The core qualities could serve as target areas for the development of interventions aimed at modifying provider behaviours so that trust can be established, maintained or improved. Future prospective longitudinal research studies are needed that enhance understanding of trust with multiple primary care provider types.

Study Objectives: To assess the sleep detection and staging validity of a non-contact, commercially available bedside bio-motion sensing device (S+, ResMed) and evaluate the impact of algorithm updates. Methods: Polysomnography data from 27 healthy adult participants was compared epoch-by-epoch to synchronized data that were recorded and staged by actigraphy and S+. An update to the S+ algorithm (common in the rapidly evolving commercial sleep tracker industry) permitted comparison of the original (S+V1) and updated (S+V2) versions. Results: Sleep detection accuracy by S+V1 (93.3%), S+V2 (93.8%), and actigraphy (96.0%) was high; wake detection accuracy by each (69.6%, 73.1%, and 47.9%, respectively) was low. Higher overall S+ specificity, compared to actigraphy, was driven by higher accuracy in detecting wake before sleep onset (WBSO), which differed between S+V2 (90.4%) and actigraphy (46.5%). Stage detection accuracy by the S+ did not exceed 67.6% (for stage N2 sleep, by S+V2) for any stage. Performance is compared to previously established variance in polysomnography scored by humans: a performance standard which commercial devices should ideally strive to reach. Conclusions: Similar limitations in detecting wake after sleep onset (WASO) were found for the S+ as have been previously reported for actigraphy and other commercial sleep tracking devices. S+ WBSO detection was higher than actigraphy, and S+V2 algorithm further improved WASO accuracy. Researchers and clinicians should remain aware of the potential for algorithm updates to impact validity.

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All nurses and nursing students today must be able assess patients for health literacy limitations and intervene to assure patient understanding of important health information. In this article the authors discuss the significance of the health literacy problem and share strategies for identifying and intervening with patients who have limited health literacy. They also describe how they incorporated health literacy content into their nursing education program and assessed the impact of this brief, health literacy education session. The analysis and results of this assessment indicated both a significant increase in student knowledge related to health literacy and the need for nurses to assess more fully patients’ understanding of what they have been taught. Patient initiative in asking for assistance in understanding health-related information was limited. Discussion and implications of these findings for nursing education and nursing practice are provided.