Concept Of Care Research Articles

The necessity of an empirical study to determine if church congregations function as a family

Scripture’s reference to believers as the ‘family of God’ may indicate that believers should mutually care for one another like members of a caring family do, and not merely that members are part of a ‘spiritual’ family. From this perspective, the article investigated the extent of mutual care within congregations. The increasing need for pastoral care, within and outside church congregations, reveals the need for mutual care between members. The necessity for empirical studies within church congregations were revealed by the differences in the intensity of the answers by the participants. Without knowledge about the experiences of church members, leaders of church congregations may overlook potential needs of their members. A quantitative empirical study was done through an anonymous online survey with church members, pastoral counsellors, and pastors and ministers from various denominations who completed the survey, according to their experiences within their individual church congregation. The concepts of fellowship (koinōnia), service (diakonia), care, and family were used in the survey to determine the experiences of mutual care between members of the church congregation. The deficiency of mutual care between members of the congregation may motivate leaders to intentionally develop relationships through fellowship (koinōnia) to foster mutual care between members, and intentionally develop members to serve (diakonia) one another and their community.Contribution: This article contributes to an interdisciplinary discussion between pastoral theology, practical theology, and systematic theology from a Reformed perspective with a focus on the practical participation of members of the church congregation in pastoral care as the ‘family of God’.

Narrative Care and Engagement in Social and Health Care: Enhancing Identity with a Small Story Approach

<p>Narrative care, an approach developed from the larger concept of narrative gerontology, considers the importance of stories as a source of identity. A type of person-centered care, narrative care in care settings encourages care workers to elicit stories to gain a more wholistic understanding of the person. Drawing on personal experience in the field, I argue that although “big” story approaches (e.g., grand life narratives) have typically been used in social and healthcare settings, “small” story approaches (e.g., snippets or moments) are more practical for care workers. The expansion of the concept of narrative care to include “narrative engagement” will be explored, which if applied in meaningful ways can promote citizenship, shift power dynamics, generate empowerment, and create systemic change in social and health care settings. Finally, newly developed train-the-trainer narrative care training will be discussed, which is designed to meet the needs of diverse social/health care workers, with a focus on meaningful methods of adopting narrative care and engagement in practice.</p>

Concept Recognition and Characterization of Patients Undergoing Resection of Vestibular Schwannoma Using Natural Language Processing

Abstract Background Natural language processing (NLP), a subset of artificial intelligence (AI), aims to decipher unstructured human language. This study showcases NLP's application in surgical health care, focusing on vestibular schwannoma (VS). By employing an NLP platform, we identify prevalent text concepts in VS patients' electronic health care records (EHRs), creating concept panels covering symptomatology, comorbidities, and management. Through a case study, we illustrate NLP's potential in predicting postoperative cerebrospinal fluid (CSF) leaks. Methods An NLP model analyzed EHRs of surgically managed VS patients from 2008 to 2018 in a single center. The model underwent unsupervised (trained on one million documents from EHR) and supervised (300 documents annotated in duplicate) learning phases, extracting text concepts and generating concept panels related to symptoms, comorbidities, and management. Statistical analysis correlated concept occurrences with postoperative complications, notably CSF leaks. Results Analysis included 292 patients' records, yielding 6,901 unique concepts and 360,929 occurrences. Concept panels highlighted key associations with postoperative CSF leaks, including “antibiotics,” “sepsis,” and “intensive care unit admission.” The NLP model demonstrated high accuracy (precision 0.92, recall 0.96, macro F1 0.93). Conclusion Our NLP model effectively extracted concepts from VS patients' EHRs, facilitating personalized concept panels with diverse applications. NLP shows promise in surgical settings, aiding in early diagnosis, complication prediction, and patient care. Further validation of NLP's predictive capabilities is warranted.

ESPEN guideline on nutrition and hydration in dementia – Update 2024

Background & aimsDementia is accompanied by a variety of changes that result in an increased risk of malnutrition and low-intake dehydration. This guideline update aims to give evidence-based recommendations for nutritional care of persons with dementia in order to prevent and treat these syndromes. MethodsThe previous guideline version was reviewed and expanded in accordance with the standard operating procedure for ESPEN guidelines. Based on a systematic search in three databases, strength of evidence of appropriate literature was graded by use of the SIGN system. The original recommendations were reviewed and reformulated, and new recommendations were added, which all then underwent a consensus process. Results40 recommendations for nutritional care of older persons with dementia were developed and agreed, seven at institutional level and 33 at individual level. As a prerequisite for good nutritional care, organizations caring for persons with dementia are recommended to employ sufficient qualified staff and offer attractive food and drinks with choice in a functional and appealing environment. Nutritional care should be based on a written care concept with standardized operating procedures. At the individual level, routine screening for malnutrition and dehydration, nutritional assessment and close monitoring are unquestionable. Oral nutrition may be supported by eliminating potential causes of malnutrition and dehydration, and adequate social and nursing support (including assistance, utensils, training and oral care). Oral nutritional supplements are recommended to improve nutritional status but not to correct cognitive impairment or prevent cognitive decline. Routine use of dementia-specific ONS, ketogenic diet, omega-3 fatty acid supplementation and appetite stimulating agents is not recommended. Enteral and parenteral nutrition and hydration are temporary options in patients with mild or moderate dementia, but not in severe dementia or in the terminal phase of life. In all stages of the disease, supporting food and drink intake and maintaining or improving nutrition and hydration status requires an individualized, comprehensive approach. Due to a lack of appropriate studies, most recommendations are good practice points. ConclusionNutritional care should be an integral part of dementia management. Numerous interventions are available that should be implemented in daily practice. Future high-quality studies are needed to clarify the evidence.

Spiritual Distress, Hopelessness, and Depression in Palliative Care: Simultaneous Concept Analysis.

Spiritual distress, hopelessness, and depression are concepts that are often used in palliative care. A simultaneous concept analysis (SCA) of these concepts is needed to clarify the terminology used in palliative care. Therefore, the aim of this study is to conduct a SCA of spiritual distress, hopelessness, and depression in palliative care. A SCA was performed using the methodology of Haase's model. A literature search was conducted in March 2020 and updated in April 2022 and April 2024. The search was performed on the following online databases: CINAHL with Full-Text, MEDLINE with Full-Text, MedicLatina, LILACS, SciELO, and PubMed. The search was achieved without restrictions on the date of publication. A total of 84 articles were included in this study. The results highlight that the three concepts are different but also share some overlapping points. Spiritual distress is embedded in the rupture of their spiritual/religious belief systems, a lack of meaning in life, and existential issues. Hopelessness is a sense of giving up and an inability to control and fix the patient's situation. Finally, depression is a state of sadness with a multi-impaired situation. In conclusion, refining the three concepts in palliative care is essential since it promotes clarification and enhances knowledge development towards intervention.

Preconceptional and Antenatal Care through Life Style with special reference to Sadvritta: A Scoping Review

Sadvritta is a group of good conducts indicated to practice throughout life for everyone. Sadvritta plays significant role in prevention of all kind of diseases and in promotion of health. Female reproductive health is responsible for proper outcomes related to maternal and child health. There are guidelines in Ayurveda which consists of concepts of preconceptional, antenatal and post-natal health care of a mother and child. Wholesome life style with physical, psychological and verbal acts along with required medication and Panchakarma are mentioned. Special guidelines are mentioned for a couple as a Garbhadhan Vidhi (method of impregnation) which is supposed to follow at the time of preconception. Wholesome regimens at physical, mental and verbal level in life style of pregnant woman and a father at the time of conception is advised to maintain. Many factors described in Garbhini Paricharya and Sadvritta other than nutrition and medication are important for prevention. Emotional health of a mother is associated with the health of a child. Sadvritta and Ayurvedic life style consists guidelines which can reduce health issues due to stress. Many countries have developed national level health programmes for mother and child health. Goals of mother and child health programme emphases on antenatal, intra-natal and post- natal health care. Objectives of MCH programme are reduction of mortality and morbidity rates of mother and child. For it, care can be started at preconceptional phase. There may be a scope to advise Sadvritta guidelines to currently established MCH with Ayurveda health care. This article is an effort to view scope in MCH through Ayurveda and Sadvritta.

The Dataveillance and Care in Teachers’ Work with Early Warning Systems

It has now become a widespread practice in both public and private organisations to analyse data collected through digital systems and tools. Datafication in schools has resulted in additional work tasks for teachers and an increased level of accountability on their part. One of these data-work-related tasks of teachers is to proactively recognize students who may be at risk of dropping out of school and help them. Machine learning holds significant promise in the creation of advanced early warning systems (EWS) for predicting such student dropouts. Such systems are in line with a positive discourse supporting teachers’ effective decision making and a deeper understanding of student behaviour. In contrast, critical scholars raise concerns about the impact of data-driven practices in education on the teaching profession. This study adds to this body of literature by exploring how teachers are regulated by and regulating EWS as part of their work practice.In this study as part of a larger working life funded project, we focus on one digital tool used in Swedish upper secondary schools called StudyBee, integrated with Google Classroom and connected to the Swedish National Agency for Education. We conducted a combination of ethnographic methods such as desktop research of application’s website and social media posts to gain a deeper knowledge on the StudyBee’s Graphical User Interface, interviews with teachers and principals, as well as go-alongs with teachers to understand their interactions with EWSs. Based on Decuypere’s (2021) topological framework, we analyse what is happening on, with, behind, and beyond EWS.To argue that teacher work is shaped by accountability mechanisms, we use a critical perspective on teacher work within the digital platform/accountability discourse, aiming to reveal underlying power dynamics. We apply the concept of dataveillance (datafied surveillance, Clarke in Lyon, 2022) to illustrate how power operates, encouraging teachers to self-regulate in alignment with school accountability. Furthermore, we utilize the concept of care (Zakharova & Jarke, 2022) to understand technology-related aspects and care for students.

Family-Centered Care Experiences in Elderly with Chronic Diseases in Communities: Qualitative Study of Patients, Families, Nurses, and Volunteers.

The family, at community, must be an important part of elderly care. However, most of the elderly experience a decrease in psychological well-being and quality of life. This is not in accordance with the concept of the family-centered care (FCC) model and can endanger the continuity of the elderly with chronic illnesses. The aim of this study was to explore experience of FCC among patients with chronic illness, nurses, families, and volunteers. This study examines the contextual-based FCC model qualitatively. In-depth interviews and focus group discussions were conducted by 12 elderly people, 3 nurses, 10 family members, and 3 volunteers. In total, 36 people, where several were FGD participants, were also interviewed in depth. Data were analyzed using thematic analysis, with codes organized into larger themes. In total, 36 interviews and FGDs were conducted. The concept of information interaction, the phenomenon of emotional interaction, the practical interaction, and various factors that can either facilitate or impede interaction, were considered the four significant themes. FCC acceptance is found in interactions between parents, nurses, family, and volunteers who are not optimistic. Lack of communication and collaboration was noted between community nurses and volunteers. Offer a new perspective on developing and implementing interventions that facilitate positive interactions, reduce family burdens, provide high-quality treatment for parents with chronic diseases, and improve the quality of care for those with advanced chronic conditions. These insights provide a fresh perspective on how to develop and implement effective interventions in this context. It is recommended that future research should employ multiple methodologies to investigate FCC across diverse health practices for the elderly population.

Facilitators, barriers and impacts to implementing dementia care training for staff in long-term care settings by using fully immersive virtual reality: a scoping review protocol

IntroductionThe rapid growth of the ageing population underscores the critical need for dementia care training among care providers. Innovative virtual reality (VR) technology has created opportunities to improve dementia care...

Between the Camp and the Makerspace: Commoning Practices, Temporal Autonomy and Care

ABSTRACT The paper explores the chronopolitics of place-making in the refugee makerspace Habibi-Works and the neighbouring Katsikas refugee camp in Ioannina, in Northern Greece. Camps are created to be ephemeral and this ephemerality is reflected in their materiality and conditions the possibilities available to those that inhabit them. Camp temporalities work by way of destabilising the residents' sense of self in the present, severing their connections with the past and limiting their future aspirations. In sheer antithesis to the camp, the makerspace disrupts these (temporal) dynamics: it enables the camp residents to manage time as a common resource (commoning), creating autonomous communities of collective care. Through mundane encounters and practices, the makerspace plays an instrumental role in enacting the residents' autonomy by facilitating access to digital technologies, low-tech manufacturing tools, and skills to reproduce a sense of lost normality. We adopt an ethnographic approach to engage with the makerspace and the camp as well as the various people involved (migrants, volunteers, makers) and understand how migrants narrate their past, negotiate their present and imagine their futures in the context of everyday life. Building on the concepts of peer production, temporal autonomy and radical care, we argue that Habibi-Works opens up a new socio-political space between the camp, the makerspace and the world.

Outpatient oncology settings: the distinctive contribution of supportive design to patient experience and wellbeing

ABSTRACT The concept of patient-centred care is increasingly shaping healthcare practices, particularly within oncology settings. Its implications extend to a hospital's constructed environment and how it is designed, yet few studies have explored patient experience of such sensitive settings, and even fewer have examined outpatient oncology facilities. This study researched how the hospital built environment affects cancer patient wellbeing using in-depth interviews with 24 patients across Australia and Egypt. Analysis of patient-narrated experiences shed light on the potential latent impact of the built environment on patient health-related outcomes, such as pre-treatment anxiety and treatment-induced sensitivities and stresses. Three overarching themes were identified, including the built environment capacity to contribute to incidences of positivity; balancing the unavoidable (necessary) presence in the hospital; and encouraging reasons to return – potentially enhancing treatment compliance. The study further demonstrates how such support may contribute to experiencing a desired climate of patient-centred care, affording additional grounds for patients to cope with the potential burdens of treatment and its side effects.

Public Awareness of Palliative Care: A Nationally Representative Sample of Jordanian Adults

ContextInternationally, studies suggest that inadequate comprehension of the concept of palliative care and misconceptions about it hinder the effective use of palliative care, especially in developing nations. ObjectiveTo assess the awareness of the adult population in Jordan regarding palliative care. MethodsThe study used a cross-sectional design and an online self-administered questionnaire survey. The recruitment method was convenience snowball sampling of three thousand nine hundred forty-two Jordanian adults covering 12 governorates. Participants were recruited through social media platforms like Facebook and WhatsApp. The process of gathering data commenced in October –December 2023. Descriptive statistics were computed. ResultsA study of 3942 respondents in Jordan found that 45% have some knowledge of palliative care, with 31% being pretty knowledgeable. Most respondents (89%) strongly agree that patients with incurable illnesses should receive palliative care, with cancer patients showing the highest level of agreement (96%). The most agreed-upon aspect of palliative care is controlling pain and symptoms at home, while the least agreed-upon aspect is providing information on benefits and financial matters. The study also highlighted the link between palliative care and mortality, suggesting the need for increased awareness and education. ConclusionThe demand for palliative care in Jordan is increasing, requiring increased access, a holistic approach, open discussions, and easily accessible information. Challenges include integrating palliative care into non-malignant progressive diseases, ensuring comprehensive end-of-life care, promoting societal receptiveness towards mortality, enhancing information accessibility, and health promotion efforts. The study's results indicate the importance of implementing educational strategies and engaging families and communities in policymaking to change public knowledge and attitudes toward palliative care.

Patient Experience: Innovating the Application of LAFKI Concept in Person-Centred Care at Healthcare Facilities

This study evaluates the implementation of the Indonesian Healthcare Facility Accreditation Agency (LAFKI)'s Person-Centred Care (PCC) principles in healthcare settings. Focusing on patient experiences, the research addresses the effectiveness of PCC practices in enhancing health outcomes and patient satisfaction. The methodology employed involves a quantitative descriptive design, gathering data through questionnaires distributed via Google Forms to participants selected through purposive sampling from hospitals, clinics, and puskesmas. Findings indicate that while a majority of patients felt treated as unique individuals, a significant gap exists in respecting cultural values and beliefs during the decision-making process. The study highlights the need for healthcare providers to improve cultural sensitivity and patient engagement to bridge the ideological and practical implementation of PCC. The research contributes to the empirical literature by identifying barriers to effective PCC implementation and offering evidence-based recommendations for healthcare facilities to enhance their services. This aligns with LAFKI's goal of not just meeting but exceeding standards in providing holistic, person-centred care.

Original Research: Exploring U.S. Nurses' Perceived Duty to Care During the COVID-19 Pandemic.

Duty to care is both an integral concept in health care and a fundamental nursing obligation. But nurses' perceptions of duty to care can be moderated by their experiences in the practice setting. Research examining nurses' perceptions of their duty to care during the COVID-19 pandemic could shed light on how the pandemic is affecting the nursing workforce. This study aimed to examine nurses' sense of duty to care during the early months of the pandemic, using the Nash Duty to Care Scale (NDCS), and to compare the high-scoring nurses with the low-scoring nurses. This quantitative study used a descriptive, cross-sectional design. It was conducted among licensed RNs enrolled at two accredited nursing programs in the Northeast region of the United States. Data were collected via a demographics questionnaire and the NDCS. A two-step cluster procedure was used to categorize participants into two groups: those with high perceived duty to care (HPDC) and those with low perceived duty to care (LPDC). Independent t tests were performed to compare NDCS results between the two groups. Nearly two-thirds (61%) of the participants had total NDCS scores indicating an HPDC, while 39% had scores indicating an LPDC. Of the NDCS's four subscales, perceived obligation and perceived risk were the most important in separating participants into the low- and high-scoring groups. This study adds to the literature about the components that affected nurses' perceived duty to care and willingness to report to work during the early months of the pandemic. Just as nurses have a duty to care, health care organizations have an obligation to provide a safe working environment so that nurses can fulfill that duty without sacrificing personal safety. The study findings may guide health care leaders, systems, and organizations regarding how to create safer work environments that support the nurse's duty to care during disasters.

The Importance of Reconstituting the Bodies of Organ and Tissue Donors: a Look at Human Dignity

Introduction: Family refusal to authorize the donation of human organs and tissues has remained high over the years. Among the many reasons for not donating, we highlight the lack of information about the process and the family’s lack of knowledge about the donor’s wishes in life, as well as other issues, such as the appearance of the donor’s body after donation. In this sense, it is necessary to bring to light the aspects that permeate the concepts of death, human dignity, and care for the donor’s image, especially in the case of tissue donors, where the removal may be more noticeable. Objectives: An integrative literature review (ILR) was carried out, seeking to highlight gaps and characterize the process of donating human organs and tissues, with a focus on the reconstruction of the donor’s body and human dignity. In addition, the aim was to describe the experience of a professional from a human tissue bank (BTH). Methods: Using the PICO strategy, the study’s guiding question was drawn up following an IR carried out over the last 10 years, operationalized by controlled descriptors in the SciELO, LILACS, Google Scholar, and PubMed databases. In addition to the search, an experience report was described on the techniques used to reconstruct the donor’s body after the tissues used by a BTH located in the interior of the state of São Paulo were harvested. Results: Nine specific studies were found on donation and the use of prostheses to reconstruct donated areas. The results show the reasons for family refusal, as well as the care taken by the technical teams in reconstructing donors’ bodies. The family’s concern about the donor’s aesthetic situation influences acceptance for donation, so it is necessary to invest in the safety and quality of the services provided by BTH to reduce family refusal for donation. Conclusion: Clear communication and the safety of the processes involved in the procurement of human organs and tissues proved to be the best way to facilitate donation and could thus increase donations.

Professionals’ account-making of institutional care for youths. Intertwined discretionary spaces and blurred collaborative practice

ABSTRACT In this article, the account-making of social workers and institutional care staff on locked institutional care for youth is analysed, based on empirical material consisting of 10 interviews with 25 members of the two professions. The study departs from a Swedish context where locked institutional care for youth is mainly provided for individuals who are in compulsory care due to criminality, drug abuse, or other socially destructive behaviour. The analytical framework draws on account theory and Emerson’s concept of institutional care as a ‘last resort’. The results show that both social workers and staff use similar justifications and excuses, relating to organizational resources and rules and to assessments and decisions made by the other professional group; but also, that different layers of accounts overlap between professionals’ account-making stories and can change as care proceeds. The results are discussed in relation to the pooled discretion that is exercised when different professional groups are involved in care decisions, and the organizationally specialized care setting resulting in intertwined discretionary spaces and blurred practice, with consequences for the quality of care and challenges in holding professionals accountable.

The Teachability of Global Citizenship to Children through Empirical Environmental Education: Reflections from a Horticultural Project in a Spanish School

In a context defined by the internationalisation of educational policies and the supranational nature of school programmes, we highlight the desirability of promoting local strategies for teaching environmental sustainability in order to contribute to the formation of global citizenship in children. Based on the experience of a horticultural curricular project in a school in northern Spain, the aim of this article is to reflect on the need for socio-educational communities to transform the objectives of environmental education into tools with which children can co-responsibly build connections to modify or enrich their everyday concepts of caring for the planet. To do this, semiotic analysis of different official school documents is used as a key methodology. Our findings invite consideration of the fact that pedagogies designed to train children in global citizenship competencies should not be limited to the classroom or to reproducing the proposals of institutional documents. Rather, they should be based on the prior knowledge and experiences of all members of the community, above all, of the children. From this perspective, the promotion of empirical learning situations is essential for the acquisition of meaningful and appropriate environmental contents, in the sense that they allow children, as future global citizens, to recognise the ethical repercussions of their own actions and decisions.

Evaluating a web-based training curriculum for disseminating best practices for the care of newborns with neonatal opioid withdrawal syndrome in a rural hospital, the NOWS-NM Program

BackgroundThe incidence of neonatal opiate withdrawal syndrome (NOWS) in the US has grown dramatically over the past two decades. Many rural hospitals not equipped to manage these patients transfer them to hospitals in bigger cities.MethodsWe created a curriculum, the NOWS-NM Program, a web-based curriculum training in best practices. To evaluate the curriculum, we conducted pre- and post-surveys of NOWS knowledge, attitudes, and care practices, plus post-curriculum interviews and focus groups.ResultsFourteen participants completed both pre- and post-curriculum surveys. They indicated an increase in knowledge and care practices. A small number of respondents expressed negative attitudes about parents of infants with NOWS at pre-test, the training curriculum appeared to have no impact on such attitudes at post-test. Sixteen participants participated in focus groups or interviews. Qualitative data reinforced the positive quantitative results and contradicted the negative survey results, respondents reported that the program did reduce stigma and improve provider/staff interactions with patients.ConclusionsThis curriculum demonstrated positive impacts on NOWS knowledge and care practices. Incorporating focus on core concepts of trauma-informed care and self-regulation in future iterations of the curriculum may strengthen the opportunity to change attitudes and address the needs expressed by participants and improve care of families and babies with NOWS.

Continuum of care in maternal and child health in Indonesia.

This paper aims to empirically analyze the socioeconomic and demographic correlates of maternal and child health (MCH) care utilization in Indonesia using the continuum of care (CoC) concept. The concept of CoC has emerged as an important guiding principle in reproductive, maternal, newborn, and child health. Indonesia's maternal mortality rate, neonatal mortality, and under-five mortality rates are among the highest in the Southeast Asian region. Using pooled data from four successive waves of the nationally representative Indonesian Demographic and Health Survey (IDHS) conducted in the years 2002, 2007, 2012, and 2017, we use multivariate regression models to analyze care across four components of the continuum: antenatal care (ANC), institutional delivery, postnatal care for children, and full immunization (IM). CoC at each stage of MCH care has improved continuously over the period 2002-2017 in Indonesia. Despite this, just less than one out of two children receive all four components of the CoC. The overall coverage of CoC from its second stage (four or more ANC visits) to the final stage (full child IM) is driven by the dropouts at the ANC visit stage, followed by the loss of postnatal checkups and child IM. We find that the probability of a child receiving CoC at each of the four stages is significantly associated with maternal age and education, the household's socioeconomic and demographic characteristics, and economic status. Complete CoC with improved, affordable, and accessible MCH care services has the potential to accelerate the progress of Sustainable Development Goal 3 by reducing maternal and childhood mortality risks. Our findings show that in Indonesia, the CoC continuously declines as women proceed from ANC to other MCH services, with a sharp decline observed after four ANC visits. Our study has identified key socioeconomic characteristics of women and children that increase their probability of failing to access care.

Epistemology and care: two thresholds between philosophy and politics

This work explores the relationship between philosophy and politics from two thresholds. The first of them recovers the thought of Gloria Anzaldúa to suggest that, between the two, writing plays a double role: on the one hand, as a political act of social transformation, but also as an epistemological shift of the subjectivity and rewriting of reality from an ontology-epistemology of radical interconnection. The second threshold refers to a theoretical conception of care with authors such as Joan Tronto, Laura Pautassi, and Nadya Araujo Guimarães to establish how this perspective implies rethinking politics that addresses intersubjectivity. From the contrast of both approaches, we propose that there is a constant dialogue between politics and philosophy, and the possibility of making visible the vulnerability and interconnection of the human condition.