ranging domains in nursing. Trial RegistrationISRCTN Registry ISRCTN32603572; http://www.isrctn.com/ISRCTN32603572 International Registered Report Identifier (IRRID)PRR1-10.2196/18894

At-home respite services seem too rigid to meet the needs of older adults and their caregivers. It is critical to develop service flexibility, as it allows for personalized care, adapted to health conditions, preferences, and evolving needs. While no prior studies used coconstruction methods to increase flexibility, this study could offer a better understanding of flexible respite for stakeholders. Using a living lab approach, this article aimed to (1) empirically determine the characteristics of this type of respite model and (2) document the levers and obstacles to consider for its implementation. Starting from a pre-existing flexible respite model named ANAAIS, the research team led workshops and interviews. First, the team carried out 2 workshops (TRIAGE and persona-scenario) with a total of 3 caregivers and 8 homecare professionals or managers. Second, a team member conducted interviews with 3 caregivers and 6 homecare professionals or managers. Content analysis was used on the data. The stakeholders coconstructed a Québec version of ANAAIS, a web application allowing caregivers to request an affordable respite, at the time wanted, and offered by a qualified care worker, through a simple application. Levers and barriers to its deployment are linked to the model's characteristics as well as its internal and external context. For example, relations and connexions were perceived as a lever to deployment, while the lack of resources was considered an obstacle. This living lab project showed the feasibility and pragmatism of coconstructing a flexible and applicable respite service model. [ABSTRACT FROM AUTHOR]

In this study we explored the relationship between nurses' emotional exhaustion and three EHR compatibility subdimensions (nurses' preferred work style, existing clinical practice, and values). We found higher emotional exhaustion with lower EHR compatibility for both preferred work style and existing clinical practice, but no relationship between emotional exhaustion and nurses' values. Efforts to improve EHR compatibility are recommended to mitigate nurses' burnout. [ABSTRACT FROM AUTHOR]

There is an increased adoption of electronic health records (EHR) motivated by many purported benefits, yet limited research has explored their impact on quality of care. We developed and tested a multidimensional measure of quality of care in relation to EHR use. 234 nurses completed a cross-sectional survey. The a score of the quality of care construct reached 0.92. Four subdimensions were identified: technology impact on nursing practice, learning and improvement capability, transition accountability, and fault responsibility. The instrument has potential to advance our understanding of the impact of EHR use on quality of care. [ABSTRACT FROM AUTHOR]

Background: As the population ages and more elderly individuals are undergoing coronary artery bypass graft surgery (CABG), there is a growing need to focus on reducing sedentary behaviour following this surgery to prevent morbidity and mortality. Objective: This pilot study sought to qualitatively evaluate the acceptability, feasibility, and outcomes of a motivational interviewing nursing intervention (MINI) for reducing sedentary behavior in elderly persons following CABG (N = 5). Method: The MINI consisted of five weekly, home-based sessions. Based on semi-structured interviews, notebook of physical activity, Abstract algorithm of stage of change, and logbook entries, we completed descriptive statistics and a thematic analysis. Results: The MINI appeared to be acceptable and feasible for the post-CABG elderly, as they progressed through the stages of change and reduced sedentary behaviour. Conclusion: Despite the need for more research, our findings suggest that a nurse-led, home-based, post-CABG intervention may support the promotion of physical activity behaviours in the elderly. [ABSTRACT FROM AUTHOR]

Introduction Serious games (SGs) are interactive and entertaining digital software with an educational purpose. They engage the learner by proposing challenges and through various design elements (DEs; eg, points, difficulty adaptation, story). Recent reviews suggest the effectiveness of SGs in healthcare professionals' and students' education is mixed. This could be explained by the variability in their DEs, which has been shown to be highly variable across studies. The aim of this systematic review is to identify, appraise and synthesise the best available evidence regarding the effectiveness of SGs and the impact of DEs on engagement and educational outcomes of healthcare professionals and students. Methods and analysis A systematic search of the literature will be conducted using a combination of medical subject headings terms and keywords in Cumulative Index of Nursing and Allied Health, Embase, Education Resources Information Center, PsycInFO, PubMed and Web of Science. Studies assessing SGs on engagement and educational outcomes will be included. Two independent reviewers will conduct the screening as well as the data extraction process. The risk of bias of included studies will also be assessed by two reviewers using the Effective Practice and Organisation of Care criteria. Data regarding DEs in SGs will first be synthesised qualitatively. A meta-analysis will then be performed, if the data allow it. Finally, the quality of the evidence regarding the effectiveness of SGs on each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Ethics and dissemination As this systematic review only uses already collected data, no Institutional Review Board approval is required. Its results will be submitted in a peerreviewed journal by the end of 2018. [ABSTRACT FROM AUTHOR]