"That's Something for Children"

2022 ◽  
Vol 6 (GROUP) ◽  
pp. 1-35
Author(s):  
Richard Paluch ◽  
Claudia Müller

Robotic systems are increasingly seen as possible technical aids against the background of demographic change and the associated pressures on care systems, with increasing numbers of care recipients and a decreasing number of trained caregivers. In human-computer interaction and computer-supported cooperative work, different design paradigms are currently being pursued to explore which features and appearances are favorable for meaningful interactions of humans with robotic systems. One such approach, labeled as "otherware", proposes to conceptualize robots beyond a naive anthropomorphism or zoomorphism, rather developing the idea of a figure that goes beyond the dichotomy between "being alive" and "being a technical artefact". We present an ethnographic study on the perceptions, attitudes, and practices of care attendants and nursing-home residents in their experimenting with off-the-shelf robotic cats and dogs. The three-week study shows specific appropriation practices of the robotic pets, and how the care attendants - partly together with the residents - define their experiences of the robotic pets, i.e., in which situations the robotic pets are considered either as living beings or as technology toys. The study provides practice-based insights into how possible uses of robotic pets could be meaningfully integrated into care practices, but also which ethical reflections were discussed during their use. Finally, this ethnographic study functioned as a collaborative learning process between researchers, care attendants, and residents, and thus also points out possible aspects that arose with regard to future learning spaces of professional and organizational development for dealing with innovative technologies in residential care contexts.

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Gerard J. Gormley ◽  
Anu Kajamaa ◽  
Richard L. Conn ◽  
Sarah O’Hare

Abstract Background The healthcare needs of our societies are continual changing and evolving. In order to meet these needs, healthcare provision has to be dynamic and reactive to provide the highest standards of safe care. Therefore, there is a continual need to generate new evidence and implement it within healthcare contexts. In recent times, in situ simulation has proven to have been an important educational modality to accelerate individuals’ and teams’ skills and adaptability to deliver care in local contexts. However, due to the increasing complexity of healthcare, including in community settings, an expanded theoretical informed view of in situ simulation is needed as a form of education that can drive organizational as well as individual learning. Main body Cultural-historical activity theory (CHAT) provides us with analytical tools to recognize and analyse complex health care systems. Making visible the key elements of an in situ simulation process and their interconnections, CHAT facilitates development of a system-level view of needs of change. Conclusion In this paper, we theorize how CHAT could help guide in situ simulation processes—to generate greater insights beyond the specific simulation context and bring about meaningful transformation of an organizational activity.


2007 ◽  
Vol 25 (17) ◽  
pp. 2414-2419 ◽  
Author(s):  
Myra Bluebond-Langner ◽  
Jean Bello Belasco ◽  
Ann Goldman ◽  
Carmen Belasco

Purpose To examine US and United Kingdom (UK) parents’ approaches to care and treatment when standard therapy has failed and consider implications for clinical practice. Methods We conducted a prospective, ethnographic study of parents, patients, and staff, including participant-observation; open-ended, semistructured interviews; and review of medical records at a US and UK pediatric oncology center. Thirty-four children (n = 17 US, 17 UK), whose disease had recurred with less than 30% chance of cure, were enrolled between March 2001 and June 2002 and followed until death (n = 11 US, 14 UK) or close of study in December 2005 (n = 6 US, 3 UK). Results There were no major differences between parents’ approaches in the US and UK despite differences in health care systems, institutions, and parents’ religion or ethnicity. All parents continued to have or request meetings with the oncologist and investigative procedures. No parent initiated discontinuation of cancer- or symptom-directed interventions. In 28 of 34 cases (13 US, 15 UK), parents continued to pursue cancer-directed therapies; in 16 of 28 cases (seven US, nine UK), parents initiated inquires beyond what was offered. Conclusion Understanding parents’ behavior requires attention to the reason and emotion they bring to decision making and their children's care, their unique responsibilities as parents, and what they learn throughout the illness. Parents do not see cancer-directed therapy and symptom-directed care as mutually exclusive, alternative approaches. Parents will not be constrained by what the oncologist offers. Physicians and parents discuss and negotiate care and treatment throughout the illness. Our findings suggest developing integrative care models incorporating cancer-directed, symptom-directed, and supportive care throughout the illness; they are most consistent with parents’ approaches and advances in pediatric oncology.


2017 ◽  
Vol 54 (3) ◽  
pp. 400-422 ◽  
Author(s):  
Liana Chase ◽  
Ram P. Sapkota

The recent rise in suicide among Bhutanese refugees has been linked to the erosion of social networks and community supports in the ongoing resettlement process. This paper presents ethnographic findings on the role of informal care practiced by relatives, friends, and neighbors in the prevention and alleviation of mental distress in two Bhutanese refugee communities: the refugee camps of eastern Nepal and the resettled community of Burlington, Vermont, US. Data gathered through interviews ( n = 40, camp community; n = 22, resettled community), focus groups (four, camp community), and participant observation (both sites) suggest that family members, friends, and neighbors were intimately involved in the recognition and management of individual distress, often responding proactively to perceived vulnerability rather than reactively to help-seeking. They engaged practices of care that attended to the root causes of distress, including pragmatic, social, and spiritual interventions, alongside those which targeted feelings in the “heart-mind” and behavior. In line with other studies, we found that the possibilities for care in this domain had been substantially constrained by resettlement. Initiatives that create opportunities for strengthening or extending social networks or provide direct support in meeting perceived needs may represent fruitful starting points for suicide prevention and mental health promotion in this population. We close by offering some reflections on how to better understand and account for informal care systems in the growing area of research concerned with identifying and addressing disparities in mental health resources across diverse contexts.


2004 ◽  
Vol 8 (2) ◽  
pp. 33-41
Author(s):  
Amy L. Kenefick

In this ethnographic study, nurses clearly described their beliefs, values, and experiences related to assessing pain in nursing home residents. These were affected by (a) the nurse’s perception of the role, (b) the resident’s ability to verbalize his or her pain, and (c) the nurse’s skill in identifying behavioral cues including nonverbal pain communications such as agitation or change in functional status. Knowledge of the individual resident was crucial; knowledge of the field of geriatric nursing was also important. Characteristics of the setting including formal and informal job expectations and the use of temporary nursing staff influenced practice.


2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Taghrid Chaaban ◽  
Mathieu Ahouah ◽  
Pierre Lombrail ◽  
Hélene Le Febvre ◽  
Adnan Mourad ◽  
...  

Background: Medication prescription is generally the responsibility of doctors. In nursing homes, the nursing staff is often the first to suspect an infection. Today, physicians are more confident with nursing assessment, relying primarily on nursing staff information. Very few studies have investigated the nurses’ influence on decision of medical prescription. This study investigates the role of nurses in antibiotic prescribing for the treatment of suspected infections in nursing home residents. Design and methods: An ethnographic study based on semi-structured interviews and participant observations was conducted. Sixteen nurses and five doctors working in five nursing homes in Paris, France participated between October 2015 and January 2016. Results: Given their proximity to elderly residents, registered nurses at the nursing homes occasionally assisted doctors in their medical diagnostic. However, nurses who are theoretically incompetent have met difficulties in their ability to participate in their decisions to prescribe antibiotics when managing residents’ infections.Conclusion: if proximity and nursing skills reinforce the relevance of the clinical judgment of nurses, the effective and collaborative communication between the nurse and the doctor may help the nurse to enhance their role in the antibiotic prescribing in nursing homes, which would enhance antimicrobial stewardship efficiency.


2021 ◽  
Vol 11 ◽  
pp. 169-187
Author(s):  
Ram Hari Dhakal

This article attempts to investigate the modern medical practices and the major factors triggering the changes in views, attitudes, and practices among the Hyolmos, an indigenous people residing in high hill region, Helambu, the northeast of Sindhupalchok, central Nepal. This ethnographic study with the key informants' interview, participant observation and household census was employed during a year-long fieldwork. The collected data were thematically analyzed and interpreted. The finding shows that the major triggering factors bringing such changes are education, communication, and transportation that increased awareness among the people for choosing alternative opportunities. Tourism and foreign employment raised the economic level that created better financial options for treatment. Conservation of forest was limited to the performance of herbalists and Amchis. To some extent, inter-caste marriage practice and the urbanization process also increased awareness about the use of western medicine.


Author(s):  
Esther Acevedo Alcaraz

Nursing homes have the characteristic of being “complete institutions” or “enclosed microcosms” and the quality of life (QoL) in late adulthood is generally perceived as a multidimensional construct. Over recent years, media reports have focused on the deficiencies in nursing home residences, and a subsequent increase in the demand for instruments capable of measuring this construct has arisen. Objective: To compare the quantitative functional mobility, level of independence, depressive symptoms and QoL of nursing home residents compared with home care recipients. Methods: have analyzed the quality of life and physical and psychological disorders 400 people over 60 years old, admitted to nursing homes or living with their families through the implementation of a questionnaire covering three different indices (Barthel Index, Yesavage and WHOQOL-OLD) to assess the degree of dependence of people. Results: has resulted in a significant reduction in quality of life of older people living in nursing homes (p<0.001) compared to older usually live with their families. Our results show that the degree of physical and / or psychological dependence on our largest is the determinant for entry into a nursing home in our community (p>0.001) factor. Conclusions: the current model residences require a change that allows responding to the real needs of our elderly institutionalized.


2005 ◽  
Vol 51 (4) ◽  
pp. 301-321 ◽  
Author(s):  
Sidney Z. Moss ◽  
Miriam S. Moss ◽  
Helen K. Black ◽  
Robert L. Rubinstein

Living and dying are inextricably associated in nursing homes. It is not unusual for old nursing home residents to express a wish to die. This article examines interwoven patterns of family responses to resident's wish to die. As part of a multi-site ethnographic study of bereavement in long-term care, we analyzed themes in audio-transcribed in-depth qualitative interviews with 20 family members in two religiously and culturally diverse nursing homes. Rooted in the contexts of the nursing home, the family system, and the socio-cultural milieu, three patterns of family responses emerged: avoidance, disconfirmation, and acceptance of the wish to die. The family members' responses reflect their efforts to make meaning of the resident's wish both for the resident and for themselves. Rather than viewing the wish to die as a symptom of mental health problems, they perceive it as reflecting the existential situation of the resident.


2019 ◽  
Vol 33 (6) ◽  
pp. 677-694 ◽  
Author(s):  
Justin Waring ◽  
Simon Bishop ◽  
Fiona Marshall ◽  
Natasha Tyler ◽  
Robert Vickers

Purpose The purpose of this paper is to investigate how three communication interventions commonly used during discharge planning and care transitions enable inter-professional knowledge sharing and learning as a foundation for more integrated working. These interventions include information communication systems, dedicated discharge planning roles and group-based planning activities. Design/methodology/approach A two-year ethnographic study was carried out across two regional health and care systems in the English National Health Service, focussing on the discharge of stroke and hip fracture patients. Data collection involved in-depth observations and 213 semi-structured interviews. Findings Information systems (e.g. e-records) represent a relatively stable conduit for routine and standardised forms of syntactic information exchange that can “bridge” time–space knowledge boundaries. Specialist discharge roles (e.g. discharge coordinators) support personalised and dynamic forms of “semantic” knowledge sharing that can “broker” epistemic and cultural boundaries. Group-based activities (e.g. team meetings) provide a basis for more direct “pragmatic” knowledge translation that can support inter-professional “bonding” at the cultural and organisational level, but where inclusion factors complicate exchange. Research limitations/implications The study offers analysis of how professional boundaries complicate discharge planning and care transition, and the potential for different communication interventions to support knowledge sharing and learning. Originality/value The paper builds upon existing research on inter-professional collaboration and patient safety by focussing on the problems of communication and coordination in the context of discharge planning and care transitions. It suggests that care systems should look to develop multiple complementary approaches to inter-professional communication that offer opportunities for dynamic knowledge sharing and learning.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S547-S547
Author(s):  
Christine E Bishop

Abstract With the promise of better care coordination, better member outcomes, and lower costs, Medicare and state Medicaid programs are implementing population-based payment systems for older adults. Medicare Advantage (MA) plans are responsible for Medicare services for their members, Medicaid managed long-term services and supports (MLTSS) programs cover a broad span of Medicaid benefits, and some state initiatives enroll beneficiaries dually eligible for both Medicaid and Medicare and integrate benefits from the two programs. Simultaneously, Medicaid programs are attempting to shift LTSS utilization away from nursing homes and toward home and community based services (HCBS). The presentations for this symposium address aspects of this changing landscape using Medicare and Medicaid claims and other data and causal econometric models. The first paper considers the effect of MA utilization on SNF staffing, quality, and financial health. The second paper compares medical care utilization outcomes, specifically risk of hospitalization, for Medicaid nursing home residents to outcomes for similar Medicaid members receiving HCBS. The third paper presents an MLTSS initiative in one state in the context of national developments and considers the challenges of evaluating its impact. The fourth paper compares hospitalization rates for MLTSS populations to rates for dually eligible-beneficiaries not enrolled in MLTSS. The discussion will bring findings together to assess early gains and costs as these systems of care evolve.


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