Concept Of Care Research Articles

Evaluation of the nation-wide implementation of ALS home monitoring & coaching: an e-health innovation for personalized care for patients with motor neuron disease

BackgroundTo improve the care for patients with motor neuron disease an e-health innovation for continuous monitoring of disease progression and patients’ well-being (ALS H&C) was implemented in 10 multidisciplinary rehabilitation settings. The first aim was to evaluate the implementation of ALS H&C by assessing several implementation outcomes, technology acceptance and usability of the innovation according to the end users. The secondary aim was to explore differences in these outcomes between the teams with sustainable and unsustainable implementation.MethodsThe chosen implementation strategy was a combination of the implementation process model by Grol & Wensing and a participatory action research approach. In three meetings with multidisciplinary project groups the innovation was introduced, the expected barriers/facilitators identified, and action plans to resolve each barrier developed. After a 3-month pilot phase, patients and their healthcare providers were asked to complete an online evaluation survey to assess implementation outcomes, based on Proctor’s evaluation framework (i.e., acceptability, feasibility, fidelity, sustainability). Telemedicine technology acceptance was assessed according the technology acceptance model of Chau, and user experiences with the System Usability Scale (SUS). Implementation outcomes of teams with sustainable implementation (continuation after completion of the pilot phase) and unsustainable implementation (discontinuation after the pilot phase) were compared.ResultsThe implementation outcomes from the patients’ perspective (N = 71) were positive; they found ALS H&C to be an acceptable and feasible care concept. Patients’ technology acceptance was high, with positive attitudes towards ALS H&C, and positive views on perceived technology control, usefulness, and ease of use. Patients rated their satisfaction with the (web) app on a scale from 1 (not satisfied at all) to 10 (very satisfied) with a 7.0 (median; IQR 1.0). Healthcare providers (N = 76) also found ALS H&C acceptable and appropriate as well, but were less positive about the feasibility and usability of ALS H&C (mean SUS 58.8 [SD 11.3]). ALS H&C has largely been implemented as intended and the implementation was sustainable in 7 teams. Teams who discontinued ALS H&C after the pilot phase (N = 2) had more fidelity issues.ConclusionsA participatory action research approach supported by theoretical approaches used in implementation science led to a sustainable implementation of ALS H&C in 7 of the participating teams. To improve implementation success, additional implementation strategies to increase feasibility, usability and fidelity are necessary.Trial registrationTrial NL8542 registered at Netherlands Trial Register (trialregister.nl) on 15th April 2020.

Masculinities and affective equality; the case of professional caring

AbstractCritical studies of men and masculinities [CSMM] aim to advance gender equality by critiquing and deconstructing male hegemony and hegemonic masculinities. Although the implicit value of gender equality is clear in CSMM generally, the conceptualization of equality is frequently vague, implied, and lacks conceptual definition. The problem is compounded in caring masculinities studies which additionally often lack engagement with critical feminist and other socio‐political perspectives on caring. These shortcomings hide the complex interrelation of different dimensions to inequality as they intersect with multiple relational identities. Caring practices are also complex, having distinct phases that engage different forms of labor within separate relational contexts. In response, this article proposes the model of affective equality (Lynch et al., 2009) and the concept of care as relational social practice (Tronto, 1993) as normative perspectives that explicitly link care with equality. The case of professional caring, where the impact of CSMM has been especially limited, is used to illustrate the micro‐politics of how men manage their identities within the context of feminized caring. Here, men face the precarious task of managing their masculine status while navigating emotional expectations. Caring masculinities studies can be advanced with greater theoretical and empirical attention to (i) the intersection of multiple inequalities; (ii) the affective circles of caring; (iii) the specificity of caring work; (iv) the inequalities of caring; and (v) the ethics of caring practices.

Effect of comprehensive geriatric assessment for frail elderly patients operated for colorectal cancer—the colorectal cancer frailty study: study protocol for a randomized, controlled, multicentre trial

BackgroundColorectal cancer (CRC) is the third most common cancer worldwide, with a median age of 72–75 years at diagnosis. Curative treatment usually involves surgery; if left untreated, symptoms may require emergency surgery. Therefore, most patients will be accepted for surgery, despite of high age or comorbidity. It is known that elderly patients suffer higher risks after surgery than younger patients, in terms of complications and mortality. Assessing frailty and offering frail elderly patients individualized treatment according to the comprehensive geriatric assessment (CGA) and care concept has been shown to improve the outcome for frail elderly patients in other clinical contexts.MethodsThis randomized controlled multicentre trial aims to investigate if CGA and care prior to curatively intended surgery for CRC in frail elderly patients will improve postoperative outcome. All patients ≥ 70 years with surgically curable CRC will be screened for frailty using the Clinical Frailty Scale (CFS-9). Frail patients will be offered inclusion. Randomization is stratified for colon or rectal cancer. Patients in the intervention group are, in addition to standard protocol, treated according to CGA and care. This consists of individualized assessments and interventions, established by a multiprofessional team. Patients in the control group are treated according to best known practice as stipulated by Swedish colorectal cancer treatment guidelines, within an enhanced recovery after surgery (ERAS) setting. The primary outcome is 90-day mortality. Secondary outcomes are the length of hospital stay and total number of hospital days within 3 months, discharge destination, 30-day readmission, ADL, safe medication assessment, CFS-9 score, complications, Health-Related Quality of Life (HRQoL) at 2-month follow-up in comparison to baseline measurements, health economical calculations including cost-effectiveness analysis based on costs of hospital care and primary care, mortality and HRQoL at baseline, 2- and 12-month follow-up and all-cause 1-year mortality.DiscussionThe trial is the first of its size and extent to investigate intervention with CGA and care prior to surgery for CRC in frail elderly patients. If this addition proves to be favourable, it could have implications on future care of frail elderly patients with CRC.Trial registrationClinicalTrials.gov NCT04358328. Registered on 4 February 2020

Identification and Successful Targeting of a Larger Than Expected Health Literacy Gap in Young People with Sickle Cell Disease Transitioning from Pediatric to Adult Care

Young people living with long-term medical conditions growing into adulthood face significant challenges inherent in the necessary new-found autonomy and unprecedented responsibility for their health along with understanding the interfaces with adult health services. Data from the United Kingdom has found that amongst people living with Sickle cell disease (SCD), young adults aged 20-29 years have the highest rates of emergency hospital admissions. This is associated with a significant increase in mortality amongst patients with SCD of this age group. It is well recognized that those who don't understand health information are less likely to seek out healthcare support appropriately and are more likely to have significant ill-health. Furnishing young people with the skills to improve their health literacy is therefore the cornerstone of any transition preparedness programme. Ready Steady Go (RSG) is a UK National Institute of Health and Care Excellence (NICE) endorsed generic transition programme that may be used to support children with long-term conditions. It comprehensively addresses the full range of issues for good transition and facilitates discussion in greater depth of any areas of need to support young people with chronic medical conditions so that they might more effectively manage the needs of their medical condition and navigate entry into adult life with confidence. Data were compared between responses of 147 young people with chronic conditions transitioning to adult care at each of the Ready, Steady and Go timepoints. Age-appropriate questionnaires were offered as part of routine patient care and 4451 unique responses to each of the questions on the age-appropriate RSG questionnaires were obtained including responses related to knowledge and understanding of the condition, its treatment and the composition of the healthcare team, capacity for self-advocacy, assessment of understanding of general adolescent health issues including sexual health, exercise and diet, educational, independence and vocational domains, psychosocial aspects and the understanding of the concept of transitional care. Experience using these questionnaires in clinical practice has taught us that often the questions not answered are at least as informative as those answered as 'need more help' and are often areas with the highest need so we elected to include questions without a response in our evaluation. Analysis revealed that at all stages the young people with SCD (n = 42) were significantly less likely to report confidence in important transition parameters compared to those living with other long-term conditions (n = 105) (figure A). This was most pronounced in questions that assessed knowledge and understanding of their medications and how they worked and ownership of taking their own medications without parental assistance (79.9% SCD vs 89.9% other chronic conditions) with low reported rates of requesting and picking up their own repeat prescriptions (13.9% SCD vs 47.4%) (figure B). Patients with SCD were more likely to report that they needed more help 'dealing with unwelcome comments or bullying' (26.1% SCD vs 3.5%) and less likely to 'feel happy with life' (73.8% SCD vs 86.4%) (figure C). They were also more likely to reply that they did not feel able to 'tell others of their condition' (36.8% SCD vs 11.8%) and were less likely to say that they were 'happy with the way they looked to others' (77.8% SCD vs 86.4%). Our data also suggested that their social support was less with 24% of respondents with SCD saying they did not 'know someone I can talk to when I feel sad or fed up' vs 8.3% of respondents with diabetes. 23.8% of young people with SCD reported they did not see friends outside of school vs 15.5% of young people with diabetes. In response to these data, a bespoke, bite-sized, animated SCD transition education package was developed (figure D). It was offered to young people living with SCD peri-transition and demonstrated an uplift in confidence and understanding from 47.8% to 84.6% after engagement with the resource (figure E). This data analysis and reflexive action research shows that there is a significant health literacy gap in young people with SCD transitioning to adult care, larger than that seen in young people with other chronic conditions and that targeted digital health education interventions are effective at increasing a young person's health literacy, engagement and confidence. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Medical and Surgical Care of Critical Burn Patients: A Comprehensive Review of Current Evidence and Practice.

Critically ill burn patients pose several unique challenges to care providers. The concepts of fluid resuscitation, nutritional management, organ support and wound care are rapidly evolving. There is a pressing need to review emerging evidence and incorporate these into practice for the effective management of burn patients.We have searched the PubMed and Google Scholar databases to review the current evidence on the acute care management of adult as well as paediatric burn patients. The rationales for current practices have been integrated into the review. The management of critically ill burn patientsrequires an in-depth knowledge of the pathophysiology of burn injury, a tailored approach for timely resuscitation, timely diagnosis oforgan specific problems, andcomprehensive wound care. This review will help the doctors and healthcare providers involved in the management of critical burn patients in their day-to-day practice.

Concepts for Early Childhood Education and Care in the Postdigital

Concepts for Early Childhood Education and Care in the Postdigital

Barriers and facilitators for coherent rehabilitation among people with inflammatory arthritis – a qualitative interview study

BackgroundPeople with chronic diseases have contact with several different professionals across hospital wards, municipality services and general practice and often experience lack of coherence. The purpose was to explore perceived barriers and facilitators to coherent rehabilitation pathways for health care users with inflammatory arthritis and how coherence can be improved.MethodsSemi-structured individual interviews were conducted before a planned inpatient rehabilitation stay, 2-3 weeks and 4-6 months after discharge. Thematic reflexive analysis guided the analysis of data. Concepts of person-centred care, complex adaptive systems and integrated care were applied in the interpretations.ResultsIn all, 11 participants with IA were included. There was one overarching theme, The importance of a person-centred approach, illuminating the significance of professionals who respect healthcare user’ preferences. To use a person-centred approach, demands professionals who are interested in exploring the persons own values, preferences and experiences and incorporate these when planning care and rehabilitation.Connected to the overarching theme, three sub-themes were derived; 1) Experiences of empowerment and dis-empowerment, covering that most want to be in control and act themselves, but felt overwhelmed and lost energy and they tended to give up; 2) Experiences of communication and coordination, encompass how people feel forced to take on coordination and communication tasks themselves although they do not always feel qualified for this. Some asked for a coordination person and 3) Facing everyday life after discharge, covering how initiatives taken by professionals were not always experienced as helpful after discharge. Some gave up and some tried to find alternative paths themselves.ConclusionProfessionals taking a person-centred approach facilitated coherent rehabilitation pathways. This encompassed care with respect for individual needs and professionals who empowered patients to self-management. Furthermore, to be aware that interprofessional communication and coordination need to take place both between professional within the same department, between departments and between professionals in different sectors.After discharge, some patients were challenged in their everyday life when trying to follow the advice from the professionals. Professionals, who do not use a person-centred approach, hinder coherence. Patients thus feel compelled to take on communication and coordination tasks.

Building an understanding of goal-oriented care through the experiences of people living with chronic conditions

ObjectiveTo understand the concept of goal-oriented care (GOC) through the experiences of people with chronic conditions. MethodInterviews with people living with chronic conditions (n = 50) were analyzed in two ways. A deductive approach based on GOC attributes generated in a concept analysis on GOC: goal-elicitation, goal-setting, goal-evaluation, patients’ context, and patients’ needs and preferences. An inductive approach based on a thematic analysis using descriptive phenomenology. ResultsThe phase of goal-elicitation was recognized by the participants, whereas goal-setting and goal-evaluation were experienced to a lesser extent. Regarding the underpinning attributes, mixed feelings were reported concerning the integration of the patient’s context and the presence of their needs and preferences throughout the care process. The inductive analysis revealed specific attention to informing patients about their condition and treatment options and discussing goals in interprofessional collaboration. ConclusionGoal-elicitation was already present and seems to be a good foundation for GOC. More attention should be given to goal-setting and goal-evaluation. Practice implicationsDeveloping guidance by means of a workflow, tools, or questions might support people with chronic conditions and providers to underpin the entire care process with patients’ personal goals.

Lived Experience of Iranian Family Caregivers of Tubercular Patients: A Qualitative Study

Objective. To investigate the lived experience of family caregivers of persons with tuberculosis. Methods. In this study, the method of hermeneutic phenomenology. Data were collected through online in-depth semi-structured interviews with nine family caregivers of TB patients. The obtained data were thematically analyzed to explain the concept of home care for TB patients through van Manen's 6-step methodology. Results. After the thematic analysis, three main themes of caregivers'; mental distresses, quality care stasis, andfacilitated care were obtained from 944 primary codes and 11 categories. Conclusion. Family caregivers of these patients suffer from mental distress. This issue affects the quality and ease of caregiving for these patients. Therefore, policymakers of this area should pay attention to the family caregivers of these patients and attempt to provide support; they should try to improve their quality of life.

Lived Experience of Iranian Family Caregivers of Tubercular Patients: A Qualitative Study.

To investigate the lived experience of family caregivers of persons with tuberculosis. In this study, the method of hermeneutic phenomenology. Data were collected through online in-depth semi-structured interviews with nine family caregivers of TB patients. The obtained data were thematically analyzed to explain the concept of home care for TB patients through van Manen's 6-step methodology. After the thematic analysis, three main themes of caregivers' mental distresses, quality care stasis, and facilitated care were obtained from 944 primary codes and 11 categories. Family caregivers of these patients suffer from mental distress. This issue affects the quality and ease of caregiving for these patients. Therefore, policymakers of this area should pay attention to the family caregivers of these patients and attempt to provide support; they should try to improve their quality of life.

Features of legal regime of medical services

The article provides a comprehensive analysis of legal regulation in the medical field, reveals the features of legal regime of medical services, defines the relationship between the concepts of medical care and medical service. The author characterizes the legal and factual basis for the provision of medical services, identifies the problem of legal nature of the contract for the provision of medical services, and proves the need to strengthen the role of the contractual structure in the framework of receiving medical care under the compulsory medical insurance program. The article substantiates the need to differentiate the rights and obligations of the participants in relations that form their legal status in the healthcare sector in order to more clearly form the content of contractual obligation to provide medical services.

Oral hygiene and oral health behavior, periodontal complaints and oral health-related quality of life in pregnant women

ObjectivesThis questionnaire-based cross-sectional study aimed in the evaluation of oral hygiene and oral health behavior, periodontal complaints and oral health-related quality of life (OHRQoL) in pregnant women in southwest-Saxony, Germany.Materials and methodsConsecutive patients attending the clinics for Obstetrics and Gynecology, Heinrich-Braun-Klinikum Zwickau, Germany, were recruited in the years 2020 and 2021. The evaluation consisted of three parts: (I) dental and oral hygiene behavior, (II) periodontal complaints and (III) German short form of oral health impact profile (OHIP G14) to assess OHRQoL.Results853 out of 1056 participants were included in the study. The pregnant women reported that they have received information on oral health during pregnancy more often from gynecologists than from dentists. Slightly more than half of the participants (51.5%) rated to regularly undergo a professional tooth cleaning. Similarly, nearly half of the women stated to perform interdental cleaning (55.8%). The most common periodontal complaint was bleeding of the gums (45.4%). The OHIP G14 findings of all questions as well as sum scores showed a median of 0. Regression analysis revealed that regular professional tooth cleaning was a predictor of better OHRQoL (β – 0.698, CI95 0.049–1.299; p < 0.04).ConclusionOral hygiene and oral health behavior of pregnant women in southwest-Saxony requires improvement. While the overall OHRQoL of the cohort was not reduced, professional tooth cleaning and thus professional preventive measures can support OHRQoL during pregnancy. Improved interdisciplinary oral health care concepts for pregnant women should be fostered. These concepts can also positively influence OHRQoL issues.

Humanising online teaching through care-centred pedagogies

One of the main challenges regarding online teaching involves creating spaces in which learners establish and maintain connections with the teacher, other learners and the content. By exploring the concept of care in online learning, we aim to address this challenge. Framed by Noddings' (2013) ethics of care, this qualitative case study explored effective course design elements and instructional behaviours in an online course to identify practices that suggest the presence of care. Data collected through student feedback and peer observations provide insights into effective pedagogical practices, and our analysis reveals that these practices overlap with some of the four components of Noddings’ care-centred model of education: modelling, dialogue, practice, and confirmation. Our study suggests that what makes an online course effective might be the invisible care elements underlying its design and implementation. Implications for practice and policy: Online education experience can be enhanced by applying care-centred pedagogies into online settings to guide course design and instruction. Educators can incorporate care principles into courses without putting excessive emphasis on emotions, which may be more preferable at higher education levels.

Human centered diabetes care.

This communication describes the concept of human centred diabetes care. It makes a distinction between patient centred and person centred care on one hand, and human centred care on the other. Human centred diabetes care is a grounded concept, which encompasses the philosophy of patient centred care, and blends it with a humanistic approach to management. It encourages the health care provider to view the person, living with diabetes, as a human being, and as part of a family, community and society. It also reminds the provider about his or her strengths and shortcomings, both of which are part of being human, and encourages him or her to strive towards becoming a better diabetes care provider, as well as human being. The human care model is relevant to all health delivery, and especially to chronic care such as diabetes management.

Accelerating the Front End of Medicine: Three Digital Use Cases and HCI Implications.

Digital applications in health care are a concurrent research and management question, where implementation experiences are a core field of information systems research. It also contributes to fighting pandemic crises like COVID-19 because contactless information flow and speed of diagnostics are improved. This paper presents three digital application case studies from emergency medicine, administration management, and cancer diagnosis with AI support from the University Medical Centers of Münster and Göttingen in Germany. All cases highlight the potential of digitalization to increase speed and efficiency within the front end of medicine as the crucial phase before patient treatment starts. General challenges for health care project implementations and human-computer interaction (HCI) concepts in health care are derived and discussed, including the importance of specific processes together with user analysis and adaption. A derived concept for HCI includes the criteria speed, accuracy, modularity, and individuality to achieve sustainable improvements within the front end of medicine.

Satisfaction with care provided by home-based palliative care service to the cancer patients in Dhaka City of Bangladesh: A cross-sectional study.

Patient satisfaction is an important quality indicator of health care service. The concept of home-based palliative care has been recently introduced in Bangladesh, but the patients' satisfaction with this care remained unexplored. This study aimed to assess the satisfaction of the cancer patients receiving this care. This cross-sectional study was conducted among 51 surviving cancer patients above 18 years of age registered under the home-based care service of the Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Data were collected by face-to-face interviews using a structured questionnaire based on the FAMCARE P16 questionnaire from February to March 2019. Descriptive analysis was done for the sociodemographic and satisfaction-related indicators. A correlation matrix was done to see the correlation among the satisfaction indicators. The majority of the patients (88.2%) were satisfied with the service provided by the home care team. Most (76.5%) of the patients were women, and the mean age was 56.25 ± 14.8 years. The median duration of getting home-based care was 4 months. Main satisfaction indicators were-assessment of physical symptoms (70.6%), providing information about pain management (70.6%), the inclusion of the family in decision making (76.5%), coordination of care between the members of the home care team (84.3%) and availability of doctors, nurses and palliative care assistants (74.5%). A high correlation was observed between satisfaction regarding the care of physical symptoms and provision of information (R = 0.814, p < 0.001). Also, satisfaction regarding the provision of information and support provided to the family is highly correlated (R = 0.722, p < 0.001). Despite the limitations, the overall satisfaction level of the patients regarding home-based palliative care services in Bangladesh is very high. Home-based palliative can be a solution to provide palliative care to patients who are unable to access institution-based care and improve their quality of life.

Tool for the assessment spiritual care after the COVID-19 pandemic: a sequential exploratory study.

The present study aimed to develop a tool to assess spiritual care after the COVID-19 Pandemic. This study is a mixed sequential (Qualitative-Quantitative) exploratory study. In the qualitative phase, through 14 in-depth semi-structured individual interviews with clerics, specialists in Islamic jurisprudence and principles, specialists in education and health promotion, and using the content analysis approach, tool items were designed. Purposeful sampling was performed with maximum diversity of experts and enthusiasts in the field of spiritual health. Content analysis of the data obtained from interviews led to explaining the concept of spiritual care after the COVID-19 Pandemic in four main themes: spiritual care needs, spiritual care characteristics, outcomes of spiritual care, and the challenge of providing spiritual care. The average content validity index of the tool was 0.94. Exploratory factor analysis showed 4 factors that explained more than 62.83% of the variance. The correlation of spiritual cares scale score for COVID-19 Pandemic with spiritual care tool was (0.86, p <0.001). Spiritual care tool is a valid and reliable tool, with 38 items to assess the spiritual care after the COVID-19 Pandemic.

‘That's the bloodline’: Does Kinship and care translate to Kinship care?

AbstractKinship for First Nations people is a fundamental, yet complex, element of one's culture, enabling both belonging and relationality, and extending beyond blood family and relations. Kinship is also recognized as important within out‐of‐home care (OOHC) systems, with kinship care being the predominant OOHC placement type in Australia (AIHW, 2021). However, when First Nations children and young people are removed by the state, and placed into OOHC, it is important to interrogate whether kinship placements enable cultural connection and continuity with First Nations ways of understanding Kinship. This article begins by contextualising current OOHC policy and practice in Australia where a westernised and homogenised concept of kinship care is touted as similar to First Nations notions of Kinship. Here, the Aboriginal and Torres Strait Islander Child Placement Principle (ATSICPP) has become oversimplified by equating kinship care with relative care, thus creating ambiguity in care and placements in OOHC, voiding First Nations traditions and ways of understanding Kinship while a young person is in care. This article then reports the findings of qualitative interviews with 37 First Nations and non‐Indigenous people concerning the use of the term ‘Kinship’ in OOHC in New South Wales (NSW), how it is operationalised and how it is understood. Wide‐ranging experiences by participants concerning Kinship within OOHC were evident, thus demonstrating the imperative for a broader understanding of Kinship. This understanding needs to be applied within OOHC in ways that are consistent with First Nations notions of Kinship, as kinship care placements on their own are not enough to keep children connected in culture. The findings from this study show that the term Kinship is applied problematically within OOHC in NSW by equating legal and policy definitions of kinship care with Aboriginal ways of understanding Kinship. Ensuring First Nations traditions, practices and notions of Kinship are applied for First Nations children and young people in OOHC contexts is paramount.

Care, provision of care and models of care in child and adolescent psychiatry in Austria

HintergrundDie Situation der Kinder- und Jugendpsychiatrischen Versorgung hat sich seit 2007, seit der Schaffung des Sonderfaches KJP+P, sukzessive verbessert. Die Arbeitsgruppe Versorgung der ÖGKJP gibt in diesem Heft einen Überblick über die KJP-Versorgungssituation in Österreich. In dieser Einführung geht es um die Darstellung der rechtlichen Vorgaben und deren Umsetzung. Es bestehen nach wie vor massive Defizite der KJP-Versorgung.Im Österreichischen Strukturplan Gesundheit (ÖSG) ist das momentan gültige Versorgungskonzept festgeschrieben und umfasst die ambulante, teilstationäre und stationäre Versorgung. Für die ambulante und stationäre Versorgung existieren Messzahlen, für die teilstationäre Versorgung nicht.Das Fachgebiet KJP hat verschiedene Besonderheiten: die Multimodalität, die Multiprofessionalität, die Altersgruppen der Betroffenen, pro Alter unterschiedliche und unterschiedlich ausgeprägte Erkrankungen, die Beschränkung auf eine bestimmte Altersgruppe (< 19 Jahre) und – das verbindet es mit dem Fach Psychiatrie – eine hohe Prävalenz der Erkrankungen sowie die Integration der Psychotherapeutischen Medizin in den Facharzt.SchlussfolgerungenDie aus diesen Besonderheiten sich ergebenden Konsequenzen – altersdifferenzierte Angebote, fachübergreifende Kooperation etc. – haben bisher keinen Eingang in die strukturellen und finanziellen Berechnungen gefunden. Anhand der den Begriff Versorgung beschreibenden Begriffe: „care“, „provision“ und „supply“ wird ein Modell vorgestellt, das bei der Planung von Gesundheitsmaßnahmen in diesem Bereich als Denkansatz herangezogen werden könnte. Da psychisch kranke Kinder und Jugendliche sich in allen Teilen der Gesellschaft finden, wird die Einrichtung einer zentral verantwortlichen und ressortübergreifenden Stelle für Mental Health gefordert.

43 EXPLORING STAFF PERCEPTIONS AND ATTITUDES TO CARE AND CAREBOTS: THE CASE OF AN ORIGINAL AIR-DISINFECTION ROBOT IN IRELAND

Abstract Background The pandemic heightened the sense of security and safety in care settings, with cleanliness and infection control becoming an even more important aspect of care delivery. Although the impact of new welfare technology on health and social care has been discussed in recent years, few studies have reported the implementation processes or human-robot interactions in care facilities in different cultural settings. The aims of this interdisciplinary research therefore were to understand needs and aspects that have to be considered for implementing an assistive robot, and to explore user perceptions, and the process by which the robots are adopted in Ireland and Japan. Methods An original air-disinfection robot (V-Air) was developed by Akara Robotics, as part of research project “Harmonisation towards the establishment of Person-centred, Robotics-aided Care System” (Toyota Foundation, D18-ST-0005). Prior to its instalment in a rehabilitation centre in Dublin, semi-structured interviews were conducted, and observations carried out with seven care professionals, as they interacted with V-Air. The robot was then trialled for eight weeks (March-May 2022) in selected areas of the facility. After four weeks, the users filled out the System Usability Score and were asked questions at the end of the trial. Their scores and answers to the questions revealed staff perceptions and attitudes to care robots. Results Overall, the users had positive perceptions of V-Air and its usability. Initial differences existed in staff’s confidence levels, depending on prior experiences with technologies. Collective sensemaking was observed, particularly, around care delivery processes and robot functionalities. The adoption process was facilitated by several factors such as the timing of introduction, user-centred design, concept of care and organisational support. Conclusion The findings suggest that the introduction of care robots in care settings can offer an additional layer of organisational safety, while highlighting the significance of the iterative process in adopting assistive technologies.