Nurses’ Experience Regarding Barriers to Providing Internet Plus Continuous Nursing: Mixed Methods Study
Bibliographic record
Abstract
Background: The novel medical model of "Internet Plus continuous nursing" has received much attention under the dual background of aging and digitalization in China. However, there is a scarcity of studies that report on the potential barriers and challenges associated with the implementation of this practice. Objective: This study aimed to investigate and understand nurses' experience regarding barriers to providing Internet Plus continuous nursing. Methods: A sequential mixed methods design was adopted. In the first phase, a self-made questionnaire was used to quantify the barriers and challenges into 3 domains: management, relational, and information continuity. In the second phase, nurses who participated in the Internet Plus continuous nursing program were invited to attend semistructured interviews to further explore, explain, and understand the complexities behind these data, obtaining more detailed information on participants' experiences, perspectives, and meanings. Results: A total of 4638 participants from 312 hospitals were selected for the final analysis; the adjusted mean score of the survey was 3.49 (SD 0.83). Among the 3 domains, management continuity had the lowest score (mean 3.32, SD 0.97), followed by relational continuity (mean 3.44, SD 0.9) and information continuity (mean 3.62, SD 0.92). The results of the multivariable analysis showed that age, education level, and a greater number of working years were predictors of continuity for Internet Plus continuous nursing (P<.001). Following the qualitive study, 8 subthemes emerged from 72 initial codes and were grouped into 3 themes: organizational changes, practice changes, and future directions. Conclusions: This mixed methods study revealed that Chinese nurses may have differential challenges when providing Internet Plus continuous nursing, particularly in management continuity. To better benefit patients and improve health care delivery, health care organizations and policymakers should implement strategies to improve interdisciplinary relationships, establish and perfect organizational management, and enhance communication.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".