Dimensions Of Care Research Articles

Treatment of Diabetic Foot Ulcers Based on an Interdisciplinary Team Approach: Exploratory Cross-Sectional Study of Patients' Views on Quality of Care.

The purpose of this study was to evaluate patients' perception and quality of diabetic foot ulcer (DFU) care delivered by an interdisciplinary team approach (ITA). Exploratory cross-sectional study. Twenty patients with a healed plantar DFU were recruited from an interdisciplinary Wound Care clinic of a Canadian University affiliated hospital. Their mean age was 64years (75% were males [n=15]), 18 (90%) were living with type 2 diabetes, and 45% (n=9) had osteomyelitis in the previous year of their enrollment in the study. The validated short form of the Quality From the Patient's Perspective questionnaire was used to evaluate quality of care dimensions (medical-technical competence of the caregivers; physical-technical conditions of the care organization; degree of identity-orientation in the attitudes and actions of the caregivers; and sociocultural atmosphere of the care organization). Respondents reported experiencing a high level of quality care with an ITA. All indicators of patient-perceived reality of care delivered were superior or equal related to their subjective importance in all dimensions of quality care (with scores ranging from 3.85 to 4.00 on a 4-Point Likert scale). Patients' satisfaction regarding the ITA was high. Study findings suggest that an ITA model provided high quality of care for treating DFUs for all quality dimensions judged important for patients.

"I pray to God that greed never sets in": Community health workers' reflections on "care" during the Covid-19 pandemic.

Care provision received renewed attention during the Covid-19 pandemic as several healthcare providers vied for the coveted title of "frontline warrior" while they struggled to provide care efficiently under varying health system constraints. While several studies on the health workforce during the pandemic highlighted their difficulties, there is little reflection on what "care" or "caring" itself meant specifically for community health workers (CHWs) as they navigated different community and health systems settings. The aim of the study was to examine CHWs' care-giving experiences during the pandemic. Twenty narrative interviews with CHWs including ASHAs (Accredited Social Health Activists) and ANMs (Auxiliary Nurse Midwives) were conducted in different states between July and December 2020. Our findings highlight the moral, affectual, and relational dimensions of care in the CHWs' engagement with their routine and Covid-19 related services, as well as the "technical" aspects of it. In this article, we argue that these two aspects are, in fact, enmeshed in complex ways. CHWs extend this moral understanding not just to their work, but also to their relationship with the health system and the government, as they express a deep sense of neglect and the lack of "being cared for" by the health system. CHWs' experiences demand a more nuanced understanding of the ethics of care or caring that challenges the binaries between the "technical" and moral aspects of care.

Parent Perceptions of Telemedicine for Acute Pediatric Respiratory Tract Infections: Sequential Mixed Methods Study.

Since 2020, parents have had increasing opportunities to use telemedicine for their children, but how parents decide whether to use telemedicine for acute pediatric care relative to alternative sites of care is not clear. One of the most common reasons parents seek acute care for their children is for acute respiratory tract infections (ARTIs). This study aims to examine parental expectations of care via telemedicine for pediatric ARTIs, contrasting expectations of care delivered via primary care telemedicine and direct-to-consumer (DTC) telemedicine. We performed a sequential mixed methods analysis to examine how parents assess telemedicine for their children's acute care. We used ARTIs as a case study for examining parent perceptions of telemedicine. First, we analyzed semistructured interviews focused on parent responses about the use of telemedicine. Each factor discussed by parents was coded to reflect whether parents indicated it incentivized or disincentivized their preferences for telemedicine versus in-person care. Results were organized by a 7-dimension framework of parental health care seeking that was generated previously, which included dimensions related to care sites (expected access, affordability, clinical quality, and site quality) and dimensions related to child or family factors (perceived illness severity, perceived child susceptibility, and parent self-efficacy). Second, we analyzed responses to a national survey, which inquired about parental expectations of primary care telemedicine, commercial DTC telemedicine, and 3 in-person sites of care (primary care, urgent care, and emergency department) across 21 factors identified through prior qualitative work. To assess whether parents had different expectations of different telemedicine models, we compared survey responses for primary care telemedicine and commercial DTC telemedicine using weighted logistic regression. Interview participants (n=40) described factors affecting their perceptions of telemedicine as a care modality for pediatric ARTIs. Generally, factors aligned with access and affordability (eg, decreased wait time and lower out-of-pocket cost) were discussed as potential incentives for telemedicine use, while factors aligned with perceived illness severity, child susceptibility, and clinician quality (eg, trustworthiness) were discussed as potential disincentives for telemedicine use. In survey responses (n=1206), primary care and commercial DTC telemedicine were rated similarly on items related to expected accessibility and affordability. In contrast, on items related to expected quality of care, primary care telemedicine was viewed similarly to in-person primary care, while commercial DTC telemedicine was rated lower. For example, 69.7% (weighted; 842/1197) of respondents anticipated their children would be comfortable and cooperative with primary care telemedicine versus 49.7% (weighted; 584/1193) with commercial DTC telemedicine (P<.001). In a mixed methods analysis focused on telemedicine for ARTIs, parents expressed more concerns about telemedicine quality in commercial DTC models compared with primary care-based telemedicine. These results could help health systems better design telemedicine initiatives to support family-centered care.

Parental satisfaction with paediatric care with and without the support of an eHealth device: a quasi-experimental study in Sweden

BackgroundThe period after a child is discharged from hospital is generally described as challenging for the parents. Their satisfaction with the health services received is an important indicator of the quality of care. eHealth devices are increasingly used in health care to support communication with parents. Differences in levels of parental satisfaction by modality of provided care or by parental background are largely unknown. This study aimed to describe satisfaction with health care between sociodemographic groups of parents, who either received or did not receive an eHealth device for communication between parents and hospital staff as a supplement to routine care after a child’s discharge from neonatal or paediatric surgery departments.MethodsData from a quasi-experimental study was collected in the south of Sweden, between 2019 and 2021. The Pediatric Quality of Life Inventory™ (PedsQL) Healthcare Satisfaction Generic Module was used to assess the parents’ satisfaction with different dimensions of health care. Seventy parents of children hospitalized in a neonatal or a paediatric surgery department were enrolled in intervention (eHealth device, n = 36) and control (no eHealth device, n = 34) groups.ResultsThe parents reported high overall satisfaction with the health care provided and were also highly satisfied within different dimensions of care. Moreover, they reported high satisfaction with using an eHealth device, although having support from the eHealth device was related to neither higher nor lower levels of satisfaction with care. There was a significant difference between fathers and mothers in the multivariate sub-analysis in certain instances regarding satisfaction with communication and the level of inclusion.ConclusionsParents were very satisfied with the health care provided, whether or not they received eHealth. Further research looking at groups with and without the support of an eHealth device is required to further develop future paediatric and neonatal care interventions. Communication and support through eHealth can be a tool to alleviate the distress parents experience after their child’s hospital admission, accommodate the family’s transfer to home, and increase satisfaction with care, but it needs to be evaluated before being implemented.Trial registrationClinical Trials NCT04150120, first registration 4/11/2019.

Unlocking the Hidden Dimensions of Cancer Care: Cross-Cultural Adaptation and Feasibility Study of ESAS-FS, Assessing Spiritual Pain and Financial Distress in a Spanish-speaking Population with Advanced Cancer

IntroductionSpiritual pain and financial distress are two important dimensions of cancer care that are often overlooked. Both dimensions can have a significant impact on the quality of life of patients with cancer and their families. MethodsThis study conducted a cross-cultural adaptation, feasibility study, and psychometric properties of the Edmonton Symptom Assessment System-Financial and Spiritual (ESAS-FS) in a Spanish-speaking population with advanced cancer. The ESAS-FS is a patient-reported outcome measure that assesses 12 symptoms, including spiritual pain and financial distress. ResultsIn the cross-cultural adaptation process, the terms “spiritual pain” and “financial distress” were refined to “sufrimiento espiritual” and “preocupación por asuntos económicos” respectively, with strong professional consensus and high patients’ acceptancy (relevant questions 80%, appropriate terms 91%). A cohort of 100 onco-hematologic patients revealed that 70% experienced spiritual pain (mean 2.9/10), while 49% reported financial distress (mean 2.2/10). Symptomatic analyses illustrated significant associations of spiritual pain with various symptoms like fatigue, drowsiness, and depression. Similarly, financial distress correlated notably with drowsiness, depression, and anxiety. Moreover, a distinct correlation was observed between spiritual pain and financial distress. ConclusionThe findings of this study suggest that the ESAS-FS is a valuable tool for assessing spiritual pain and financial distress in Spanish-speaking patients with advanced cancer. The tool can be used to identify patients who are experiencing these dimensions of distress and to provide them with appropriate care.

Taking Care of Others and the Self through Islamic Funeral Service in Berlin

This article examines how Islamic funeral services contribute to the production of care in Berlin. Deriving from participant observations, in-depth interviews with migrant undertakers with Turkish backgrounds, and a collection of textual and visual materials, the article focuses on the practices of migrant undertakers. Against the essentialist arguments inherent to the identity politics of the existing scholarship on migrant death in Berlin and in Germany, I analyze this case study through a critical reading of the scholarship on ethnic entrepreneurship. In this context, I illustrate three findings on the production of care, which emerge at the intersection of technologies of the self and domination à la Foucault. In the first dimension, care is given to the deceased, (particularly those with an “immigrant background” from Turkey), their bereaved families and co-migrants, visitors, and employees of various institutions in Berlin. The second dimension of care is produced, as a form of self-examination, through migrant undertakers' recollections and reflections. In the third dimension, care is the result of socio-economic policies, related to the prospect of the emergence and development of ethnic entrepreneurship.

The everyday life occupations of older women in social vulnerability in Brazil

ABSTRACT Population aging is widely discussed due to the impacts of increased life expectancy, especially in socially vulnerable populations. This descriptive-exploratory qualitative study aims to understand older women’s perceptions of their occupations in a socially vulnerable community. The participants were 11 women, aged 60 years or older, living in Vila Marçola, Aglomerado da Serra, Minas Gerais, Brazil. Semi-structured interviews were carried out and the content was analyzed by using thematic analysis. Findings indicated four care dimensions: 1) Household care and caring for other people, 2) Community care, 3) Self-care, and 4) Expanding the experiences of care in old age. Older, mostly black, and poor women from Vila Marçola highlighted the unequal living conditions in Brazil. These women were overloaded with occupations, especially paid and unpaid household care, and did not have access to or stability in other occupations. However, retirement allowed them to participate in educational and social projects, increasing their occupational repertoire. This study contributes to the construction of intersectional knowledge in the field of occupational science, expanding the understanding of the socio-cultural dimensions that involve the diversity of people around the world, especially in situations of social vulnerability.

The "New-Old" Dimensions of Caring in Humanitarian Response: The Opportunity for Public Health Palliative Care to Advance the Humanitarian-Development Nexus, Decoloniality, and Localization Thought.

How can palliative care framings advance humanitarian discourse? The imperative for palliative care in humanitarian settings is increasingly urgent. Recent efforts by health and humanitarian organizations demonstrate increasing attention to the issue. Yet palliative care is still not adequately formally considered or enacted by humanitarian agencies in rhetoric, policy, research, or practice. Even where it is considered in humanitarian action, palliative care is often assumed to be a novel intervention, rather than a caring practice that has existed from time immemorial, including in humanitarian situations. The generation of ideas in this paper has followed a dynamic, iterative, and reflexive process through engagement with key literature, critical thinking, conversations with colleagues across both sectors, primary data, and debate amongst the authors. The paper argues that the current dominant frame of a new, specialized, professionalized, and medicalized palliative care in the humanitarian sector would perpetuate existing challenges. It contends that viewing both fields through a "new-old" lens, where historical and traditional caring practices intertwine with progressive discourse for a more just and appropriate public health response, can further humanitarianism. It posits that the humanitarian-development nexus, decoloniality, and localization thought can benefit from palliative care practice through critical interaction with a broad range of literature.

"They must have seen it, you know." Body talk, extension talk, and action talk: A qualitative study on how palliative care patients and their significant others express experiencing these nonverbal cues.

Communication about life-threatening disease and palliative care is essential but often experienced as difficult by those concerned and has mainly been studied in terms of its verbal components. Despite the fundamentality of nonverbal communication, its dimensions in care, especially in the communication by patients and their significant others, has not been as extensively examined. Drawing on a secondary qualitative content analysis of data from 23 interviews-15 with patients in specialized palliative home care in Sweden and 8 with their significant others-this study aims at understanding and characterizing how patients verbally express experiences of conveying nonverbal cues about life-threatening disease and its consequences and how their significant others express perceiving these cues. Patients expressed experiences of nonverbal communication in the form of cues conveying meaning about their disease and its consequences, often beyond their control. Whether and how the patients reinforced these cues verbally, depended on individual needs, care for others, and evaluations of relationships. Significant others acknowledged the presence of nonverbal cues and tried to interpret their meaning. Both patients and significant others emphasized the importance of nonverbal cues and actively related to how cues in the form of bodily appearance, aids, objects and acts, serve communicative functions about disease and its consequences. These dimensions of nonverbal communication are characterized as: body talk, extension talk and action talk. This study contributes to an international knowledge base on the complexities of nonverbal communicative aspects in these dimensions and how it affects patients and significant others. Professionals should be aware that dimensions of care, such as prescribed aids, from the patients' perspective can be perceived as nonverbal cues that might "speak of" disease progression.

Evaluating ICU nurses' education, practice, and competence in palliative and end-of-life care in Saudi Arabia: A cross-sectional study.

In palliative and end-of-life (PEOL) care, especially within intensive care units (ICUs), nurses' unique skills are critical, yet their expertise remains under-explored, particularly in Saudi Arabia. This study aimed to evaluate the education, practice, and perceived competence of adult ICU nurses in Saudi Arabia regarding PEOL care and to pinpoint key factors that influence this aspect of healthcare delivery. A cross-sectional design was utilized in this study. Participants were recruited from five public hospitals and one specialized center in Hail, Saudi Arabia. Data were gathered in September 2023 using the PEOL Care Index, which measures various care dimensions on a Likert scale in Arabic and English. IBM SPSS Statistics 29.0 was used for statistical analysis, particularly to conduct ANOVA, t-test, and multiple regression. 142 out of the targeted 171 ICU nurses completed the survey, yielding a response rate of 83.04%. Although 81% of the nurses had experience caring for dying patients, only 30.3% had received in-service PEOL care training. Those with this training demonstrated significantly higher scores in education, clinical practice, and perceived competence than their counterparts (p <0.05). Mean scores across these areas were 69.67, 71.01, and 71.61, respectively. In-service training positively correlated with these metrics (p <0.05). Multiple regressions also revealed that in-service training, job satisfaction, and communication authority are strong influencers, explaining 21.6% of the variation in clinical practice and 16.9% in perceived competence. The study highlighted the proficiency of ICU nurses in PEOL care, emphasizing that in-service training, job satisfaction, and the authority to communicate effectively with patients and their families significantly improved clinical practice and nurses' competence in PEOL care. This underlines the critical need for healthcare institutions to acknowledge and address these key factors to optimize patient care outcomes.

Construção e validação de conteúdo de instrumento de autoavaliação da qualidade do cuidado em instituição de longa permanência para pessoas idosas

Abstract Objective To develop and validate the content of a self-assessment instrument for the quality of care in Long-Term Care Facilities for Older Adults (Instituições de Longa Permanência para Idosos - ILPIs), named QualificaILPI. Method A methodological study conducted between March and December 2021. The instrument was developed based on a multidimensional quality model, Brazilian legislation, and literature research. It contains quality standards for self-assessment of ILPIs in the dimensions of environment, home, care, family and community involvement, work team, and management. Each standard is described and followed by a scale with parameters to classify the level of ILPI quality as incipient, intermediate, or consolidated. The modified Delphi Technique was employed for validation by a committee of 10 experts regarding the relevance of the standard for ILPI quality assessment, the appropriateness of objectives, the evaluation scale, and clarity, allowing for comments. The standard was retained when there was 75% agreement among the experts. The instrument was also evaluated by the target audience, consisting of coordinators from 10 ILPIs selected for convenience. Results In the first assessment cycle, three standards were excluded, and two new ones were created. In the second cycle, the dimension of one standard was changed, and two standards were combined. In the end, 29 standards remained, divided into six dimensions. The target audience, ILPI managers, suggested changes in the wording of some standards. There was a consensus of 80% or higher for all standards. Conclusion QualificaILPI has the potential to contribute to monitoring ILPIs, promoting the improvement of care offered to residents.

Conhecimento dos médicos residentes de Pediatria quanto aos conceitos e ensino dos cuidados paliativos durante a pós-graduação

Introduction: Palliative care consists of multidisciplinary assistance capable of improving the quality of life of patients with serious and threatening illnesses, integrating physical, psychological, social and spiritual aspects to the so-called “conventional” treatment, relieving pain and suffering in all its aspects faces. Objective: to evaluate the knowledge of pediatric residents about the concepts and teaching of palliative care during postgraduate studies. Methods: This is a descriptive, qualitative and phenomenological study. Results: 12 residents of the last year of the medical residency program participated, who, when expressing their conceptions on the subject, presented peculiarities of a care that has been improved over time, breaking paradigms, such as the search for cure and maintenance of life at any time. price, without making room for an approach aimed at the human being in its entirety. For them, this Gordian knot can be resolved with the acquisition of technical skills, communication, rehabilitation and knowledge of the process of dying and death. Discussion: Human beings are very innately resistant to facing death naturally, as part of life; this stems from social, cultural, spiritual, emotional aspects and teaching in the health area itself, evidenced by the interviewees lack of knowledge about the dimension of palliative care, without, however, disregarding its importance. Conclusion: Such characters do not feel empowered to interact with patients and family members in order to discuss the terminality. These results show a timid posture, and the peremptory need for this topic in professional training.

Bergson and the Aesthetics of Early Childhood Education and Care

Aesthetics has always been a fundamental dimension of Early Childhood Education and Care (ECEC), and it has been treated as a relation between matter and mind in a non-dualist and integrated way. Today, however, this dimension and relation is neglected. Abstract and formalist ideas of education, expressed in generalized standards, accountability and neuroscientific explanations, are forced upon educational practice and theory. To counter such neglect, one of Bergson’s major works, Matter and Memory (1988), is in this article used to critically assess abstract formalism as a badly stated problem in the aesthetics of ECEC and it is joined with historical and contemporary pedagogical-aesthetical resources that may be capable of re-activating the aesthetics of ECEC.

Satisfaction With Care Among Cancer Survivors With Medicare Coverage: Are There Rural Versus Urban Inequities?

Rural cancer survivors often face greater barriers to treatment, which may translate into worse satisfaction with health care. To examine rural versus urban differences in satisfaction with health care among Medicare cancer survivors. Data are from the 2020 Medicare Current Beneficiary Survey (MCBS). Rao-Scott chi-square analyses were conducted to examine rural versus urban inequities in satisfaction with 9 dimensions of health care (health professionals' concern for health, information about what was wrong, ease/convenience from home, ease of obtaining answers over telephone, getting needs taken care of at same location, availability of specialists, overall quality, and out-of-pocket costs, and availability of care at night/on weekends). Multiple logistic regression analyses were conducted to test for rural/urban differences while adjusting for race/ethnicity, gender, marital status, educational attainment, health insurance (traditional Medicare, Medicare Advantage, dual Medicaid coverage, employer, or self-purchased insurance), and self-rated overall health. Rural cancer survivors were less satisfied with the ease/convenience of getting to health professionals (93.35% rural and 96.87% urban) and less satisfied with getting all health care needs taken care of at the same location (88.32% rural and 92.22% urban). These rural/urban differences persisted when adjusting for other factors. Health care providers serving rural areas may need to consider new strategies to satisfy some of the unique needs of rural cancer survivors, such as better organizing services at single clinic sites and utilizing telehealth when feasible to reduce the need to travel for in-person services.

How does person-centered maternity care relate to postpartum contraceptive counseling and use? Evidence from a longitudinal study of women delivering at health facilities in Ethiopia

ObjectivesThis study examines the relationship between integrated, person-centered maternity care (PCMC), the provision of postpartum family planning (PPFP) services, and postpartum contraceptive use among women delivering at health facilities in Ethiopia. Study designWe analyze 2019–2021 longitudinal data from a representative sample of pregnant and recently postpartum women in Ethiopia. This study examines baseline, 6-week, and 6-month survey data collected from women who delivered at a health facility. ResultsMaternity patients who reported more person-centered care were more likely to be counseled on postpartum contraceptive methods before discharge. Overall, 27.5% of women delivering in a health facility received family planning counseling before discharge, ranging from 15.2% in the lowest PCMC quintile to 36.3% in the highest PCMC quintile. The receipt of PPFP counseling was associated with increased odds of postpartum contraceptive use. ConclusionsFindings suggest dimensions of quality care are interlinked, and person-centered care is associated with greater integration of recommended PPFP services into predischarge procedures. However, even among women who report relatively high levels of person-centered care, our results highlight that family planning is not routinely discussed prior to discharge from delivery, and very few women receive a contraceptive method or referral prior to discharge. ImplicationsWhile most postpartum women report they wish to limit or space future pregnancies, the uptake of modern contraceptive methods in the postpartum period is low. As women increasingly opt to deliver in health facilities, further integration of family planning services into predischarge procedures within maternity care can improve contraceptive access. Data statementThe data used in these analyses were collected as part of the PMA Ethiopia study. Data are publicly available at https://www.pmadata.org/data/request-access-datasets.

Evidence Synthesis for the Development of National Nursing-Sensitive Indicators in Malaysia: A Literature Review and Stakeholder Engagement Approach.

Nursing-sensitive indicators measure and evaluate nursing care quality and its contribution to patient care. The identification of indicators that demonstrate nursing care contribution and the quality of care delivered locally is of paramount importance, and national indicators that demonstrate this are essential. This paper aims to provide an evidence base of nursing-sensitive indicators that can facilitate the conceptualization of local nursing national indicators. A multifaceted and iterative approach incorporating literature review, and stakeholder engagements was utilized in evidence synthesis. A review of indicators present internationally complemented by the inclusion of context-specific local NSIs through stakeholder engagements was performed. Secondary data analysis of documents from an environmental scan was also included to highlight areas of concern for nursing-sensitive indicator prioritization from the viewpoint of nurses. A total of 64 articles were reviewed and indicators were coded according to the Nursing Care Performance Framework subsystems, dimensions, and variables. All papers reviewed had documented outcome indicators. From our secondary data analysis, nurses identified areas of concern such as nursing staff supply, staff maintenance, nursing processes and risk outcomes, and safety to be prioritized for developing quality indicators. This paper provides a list of NSIs coded systematically with definitions to aid stakeholders in prioritizing indicators for national indicator development. The inclusion of areas of concern provides insight into NSIs that nurse practitioners find relevant to the local context. To our knowledge, this is the first paper that includes evidence available in the literature and incorporates stakeholders' perspectives in synthesizing evidence needed to guide the development of national nursing indicators. This iterative approach is crucial because it enhances the likelihood of knowledge translation.

Dual Management: Diabetes and Sickle Cell Anemia in Patient Care

The coexistence of diabetes mellitus (DM) and sickle cell anemia (SCA) presents a complex medical challenge, necessitating an integrated approach to patient care. This review explores the interplay between diabetes and sickle cell anemia, addressing the epidemiology, pathophysiological intricacies, and the compounded complications associated with these comorbidities. Emphasizing the need for an interdisciplinary care model, the review discusses the challenges in patient care, encompassing both physiological and psychosocial dimensions. Furthermore, it outlines innovative treatment strategies, including medication management and lifestyle interventions, aiming to optimize outcomes for individuals navigating the dual management of diabetes and sickle cell anemia. By synthesizing current research findings and highlighting areas for future investigation, this review provides valuable insights into the complexities of dual management and offers a foundation for enhancing the quality of care for this unique patient population

“Existe o espaço, mas ao mesmo tempo não existe”: análise do processo de cuidado no tratamento psicofarmacológico na saúde mental

Considering the challenges to psychosocial rehabilitation, this study was aimed at understanding the perspective of users and workers regarding psychopharmacological treatment. This is a qualitative study, which interviewed six providers and ten users of the Psychosocial Care Center of a municipality in the north of Minas Gerais. The transcripts were treated in Coding Cycles and examined by Discourse Analysis. Three categories related to the micropolitical dimension of care were defined: the institutional flowchart; the intercessory spaces; and the subjective production of the agents. Dissonances were revealed between statements alluding to the psychosocial care policy, with the competition of emancipatory and restrictive conceptions and technologies of care. The importance of the micropolitical analysis of care in psychopharmacological treatment was verified, favoring the processes of contractuality, protagonism, and user autonomy.

From care practices to speculative vignettes-design considerations for robots in good care.

The care sector has become one of the test beds for developing robotic technologies, which have been promised to mitigate problems with aging populations and labor shortages. Despite these promises, the practical application of such technologies have been met with limited success. Apart from technical limitations, other challenges exist in the way we approach designing these technologies. Critical to the development in the care sector is understanding the complexity of the contexts, the needs and goals of diverse actors, and how these are socio-materially scaffolded. This paper presents a study conducted at the intersection of a value sensitive design and speculative design to understand these sensitivities. Based on the data collected in interviews (n = 6) and card workshops (n = 6) from care workers and residents in mobile care and care home contexts in Austria, we developed five themes capturing situated practices and understandings of good care as built on trust-developing routines, negotiations between different actors, affective and reciprocal dimension of care, care worker self-care, and material mediations. Subsequently, we created six speculative vignettes which serve as rhetorical devices to emphasize the tensions that arise with any technological intervention entering and reshaping existing care practices and relations. We argue that our approach can support robot designers to develop a rich understanding of the values and tensions in the specific context under study from the before design and development begin.

Customer definitions of moral value for retail brands: A qualitative understanding

The present study investigates consumer definitions of morality for brand value (BV) and whether the definitions are similar or different from ethics. Past research has identified many dimensions (e.g., functional value) of BV but not moral and ethical, which is surprising. There is also a constant debate on whether morality is similar or different from ethics, but only some scholars offer limited empirical research. Some clarity informed by in-depth qualitative insights will illuminate the debate and whether morality is necessary or redundant to a BV framework after ethics has been considered. Hence, we purposefully recruited and interviewed 12 British consumers from varied backgrounds to gauge their morality and ethical definitions of BV. Our work suggests that morality and ethics are necessary to develop a BV framework because they are not identical. Whilst they share the caring dimension, they are also distinct. Morality is more about cooperation/teamwork and prudence, whereas ethics is more about compliance plus fairness/honesty.