Care Relationships Research Articles

Exploring Product Design Innovation through Repair Techniques: Insights from Knowledge and Experience

Repair has been a longstanding activity in human society. However, in modern times, the production strategy of “planned obsolescence” has led to a decline in product quality and lifespan, resulting in closed and non-repairable products. Additionally, advertising manipulates consumers' desires, leading them to prefer replacing old items with new ones rather than repairing them. This has resulted in issues such as overconsumption, massive waste, and recycling challenges. Nevertheless, many DIY repair enthusiasts promote repair activities through communities and online media, highlighting the joy and creativity of repair. This unique relationship of care between people and objects extends the life of products and alters their original appearance and function, creating new possibilities to meet consumers’ needs. This study analyzes actual cases to explore how DIY repairers innovate during the repair process, reinterpret old items, and elucidate the interaction between people and objects. Furthermore, it argues that repair activities represent a radical approach to mitigating waste and are crucial for advancing sustainable development.

A transdisciplinary co‐conceptualisation of marine identity

Abstract Challenge 10 of the United Nations Decade of Ocean Science for Sustainable Development (2021–2030) calls for the restoration of society's relationship with the ocean. Research suggests that the relationship people have with marine environments can influence their depth of engagement in marine citizenship action, and the important role for ‘marine identity’ in driving that action. Although identity is well‐researched, marine identity is a concept novel to academia and a baseline understanding is required, both to grasp the scope of the concept, and to support research into its role in transforming the human‐ocean relationship. Here, a transdisciplinary study, endorsed as a UN Ocean Decade Activity and by the EU Mission Ocean & Waters, brought together a multinational community of marine researchers and practitioners to co‐produce a baseline conceptualisation of marine identity, drawing on photovoice and deliberative methodology. This paper presents the findings of the co‐production process and offers a first introduction in the literature of the multiple variations and formations of marine identity. We find marine identity to be a complex and multidimensional concept, suffused with individual experiences and understandings of the marine environment, based on social and cultural understandings of the ocean, contemporarily and historically. We present real‐world examples of marine identity to illustrate key themes that were developed through co‐production. Policy implications: We propose marine identity as a catalyst for understanding existing multifaceted and caring relationships with the ocean, as well as the restoration of society's relationship with the ocean. Marine identity research should, therefore, be prioritised in research seeking to contribute to the UN Ocean Decade Challenge 10, as this will support integration of non‐material values of the ocean into marine planning processes and policy making, enabling effective responses to Challenge 10's emphasis on integrating traditional/cultural ways of knowing and valuing the marine environment, through diverse marine identities. We welcome research efforts that will further develop the marine identity concept and empirically investigate the relationships between marine identity, marine citizenship, and people's relationships with the ocean. Read the free Plain Language Summary for this article on the Journal blog.

Managing expression and hand holding in The Good Wife: how ‘leaning in’ demands emotional labour

The Good Wife takes a seemingly feminist approach to the well-known media narrative of the disgraced politician and his stoic forgiving wife. The CBS series is widely understood as embodying neoliberal feminism akin to that of Sheryl Sandberg's Lean In: Women, Work, and the Will to Lead. While The Good Wife predates the publication of Lean In, its protagonist Alicia Florrick (Julianna Margulies) is a proto-Sandberg who thrives in a cut-throat corporate environment thanks to her capacity to bring the skills she cultivated as a mother and political wife into her restarted law career. Alicia's corporate success is enabled by her defence of her husband's actions in the media, capacity to emotionally manipulate colleagues and clients, influence over jury members and witnesses and the suppression of her feelings for the benefit of her employers, clients and family. This article argues that The Good Wife makes apparent the centrality of emotional labour to neoliberal feminism, whereby traditionally feminised ‘soft’ skills like care work, emotion management, negotiation, relationship building and persuasion are put to work for capitalist success . In The Good Wife, ‘managing expression’ and ‘hand holding’ are key to Alicia's corporate success, highlighting how under neoliberal feminism, emotion is both labour and liability.

Self-Reported Perceptions of Patients and Staff on Participation and Verbal and Social Interactions in High-Security Forensic Psychiatric Care in Sweden.

Studies suggest that experiences of patient participation, as described by both patients and staff, are associated with a significant caring relationship of high quality. This study aimed to investigate staffs' and patients' self-reported perceptions on participation and the frequency and importance of verbal and social interactions in high-security forensic psychiatry. The questionnaire Verbal and Social Interactions (VSI) was used together with the subscale Participation from Quality in Psychiatric Care (QPC). The study was conducted at a large forensic psychiatric clinic in Sweden. Staff and patients rated the frequency of VSI differently while reporting the same perceived degree of patient participation. All categories of VSI were significantly correlated with perceived level of participation with medium or small effect size for the patients. Patients' perceived participation seems to depend on verbal and social interaction within the specific categories 'Showing interest in the patients' feelings, experiences, and behavior' and 'Helping the patients establish structure and routines in their everyday life'. There was, however, a negative association for the latter. The results give a better understanding of what kind of interactions that affect patients' perceived level of participation. Patient participant is a prioritised area for development in forensic psychiatry. The study contributes to a better understanding of what types of interactions that affect the perceived level of participation, while at the same time, it shows important similarities and differences between patient and staff perspectives.

Beyond error: A qualitative study of human factors in serious adverse events.

The field of healthcare quality and safety has been informed by the study of Human Factors contributing to adverse events. Hitherto, much of the study of Human Factors has been focused on a narrow lens of human error, identifying cognitive-based or knowledge-based errors and cognitive processes such as loss of situational awareness contributing to error. While these factors are important, this narrow approach fails to consider the complexity of relational and systemic factors that also contribute to adverse events. We aimed to explore the relational and systemic human factors, including shared clinician attitudes and behavior, that contribute to serious adverse patient events in a public health setting. The study, set in a metropolitan local health district in New South Wales, Australia, was conducted using a retrospective qualitative multi-incident content analysis design. Serious adverse event reviews (SAER) over 6 months (2022-2023) were subject to qualitative content analysis until data saturation was reached. Data saturation reached at 20 reports. Emergent themes related to human factors in serious adverse events included: (i) delays and inertia-with a subtheme of inertia of ageism; (ii) "All-or-nothing" approach to end-of-life care and planning; (iii) communication lapses; and (iv) implementation gap between standards and practice. Error-based incidents accounted for only 35% of the serious adverse events examined. The sample studied involved mostly (65%) male patients, with a mean age of 69 (70% aged >65), managed across the gamut of specialties, with the most common incident being the management of acutely deteriorating patients. In conclusion, there is more to Human Factors in adverse events than cognitive or knowledge-based error. While identifying and correcting errors is absolutely essential, we need adjunctive "soft measures" to address clinical attitudes, behaviors, and relationships in health care, particularly in increasingly complex, fraught, and stressful health care environments.

Fostering nurse-patient relationships in palliative care: An integrative review with narrative synthesis.

Nurse-patient relationships are an integral component of person-centred palliative care. Greater understanding of how nurse-patient relationships are fostered and perceived by patients and nurses can be used to inform nursing practice. To systematically identify and synthesise how nurse-patient relationships are fostered in specialist inpatient palliative care settings, and how nurse-patient relationships were perceived by patients and nurses. Integrative review with narrative synthesis. The review protocol was registered with PROSPERO (CRD42022336148, updated April, 2023). Five electronic databases (PubMed, CINAHL Complete, Medline, Web of Science and PsycINFO) were searched for articles published from their inception to December 2023. Studies were included if they (i) examined nurse and/or patient perspectives and experiences of nurse-patient relationships in specialist inpatient palliative care, (ii) were published in English in a (iii) peer-reviewed journal. The Mixed Methods Appraisal Tool was used to evaluate study quality. Data were synthesised using narrative synthesis. Thirty-four papers from 31 studies were included in this review. Studies were mostly qualitative and were of high methodological quality. Four themes were identified: (a) creating connections; (b) fostering meaningful patient engagement; (c) negotiating choices and (d) building trust. Nurses and patients are invested in the nurse-patient relationship, benefitting when it is positive, therapeutic and both parties are valued partners in the care. Key elements of fostering the nurse-patient relationship in palliative care were revealed, however, the dominance of the nurses' perspectives signifies that the nature and impact of these relationships may not be well understood.

Moral distress related to paid and unpaid care among healthcare workers during the COVID-19 pandemic.

While there is growing literature on experiences of healthcare workers and those providing unpaid care during COVID-19, little research considers the relationships between paid and unpaid care burdens and contributions. We administered a moral distress survey to healthcare workers in Canada, in 2022, collecting data on both paid and unpaid care. There were no significant differences in the proportion of participants providing unpaid care by gender, with both genders equally affected by certain responsibilities such as reduced contact with family/loved ones. However, men were significantly more distressed about specific unpaid care responsibilities. Unpaid care was not significantly associated with differences in intention to leave work. At work, women were significantly more concerned about patients unable to see family, while men were distressed by others mistreating COVID patients. This study enhances understanding of paid and unpaid care relationships, particularly during crises, and proposes an innovative method for assessing unpaid care burdens.

Platforms mediating domestic care work as service gigs in European cities: Reorganisation of social reproduction through marketisation

In European cities, lean labour platforms increasingly mediate domestic service gigs related to social reproduction, such as food delivery and cleaning tasks on-demand. This fast-growing type of platform depends on spatial proximity and the population density of cities, economic relations enabled by digital technologies and embodied gendered and racialised norms. At the same time, platforms are linked to the crisis of social reproduction and to a constant supply of people in precarious positions looking for income. The paper tackles the question how platform-mediated service gigs related to grocery shopping, cooking and cleaning change caring relationships. This comprises considerations of the dimensions of marketisation and the transformation of reproductive work symbolically, materially, and socially and is presented with a feminist perspective pointing to social reproduction as an essential but devalued part of everyday life. These endeavours are explored with findings from various case studies dealing with food delivery and cleaning platforms in Austria and Germany and are discussed with reference to relational care ethics. Put forward here is a reflection on the ways in which digital mediation of domestic care work relies on gendered and racialised norms – and how this dependence intensifies structural inequalities inherent to social reproduction.

Words and views on old age, or how ageism undermines the care relationship

Anxiety about ageing, as well as old age, is rooted in public discourse and has a negative impact on the quality of the relationship with the elderly, particularly in the context of care relationships with more vulnerable seniors. This text proposes a theoretical and empirical reflection on ageism, manifested as much in its hostile as in its compassionate forms.

EAducation: Letters from Hawai'i to Palestine

Abstract: This essay explores ways to strengthen solidarity from Hawai'i to Palestine, in our classrooms and organizing spaces. We are particularly interested in the role that stories have to play in forging relationships of care. We look to the power that stories hold in creating bonds of friendship that are at the core of political community, and to their importance in EAducation, which we contend is central to solidarity. (As it includes the word EA , or sovereignty, breath, rising, the term EAducation bridges liberation and learning inside and beyond the classroom.) Written as a series of letters, to our readers and to one another, we theorize the significance of letters as what the Palestinian scholar and organizer Sarah Ihmoud calls "material expressions of an abolitionist praxis of decolonial love." In their form, our letters also put into practice the principles we embrace. As we explore and enact ways to build solidarity, we look to the work we do in our own classrooms, and to organizing we have done as members of Students and Faculty for Justice in Palestine at the University of Hawai'i (SFJP@UH). In documenting this history, we hope that the stories we tell will help to inspire more such stories, strengthening what Steven Salaita calls "inter/nationalism," and what Haunani-Kay Trask calls "the rope of resistance."

Fathers' transformative caring experiences of engaging in music and singing with their children

AbstractThis study explores the role of music and singing in fostering transformative caring relationships between fathers and their children. It aims to understand how these interactions contribute to fatherhood identity and relational dynamics, filling a significant gap in research on musical fatherhood. Employing a phenomenological‐hermeneutic approach, the study conducted open‐ended interviews with eight fathers, analysing data through the lens of Paul Ricoeur's theory of interpretation. Findings reveal that musical activities enable fathers to engage intuitively and responsively with their children, facilitating a pre‐verbal form of communication that deepens emotional bonds and enhances paternal identity. Music and singing emerge as powerful tools that transcend traditional parenting roles, allowing fathers to experience and express a potentiated sense of fatherhood marked by empathy, connection and care. This study highlights the profound impact of musical engagement on father–child relationships and suggests broader implications for emotional intelligence and gender roles in parenting.

Transnational belonging and disrupted care relationships

Transnational belonging and disrupted care relationships

Exploring expressed emotion and its influencing factors among family caregivers of dementia people: a 3-month study in Japan.

Family caregivers of dementia patients face significant challenges, including managing their own emotional responses. Understanding factors influencing expressed emotion (EE) is crucial for effective support interventions. The aim of this study was to explore and describe changes in EE among family caregivers of dementia and its associated factors at different time points over 3 months. A 3-month observational study was conducted in Japan. We collected demographically detailed data on family caregivers currently providing care, including care burden, relationship closeness, and depression. We assessed EE using the validated Family Attitude Scale (FAS). After adjustment for multiple confounding factors, multivariate linear regression analysis was performed to assess factors affecting EE at various time points. Linear regression analysis with generalised estimating equations was used to assess associations between 3-month time-varying EE and burden, intimacy, and depression. Fifty-six family caregivers completed the study. Changes in FAS scores did not show statistical differences over 3 months. It is worth noting that the degree of relationship closeness and care burden are important influencing factors of EE in both cross-sectional analysis and longitudinal analysis. Early identification of risk factors can aid in developing interventions aimed at preventing high levels of EE in the dementia family, thereby mitigating their detrimental effects. Tailored interventions are essential to enhance caregiver well-being and cultivate positive caregiver-patient relationships.

Unveiling the dynamics of older person care: a qualitative exploration of the intersection between formal and informal caregiving from the perspectives of registered nurses in Greece

In the evolving landscape of older person care, the imperative to explore holistic approaches persists, especially in regions with distinct societal norms around informal caregiving. The deeply ingrained tradition of familial caregiving, often led by female family members, has historically compensated for healthcare system gaps in less integrated systems. Hence, societal expectations may affect registered nurses’ experiences and impact the quality of care for older persons. This study aims to describe the meaning of caring for older persons in care settings in Greece. Ten in-depth interviews with registered nurses in older person care settings underwent qualitative thematic analysis. Four themes emerged from the analysis: (i) Living and bonding with older people as a basis for caring, (ii) Caring as a double-faced fulfillment, (iii) A sense of insufficiency in the caring relationship, and (iv) The encounter of existential issues creating loneliness. This research provides insights into the meaning of caring for older persons, highlighting the experiences of the closest professional caregivers of older individuals. A specific capture of the entanglement of cultural norms, societal expectations, and their impact on professional caregivers’ experiences may contribute to quality care provision in systems rooted in familial caregiving traditions.

Competence Profile of the Intra-Hospital Emergency Team Nurse: A Scoping Review

Background: Nurses in intra-hospital emergency teams are required to be competent in responding to situations of clinical deterioration and emergency. This study aimed to map the extent, variety, and nature of the literature on the competences of the intra-hospital emergency teams nurse. Methods: A scoping review based on the principles of the Joanna Briggs Institute. The search of the databases was conducted in July and August 2023, and the search strategy was adjusted. The analysis of the relevance of the articles, data extraction, and synthesis were conducted by two reviewers. Discrepancies were resolved by a third reviewer. The data were extracted using the competency outcomes and performance assessment (COPA) model. Results: Fourteen results were analyzed, and the competences organized by the domains of the COPA model which are considered by some authors to be advanced or specialized are as follows: assessment and intervention, communication, critical thinking, teaching, human caring relationships, management, leadership, and knowledge integration. Other competences, such as self-confidence, ability to remain calm, concentration, quick reaction, and a sense of humor, were mentioned. Conclusions: The results highlighted the competences of the intra-hospital emergency team nurse. This knowledge could contribute to educational programs and shape the competency profile of intra-hospital emergency team nurses.

Which factors affect post-transfer gaps in follow-up care? A qualitative study of the insights of healthcare providers in Sweden and Belgium

BackgroundYoung people with congenital heart disease (CHD) are frequently affected by discontinued follow-up when transferring from paediatric to adult care. Identified predictors for discontinuation include mostly patient-related factors, and further...

Intellect, Emotion, and Will: A Duoethnography on Human Education

We engaged in duoethnographic research to deepen our understanding of Japanese educator Daisaku Ikeda’s notion of ningen kyōiku, or “human education,” a lifelong process of transformation based on commitments to dialogue, value creation, global citizenship and creative coexistence. In particular, we examine the cultivation of intellect, emotion, and will from Ikeda’s human education perspective, focusing on our experiences both as students and as teachers in K-12 schools. Data sources included notes and transcriptions of video conferences and past conference presentation scripts. We found that our own education neglected some aspects of human education. Our student experiences propelled us as teachers toward creating educational experiences that support the development of intellect, emotion, and will through building trusting and caring relationships and creating structure to support student autonomy. Further, we realized that when one becomes aware of the interconnectedness of all life, the three aspects of human education—intellect, emotion, and will—transform into wisdom to use knowledge, compassion to maintain an imaginative empathy, and courage to take action. In our explorations, we worked to articulate an alternative to the current culture of schooling, and the study has helped us imagine future possibilities by explicating the lived curriculum, or currere, of human education. We hope that this study might encourage more educators to focus on guiding their students’ holistic growth as human beings in their unique contexts.

Quality of care and patient satisfaction: Future trends and economic implications for the healthcare system

AbstractThe healthcare system is a fundamental pillar for the economy of any country. One of its main goals is to reach an adequate effectiveness of medical care so that certain levels of well‐being are achieved. In recent years, healthcare has experienced important changes to take into account quality of care and patient satisfaction as the drivers of effectiveness and financial performance. In this sense, it is specifically important to bring together in a single document all aspects that participate in the quality of care and patient satisfaction relationship. The purpose of this paper is to analyze, organize, and synthesize all the theories, methodologies, factors, and variables that conform to this relationship. To achieve that, a systematic literature review of 90 articles is performed. The main contributions of this paper are to reveal all factors and aspects relevant for the quality of care and patient satisfaction binomial, and the classification of impactful articles, methodological and theoretical approaches, leading journals, and variables of interest that exist in quality of care and patient satisfaction research. Eventually, important research gaps and further research lines are highlighted.

Shifting more‐than‐human relationships amidst social–ecological disturbance

Abstract Social–ecological disruptions, such as changing climate, extreme weather‐related events and the COVID‐19 pandemic, can have cascading and long‐term consequences for people, ecosystems and multispecies relationships. As the early COVID‐19 pandemic disrupted people's lives through isolation and restricted human contact, more‐than‐human relationships played a heightened role in individuals' day‐to‐day lives with potential long‐term impacts on multispecies justice. We analysed 72 interviews conducted during the early (May–June 2020) COVID‐19 lockdown in the United States to investigate how social–ecological disruptions and spatial re‐orderings, exemplified by the pandemic, reassemble more‐than‐human relationships. We consider new relational values through a transformative multispecies justice framing, which contends that times of uncertainty can inspire meaningful connections with the more‐than‐human world, facilitating care and reciprocal relationships during times of disruption. Among interviewee accounts, we find that disorderings of daily life during the pandemic interweave with past and ongoing experiences of inequity to form mosaics of disruption. These mosaics of disruption created circumstances in which interviewees formed new connections with the more‐than‐human world. The more‐than‐human connections of interviewees sat along a spectrum and did not universally represent the same strength of relational values. The more‐than‐human connections were defined by individual's positionality and restricted geographies of the circumstances. However, the newly formed relationships seemed to be ephemeral, indicating that they would not necessarily endure outside of an early‐pandemic context. Thus, while individuals reported rearranged relationships out of pandemic precarity, their transitory qualities do not directly promise long‐term transformational multispecies connections. Our findings suggest that moments of disruption alone do not necessarily produce durable change and there is a need to go beyond merely recognizing relationality. Policy implications: Transformative multispecies justice requires long‐term, routine commitment to deepening relationships with the more‐than‐human world. While future social–ecological and spatial disturbances can be a window of opportunity to initiate multispecies relationships, future initiatives and policies must actively support and foster these relationships and strong relational values beyond the disturbances—recognizing the long‐term, non‐linear processes of transformation needed to address our future challenges. Read the free Plain Language Summary for this article on the Journal blog.

‘It hurts my heart’: Afghan women in London negotiating family relationships and (im)mobility regimes across borders

AbstractThis paper aims to contribute new insights into transnational care relationships by drawing on qualitative longitudinal data, to explore the complexities and nuances of Afghan women's dynamic family relations across multiple countries and continents. Rather than treating transnational families as a homogeneous unit, we present rich case studies to explore relationships with particular relatives, such as mothers, sisters and in‐laws, to understand the different dynamics within specific familial ties. Paying attention to the specificities of spatial contexts and infrastructures in framing opportunities and obstacles to transnational care, we apply the concept of immobility regimes. Beyond a simple bi‐national focus on countries of origin and residence, we explore how the women navigate these regimes, across multiple countries and different visa regimes to arrange in‐person visits with geographically dispersed kin. We consider the role of ICTs and the limitations of poor connectivity, especially in countries like Afghanistan, and the gender power dynamics that may limit women's access to technologies.