CJNR Editorial Vol. 39, No. 1, March 2007
Health Information Technology and Nursing Care
Carmen G. Loiselle and Sylvie Cossette
Nursing in the information age presents ample opportunities to transcend
disciplinary, socio-economic, and geographical boundaries to enhance
health-related outcomes.
With this first CJNR issue on Health Information Technology and Nursing
Care, Drs. Gottlieb and Clarke had the vision of setting up a context
for nurse researchers and others engaged in this booming field to share
expertise on timely topics such as the latest knowledge developments,
methodological challenges, and informative study findings as well as
future directions.
Described as society's most knowledge-intensive environments (Snyder-Halpern,
Corcoran-Perry, & Narayan, 2001; Sorrells-Jones & Weaver, 1999),
health-care settings (which include health-care sites, health-care systems,
and individual users) have been transformed by the information age and
associated communication technologies. Ready access to timely information
means that clinicians, administrators, policy-makers, researchers, and
the public can more proactively engage in the processes of accessing
health care, engaging in preventive actions, managing illness and trauma,
considering treatment options, and ensuring follow-up care - regardless
of where people live. However, with dramatic increases in health information
and technology, nursing has begun to address critical issues pertaining
to quality, usability, and equity of informational support while keeping
in mind the context of users' background in terms of age, literacy,
health and socio-economic status, and culture.
Although the concepts of health information technology, health informatics,
nursing informatics, and e-health have yet to be clearly delineated,
the articles presented herein share the goal of generating new knowledge
and innovative care interventions that address the above issues to ensure
that the resulting care approaches are safe, timely, effective, and
efficient while responding to the needs of individuals (see also Bakken,
2006). In their study undertaken in Leuven, Belgium, on the effectiveness
of a videophone nursing intervention on functioning of the homebound
elderly, Drs. Arneart and Delesie show how such interventions enhance
functioning for subgroups such as the elderly with restricted resources,
whether family, social, or professional. Because home-based services
are key to future health-care delivery, this article contributes to
our knowledge about the types of interventions that are most suitable
to particular groups of individuals. The findings of Drs. Arnaert and
Delesie underscore the need to address issues of what, when, to whom,
and how in terms of nursing interventions in the context of increasingly
limited health-care resources.
In their cutting-edge study, Dr. Bottorff and her colleagues tested
the impact of providing individualized information about personal risk
for breast cancer on women's intention to undergo yearly breast cancer
screening and on their perceptions of breast cancer risk status. This
article informs nursing practice that relevant information provided
to women enhances their self-confidence in engaging in preventive behaviours.
This study also suggests that providing patients with health-related
information does not necessarily increase their anxiety. Although general
information about health and illness is widely available through e-health,
personally relevant diagnostic information such as presented in this
article, although often difficult to access, can be of great benefit
to people.
The article by Drs. Kennedy and Hannah on the impact of an international
classification system for nursing practice on health-care outcomes informs
readers about the reliability of using standardized language to document
nursing practice in various health-care settings. As Dr. Mathieu points
out in the Discourse, there is an emerging trend towards the use of
uniform nursing language to demonstrate the impact of specific nursing
interventions on health-related outcomes across settings. Drs. Kennedy
and Hannah provide evidence that the development of such a system can
be well informed by research pertaining to nursing phenomena, nursing
actions, and nursing outcomes.
Dr. Kerr and her colleagues test the contribution of two different
preventive messages (tailored and targeted, provided through interactive
game-type multimedia) on use of hearing protection among construction
workers. Although noise-induced hearing loss is a major public health
problem, conventional educational messages certainly did not attain
their goal of modifying behaviour in this population, some three quarters
of whom are affected by significant hearing loss. This article informs
nursing practice by suggesting that social and interpersonal influences
and perceptions of both barriers and benefits play important roles in
explaining use of hearing protection.
Through a broad lens that includes the fields of consumer psychology
and marketing, Ma and his colleagues propose an interesting research
paradigm that involves both psychological and biological indicators
of stress related to mammography screening, using a computer-based imagery
technique instead of relying solely on self-report of stress. These
more sensitive measures show promise for detecting biomarkers of stress.
By knowing if and how various preventive screening procedures induce
stress, nurses will be able to design more targeted interventions to
help alleviate such stress.
Last, Dr. Nguyen and her colleagues discuss methodological challenges
in study design in e-health intervention studies. The discussion centres
on issues encountered in previous studies but is also informed by the
authors' own ongoing intervention work. Because the scientific underpinnings
pertaining to e-health interventions remain in early developmental stages,
there is ample opportunity for such theoretical and methodological discussions.
Recent research advances in the field are indeed well represented by
the series of papers selected for this issue of CJNR. These works attest
to nursing's readiness to engage actively in advancing the enriched
care environment afforded by health information technology. A remaining
challenge is to more directly address topics that have yet to receive
enhanced empirical attention, such as e-health literacy, impact of e-technology
on nursing practice and outcomes, acceptance and use of health information
technology, patients' privacy and confidentiality issues, and the impact
of nursing informatics on the nurse-patient relationship. Health information
technology in nursing care is at a most promising juncture, with immense
potential for advances in research, education, administration, and practice.
The dynamic and responsive research agenda in nursing informatics being
formed worldwide is likely to benefit both those receiving nursing care
and the providers of such care.
References
Bakken, S. (2006). Informatics for patient safety: A nursing research
perspective. Annual Review of Nursing Research, 24, 219-254.
Snyder-Halpern, R., Corcoran-Perry, S., & Narayan, S. (2001). Developing
clinical practice environments supporting the knowledge work of nurses.
Computers in Nursing, 19(1), 17-26.
Sorrells-Jones, J., &Weaver, D. (1999). Knowledge workers and knowledge-intense
organizations. Part 1: A promising framework for nursing and healthcare.
Journal of Nursing Administration, 29(7/8), 12-18.
Carmen G. Loiselle, N, PhD, is Assistant Professor, School of Nursing,
and Director, Oncology Nursing Program, McGill University; Senior Researcher,
SMBD Jewish General Hospital; and Scientific Director, Psychosocial
Oncology Research Training (PORT) program, Montreal, Quebec, Canada.
Sylvie Cossette, N, PhD, is Associate Professor, Faculté des
sciences infirmières, Université de Montréal, Researcher,
Centre de recherche de l'Institut de cardiologie de Montréal,
and Co-director, Groupe de recherche interuniversitaire en sciences
infirmières de Montréal.
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