Nurses’ behavioral intention in using virtual clinical simulation training: By structural equation modeling

AimTo examine the relationship between the nurses’ behavioral intention to use virtual clinical simulation training and study variables, including perceived usefulness, perceived ease of use, self-efficacy, technology anxiety, perceived enjoyment and personal innovativeness.BackgroundLittle is known about the nurses’ behavioral intentions behind using virtual clinical simulation training.DesignA cross-sectional study.MethodsA total of 206 registered nurses participated in this survey. Data were collected through online survey from March 20, 2021, to April 2, 2021, since entry into the hospital was strictly controlled due to the COVID-19 outbreak.ResultsStructural equation modeling identified that both perceived usefulness and perceived ease of use were the predictors which influenced behavioral intention. Additionally, perceived enjoyment indirectly affected behavioral intention by influencing both perceived usefulness and perceived ease of use.ConclusionThe successful introduction of virtual clinical simulation training depends on nurses’ willingness and acceptance of its use. The findings of this study show that virtual clinical simulation training should be perceived as useful, easy to use and enjoyable to be accepted by nurses. Virtual clinical simulation programs may have the potential to help improve nurses’ clinical skills and competencies in patient care.Tweetable abstractThis study revealed that the usefulness of its contents, ease of use and enjoyment are important to increase nurses' behavioral intention to use virtual clinical simulation training.     

Bladder Cancer Stage Development, 2004-2014 in Europe Compared With the United States: Analysis of European Population-based Cancer Registries,the United States SEER Database,and a Large Tertiary Institutional Cohort

BackgroundThe purpose of this study was to analyze trends of bladder cancer (BC) stages and incidence in Europe and the United States (US).Materials and MethodsTumor stages after radical cystectomy were assessed in a monocentric cohort from 2006 to 2016. BC incidence was assessed between 2004 and 2014 based on the German Center for Cancer Registry Data dataset at the Robert Koch Institute (n = 111,002), the Netherland Cancer Registry (n = 64,226), cancer registration statistics of England (n = 179,883), and the pooled data from the Scandinavian cancer registries, NORDCAN (n = 77,585) and the SEER (Surveillance, Epidemiology, and End Results) database (n = 184,519) for the complete populations and gender-specific subgroups. The average annual percent changes (AAPC) were used for statistical evaluation.ResultsNon–muscle-invasive BC (NMIBC) and muscle-invasive BC (MIBC) did not change in the institutional cohort at the point of radical cystectomy. The incidence of total BC (AAPC, −0.3), NMIBC (AAPC, −0.1), and non-metastasized MIBC (AAPC, 0.1) did not change in Germany during the time period under survey. BC total incidence in the Netherlands did not change significantly. In England and the Nordic countries, the incidence of total BC increased (AAPC, 0.8 and 0.5, respectively). In contrast, both the incidence of total BC (AAPC, −1.4), NMIBC (AAPC, −1.6), and non-metastasized MIBC (AAPC, −1.6) significantly decreased in the US.ConclusionsBetween 2004 and 2014 the incidence of BC was significantly sinking in the US, was stable in Germany and the Netherlands, and increased in England and the Nordic countries. Predominantly, differences in the smoking prevalence within the last decades but also gender-specific factors might be responsible for this discrepancy.     

Circumstances of substance use by street youth in Egypt support the case for intervening to prevent adverse childhood experiences

Background: Egyptian street youth use substances including tobacco, illicit drugs, and pharmaceutical drugs. To understand the circumstances, including adverse childhood experiences, that place adolescents at risk for engaging in substance use, we conducted in-depth interviews among a sample of Egyptian street children. Methods: From youth residing at or attending Caritas, a non-profit organization, which provides shelter and education to street youth, seven girls and twelve boys, aged 12–18 years, participated in open-ended, in-depth interviews. Results: Eight out of the 19 participants reported family history (early exposure) to substance use; and seven of them were initiated by either a family member (sibling), friend or coworker. Most of the participants reported a history of conflict with or abuse (verbal or physical) by their parents or siblings, or stressful situations at home; they used substance(s) to alleviate their stress. Few attended school, and some were forced to work and help their family. Conclusions: Among Egyptian youth, adverse childhood experiences, such as poverty, child abuse, and family substance use, challenge somewhat susceptible youths and lead them to the path of substance use and addiction. Prevention intervention should be multifaceted, culturally adaptable, and primarily targeting the social environment during childhood.