Majda Pajnkihar

Mobile Applications for Control and Self Management of Diabetes: A Systematic Review

Mobile applications (apps) can be very useful software on smartphones for all aspects of people’s lives. Chronic diseases, such as diabetes, can be made manageable with the support of mobile apps. Applications on smartphones can also help people with diabetes to control their fitness and health. A systematic review of free apps in the English language for smartphones in three of the most popular mobile app stores: Google Play (Android), App Store (iOS) and Windows Phone Store, was performed from November to December 2015. The review of freely available mobile apps for self-management of diabetes was conducted based on the criteria for promoting diabetes self-management as defined by Goyal and Cafazzo (monitoring blood glucose level and medication, nutrition, physical exercise and body weight). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was followed. Three independent experts in the field of healthcare-related mobile apps were included in the assessment for eligibility and testing phase. We tested and evaluated 65 apps (21 from Google Play Store, 31 from App Store and 13 from Windows Phone Store). Fifty-six of these apps did not meet even minimal requirements or did not work properly. While a wide selection of mobile applications is available for self-management of diabetes, current results show that there are only nine (5 from Google Play Store, 3 from App Store and 1 from Windows Phone Store) out of 65 reviewed mobile apps that can be versatile and useful for successful self-management of diabetes based on selection criteria. The levels of inclusion of features based on selection criteria in selected mobile apps can be very different. The results of the study can be used as a basis to prvide app developers with certain recommendations. There is a need for mobile apps for self-management of diabetes with more features in order to increase the number of long-term users and thus influence better self-management of the disease.

Patterns of clinical mentorship in undergraduate nurse education: A comparative case analysis of eleven EU and non-EU countries.

BACKGROUND In spite of the number of studies available in the field and policy documents developed both at the national and the international levels, there is no reliable data available regarding the variation of roles occupied by clinical mentors (CMs) across countries. OBJECTIVES To describe and compare the CMs role; responsibilities; qualifications; employment requirements and experience in undergraduate nurse education as enacted in 11 European Union (EU) and non- EU countries. DESIGN A case study design. PARTICIPANTS AND SETTING A panel of expert nurse educators from 11 countries within and outside of the EU (Croatia, Czech Republic, England, Iceland, Ireland, Italy, Poland, Serbia, Slovenia, Spain, and the USA). METHODS A questionnaire containing both quantitative and qualitative questions was developed and agreed by the panel using a Nominal Group Technique (NGT); four cycles of data collection and analysis were conducted involving key experts in nursing education in each country. RESULTS In all countries, there are at least two types of clinical mentorship dedicated to undergraduate nursing students: the first is offered by higher education institutions, and the second is offered by health care providers. Variation was noted in terms of profile, responsibilities and professional requirements to act as a CM; however, the CM role is mainly carried out by registered nurses, and in most countries there are no special requirements in terms of education and experience. Those who act as CMs at the bedside continue to manage their usual caseload, thus the role adds to their work burden. CONCLUSIONS Whilst it is imperative to have respect for the different national traditions in undergraduate nurse education, the globalisation of the nursing workforce and greater opportunities for student mobility during the course of their undergraduate education suggests that in areas such as clinical mentorship, jurisdictions, particularly within the EU, should work towards greater system harmonisation.

Clinical practice models in nursing education: implication for students' mobility.

BACKGROUND In accordance with the process of nursing globalization, issues related to the increasing national and international mobility of student and qualified nurses are currently being debated. Identifying international differences and comparing similarities for mutual understanding, development and better harmonization of clinical training of undergraduate nursing students is recommended. AIMS The aim of the study was to describe and compare the nature of the nursing clinical practice education models adopted in different countries. METHODS A qualitative approach involving an expert panel of nurses was adopted. The Nominal Group Technique was employed to develop the initial research instrument for data collection. Eleven members of the UDINE-C network, representing institutions engaged in the process of professional nursing education and research (universities, high schools and clinical institutes), participated. Three data collection rounds were implemented. An analysis of the findings was performed, assuring rigour. RESULTS Differences and homogeneity are reported and discussed regarding: (a) the clinical learning requirements across countries; (b) the prerequisites and clinical learning process patterns; and (c) the progress and final evaluation of the competencies achieved. CONCLUSIONS A wider discussion is needed regarding nursing student exchange and internalization of clinical education in placements across European and non-European countries. A clear strategy for nursing education accreditation and harmonization of patterns of organization of clinical training at placements, as well as strategies of student assessment during this training, are recommended. There is also a need to develop international ethical guidelines for undergraduate nursing students gaining international experience.

Is caring a lost art in nursing

In her recent editorial Juliet Corbin asked the question ‘is caring a lost art in nursing’ (Corbin, 2008). Let us begin with an answer from my perspective in Slovenia, one of the ‘new’ European States; my answer is no, it is not; rather it is the opposite. Caring is a growing art in nursing’’. Nursing is commonly defined as a caring profession. The definition in the English Collins dictionary (1999, p. 243), reads ‘‘the caring professions are those such as nursing and social work that are involved with looking after people who are ill or who need help in coping with their lives’’. There is no easy way to translate the term ‘‘caring’’ into Slovene. I have paraphrased it for Slovene understanding with ‘‘care about and care for’’ the patient, family and society at large (Pajnkihar, 2003). The core of nursing has roots from the very beginning in care for others (children, parents, relatives) therefore it is not surprising that elements of caring are also found in Nightingale’s work ‘‘Notes on Nursing’’. In Nightingale’s times and conditions it is more than reasonable that she described nursing only from the point of view of the physical environment and well-being of patients. The biomedical model employed in nursing from Nightingale’s time to the 1950s and in some countries much longer than that, did not consider ‘‘caring’’ in the way it is understood today. Many authors describe nursing practice within a biomedical model, which is largely tied to a traditional approach and has been rejected by many patients and nurses. Authors such as Wright (1995), Hawthorne and

Evaluation of Major Online Diabetes Risk Calculators and Computerized Predictive Models

Classical paper-and-pencil based risk assessment questionnaires are often accompanied by the online versions of the questionnaire to reach a wider population. This study focuses on the loss, especially in risk estimation performance, that can be inflicted by direct transformation from the paper to online versions of risk estimation calculators by ignoring the possibilities of more complex and accurate calculations that can be performed using the online calculators. We empirically compare the risk estimation performance between four major diabetes risk calculators and two, more advanced, predictive models. National Health and Nutrition Examination Survey (NHANES) data from 1999–2012 was used to evaluate the performance of detecting diabetes and pre-diabetes. American Diabetes Association risk test achieved the best predictive performance in category of classical paper-and-pencil based tests with an Area Under the ROC Curve (AUC) of 0.699 for undiagnosed diabetes (0.662 for pre-diabetes) and 47% (47% for pre-diabetes) persons selected for screening. Our results demonstrate a significant difference in performance with additional benefits for a lower number of persons selected for screening when statistical methods are used. The best AUC overall was obtained in diabetes risk prediction using logistic regression with AUC of 0.775 (0.734) and an average 34% (48%) persons selected for screening. However, generalized boosted regression models might be a better option from the economical point of view as the number of selected persons for screening of 30% (47%) lies significantly lower for diabetes risk assessment in comparison to logistic regression (p < 0.001), with a significantly higher AUC (p < 0.001) of 0.774 (0.740) for the pre-diabetes group. Our results demonstrate a serious lack of predictive performance in four major online diabetes risk calculators. Therefore, one should take great care and consider optimizing the online versions of questionnaires that were primarily developed as classical paper questionnaires.

Bologna process, more or less: nursing education in the European economic area: a discussion paper.

Abstract The Bologna Declaration and the subsequent processes is the single most important reform of higher education taking place in Europe in the last 30 years. Signed in 1999, it includes 46 European Union countries and aimed to create, a more coherent, compatible, comparable and competitive European Higher Education Area. The purpose of this paper is to discuss the Bologna Declaration achievements in nursing education at 2010 within eight countries that first signed the Declaration on 1999. Researchers primarily identified national laws, policy statements, guidelines and grey literature; then, a literature review on Bologna Declaration implementation in nursing was conducted on the Medline and CINAHL databases. Critical analyses of these documents were performed by expert nurse educators. Structural, organizational, functional and cultural obstacles are hindering full Bologna Process implementation in nursing education within European Economic Area. A call for action is offered in order to achieve a functionally unified system within nursing.

Validation of the Finnish Diabetes Risk Score (FINDRISC) questionnaire for undiagnosed type 2 diabetes screening in the Slovenian working population

We performed a cross-sectional population-based study on 632 participants, aged 20-65, who were screened using the Finnish Diabetes Risk Score (FINDRISC) questionnaire. Optimal results for men were achieved at FINDRISC⩾7 (100.0% sensitivity and 0.78 AUC) and for women at FINDRISC⩾13 (60.0% sensitivity and 0.78 AUC).

Theoretical Foundations of Nursing Practice in Poland

This authors of this column explore the use of nursing theory in Poland. A quasi-experimental pretest-posttest study was conducted to explore what, if any nursing theories were used by nurses in Poland, and if an education program on nursing theory increased the use of nursing theory. The study found that while there were discrepancies between the nurses’ theoretical knowledge base and their use of these theories in practice, there is evidence of the use of the ideas and theory of Nightingale, Orem, and Henderson in nursing practice in Poland.

Psychometric testing of the Slovenian Person-centred Climate Questionnaire - staff version

AIM To test the psychometric properties of the Slovenian version of the Person-centred Climate Questionnaire - staff version. BACKGROUND Person-centredness can be a quality care indicator, but there are no valid and reliable instruments in the Slovene language aimed at exploring the person-centred care climate from a nursing staff perspective. METHODS Content validity based on expert agreement was evaluated by calculating content validity indices. A cross-sectional survey design using a convenience sample of 790 nurses and nursing assistants from medical and surgical wards in 11 hospitals was used to test the construct validity and internal consistency reliability. RESULTS The average content validity index for the scale was 0.97, all items had content validity indices higher than 0.78, showing satisfactory content validity. Three components, climate of safety, community and everydayness explained 71.22% of the variance in the data and thus confirmed scale dimensionality. Cronbachs α was acceptable for whole scale (0.90) and for subscales (0.89, 0.89 and 0.86). CONCLUSION The Slovene version of the Person-centred Climate Questionnaire - staff version is valid and reliable and can be further used in surgical and medical wards in hospital settings. IMPLICATION FOR NURSING MANAGEMENT The instrument enables further exploration of the relationships between perceived person-centredness and organisational outcomes.

Challenges associated with missing data in electronic health records: A case study of a risk prediction model for diabetes using data from Slovenian primary care

The increasing availability of data stored in electronic health records brings substantial opportunities for advancing patient care and population health. This is, however, fundamentally dependant on the completeness and quality of data in these electronic health records. We sought to use electronic health record data to populate a risk prediction model for identifying patients with undiagnosed type 2 diabetes mellitus. We, however, found substantial (up to 90%) amounts of missing data in some healthcare centres. Attempts at imputing for these missing data or using reduced dataset by removing incomplete records resulted in a major deterioration in the performance of the prediction model. This case study illustrates the substantial wasted opportunities resulting from incomplete records by simulation of missing and incomplete records in predictive modelling process. Government and professional bodies need to prioritise efforts to address these data shortcomings in order to ensure that electronic health record data are maximally exploited for patient and population benefit.