Pictures and a thousand words: the experiences of significant others whose loved ones have a severe brain injury who are being discharged home

Purpose: To investigate the experiences of significant others when their loved one with a severe acquired brain injury (ABI) is being discharged from an ABI-specific rehabilitation unit. Participants: Significant others of loved ones with an ABI participated in interviews close to their loved ones being discharged from inpatient ABI rehabilitation. Methods: Semi-structured interviews were conducted, and thematic analysis applied. Additionally, the drawing method was also used which involved participants drawing what it was like for them as their loved one was going home. Image analysis was then combined with the interview data. Results: Eight significant others participated in interviews on discharge and completed a drawing describing their experience. Five themes were identified (Change, Mixed feelings, Support of family and friends, Journey and Staff interactions). Conclusion: The experience of having a loved one with a severe ABI in rehabilitation is an emotional event. Compassionate communication, consistency of information and thorough discharge planning practices were cornerstones to enhancing the experience of significant others, empowering them to undertake their new role.

“I'm Being Forced to Make Decisions I Have Never Had to Make Before”: Oncologists' Experiences of Caring for Seriously Ill Persons With Poor Prognoses and the Dilemmas Created by COVID-19

PURPOSE: The COVID-19 pandemic has created a new set of problems for clinicians. This study examines the experiences of oncologists providing care to seriously ill persons near the end of life in the context of the COVID-19 pandemic. METHODS: Between January 2020 and August 2020, we conducted semistructured, in-depth individual interviews with 22 purposefully sampled oncologists from practices enrolled in the Michigan Oncology Quality Consortium. Deidentified transcripts of the interviews were examined using thematic analysis. RESULTS: Our respondents described several novel problems created by the COVID-19 pandemic, including: (1) ethical challenges, (2) the need to manage uncertainty—physically and emotionally—on the part of both patients and oncologists, and (3) the difficulty of integrating technology and communication for seriously ill persons. These problems were made more complex by features of the pandemic: resource scarcity (and the need to fairly allocate poor resources), delays in care, high levels of fear, and the increased importance of advance care planning. Nonabandonment served as a way to cope with increased stress, and the use of telemedicine became an increasingly important medium of communication. CONCLUSION: This study offers an in-depth exploration of the problems faced by oncologists as a result of the COVID-19 pandemic and how they navigated them. Optimal decision making for seriously ill persons with cancer during the COVID-19 pandemic must include open acknowledgment of the ethical challenges involved, the emotions experienced by both patients and their oncologists, and the urgent need to integrate technology with compassionate communication in determining patient preferences.

‘Good’ and ‘Bad’ deaths during the COVID-19 pandemic: insights from a rapid qualitative study

Dealing with excess death in the context of the COVID-19 pandemic has thrown the question of a ‘good or bad death’ into sharp relief as countries across the globe have grappled with multiple peaks of cases and mortality; and communities mourn those lost. In the UK, these challenges have included the fact that mortality has adversely affected minority communities. Corpse disposal and social distancing guidelines do not allow a process of mourning in which families and communities can be involved in the dying process. This study aimed to examine the main concerns of faith and non-faith communities across the UK in relation to death in the context of the COVID-19 pandemic. The research team used rapid ethnographic methods to examine the adaptations to the dying process prior to hospital admission, during admission, during the disposal and release of the body, during funerals and mourning. The study revealed that communities were experiencing collective loss, were making necessary adaptations to rituals that surrounded death, dying and mourning and would benefit from clear and compassionate communication and consultation with authorities.

Development Issues of Healthcare Robots: Compassionate Communication for Older Adults with Dementia

Although progress is being made in affective computing, issues remain in enabling the effective expression of compassionate communication by healthcare robots. Identifying, describing and reconciling these concerns are important in order to provide quality contemporary healthcare for older adults with dementia. The purpose of this case study was to explore the development issues of healthcare robots in expressing compassionate communication for older adults with dementia. An exploratory descriptive case study was conducted with the Pepper robot and older adults with dementia using high-tech digital cameras to document significant communication proceedings that occurred during the activities. Data were collected in December 2020. The application program for an intentional conversation using Pepper was jointly developed by Tanioka’s team and the Xing Company, allowing Pepper’s words and head movements to be remotely controlled. The analysis of the results revealed four development issues, namely, (1) accurate sensing behavior for “listening” to voices appropriately and accurately interacting with subjects; (2) inefficiency in “listening” and “gaze” activities; (3) fidelity of behavioral responses; and (4) deficiency in natural language processing AI development, i.e., the ability to respond actively to situations that were not pre-programmed by the developer. Conversational engagements between the Pepper robot and patients with dementia illustrated a practical usage of technologies with artificial intelligence and natural language processing. The development issues found in this study require reconciliation in order to enhance the potential for healthcare robot engagement in compassionate communication in the care of older adults with dementia.