Fontaine Guillaume, Cossette Sylvie
Author Affiliations: Clinical Epidemiology Program, Ottawa Hospital Research Institute; and Faculty of Medicine, University of Ottawa, Ontario; and Research Centre, Université de Montréal Hospital Centre (Dr Fontaine); and Faculty of Nursing, Université de Montréal; and Montreal Heart Institute Research Center (Dr Cossette), Quebec, Canada.
Comput Inform Nurs. 2023 Mar 1;41(3):130-141. doi: 10.1097/CIN.0000000000000942.
Brief counseling, when provided by adequately trained nurses, can motivate and support patient health behavior change. However, numerous barriers can impede nurses' capability and motivation to provide brief counseling. Theory-based interventions, as well as information and communication technologies, can support evidence-based practice by addressing these barriers. The purpose of this study was to document the development process of the E_MOTIV asynchronous, theory-based, adaptive e-learning program aimed at supporting nurses' provision of brief counseling for smoking cessation, healthy eating, and medication adherence. Development followed French's stepwise theory- and evidence-based approach: (1) identifying who needs to do what, differently, that is, provision of brief counseling in acute care settings by nurses; (2) identifying determinants of the provision of brief counseling; (3) identifying which intervention components and mode(s) of delivery could address determinants; and (4) developing and evaluating the program. The resulting E_MOTIV program, guided by the Theory of Planned Behavior, Cognitive Load Theory, and the concept of engagement, is unique in its adaptive functionality-personalizing program content and sequence to each learners' beliefs, motivation, and learning preferences. E_MOTIV is one of the first adaptive e-learning programs developed to support nurses' practice, and this study offers key insights for future work in the field.
当由训练有素的护士提供简短咨询时，可以激发并支持患者健康行为的改变。然而，众多障碍可能会阻碍护士提供简短咨询的能力和积极性。基于理论的干预措施以及信息和通信技术，可以通过消除这些障碍来支持循证实践。本研究的目的是记录E_MOTIV异步、基于理论的适应性电子学习项目的开发过程，该项目旨在支持护士为戒烟、健康饮食和药物依从性提供简短咨询。开发遵循了弗伦奇基于理论和证据的逐步方法：（1）确定谁需要以不同方式做什么，即在急性护理环境中由护士提供简短咨询；（2）确定提供简短咨询的决定因素；（3）确定哪些干预组件和交付模式可以解决这些决定因素；（4）开发并评估该项目。由此产生的E_MOTIV项目以计划行为理论、认知负荷理论和参与概念为指导，其适应性功能独具特色——根据每个学习者的信念、动机和学习偏好对项目内容和顺序进行个性化设置。E_MOTIV是最早开发的支持护士实践的适应性电子学习项目之一，本研究为该领域的未来工作提供了关键见解。
