Huang Huanhuan, Chen Zhiyu, Chen Lijuan, Du Xingyao, Huang Qi, Jia Wenbi, Zhao Qinghua
Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, 1st Youyi Road, Chongqing, 400016, China, 86 89012206.
Nursing Research Centre, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
JMIR Med Inform. 2025 Jul 2;13:e65445. doi: 10.2196/65445.
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.
This study aimed to investigate and understand nurses' experience regarding barriers to providing Internet Plus continuous nursing.
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.
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.
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.
在中国老龄化和数字化的双重背景下，“互联网+延续护理”这一新型医疗模式备受关注。然而，鲜有研究报道该实践实施过程中潜在的障碍和挑战。
本研究旨在调查并了解护士在提供互联网+延续护理时遇到的障碍。
采用序列混合研究设计。第一阶段，使用自制问卷将障碍和挑战量化为3个领域：管理、关系和信息连续性。第二阶段，邀请参与互联网+延续护理项目的护士参加半结构化访谈，以进一步探索、解释和理解这些数据背后的复杂性，获取有关参与者经历、观点和意义的更详细信息。
最终分析选取了来自312家医院的4638名参与者；调查的调整后平均分为3.49（标准差0.83）。在这3个领域中,管理连续性得分最低（平均3.32，标准差0.97），其次是关系连续性（平均3.44，标准差0.9）和信息连续性（平均3.62，标准差0.92）。多变量分析结果显示，年龄、教育水平和工作年限较长是互联网+延续护理连续性的预测因素（P<0.001）。定性研究后，从72个初始编码中提炼出8个子主题，并归纳为3个主题：组织变革、实践变革和未来方向。
这项混合研究表明，中国护士在提供互联网+延续护理时可能面临不同的挑战，尤其是在管理连续性方面。为了更好地造福患者并改善医疗服务，医疗机构和政策制定者应实施策略以改善跨学科关系、建立和完善组织管理并加强沟通。
