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Objective To explore the effect of Omaha system-based continuous care intervention in pa- tients with neurogenic bladder with spinal cord injury. Methods A total of 72 patients with neurogenic blad- der due to spinal cord injury were selected from June 2019 to June 2022 in the No. 908th Hospital of Joint Logistic Support Force. The patients were randomly divided into the control group (36 cases) and the observation group (36 cases) by random number table method. The control group received routine nursing care, while the observation group received Omaha system-based continuous care on the basis of routine nursing care. The cognition, behavior and status of the patients in the observation group were scored by the effect/outcome evaluation system at three and six months after discharge. Simple residual urine volume and volume of bladder were used to compare the bladder function of the two groups at six months after discharge. Urinary tract infection six months after discharge was compared between the two groups by urine laboratory examination. The quality of life in six months after discharge of the two groups was compared by using the comprehensive assessment questionnaire-74. The nursing satisfaction of the two groups was compared with the nursing satisfaction questionnaire made by the hospital, Results After half a year follow-up the scores of cognition behavior and condition in the observation group were significantly improved compared with those before intervention, with statistical significance (P<0.01). The bladder function, quality of life score and satisfaction in observation group were higher than those in control group, but the incidence of urinary tract infection was lower than that in control group, with statistical significance (P<0,05). Conclusion Omaha system-based continuous care model can effectively improve the bladder function, quality of life and nursing satisfaction of patients, reduce urinary tract infection and improve the outcome of nursing care. [ABSTRACT FROM AUTHOR]

This study aimed to identify the health behavioral needs of older adults based on the Omaha System. This descriptive study was conducted in Northern Cyprus between May and October 2021. The sample comprised 400 older adults who resided in the Gecitkale municipality. The problem-classification scheme of the Omaha system was used for data collection. The main behavioral health problems concerned nutrition (100%), physical activity (87.25%), and medication regimen (87.25%). In addition, all behavioral health problems defined by the Omaha system were evident in participants who were 75 years and older, female, single, childless, educated, and with incomes that did not cover expenses (p <.05). This study identified the basic healthcare needs of older adults, which increased in parallel with age. The Omaha system may help health professionals deliver services focusing on older people's needs. Plain language summary: This study, conducted in a descriptive research design, identified the health care needs of the elderly in a region of Northern Cyprus using the Omaha Classification System. It has been determined that the health care needs of older people are mostly related to nutrition, physical activity, and medication use. The results of this study suggest that valid and reliable care classification tools, such as OS, can help nurses plan interventions and assess patient outcomes related to the basic health-related needs of older adults, including nutrition, physical activity, medication adherence, and substance. resort. Interventions to promote and perform health behaviors and education to improve health-promoting behaviors in older adults to meet their needs in-home care may be suggested. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

[Objectives] To explore the effect of continuous nursing model based on the Omaha system on stroke patients. [Methods] A total of 40 stroke patients in the inpatient department of the Rehabilitation Department of Affiliated Hospital of Jinggangshan University were selected and divided into two groups by the random number table method. Patients in the control group were given routine nursing, and those of the observation group were given continuous nursing based on the Omaha system theory. The score of neurological impairment, daily living ability scale and the quality of life, as well as patients' satisfaction rate before and after treatment were compared between the two groups. [Results] The score of neurological impairment, daily living activity ability and the quality of life, as well as patients' nursing satisfaction rate in the observation group were significantly better than those of the control group, with statistical significance (P<0.05). [Conclusions] The continuous nursing model based on the Omaha system can significantly improve the neurological function of stroke patients, improve their quality of life and life ability, and promote their rehabilitation. [ABSTRACT FROM AUTHOR]

Objective Theory-based research of social and behavioral determinants of health (SBDH) found SBDH-related patterns in interventions and outcomes for pregnant/birthing people. The objectives of this study were to replicate the theory-based SBDH study with a new sample, and to compare these findings to a data-driven SBDH study. Materials and Methods Using deidentified public health nurse-generated Omaha System data, 2 SBDH indices were computed separately to create groups based on SBDH (0–5+ signs/symptoms). The data-driven SBDH index used multiple linear regression with backward elimination to identify SBDH factors. Changes in Knowledge, Behavior, and Status (KBS) outcomes, numbers of interventions, and adjusted R-squared statistics were computed for both models. Results There were 4109 clients ages 13–40 years. Outcome patterns aligned with the original research: KBS increased from admission to discharge with Knowledge improving the most; discharge KBS decreased as SBDH increased; and interventions increased as SBDH increased. Slopes of the data-driven model were steeper, showing clearer KBS trends for data-driven SBDH groups. The theory-based model adjusted R-squared was 0.54 (SE = 0.38) versus 0.61 (SE = 0.35) for the data-driven model with an entirely different set of SBDH factors. Conclusions The theory-based approach provided a framework to identity patterns and relationships and may be applied consistently across studies and populations. In contrast, the data-driven approach can provide insights based on novel patterns for a given dataset and reveal insights and relationships not predicted by existing theories. Data-driven methods may be an advantage if there is sufficiently comprehensive SBDH data upon which to create the data-driven models. [ABSTRACT FROM AUTHOR]

Nursing terminologies like the Omaha System are foundational in realizing the vision of formal representation of social determinants of health (SDOH) data and whole-person health across biological, behavioral, social, and environmental domains. This study objective was to examine standardized consumer-generated SDOH data and resilience (strengths) using the MyStrengths+MyHealth (MSMH) app built using Omaha System. Overall, 19 SDOH concepts were analyzed including 19 Strengths, 175 Challenges, and 76 Needs with additional analysis around Income Challenges. Data from 919 participants presented an average of 11(SD = 6.1) Strengths, 21(SD = 15.8) Challenges, and 15(SD = 14.9) Needs. Participants with at least one Income Challenge (n  = 573) had significantly (P  < .001) less Strengths [9.4(6.4)], more Challenges [27.4(15.5)], and more Needs [15.1(14.9)] compared to without an Income Challenge (n  = 337) Strengths [13.4(4.5)], Challenges [10.5(8.9)], and Needs [5.1(10.0)]. This standards-based approach to examining consumer-generated SDOH and resilience data presents a great opportunity in understanding 360-degree whole-person health as a step towards addressing health inequities. [ABSTRACT FROM AUTHOR]

Objective Numerous studies indicate that the social determinants of health (SDOH), conditions in which people work, play, and learn, account for 30%–55% of health outcomes. Many healthcare and social service organizations seek ways to collect, integrate, and address the SDOH. Informatics solutions such as standardized nursing terminologies may facilitate such goals. In this study, we compared one standardized nursing terminology, the Omaha System, in its consumer-facing form, Simplified Omaha System Terms (SOST), to social needs screening tools identified by the Social Interventions Research and Evaluation Network (SIREN). Materials and Methods Using standard mapping techniques, we mapped 286 items from 15 SDOH screening tools to 335 SOST challenges. The SOST assessment includes 42 concepts across 4 domains. We analyzed the mapping using descriptive statistics and data visualization techniques. Results Of the 286 social needs screening tools items, 282 (98.7%) mapped 429 times to 102 (30.7%) of the 335 SOST challenges from 26 concepts in all domains, most frequently from Income , Home , and Abuse. No single SIREN tool assessed all SDOH items. The 4 items not mapped were related to financial abuse and perceived quality of life. Discussion SOST taxonomically and comprehensively collects SDOH data compared to SIREN tools. This demonstrates the importance of implementing standardized terminologies to reduce ambiguity and ensure the shared meaning of data. Conclusions SOST could be used in clinical informatics solutions for interoperability and health information exchange, including SDOH. Further research is needed to examine consumer perspectives regarding SOST assessment compared to other social needs screening tools. [ABSTRACT FROM AUTHOR]

Objective This study aimed to identify phenotypes of nutritional needs of home-visited clients with low income, and compare overall changes in knowledge, behavior, and status of nutritional needs before and after home visits by identified phenotypes. Materials and methods Omaha System data collected by public health nurses from 2013 to 2018 were used in this secondary data analysis study. A total of 900 low-income clients were included in the analysis. Latent class analysis (LCA) was used to identify phenotypes of nutrition symptoms or signs. Score changes in knowledge, behavior, and status were compared by phenotype. Results The five subgroups included Unbalanced Diet, Overweight, Underweight, Hyperglycemia with Adherence, and Hyperglycemia without Adherence. Only the Unbalanced Diet and Underweight groups showed an increase in knowledge. No other changes in behavior and status were observed in any of the phenotypes. Discussion and conclusions This LCA using standardized Omaha System Public Health Nursing data allowed us to identify phenotypes of nutritional needs among home-visited clients with low income and prioritize nutrition areas that public health nurses may focus on as part of public health nursing interventions. The sub-optimal changes in knowledge, behavior, and status suggest a need to re-examine the intervention details by phenotype and develop strategies to tailor public health nursing interventions to effectively meet the diverse nutritional needs of home-visited clients. [ABSTRACT FROM AUTHOR]

This poster presentation describes innovative use of the Omaha System, a standardized terminology, into public health nurses' (PHNs) workflow and electronic records within a local health department's Childhood Lead Poisoning Prevention Program. The Omaha System facilitated the tracking of evidence-based interventions and client outcomes, showing a significant improvement in record completeness (from 33% pre-implementation to 84% post-implementation) and client outcomes in health care supervision, growth and development, and nutrition. Outcome data analysis revealed improvement across all post-implementation records from initial assessments to interim assessments for Health care .supervision (p<.001), Growth and development (p<.001), and Nutrition (p = .025). This achievement has given program leaders and employees the ability to clearly present their services and results to policymakers, facilitating better assessment of the program's effectiveness. The successful implementation illustrates its potential applicability to other public health projects and areas. [ABSTRACT FROM AUTHOR]

Purpose: Heavy biomechanical loadings at workplaces may lead to high risks of work-related musculoskeletal disorders. This study aimed to explore the efficacy of an Omaha System-based remote ergonomic intervention program on self-reported work-related musculoskeletal disorders among frontline nurses. Materials and methods: From July to October 2020, 94 nurses with self-reported pain in one of the three body parts, i.e., neck, shoulder, and low back, were selected and were randomly divided into two groups. The intervention group received a newly developed remote program, where the control group received general information and guidance on health and life. Program outcome was evaluated by a quick exposure check approach. Results: After 6 weeks, the intervention group exhibited significantly less stress in the low back, neck, and shoulder/forearms, compared to the control group (p

Aim: To identify and classify the transitional and aftercare needs of persons hospitalised with and recovering from COVID‐19. Background: Several studies exist that describe the patient needs at the acute phase of COVID‐19. The transitional and aftercare needs that emerge during recovery, however, remain vague. Methods: A scoping review was conducted and reported according to the PRISMA extension guidelines for scoping reviews (PRISMA‐ScR). Primary studies were identified from database search. Narrative synthesis was undertaken, with the Omaha System as a framework. Results: Forty studies were included. Persons recovering from the infection may have several needs in all domains of the Omaha System. Although the severity and persistence of the needs may be unrelated to the severity of the initial infection, they may vary based on factors such as age and pre‐morbid factors. Conclusion: Recovering from COVID‐19 is associated with varied biopsychosocial‐environmental needs which can adversely affect the quality‐of‐life experience. The review findings represent an inventory of needs that can guide the development of multi‐disciplinary post‐acute or aftercare programmes. Relevance to Clinical Practice: Recovering from COVID‐19 can be a protracted process requiring ongoing professional support after discharge. Policies are required to support the development and implementation of post‐acute programmes of care. Comprehensive transitional and aftercare rehabilitative programmes are needed to support the recovery process. [ABSTRACT FROM AUTHOR]

Objective: To characterize patterns in whole‐person health of public health nurses (PHNs). Design and Sample: Survey of a convenience sample of PHNs (n = 132) in 2022. PHNs self‐identified as female (96.2%), white (86.4%), between the ages 25–44 (54.5%) and 45–64 (40.2%), had bachelor's degrees (65.9%) and incomes of $50‐75,000 (30.3%) and $75‐100,000/year (29.5%). Measurements: Simplified Omaha System Terms (SOST) within the MyStrengths+MyHealth assessment of whole‐person health (strengths, challenges, and needs) across Environmental, Psychosocial, Physiological, and Health‐related Behaviors domains. Results: PHNs had more strengths than challenges; and more challenges than needs. Four patterns were discovered: (1) inverse relationship between strengths and challenges/needs; (2) Many strengths; (3) High needs in Income; (4) Fewest strengths in Sleeping, Emotions, Nutrition, and Exercise. PHNs with Income as a strength (n = 79) had more strengths (t = 5.570, p <.001); fewer challenges (t = ‐5.270, p <.001) and needs (t = ‐3.659, p <.001) compared to others (n = 53). Conclusions: PHNs had many strengths compared to previous research with other samples, despite concerning patterns of challenges and needs. Most PHN whole‐person health patterns aligned with previous literature. Further research is needed to validate and extend these findings toward improving PHN health. [ABSTRACT FROM AUTHOR]

Problem: The death of a parent is a traumatic experience for adolescents. Studies to ensure post‐traumatic growth in adolescents are limited. The aim of this study to evaluate the effect of nursing care based on Watson's Theory of Human Caring on posttraumatic growth in parentally bereaved adolescents. Methods: This study was participatory action research. The study was carried out with four participants through online interviews. In the study, pre‐ and post‐action data were obtained through individual interviews and scales. During the action process, nursing care based on the Theory of Human Caring was provided to the participants individually tracked through the Omaha System. Pre and post‐action qualitative data were analyzed using the descriptive analysis method. In quantitative data, scale total and sub‐scores were documented. Findings: During the action, it was determined via Omaha System coding that the participants mostly experienced grief and mental health problems. In the pre‐action, the participants stated that they experienced various difficulties regarding grief. In the post‐action, the participants stated that the meaning of parental loss,its effects on life, and their ability to cope with loss changed and they experienced positive changes. In addition, when the scale scores of the participants' pre‐ and post‐action were compared, it was found that the Mourning Scale scores decreased, and the Post‐traumatic Growth Inventory scores increased. Conclusions: The result of this study demonstrate that nursing care based on Theory of Human Caring reduces the grief symptoms and contributes to post‐traumatic growth in parentally bereaved adolescents. [ABSTRACT FROM AUTHOR]

Objectives: In this study we aimed to describe and compare groups formed by a rules‐based algorithm to prospectively identify clients at risk of poor outcomes in order to guide tailored public health nursing (PHN) intervention approaches. Design: Data‐driven methods using standardized Omaha System PHN documentation. Sample: Clients ages 13–40 who received PHN home visiting services for both the Caretaking/parenting and Mental health problems (N = 4109). Measurement: We applied a theory‐based algorithm consisting of six rules using existing Omaha System data. We examined the groups formed by the algorithm using standard descriptive, inferential statistics, and Latent Class Analysis. Results: Clients (N = 4109) were 25.1 (SD = 5.9) years old and had an average of 7.3 (SD = 3.2) problems, 250 (SD = 319) total interventions, and 32 (SD = 44) Mental health interventions. Overall outcomes improved after PHN interventions (p <.001 for all) and having more Mental health signs/symptoms was negatively associated with outcome scores (p <.001 for all). Conclusions: This algorithm may be helpful in identifying high‐risk clients during a baseline assessment who may benefit from more intensive mental health interventions. Findings show there is value using the Omaha System for PHN documentation and algorithm clinical decision support development. Future research should focus on algorithm implementation in PHN clinical practice. [ABSTRACT FROM AUTHOR]

Background: In COVID-19 survivors, symptom burden is a significant and multifaceted personal and societal challenge. The Omaha system is a standardized terminology used by researchers and clinicians for documentation and analysis of meaningful data for whole-person health. Given the urgent need for a standardized symptom checklist specific to the long COVID population, the purpose of the present study was to identify long COVID symptoms from the published literature (native symptoms) and map those to the Omaha system signs/symptoms terms. Methods: The long COVID symptoms identified from 13 literatures were mapped to the Omaha system signs/symptoms, using an expert consensus approach. The criteria for mapping were that the long COVID signs/symptoms had to contain either a one-to-one match (exact meaning of the native terms and the signs/symptoms) or a partial match (similar but not exact meaning). Results: The synthesis of the 217 native symptoms of long COVID and mapping analysis to the Omaha problems and signs/symptoms level resulted in a combined, deduplicated, and standardized list of 74 signs/symptoms for 23 problems. Of these, 72 (97.3%) of native signs/symptoms were a full match at the problem level, and 67 (90.5%) of native signs/symptoms were a full or partial match at the sign/symptoms level. Conclusions: The present study is the first step in identifying a standardized evidence-based symptom checklist for long COVID patients. This checklist may be used in practice and research for assessment, tracking, and intervention planning as well as longitudinal analysis of symptom resolution and intervention effectiveness. [ABSTRACT FROM AUTHOR]

Objective To explore the application of workshop education model based on Omaha system in the perioperative nursing of patients undergoing endoscopic lumbar discectomy for lumbar disc herniation, and evaluate its effect on compliance behavior of patients. Methods A convenience sample of 120 patients who underwent with endoscopic lumbar discectomy for lumbar disc herniation were included and divided into the control group. Based on the routine orthopedic care bundles, the control group received routine health education during hospitalization, and the observation group received workshop education mode based on Omaha system. The patient compliance, rehabilitation outcome and satisfaction was evaluated by compliance behavior and LDG-Knowledge questionnaire, Japanese Orthopaedic Association (JOA) scale and self-made satisfaction questionnaire, respectively. Results There was 1 case of death and 3 cases lost to follow-up, and clinical data of 57 cases in the control group and 59 cased in the observation group were analyzed. Scores of compliance behavior and LDG-Knowledge questionnaire in the observation group were higher than those in the control group at discharge form hospital, 1 month and 3 months after discharge from hospital respectively (P

Aims: To identify clusters of risk factors in home health care and determine if the clusters are associated with hospitalizations or emergency department visits. Design: A retrospective cohort study. Methods: This study included 61,454 patients pertaining to 79,079 episodes receiving home health care between 2015 and 2017 from one of the largest home health care organizations in the United States. Potential risk factors were extracted from structured data and unstructured clinical notes analysed by natural language processing. A K‐means cluster analysis was conducted. Kaplan–Meier analysis was conducted to identify the association between clusters and hospitalizations or emergency department visits during home health care. Results: A total of 11.6% of home health episodes resulted in hospitalizations or emergency department visits. Risk factors formed three clusters. Cluster 1 is characterized by a combination of risk factors related to "impaired physical comfort with pain," defined as situations where patients may experience increased pain. Cluster 2 is characterized by "high comorbidity burden" defined as multiple comorbidities or other risks for hospitalization (e.g., prior falls). Cluster 3 is characterized by "impaired cognitive/psychological and skin integrity" including dementia or skin ulcer. Compared to Cluster 1, the risk of hospitalizations or emergency department visits increased by 1.95 times for Cluster 2 and by 2.12 times for Cluster 3 (all p <.001). Conclusion: Risk factors were clustered into three types describing distinct characteristics for hospitalizations or emergency department visits. Different combinations of risk factors affected the likelihood of these negative outcomes. Impact Cluster‐based risk prediction models could be integrated into early warning systems to identify patients at risk for hospitalizations or emergency department visits leading to more timely, patient‐centred care, ultimately preventing these events. Patient or Public Contribution: There was no involvement of patients in developing the research question, determining the outcome measures, or implementing the study. [ABSTRACT FROM AUTHOR]

AimTo explore the feasibility of Omaha system theory in the care of children with dilated cardiomyopathy (DCM), which may provide a practical basis for the continuous nursing of DCM children.MethodsA total of 1,392 records describing symptoms, signs, and nursing interventions were extracted from the medical records of 76 children suffered from DCM. Content analysis method was used to find out existent nursing problems, make precise nursing plans, and take corresponding nursing measurements according to the medical records of DCM children. Cross-mapping method was utilized to compare the conceptual consistency of the medical records and Omaha system (problem classification and intervention subsystems).ResultsOf the total 1,392 records, 1,094 (78.59%) were complete consistency, while 245 (17.60%) were partial consistency, and 53 (3.81%) were inconsistency with the Omaha system concepts. The concept matching degree of medical records and Omaha system was approximately 96.19%.ConclusionsThe Omaha system may be an effective nursing language for Chinese DCM children, which may be useful to guide nurses in the care of DCM. Further well-design studies need to fully evaluate the feasibility and effectiveness of the Omaha system in nursing children with DCM.

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To examine the effects of the transitional tele-rehabilitation programme on quality of life of adult burn survivors.A prospective, single centre, randomised controlled trial and reported according to the Consolidated Standards of Reporting Trials (CONSORT) guidelines.Adult burn survivors aged ≥18 years with burn size ≥10% total body surface area irrespective of the depth was considered eligible to participate.The intervention was in two phases: pre-discharge and active follow-up phase (which occurred via WeChat). In both phases, comprehensive assessment and intervention guided by the Omaha System and evidenced-based protocols guided the care delivery over an 8-week period.The outcome of interest was quality of life. Two outcome measures were used to assess the outcome of interest: Burn Specific Health Scale-Brief (BSHS-B) and the EQ-5D-5L tools. The outcome was assessed at three time points: T0 (baseline), T1 (immediate post-intervention) and T2 (4 weeks from T1).In total, 60 adult burn survivors were randomly allocated to undergo the new programme. The transitional tele-rehabilitation programme elicited statistically significant improvement in simple abilities, affect, interpersonal relationship (T2) and overall quality life (T1 and T2) measured on the BSHS-B.Ongoing rehabilitative care is essential to support the recovery process of burn survivors considering that some quality-of-life subscales may improve faster than others. The study findings highlight the potential of employing a social media platform to improve post-burn quality of life outcomes.ClinicalTrials.govNCT04517721. Registered on 20 August 2020 [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine nurse coach scope of practice in relation to existing evidence-based guideline interventions using the Omaha System. The majority of interventions were within scope for nurse coach practice, and problem, category, and target terms showed differential nurse coach practice applicability across interventions. The Omaha System terminology was aligned with nurse coach practice in that both represent and employ comprehensive and holistic perspectives. This study provides a platform for multiple initiatives in nurse coach quality and documentation and provides a methodology for examining the Omaha System guidelines and interventions for other interprofessional roles. [ABSTRACT FROM AUTHOR]

The Omaha System has been providing a useful clinical documentation structure for health practice, education, and research since 1975. To understand its current applications, we updated a literature review from 2013, using the same descriptors ('Omaha System') which resulted in 559 documents. After applying filters and different forms of screening, 35 papers published from 2012 to 2022 composed the final sample for the review. From its critical analysis we realized that the Omaha System is still a valuable tool for the evaluation of health care outcomes in a variety of settings. Its benefits include promoting communication, supporting evidence-based dec;ision-making, and improving the quality of care and it is interoperable with other classifications and terminologies in healthcare. The use of the Omaha System still enables a consistent integration between patient, community, and health professionals, ensuring the collection and analysis of data that contributes to holistic care in a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Background: About one in five patients receiving home healthcare (HHC) services are hospitalized or visit an emergency department (ED) during a home care episode. Early identification of at-risk patients can prevent these negative outcomes. However, risk indicators, including language in clinical notes that indicate a concern about a patient, are often hidden in narrative documentation throughout their HHC episode. Objective: The aim of the study was to develop an automated natural language processing (NLP) algorithm to identify concerning language indicative of HHC patients' risk of hospitalizations or ED visits. Methods: This study used the Omaha System—a standardized nursing terminology that describes problems/signs/symptoms that can occur in the community setting. First, five HHC experts iteratively reviewed the Omaha System and identified concerning concepts indicative of HHC patients' risk of hospitalizations or ED visits. Next, we developed and tested an NLP algorithm to identify these concerning concepts in HHC clinical notes automatically. The resulting NLP algorithm was applied on a large subset of narrative notes (2.3 million notes) documented for 66,317 unique patients (n = 87,966 HHC episodes) admitted to one large HHC agency in the Northeast United States between 2015 and 2017. Results: A total of 160 Omaha System signs/symptoms were identified as concerning concepts for hospitalizations or ED visits in HHC. These signs/symptoms belong to 31 of the 42 available Omaha System problems. Overall, the NLP algorithm showed good performance in identifying concerning concepts in clinical notes. More than 18% of clinical notes were detected as having at least one concerning concept, and more than 90% of HHC episodes included at least one Omaha System problem. The most frequently documented concerning concepts were pain, followed by issues related to neuromusculoskeletal function, circulation, mental health, and communicable/infectious conditions. Conclusion: Our findings suggest that concerning problems or symptoms that could increase the risk of hospitalization or ED visit were frequently documented in narrative clinical notes. NLP can automatically extract information from narrative clinical notes to improve our understanding of care needs in HHC. Next steps are to evaluate which concerning concepts identified in clinical notes predict hospitalization or ED visit. [ABSTRACT FROM AUTHOR]

Background and Purpose : The objective of this study was to examine the content validity of the Omaha System to represent integrative healthcare (IH) interventions. Methods : A two-step classification procedure was used to validate Omaha System target terms that can represent IH interventions. Target terms were initially sorted based on evidence of use in IH interventions, including systematic reviews published in scientific journals and the Omaha System Guidelines website. Three Omaha System and integrative nursing content experts reviewed and validated target terms based on their definitions. Expert comments were reviewed and addressed, and final decisions were reached by consensus. Results : The content validity of Omaha System target terms was established for 49 of 75 (65.3%) target terms for IH interventions. These 49 targets were employed in 1145 of 1639 (69.9%) interventions in all Omaha System guidelines available online. Implications for Practice : A majority of Omaha System target terms may be used to represent IH interventions. Use of the Omaha System may facilitate efficient, structured, and thorough IH data collection to leverage informatics technology for supporting IH intervention clinical decisions, delivery, evaluation, and knowledge discovery. [ABSTRACT FROM AUTHOR]

Introduction. The activities and consultations undertaken by Māori health provider nurses are likely broad and operate within a Māori nursing model of care. However, there is little quantitative evidence to document and describe these encounters with clients. The Omaha coding system provides a mechanism in which to quantify nursing encounters through classifying client problems by domain, interventions and specific targets relating to interventions. Aim. The aim of this study was to document the types of encounters and interventions undertaken by Māori health provider nurses. Methods. An audit was undertaken of patient encounters occurring within a Māori health provider between 1 January 2020 and 31 December 2020. Encounters were randomly selected and problems, activities and interventions coded utilising the Omaha coding system. Simple descriptive statistics were used. Results. A total of 5897 nurse-client encounters occurred over the study period. Overall, 61% of the audited nurse-client encounters related to the physiological domain and only 6% of encounters were related to the psychosocial domain. And 29% of nursing interventions involved teaching/guiding/counselling and a further 29% of interventions were case management. Discussion. The wide variety of conditions seen and the number of interventions carried out indicate the broad scope of Māori health provider nurses. However, there were likely undocumented problems, which could reflect the medicalisation of the electronic health record. Redesigning electronic health records to apply more of a nursing and Māori health provider lens may facilitate more inclusive ways of documentation. [ABSTRACT FROM AUTHOR]

Objective: To identify the risk factors home healthcare (HHC) clinicians associate with patient deterioration and understand how clinicians respond to and document these risk factors.Methods: We interviewed multidisciplinary HHC clinicians from January to March of 2021. Risk factors were mapped to standardized terminologies (eg, Omaha System). We used directed content analysis to identify risk factors for deterioration. We used inductive thematic analysis to understand HHC clinicians' response to risk factors and documentation of risk factors.Results: Fifteen HHC clinicians identified a total of 79 risk factors that were mapped to standardized terminologies. HHC clinicians most frequently responded to risk factors by communicating with the prescribing provider (86.7% of clinicians) or following up with patients and caregivers (86.7%). HHC clinicians stated that a majority of risk factors can be found in clinical notes (ie, care coordination (53.3%) or visit (46.7%)).Discussion: Clinicians acknowledged that social factors play a role in deterioration risk; but these factors are infrequently studied in HHC. While a majority of risk factors were represented in the Omaha System, additional terminologies are needed to comprehensively capture risk. Since most risk factors are documented in clinical notes, methods such as natural language processing are needed to extract them.Conclusion: This study engaged clinicians to understand risk for deterioration during HHC. The results of our study support the development of an early warning system by providing a comprehensive list of risk factors grounded in clinician expertize and mapped to standardized terminologies. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies showed that transitional care reduces the complication rate and readmission rate and improves the quality of life in kidney transplant receipts, nevertheless, in fact there are no standard evaluation indexes and debatable scientific of existing indexes in kidney transplant recipients. Therefore, the aim of this study was to construct an evaluation index system to assess the effects of transitional care in kidney transplant recipients. Methods Based on Omaha system, an initial evaluation index system about the effects of transitional care in kidney transplant recipients was drafted by the literature review and semi-structured interview. Two rounds of correspondence were conducted in 19 experts and the analytic hierarchy process (AHP) was used to calculate the weights of all indexes. Results Five first-level indexes, sixteen second-level indexes, and forty-eight third-level indexes were selected in the initial evaluation index system. The authority coefficient of two-round expert consultations was 0.90 and coordination coefficients of indexes ranged from 0.24 to 0.34. Conclusion The established evaluation index system for the effectiveness of transitional care for kidney transplant recipients was scientific and reliable. Furthermore, it would be a potential method to evaluate effects of transitional care in kidney transplant recipients after further examination.

Objective: This study aimed to explore the use of the Omaha System in rehabilitation and nursing methods and the effects on patients within the community who had experienced stroke and previous falls. Methods: This study enrolled 42 patients who had experienced stroke and previous falls and had returned to the community after being discharged from the Department of Neurology and Rehabilitation of the Affiliated Hospital of Nanchang University from January to July 2018. The patients were randomly divided into two groups: an experimental group (n = 21) and a control group (n = 21). Patients in the control group received routine community rehabilitation care, and patients in the experimental group received community rehabilitation care on the basis of the Omaha System. Intervention lasted for 1 year. The Omaha outcome score, the ability to perform activities of daily living (ADL) (measured via the Modified Barthel Index [MBI]), and the incidence of falls for each group were compared before and after the intervention. Results: After 1 year of intervention, the Omaha outcome score and MBI of both groups were higher than before; the Omaha outcome score and MBI of the experimental group were higher than those of the control group; the differences were statistically significant (P < 0.05). No fall occurred in either of the two groups. Conclusion: The Omaha System can comprehensively evaluate the health problems of patients, guide nursing intervention, and quantitatively evaluate the effect of nursing intervention; it is therefore worthy of promotion. [ABSTRACT FROM AUTHOR]

The Omaha System is one of the most applicable classification systems and can be used effectively to recognize occupational health nurse(s) in practice. Describing occupational health nurse interventions and outcomes can be an example for planning care in a specific case such as hair stylist apprentices with hand eczema symptoms by using the Omaha System. The study consists of 15 cases. The "Turkish-Nordic Occupational Skin Questionnaire" was used for data collection related to eczema symptoms. The assessment was made by using electronic health record system based on the Omaha System. For the 15 cases, 113 problems and 624 nursing interventions were reported. According to the Omaha System's Problem Classification Scheme, the frequently diagnosed problems were skin (100%), neighborhood/workplace safety (100%), health care supervision (67%), respiration (53%), and pain (40%). The identified intervention categories were 98.5% about teaching, guidance, and counseling; 89.2% about surveillance; and 6.4% about case management. The occupational health nursing outcomes scores were more likely to show higher level after the intervention (p <.05). The Omaha System can be effectively used in occupational healthcare settings for specific cases in workplaces. [ABSTRACT FROM AUTHOR]

ObjectiveThis study aimed to explore the use of the Omaha System in rehabilitation and nursing methods and the effects on patients within the community who had experienced stroke and previous falls.MethodsThis study enrolled 42 patients who had experienced stroke and previous falls and had returned to the community after being discharged from the Department of Neurology and Rehabilitation of the Affiliated Hospital of Nanchang University from January to July 2018. The patients were randomly divided into two groups: an experimental group (n = 21) and a control group (n = 21). Patients in the control group received routine community rehabilitation care, and patients in the experimental group received community rehabilitation care on the basis of the Omaha System. Intervention lasted for 1 year. The Omaha outcome score, the ability to perform activities of daily living (ADL) (measured via the Modified Barthel Index [MBI]), and the incidence of falls for each group were compared before and after the intervention.ResultsAfter 1 year of intervention, the Omaha outcome score and MBI of both groups were higher than before; the Omaha outcome score and MBI of the experimental group were higher than those of the control group; the differences were statistically significant (P < 0.05). No fall occurred in either of the two groups.ConclusionThe Omaha System can comprehensively evaluate the health problems of patients, guide nursing intervention, and quantitatively evaluate the effect of nursing intervention; it is therefore worthy of promotion.

This study aimed to determine the effect of health screening and school nurse interventions using a community-based, comprehensive practice and documentation system to improve knowledge, behavior, and status scores of primary school students. A quasi-experimental study design with pretest and posttest of a single group was used. The research was conducted between November 2017 and January 2018 with 473 students at a primary school in southern Turkey. Health screening procedures and the Omaha System were used to identify health problems. Evidence-based school nurse interventions were implemented. The outcomes, including knowledge, behaviors, and status scores, were measured using the Problem Rating Scale for Outcomes. The scores were evaluated at the baseline and at the end of 10 weeks. Students' health problems, such as inadequate vision, hypertension, obesity, and second-hand smoke, were identified during the health screening. None of the students was neglected or abused. The most common health problems concerned Oral health, Neuro-musculo-skeletal function, Nutrition, and Vision. The intervention categories included Teaching, Guidance, and Counseling (58.1%); Case Management (20.9%); Surveillance (17.8%); and Treatment and Procedures (3.2%). A significant increase in Knowledge, Behavior, and Status scores was noted after interventions. The results showed that health screening was effective in detecting school-age children's health problems. Knowledge, behavior, and status of primary students improved after school nurse interventions. School nurses can use health screening and evidence-based interventions to protect and improve children's health. The Omaha System enables robust documentation to demonstrate outcomes after interventions. • Health problems detected during health screening can be documented with the Omaha System. • Knowledge, Behavior and Status scores increased after School Nurse Interventions. • Student reported health behavior improved after health screening and study interventions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this data visualization study was to identify patterns in patient‐generated health data (PGHD) of women with and without Circulation signs or symptoms. Specific aims were to (a) visualize and interpret relationships among strengths, challenges, and needs of women with and without Circulation signs or symptoms; (b) generate hypotheses based on these patterns; and (c) test hypotheses generated in Aim 2. Design: The design of this visualization study was retrospective, observational, case controlled, and exploratory. Methods: We used existing de‐identified PGHD from a mobile health application, MyStrengths+MyHealth (N = 383). From the data, women identified with Circulation signs or symptoms (n = 80) were matched to an equal number of women without Circulation signs or symptoms. Data were analyzed using data visualization techniques and descriptive and inferential statistics. Findings: Based on the patterns, we generated nine hypotheses, of which four were supported. Visualization and interpretation of relationships revealed that women without Circulation signs or symptoms compared to women with Circulation signs or symptoms had more strengths, challenges, and needs—specifically, strengths in connecting; challenges in emotions, vision, and health care; and needs related to info and guidance. Conclusions: This study suggests that visualization of whole‐person health including strengths, challenges, and needs enabled detection and testing of new health patterns. Some findings were unexpected, and perspectives of the patient would not have been detected without PGHD, which should be valued and sought. Such data may support improved clinical interactions as well as policies for standardization of PGHD as sharable and comparable data across clinical and community settings. Clinical Relevance: Standardization of patient‐generated whole‐person health data enabled clinically relevant research that included the patients' perspective. [ABSTRACT FROM AUTHOR]

During a pandemic, basic public health precautions must be taken across settings and populations. However, confinement conditions change what can be done in correctional settings. Correctional nursing (CN) care, like all nursing care, needs to be named and encoded to be recognized and used to generate data that will advance the discipline and maintain standards of care. The Omaha System is a standardized interprofessional terminology that has been used since 1992 to guide and document care. In 2019, a collaboration between the newly formed American Correctional Nurses Association and the Omaha System Community of Practice began a joint effort with other stakeholders aimed at encoding evidence-based pandemic response interventions used in CN. The resulting guidelines are included and illustrated with examples from CN practice. [ABSTRACT FROM AUTHOR]

Purpose: To explore resilience in the context of whole‐person health and the social determinants of health at the individual and community levels using large, standardized nursing datasets. Design: A retrospective, observational, correlational study of existing deidentified Health Insurance Portability and Accountability Act (HIPAA)‐compliant data using the Omaha System and its equivalent, Simplified Omaha System Terms. Methods: We used three samples to explore for patterns of resilience: pre‐COVID‐19 community‐generated data (N = 383), pre‐COVID‐19 clinical documentation data (N = 50,509), and during‐COVID‐19 community‐generated data (N = 102). Community participants used the My Strengths + My Health (MSMH) app to generate the two community datasets. The clinical data were obtained from the Omaha System Data Collaborative. We operationalized resilience as Omaha System Status scores of 4 (minimal signs or symptoms) or 5 (no signs or symptoms) as a discrete strengths measure for each of 42 Omaha System problem concepts. We used visualization techniques and standard descriptive and inferential statistics for analysis. Findings: It was feasible to examine resilience, operationalized as strengths by problem concept, within existing Omaha System or Simplified Omaha System Terms (MSMH) data. We identified several patterns indicating strengths and resilience that were consistent with literature related to community connectedness for community participants, and sleep for individuals in the clinical data. Conclusions: When used consistently, the Omaha System within MSMH enabled robust data collection for a comprehensive, holistic assessment, resulting in better whole‐person data including strengths, and enabled us to discover a potentially useful approach for defining resilience in new ways using standardized nursing data. Clinical Relevance: The notion that how we assess individuals and communities (i.e., the completeness of our assessments in relation to whole‐person health) determines what we can know about resilience is seemingly in opposition to the critical need to decrease documentation burden, despite the potential to shift from a problem deficit‐based assessment to one of strengths and resilience. However, a patient‐facing comprehensive assessment that includes resilience and the social determinants of health can provide a transformative, whole‐person platform for strengths‐based care and population management. [ABSTRACT FROM AUTHOR]

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To explore the effects of “hospital–community integrated transitional care” model on quality of life in patients with chronic obstructive pulmonary disease (COPD).

Background: Previous studies showed that transitional care reduces the complication rate and readmission rate and improves the quality of life in kidney transplant receipts, nevertheless, in fact there are no standard evaluation indexes and debatable scientific of existing indexes in kidney transplant recipients. Therefore, the aim of this study was to construct an evaluation index system to assess the effects of transitional care in kidney transplant recipients.Methods: Based on Omaha system, an initial evaluation index system about the effects of transitional care in kidney transplant recipients was drafted by the literature review and semi-structured interview. Two rounds of correspondence were conducted in 19 experts and the analytic hierarchy process (AHP) was used to calculate the weights of all indexes.Results: Five first-level indexes, sixteen second-level indexes, and forty-eight third-level indexes were selected in the initial evaluation index system. The authority coefficient of two-round expert consultations was 0.90 and coordination coefficients of indexes ranged from 0.24 to 0.34.Conclusion: The established evaluation index system for the effectiveness of transitional care for kidney transplant recipients was scientific and reliable. Furthermore, it would be a potential method to evaluate effects of transitional care in kidney transplant recipients after further examination. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to describe and examine the impact of medication intervention practices among African‐American clients in two nurse‐led community nursing centers (CNCs). Methods: This study used a retrospective‐descriptive design. Omaha System data from visits of 196 African‐American adults living with chronic disease and having two or more CNC visits in which medication regimen was an identified problem and the main reason for the visit was analyzed. Results: The sample had a mean age of 53.1 (6.67) and was primarily women (82%), uninsured, and with high school or less education. A total of 9,259 Medication regimen interventions were documented and implemented during 1,146 client CNC visits. A paired samples t test revealed statistically significant improvements in Knowledge (t = 2.434, p <.01). Behavior (t = 0.077, p =.94) and Status (t = 1.489, p =.14) remained unchanged, although the ratings trended toward improvement for each. Conclusion: This study provides evidence that the nursing center model of care does improve the knowledge of medications among African‐American clients. The study also demonstrated the Omaha System's utility to evaluate the impact of nursing interventions in community settings. [ABSTRACT FROM AUTHOR]

Background and aim: There is a need for new approaches and a focus on development of health information technologies for effective hypertension management. The Omaha System is comprehensive, evidence-based, holistic assessment tool for documenting, organizing, and storing clinical data. The aim of this study was to evaluate the problems, nursing interventions and care outcomes of hypertensive individuals in primary care with using the Omaha System, and to examine feasibility of using the Omaha System as a clinical information system in hypertension management. Methodology: The sample included 88 hypertensive patients who taking health care services from the two family health centers in Istanbul. Manual and electronic forms of the Omaha System were used as the assessment instrument. Results: Identified problems were respectively; circulation, nutrition, physical activity, medication regimen, mental health, substance use, health care supervision, sleep and rest patterns, and income. In all selected problems except income; knowledge, behavior and status scores increased significantly. Conclusion: The feasibility of the Omaha System as a guideline to timely and holistic assessment of hypertensive patient in primary care was demonstrated. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of continuing nursing care application in diabetes complicating stroke based on the Omaha system. Methods Ninety-two patients with diabetes complicating stroke in this hospital from September 2018 to August 2019 were selected and divided into the study group and control group according to the admission time, 46 cases in each group. The control group was given the routine nursing. On the basis of routine nursing, the study group was given the continuing care based on the Omaha system. Then the self-management ability score, self-care behavior, nursing effect, and nursing satisfaction were compared between the two groups. Results The self-management ability scores on 3 d before discharge from hospital had no statistical difference between the two groups (P>0.05). The self-management ability scores on 30 dafter discharge from hospital in the study group were significantly higher than those in the control group, the diet, motion, blood glucose monitoring, feet care scores, total effective rate and total satisfaction in the study group were significantly higher than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The continuing care based on the Omaha system has an active effect on improving the self-management level and quality of life in the patients with diabetes complicating stroke and has the significant effect. [ABSTRACT FROM AUTHOR]

Background: To establish a conceptual understanding of the needs of burn patients, the specific research question asked is: "What are the needs of burn patients from 1‐week pre‐discharge to the post‐discharge period?" Methods: Whittemore and Knafl's integrative review approach was used to answer the review question. The databases searched were the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Embase, and Scopus. Thirty‐two primary studies were retained at the end of the screening process. Directed content analysis was undertaken, with the Omaha system as an organizing framework. Results: Recovery after burns is not a linear process, but an intricate one filled with varied needs in the physiological (pain, skin, neuro‐musculo‐skeletal, and infection), psychosocial (social contact, role changes, spirituality, grief, mental health, and sexuality), health‐related behavior (nutrition, sleep and rest patterns, and physical activity), and environmental (income) domains of the Omaha system. The nature and intensity of these needs change over time, suggesting that recovery for the burn patient is an ongoing process. Conclusions: Several needs exist from 1 week before discharge to the post‐discharge period. The mutual relationship and evolving nature of these needs create an avenue for a flexible, regular, holistic transitional program, similar to the support offered to persons living with chronic conditions. Clinical Relevance: Hospital discharge does not imply an end to the recovery of burn patients, and burn survivors still require holistic care even after discharge. The review shows the applicability of the Omaha system in exploring and classifying the needs of burn survivors and situates nursing at the core of such a program. It is possible that a nurse‐led program of care needs to be considered. [ABSTRACT FROM AUTHOR]

Objective To explore the practical effect of the newly continuous nursing mode constructed for patients with enterostomy. Methods With holistic care as the core concept, Omaha system as the theoretical framework, demand level theory and the forgetting curve principle as the reference basis, the model of continuous care for patients with intestinal stoma was established from five aspects : continuous care team, follow up form, follow up frequency, nursing content and nursing process. 128 cases patients who underwent enterostomy for colorectal cancer in the hospital from April to December 2017 were selected as the study subjects and randomly divided into the experimental group (n = 63) and the control group (n=65) through the random number table method. The experimental group implemented the extended care model established above, and the control group received routine discharge care. After 6 months of intervention, the practice effect was analyzed by means of cognitive behavior status (KBS) score, stomatal adaptability, stomatal self care ability, stomatal complication rate and discharge nursing satisfaction. Results The KBS scores of the experimental group before and after the intervention showed statistically significant differences (P < 0.05), and the stomatal adaptability and self care ability were significantly improved compared with those before the intervention (t = -16. 217, 29.287, P< 0.05). In the experimental group, the stoma adaptability, stoma self care ability and nursing service satisfaction were significantly higher than those in the control group, and the incidence of stoma complications was significantly lower than that in the control group, with statistically significant differences ( t = - 9.753, 6.648, - 9.357,X'= 12.098,P<0. 05). Conclusion The continuous nursing model constructed is scientific and practical, which effectively improves the health status of patients with enterostomy, reduces the incidence of complications, improves the stoma adaptability and self care ability, and improves the satisfaction of nursing. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of transitional care based on Omaha system and WeChat platform on the rehabilitation after breast cancer surgery. Methods Totally 98 patients undergoing with axillary lymphadenectomy for breast cancer were selected by a convenient sampling method. Patients were randomly divided into control group and observation group, with 49 each. The control group was given routine nursing after breast cancer surgery, and the observation group was given routine nursing and transitional care based on Omaha system and WeChat platform for 3 months. Follow-up was performed before discharge, 1, 2 and 3 months after surgery. The upper limb circumference was measured and the exercise compliance scale was filled out. Results The rates of lymphedema in the control group in the first, second, and third months were significant higher than those in the intervention group, respectively (P < 0.05). At the end of second and third months after discharge from hospital, the total score of the exercise compliance scale and factor scores of physical exercise, active advice seeking, postoperative precaution were higher than those in the control group (P < 0.05). Conclusion The transitional ere based on the Omaha system and WeChat platform is more conducive to reducing the incidence of postoperative lymphedema in breast cancer patients, improving postoperative exercise compliance and rehabilitation after surgery. [ABSTRACT FROM AUTHOR]

Purpose: This study was aimed to develop and conduct an Omaha system-based continuing nursing program for chronic kidney disease (CKD) patients undergoing peritoneal dialysis (PD) and to explore its effect on patients' nutritional status. Methods: A randomized controlled trial was performed in a teaching hospital in China between June 2017 and July 2018. A total of 203 eligible patients were included and then randomly assigned to the study group (n = 101) or the control group (n = 102). In the study group, health education, treatments and procedures, case management, and surveillance based on the Omaha system were used. In the control group, only common outpatient nursing intervention was given to the patients. Changes in subjective global assessment (SGA), anthropometric measurements including body mass index (BMI), triceps skin-fold thickness (TSF), mid-arm muscle circumference (MAMC), and handgrip strength (HGS), and biochemical parameters (hemoglobin, albumin, pre-albumin, total cholesterol, and creatinine) were evaluated before the intervention and 6 months after the intervention and differences in measurements were analyzed. Results: After intervention, the proportion of well-nourished patients in the study group was significantly improved from 6.19 to 29.90% (χ 2 = 18.441, P < 0.001), and after 6 months, this was higher in the study group than that in the control group (29.90% vs 9.28%, χ 2 = 13.090, P < 0.001). Also, mean TSF, MAMC, and HGS were significantly improved in the study group and after 6 months, these levels were higher in the study group than those in the control group (P < 0.05). In addition, levels of hemoglobin, albumin, and pre-albumin in patients in the study group were significantly increased and after 6 months, these levels were higher in the study group than those in the control group (P < 0.05). Conclusions: The continuing nursing program based on the Omaha system improved patients' nutritional status and should be further examined in future studies. [ABSTRACT FROM AUTHOR]

Aim: To refine and assess the inter‐rater reliability and content validity of the embedded interface of nursing/midwifery activities in the Time Capture Tool (TimeCaT) using an interface terminology, the Omaha System. Methods: This methodological study was conducted in two Family Health Centers (FHCs) in Turkey with a total of 13 nurses and midwives. In phase one, five nurses/midwives in a FHC were observed for a total of 80 hr, and 84 nursing/midwifery activities were generated and validated with 15 content experts. In phase two, the nursing/midwifery activities were mapped to the Omaha System and inter‐rater reliability of the mapping was assessed. The mapping was validated with seven content experts. The nursing/midwifery activities were embedded in the interface of the TimeCaT. In phase three, the embedded interface of the TimeCaT was evaluated while observing eight nurses and midwives in the other FHC. Results: The scale‐level content validity index was 0.98 for the generated activities in phase one and 0.96 for the mapped activities in phase two. Kappa statistics for inter‐rater reliability was 0.88 for Omaha System problems, 0.83 for categories and 0.83 for targets. The nursing/midwifery activities were adequately mapped to the Omaha System. The embedded interface of the TimeCaT has acceptable inter‐rater reliability and content validity values for using in the Turkish FHC context. Conclusion: The study results confirm that the TimeCaT using the Omaha System is a valid and reliable tool to measure nursing/midwifery workflow in FHC settings. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the physical activity (PA) and associated factors among insufficiently active adults attending Family Health Centers in Istanbul, Turkey using the Omaha System. Design and Sample: This descriptive‐correlational study guided by the Ecological Model for Health Promotion used a convenience sample of 335 Turkish adults with insufficient PA behavior defined as an Omaha System PA Behavior rating <4. Measurements: Measures included Omaha System problems; Knowledge, Behavior, and Status ratings; demographics; and ecological factors operationalized with the Omaha System Problem Classification Scheme. Data were analyzed using chi‐square, independent t tests, and logistic regression. Results: Participants were females (76.7%) and males (23.3%) with a mean age of 38.5 years. Almost half (43.6%) engaged in no appropriate PA Behavior. The most common Physiological, Psychosocial, and Environmental domain problem were oral health (61.2%), mental health (21.5%), and neighborhood/workplace safety (41.2%), respectively. Logistic regression revealed marital status, age, sex, and physiological and environmental domain problems significantly predicted PA behavior. Conclusions: Interventions tailored to insufficiently active Turkish adults should include assessing for physiological health problems; targeting older, married adults; and advocating for policy change that supports the provision of safe, affordable, accessible, and culturally appropriate places for physical activity. [ABSTRACT FROM AUTHOR]