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Ishikura T, Sato W, Takamatsu J, Yuguchi A, Cho SG, Ding M, Yoshikawa S, Ogasawara T. Delivery of pleasant stroke touch via robot in older adults. Front Psychol 2024; 14:1292178. [PMID: 38264418 PMCID: PMC10803411 DOI: 10.3389/fpsyg.2023.1292178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/11/2023] [Indexed: 01/25/2024] Open
Abstract
Touch care has clinically positive effects on older adults. Touch can be delivered using robots, addressing the lack of caregivers. A recent study of younger participants showed that stroke touch delivered via robot produced subjective and physiologically positive emotional responses similar to those evoked by human touch. However, whether robotic touch can elicit similar responses in older adults remains unknown. We investigated this topic by assessing subjective rating (valence and arousal) and physiological signals [corrugator and zygomatic electromyography (EMG) and skin conductance response (SCR)] to gentle stroking motions delivered to the backs of older participants by robot and human agents at two different speeds: 2.6 and 8.5 cm/s. Following the recent study, the participants were informed that only the robot strokes them. We compared the difference between the younger (their data from the previous study) and the older participants in their responses when the two agents (a robot and a human) stroked them. Subjectively, data from both younger and older participants showed that 8.5 cm/s stroking was more positive and arousing than 2.6 cm/s stroking for both human and robot agents. Physiologically, data from both younger and older participants showed that 8.5 cm/s stroking induced weaker corrugator EMG activity and stronger SCR activity than the 2.6 cm/s stroking for both agents. These results demonstrate that the overall patterns of the older groups responses were similar to those of the younger group, and suggest that robot-delivered stroke touch can elicit pleasant emotional responses in older adults.
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Affiliation(s)
- Tomoki Ishikura
- Robotics Laboratory, Division of Information Science, Nara Institute of Science and Technology, Ikoma, Japan
| | - Wataru Sato
- Psychological Process Research Team, Guardian Robot Project, RIKEN, Kyoto, Japan
| | - Jun Takamatsu
- Applied Robotics Research, Microsoft Corporation, Redmond, WA, United States
| | - Akishige Yuguchi
- Robotics Laboratory, Department of Medical and Robotic Engineering Design, Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
- Knowledge Acquisition and Dialogue Research Team, Guardian Robot Project, RIKEN, Kyoto, Japan
| | - Sung-Gwi Cho
- Division of Electronic Engineering, School of Science and Engineering, Tokyo Denki University, Saitama, Japan
| | - Ming Ding
- Institutes of Innovation for Future Society, Nagoya University, Nagoya, Japan
| | - Sakiko Yoshikawa
- Institute for Philosophy and Science of Art, Kyoto University of the Arts, Kyoto, Japan
| | - Tsukasa Ogasawara
- Robotics Laboratory, Division of Information Science, Nara Institute of Science and Technology, Ikoma, Japan
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Md Hussin NS, Karuppannan M, Gopalan Y, Tan KM, Gnanasan S. Exploration of non-pharmacological interventions in the management of behavioural and psychological symptoms of dementia. Singapore Med J 2023; 64:497-502. [PMID: 34600449 PMCID: PMC10476919 DOI: 10.11622/smedj.2021125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 01/07/2021] [Indexed: 11/18/2022]
Abstract
Introduction Behavioural and psychological symptoms of dementia (BPSD) are considered integral parts of dementia. While pharmacotherapy is reserved for severe symptoms of BPSD, the associated adverse effects can be detrimental. Therefore, non-pharmacological intervention is recommended as the first line of treatment in the management of BPSD. This study aimed to explore the non-pharmacological approaches for the management of BPSD and the strategies and barriers to implementing them in secondary care facilities in Malaysia. Methods A qualitative study design was employed. Data were collected through observations and semi-structured interviews of 12 caregivers and 11 people with dementia (PWD) at seven secondary care facilities. Observations were written in the field notes, and interviews were audio-recorded and transcribed. All data were subjected to thematic analysis. Results Some personalised non-pharmacological interventions, such as physical exercise, music therapy, reminiscence therapy and pet therapy, were conducted in several nursing care centres. Collaborative care from the care providers and family members was found to be an important facilitating factor. The lack of family support led to care providers carrying additional workload beyond their job scope. Other barriers to non-pharmacological interventions were cultural and language differences between the care providers and PWD, inadequate staff numbers and training, and time constraints. Conclusion Although non-pharmacological approaches have been used to some extent in Malaysia, continuous education and training of healthcare providers and the family members of PWD is needed to overcome the challenges to their successful implementation.
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Affiliation(s)
- Nur Sabiha Md Hussin
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Selangor, Malaysia
| | - Mahmathi Karuppannan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Selangor, Malaysia
| | - Yogheswaran Gopalan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Selangor, Malaysia
| | - Kit Mun Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shubashini Gnanasan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Selangor, Malaysia
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Nakazawa A, Iwamoto M, Kurazume R, Nunoi M, Kobayashi M, Honda M. Augmented reality-based affective training for improving care communication skill and empathy. PLoS One 2023; 18:e0288175. [PMID: 37428739 DOI: 10.1371/journal.pone.0288175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 06/21/2023] [Indexed: 07/12/2023] Open
Abstract
It is important for caregivers of people with dementia (PwD) to have good patient communication skills as it has been known to reduce the behavioral and psychological symptoms of dementia (BPSD) of PwD as well as caregiver burnout. However, acquiring such skills often requires one-on-one affective training, which can be costly. In this study, we propose affective training using augmented reality (AR) for supporting the acquisition of such skills. The system uses see-through AR glasses and a nursing training doll to train the user in both practical nursing skills and affective skills such as eye contact and patient communication. The experiment was conducted with 38 nursing students. The participants were assigned to either the Doll group, which only used a doll for training, or the AR group, which used both a doll and the AR system. The results showed that eye contact significantly increased and the face-to-face distance and angle decreased in the AR group, while the Doll group had no significant difference. In addition, the empathy score of the AR group significantly increased after the training. Upon analyzing the correlation between personality and changes of physical skills, we found a significant positive correlation between the improvement rate of eye contact and extraversion in the AR group. These results demonstrated that affective training using AR is effective for improving caregivers' physical skills and their empathy for their patients. We believe that this system will be beneficial not only for dementia caregivers but for anyone looking to improve their general communication skills.
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Affiliation(s)
- Atsushi Nakazawa
- Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Japan
| | - Miyuki Iwamoto
- Department of Advanced Fibro-Science, Kyoto Institute of Technology, Kyoto, Japan
| | - Ryo Kurazume
- Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Masato Nunoi
- School of Human Sciences, Sugiyama Jogakuen University, Nagoya, Aichi, Japan
| | - Masaki Kobayashi
- Division of geriatric medicine, Rochester Regional Health System, Rochester, NY, United States of America
| | - Miwako Honda
- Division of Geriatric Research, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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Kobayashi M, Katayama M, Hayashi T, Hashiyama T, Iyanagi T, Une S, Honda M. Effect of multimodal comprehensive communication skills training with video analysis by artificial intelligence for physicians on acute geriatric care: a mixed-methods study. BMJ Open 2023; 13:e065477. [PMID: 36868602 PMCID: PMC9990644 DOI: 10.1136/bmjopen-2022-065477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVES To quantitatively analyse by artificial intelligence (AI) the communication skills of physicians in an acute care hospital for geriatric care following a multimodal comprehensive care communication skills training programme and to qualitatively explore the educational benefits of this training programme. DESIGN A convergent mixed-methods study, including an intervention trial with a quasi-experimental design, was conducted to quantitatively analyse the communication skills of physicians. Qualitative data were collected via physicians' responses to an open-ended questionnaire administered after the training. SETTING An acute care hospital. PARTICIPANTS A total of 23 physicians. INTERVENTIONS In a 4-week multimodal comprehensive care communication skills training programme, including video lectures and bedside instruction, from May to October 2021, all the participants examined a simulated patient in the same scenario before and after their training. These examinations were video recorded by an eye-tracking camera and two fixed cameras. Then, the videos were analysed for communication skills by AI. MAIN OUTCOME MEASURES The primary outcomes were the physicians' eye contact, verbal expression, physical touch and multimodal communication skills with a simulated patient. The secondary outcomes were the physicians' empathy and burnout scores. RESULTS The proportion of the duration of the participants' single and multimodal types of communication significantly increased (p<0.001). The mean empathy scores and the personal accomplishment burnout scores also significantly increased after training. We developed a learning cycle model based on the six categories that changed after training from the physicians' perspective: multimodal comprehensive care communication skills training; increasing awareness of and sensitivity to changes to geriatric patients' condition; changes in clinical management; professionalism; team building and personal accomplishments. CONCLUSIONS Our study showed that multimodal comprehensive care communication skills training for physicians increased the proportions of time spent performing single and multimodal communication skills by video analysis through AI. TRIAL REGISTRATION NUMBER UMIN Clinical Trials Registry (UMIN000044288; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050586).
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Affiliation(s)
- Masaki Kobayashi
- Department of Geriatric Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
- Division of Geriatric Medicine, Rochester Regional Health System, Rochester, New York, USA
| | - Mitsuya Katayama
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Tomofumi Hayashi
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Takuhiro Hashiyama
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Toshinori Iyanagi
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Saki Une
- Department of Geriatric Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
| | - Miwako Honda
- Department of Geriatric Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan
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Soun S, Hunter KF, Dahlke S. Nursing Care Management of Responsive Behaviors for Persons Living With Dementia in Acute Care Settings: An Integrative Review. J Gerontol Nurs 2023; 49:19-25. [PMID: 36719660 DOI: 10.3928/00989134-20230106-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The current integrative review was performed to understand how acute care nurses manage responsive behaviors among persons living with dementia (PLWD) in acute care settings. Eight studies were included, and three themes were developed: Person-Centered Approach, Non-Person-Centered Approach, and Facilitators and Barriers to Care Approaches. Nurses expressed difficulties in caring for hospitalized PLWD due to lack of knowledge of dementia care, pressure to work more efficiently, and prioritization of acute medical concerns. Nurses frequently used nonpharmacological approaches that required less time spent with patients. Results suggest that nurses in acute care settings require further education regarding dementia and person-centered care approaches for PLWD. Nursing management can support nurses' learning needs through education and policies to improve patient outcomes. [Journal of Gerontological Nursing, 49(2), 19-25.].
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Ishikura T, Kitamura Y, Sato W, Takamatsu J, Yuguchi A, Cho SG, Ding M, Yoshikawa S, Ogasawara T. Pleasant Stroke Touch on Human Back by a Human and a Robot. SENSORS (BASEL, SWITZERLAND) 2023; 23:1136. [PMID: 36772176 PMCID: PMC9919452 DOI: 10.3390/s23031136] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Pleasant touching is an important aspect of social interactions that is widely used as a caregiving technique. To address the problems resulting from a lack of available human caregivers, previous research has attempted to develop robots that can perform this kind of pleasant touch. However, it remains unclear whether robots can provide such a pleasant touch in a manner similar to humans. To investigate this issue, we compared the effect of the speed of gentle strokes on the back between human and robot agents on the emotional responses of human participants (n = 28). A robot or a human stroked on the participants' back at two different speeds (i.e., 2.6 and 8.5 cm/s). The participants' subjective (valence and arousal ratings) and physiological (facial electromyography (EMG) recorded from the corrugator supercilii and zygomatic major muscles and skin conductance response) emotional reactions were measured. The subjective ratings demonstrated that the speed of 8.5 cm/s was more pleasant and arousing than the speed of 2.6 cm/s for both human and robot strokes. The corrugator supercilii EMG showed that the speed of 8.5 cm/s resulted in reduced activity in response to both human and robot strokes. These results demonstrate similar speed-dependent modulations of stroke on subjective and physiological positive emotional responses across human and robot agents and suggest that robots can provide a pleasant touch similar to that of humans.
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Affiliation(s)
- Tomoki Ishikura
- Division of Information Science, Nara Institute of Science and Technology, Ikoma 630-0192, Japan
| | - Yuki Kitamura
- Division of Information Science, Nara Institute of Science and Technology, Ikoma 630-0192, Japan
| | - Wataru Sato
- Psychological Process Research Team, Guardian Robot Project, RIKEN, Seika-cho, Soraku-gun, Kyoto 619-0228, Japan
| | - Jun Takamatsu
- Division of Information Science, Nara Institute of Science and Technology, Ikoma 630-0192, Japan
| | - Akishige Yuguchi
- Division of Information Science, Nara Institute of Science and Technology, Ikoma 630-0192, Japan
- Knowledge Acquisition and Dialogue Research Team, Guardian Robot Project, RIKEN, Seika-cho, Soraku-gun, Kyoto 619-0228, Japan
| | - Sung-Gwi Cho
- Division of Information Science, Nara Institute of Science and Technology, Ikoma 630-0192, Japan
- Division of Electronic Engineering, School of Science and Engineering, Tokyo Denki University, Hatoyama-machi, Hiki-gun, Saitama 350-0394, Japan
| | - Ming Ding
- Division of Information Science, Nara Institute of Science and Technology, Ikoma 630-0192, Japan
- Institutes of Innovation for Future Society, Nagoya University, Nagoya 464-8601, Japan
| | - Sakiko Yoshikawa
- Faculty of Art and Design, Kyoto University of the Arts, Kyoto 606-8271, Japan
| | - Tsukasa Ogasawara
- Division of Information Science, Nara Institute of Science and Technology, Ikoma 630-0192, Japan
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Renghea A, Cuevas-Budhart MA, Yébenes-Revuelto H, Gómez Del Pulgar M, Iglesias-López MT. "Comprehensive Care" Concept in Nursing: Systematic Review. INVESTIGACION Y EDUCACION EN ENFERMERIA 2022; 40:e05. [PMID: 36867778 PMCID: PMC10017140 DOI: 10.17533/udea.iee.v40n3e05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 10/05/2022] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Integrated health care is a concept widely used in the planning and organisation of nursing care. It is a highly topical concept, but at the same time it is deeply rooted in the theory and models of Nursing right from its inception as a science. There is no clear, agreed definition that describes it. OBJETIVE To systematise the knowledge available on the concept of "comprehensive care" in Nursing from the point of view of nursing care, its domains and characteristics. METHODS A literature search has been carried out in several languages (Spanish, Portuguese, English and Romanian) in the databases Web of Science, Scopus, Medline, PubMed, Cochrane and Dialnet, covering the period between 2013 and 2019. The search terms used were: comprehensive health care, health and nursing. Prospero register 170327. RESULTS Sixteen documents were identified, which grouped 8 countries, mainly Brazil, being the country with the highest output on this context 10 documents were found within the qualitative paradigm and 6 quantitative ones. The concept "Comprehensive Care" is commonly used to refer to comprehensive nursing care techniques, protocols, programmes and plans, covering care in all aspects of the individual as a complement to or independent of the clinical needs arising from health care. CONCLUSIONS The definition of features pertaining to the concept "Comprehensive Care" encourages the use and standardisation of nursing care plans, improving patient follow-up, the detection of new risk factors, complications and new health problems not related to the reason for admission.This increases the capacity for prevention and improves the patients quality of life, and their primary and/or family caregivers, which translates into lower costs in the health system.
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Affiliation(s)
- Alina Renghea
- Facultad de Ciencias de la Salud. Universidad Francisco de Vitoria
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Giang TA, Koh JEJ, Cheng LJ, Tang QC, Chua MJ, Liew TM, Wee SL, Yap PLK. Effects of Humanitude care on people with dementia and caregivers: A scoping review. J Clin Nurs 2022. [PMID: 35922958 DOI: 10.1111/jocn.16477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/22/2022] [Accepted: 07/18/2022] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to comprehensively review the research literature to provide an overview of the effects of Humanitude on people with dementia and their caregivers. BACKGROUND Humanitude is a relationship-centred and compassionate care approach that focuses on improving the communication between people with dementia and their caregivers. There is a lack of updated and comprehensive synthesis on the evidence of the effects of Humanitude in dementia care. DESIGN AND METHODS This paper adopted the scoping review framework by Arksey and O'Malley. We searched through the following databases: Pubmed, CINAHL, EMBASE, PsycINFO, ProQuest, Scopus and Web of Science from its inception to 3 September 2021. Three investigators independently screened the titles and abstracts and assessed the full-text articles for eligibility. The PRISMA-ScR checklist was included in this scoping review. RESULTS We retrieved 1317 articles from databases and grey sources. Eleven studies were included after the screening. The synthesised results suggest that Humanitude can reduce agitation and psychological symptoms and improve the general well-being of people with dementia. Humanitude also has positive effects in improving care communication, empathy, job satisfaction and reducing burnout among caregivers. CONCLUSION Humanitude shows the potential for positive effects on people with dementia and their caregivers. However, most studies did not include a comparator group and could not provide rigorous findings as compared to randomised controlled trials. There is a need for randomised controlled studies to demonstrate the effectiveness of Humanitude on people with dementia and their caregivers. RELEVANCE FOR CLINICAL PRACTICE This paper reviewed the literature on all types of publications that examine the use of Humanitude in people with dementia and their caregivers. Thus, it provided an up-to-date overview of the effects of Humanitude to inform clinical practice.
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Affiliation(s)
- Thuy-Anh Giang
- Department of Rehabilitation Services, Khoo Teck Puat Hospital, Singapore, Singapore.,Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Jonathan Ern Juan Koh
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Ling-Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Qian-Ci Tang
- Department of Rehabilitation Services, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Min-Jia Chua
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Tau-Ming Liew
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Department of Psychiatry, Singapore General Hospital, Singapore, Singapore
| | - Shiou-Liang Wee
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Philip Lin Kiat Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
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Shaw C, Ward C, Gordon J, Williams K, Herr K. Characteristics of elderspeak communication in hospital dementia care: Findings from The Nurse Talk observational study. Int J Nurs Stud 2022; 132:104259. [PMID: 35623154 PMCID: PMC10408664 DOI: 10.1016/j.ijnurstu.2022.104259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/28/2022] [Accepted: 04/17/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Elderspeak communication is typically viewed as patronizing and infantilizing by older adults and can lead to resistive behaviors in persons living with dementia. Little is known about the presence of elderspeak communication in hospitals in the United States. Understanding this phenomenon in the hospital setting is needed in order to improve hospital dementia care. OBJECTIVES The purpose of the Nurse Talk study was to (1) describe attributes of elderspeak use in hospital dementia care and to (2) determine what characteristics are associated with nursing staff use of elderspeak communication with hospitalized patients with dementia. DESIGN A cross-sectional observational study design was used to collect and analyze audio-recordings of nursing staff during care for hospitalized patients with dementia. SETTING Three hospital units in one Midwestern university hospital in the United States. PARTICIPANTS A convenience sample of 53 staff nurses and nursing assistants that provided direct care to 16 patients with mild or more severe dementia recruited from October 2019 through mid-March 2020. METHODS Eighty-eight care encounters were audio-recorded and coded for elderspeak communication using the Iowa Coding of Elderspeak scheme to determine the frequency and characteristics of elderspeak communication. A linear mixed effects model was used to determine what characteristics were associated with elderspeak and the frequency of elderspeak use by nursing staff to hospitalized patients with dementia. RESULTS Over a quarter (28.7%) of all nursing staff speech directed towards patients with dementia constituted elderspeak and nearly all (96.6%) care encounters included some elderspeak. Particularly common attributes of elderspeak were minimizing words and mitigating expressions, childish terms and phrases, and collective pronoun substitution. A statistically significant interaction was identified between staff role and age (95% CI: -0.02, -0.00, p = .008) in predicting the frequency of elderspeak use, indicating that elderspeak was used more often by older staff nurses, whereas the age of nursing assistants remained constant across elderspeak use. Statically significant effects for delirium and length of stay were also demonstrated. Elderspeak use was 12.5% higher with patients with delirium (95% CI: 0.02, 0.23, p = .025) and increased 1.5% for each additional day the patient with dementia was hospitalized (95% CI: 0.00, 0.03, p = .035). CONCLUSIONS Elderspeak is present and pervasive in the acute care setting. Interventions targeted towards older staff nurses and nursing staff from hospital units that care for patients with delirium and longer lengths of stay are needed. TWEETABLE ABSTRACT This study identified that nursing staff are frequently using elderspeak (infantilizing speech) with hospitalized patients with dementia. @claireshaw_phd @IowaNursing.
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Affiliation(s)
- Clarissa Shaw
- University of Iowa College of Nursing, Iowa City, Iowa, USA.
| | - Caitlin Ward
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA; Department of Mathematics and Statistics, Faculty of Science, University of Calgary, Calgary, Canada
| | - Jean Gordon
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA
| | - Kristine Williams
- School of Nursing, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Keela Herr
- University of Iowa College of Nursing, Iowa City, Iowa, USA
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Kurazume R, Hiramatsu T, Kamei M, Inoue D, Kawamura A, Miyauchi S, An Q. Development of AR training systems for Humanitude dementia care. Adv Robot 2022. [DOI: 10.1080/01691864.2021.2017342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Ryo Kurazume
- Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Tomoki Hiramatsu
- Graduate School of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Masaya Kamei
- Graduate School of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Daiji Inoue
- Graduate School of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Akihiro Kawamura
- Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Shoko Miyauchi
- Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
| | - Qi An
- Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka, Japan
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Sumioka H, Shiomi M, Honda M, Nakazawa A. Technical Challenges for Smooth Interaction With Seniors With Dementia: Lessons From Humanitude™. Front Robot AI 2021; 8:650906. [PMID: 34150858 PMCID: PMC8207295 DOI: 10.3389/frobt.2021.650906] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/20/2021] [Indexed: 11/13/2022] Open
Abstract
Due to cognitive and socio-emotional decline and mental diseases, senior citizens, especially people with dementia (PwD), struggle to interact smoothly with their caregivers. Therefore, various care techniques have been proposed to develop good relationships with seniors. Among them, Humanitude is one promising technique that provides caregivers with useful interaction skills to improve their relationships with PwD, from four perspectives: face-to-face interaction, verbal communication, touch interaction, and helping care receivers stand up (physical interaction). Regardless of advances in elderly care techniques, since current social robots interact with seniors in the same manner as they do with younger adults, they lack several important functions. For example, Humanitude emphasizes the importance of interaction at a relatively intimate distance to facilitate communication with seniors. Unfortunately, few studies have developed an interaction model for clinical care communication. In this paper, we discuss the current challenges to develop a social robot that can smoothly interact with PwDs and overview the interaction skills used in Humanitude as well as the existing technologies.
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Affiliation(s)
- Hidenobu Sumioka
- Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Masahiro Shiomi
- Advanced Telecommunications Research Institute International, Kyoto, Japan
| | - Miwako Honda
- National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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12
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Melo RCCP, Queirós PJP, Tanaka LH, Henriques LVL, Neves HL. Nursing Students' Relational Skills with Elders Improve through Humanitude Care Methodology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228588. [PMID: 33227990 PMCID: PMC7699295 DOI: 10.3390/ijerph17228588] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/08/2020] [Accepted: 11/15/2020] [Indexed: 11/16/2022]
Abstract
Nursing students have difficulties interacting with cognitively impaired elders. This study aimed to identify students' difficulties in interacting with elders, the causes of the difficulties in interacting with elders, the strategies used to reduce these difficulties, and the importance attributed to the Structured Sequence of Humanitude Care Procedures (SSHCP). It also aimed to assess the contribution of the Humanitude Care Methodology (HCM) to the development of interaction skills in nursing students. An exploratory descriptive study with a quasi-experimental design was conducted with a sample of 64 nursing students during their hospital clinical training. A control group (usual training) and an experimental group (HCM training) were used. Data were collected through a questionnaire applied at baseline and follow-up. Content analysis, chi-square tests, and Student's t-tests were performed. The main difficulty identified was caring for agitated and confused elders. Difficulties were associated with a lack of theoretical-practical teaching, the clinical training context, lack of experience, and personality traits. HCM impacted positively on the development of students' interaction skills. This study shows that HCM is an innovative methodology in nursing education that will allow for moving from an instrumental and technicist education into a more humanized training capable of transforming care.
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Affiliation(s)
- Rosa Cândida Carvalho Pereira Melo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal; (P.J.P.Q.); (L.V.L.H.); (H.L.N.)
- Correspondence:
| | - Paulo Joaquim Pina Queirós
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal; (P.J.P.Q.); (L.V.L.H.); (H.L.N.)
| | - Luiza Hiromi Tanaka
- Department of Collective Health, Paulista School of Nursing, Federal University of São Paulo, São Paulo 04024-002, Brazil;
| | - Liliana Vanessa Lúcio Henriques
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal; (P.J.P.Q.); (L.V.L.H.); (H.L.N.)
| | - Hugo Leiria Neves
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal; (P.J.P.Q.); (L.V.L.H.); (H.L.N.)
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Gilbert J, Ward L, Walter R. A labour of love: Reward and satisfaction for nurses: Findings from a grounded theory study in dementia care. DEMENTIA 2020; 20:1697-1710. [DOI: 10.1177/1471301220965557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Aim To understand nurses’ perceptions of quality nursing care in the dementia-specific care unit. As the world’s population ages, the incidence of dementia is projected to rise in tandem. The requirement for skilled, dementia-trained registered nurses who can provide quality nursing care will need to increase accordingly to meet the needs of these individuals. Extensive research has been completed on dementia nursing care in a variety of settings; however, little research has been undertaken into nurses’ perceptions of quality nursing care in the dementia-specific care unit. Understanding how registered nurses perceive quality nursing care in the dementia-specific care unit is important and provides valuable information about nursing practice in this environment for nurses and decision-makers. Gaining a better understanding of quality nursing care in this care unit may result in better nurse education and an improved patient experience. It may also assist nursing organisations, residential aged-care facilities, government bodies and nongovernment agencies that support, manage, and oversee dementia-specific care units. Method A grounded theory study was conducted to understand nurses’ perceptions of quality nursing care in dementia-specific care units. The study involved interviewing nine registered nurses working in two dementia-specific care units on the Gold Coast, Queensland. Data were collected during semi-structured interviews and analysed using both constant comparison and thematic analysis. Findings Three themes emerged from this study— Caring at the Coalface, Labour of love and the Business of Dementia Healthcare. The largest theme, Labour of love, represents the personal reward and feeling of satisfaction six nurses said they experienced when interacting with individuals living in the dementia-specific care unit. They identified and repeatedly discussed the joy and fulfilment they experienced when caring for them, and considered this to be an essential element of quality nursing care. It was evident from the data that the nurses cared very deeply about these individuals, and despite increased risks to personal safety at work, they did not want to work anywhere else. This article reports on the largest and key theme identified in the study Labour of Love.
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Beaver J, Goldberg SE, Edgley A, Harwood RH. 'Socialised care futility' in the care of older people in hospital who call out repetitively: An ethnographic study. Int J Nurs Stud 2020; 107:103589. [PMID: 32446017 DOI: 10.1016/j.ijnurstu.2020.103589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND People living with dementia may call out repetitively, sometimes called disruptive vocalisation, or verbal agitation. In literature and policy, patients who call out repetitively are assumed to be expressing an unmet need, which should be met. Yet there has been little systematic study of this patient group in an acute hospital setting. OBJECTIVES To better understand patients who call out repetitively and to identify what care looks like in an acute hospital setting. DESIGN Ethnography. SETTINGS Ten acute geriatric medical wards in two hospitals. PARTICIPANTS 30 cognitively impaired patients who were calling out repetitively, and 15 members of hospital staff. METHODS Semi-structured interviews with hospital staff, 150 h of ward observations and informal conversations with staff, scrutiny of medical and nursing documentation, and measures of patient health status. RESULTS Patients who called out were moderately or severely cognitively impaired, often had delirium, were very physically disabled, and many were approaching the end of life. Most hospital staff were found to hold contradictory views: that calling out represents distress or unmet need, but that nothing can be done to alleviate the calling out. During informal conversations, most staff also tended to say that they intuitively recognised when intervening was likely to alleviate calling out. During observations, many staff appeared to and spoke of the ability to 'block' calling out. As a result we argue that social, emotional and physical needs may get overlooked. We argue that some calling out is due to a need that is unmeetable. We also found that while staff would talk about strategies for identifying need, observations and hospital documentation did not support evidence of systematic attempts to identify potential need. CONCLUSION Calling out repetitively within a hospital setting is difficult for staff to understand and to respond to. This is because many of these patients are severely cognitively impaired, often immobile and dependent on their professional carers. We argue that a form of socialised care futility is communicated between staff and is used to rationalise becoming unresponsive to calling-out. We explain this phenomenon as resulting from two protective mechanisms: defence of staff's professional identity as competent practitioners; and defence of staff as having personal morality. Socialised care futility risks good quality care, therefore systematic strategies to assess and manage possible need should be developed, even if calling out remains irresolvable in some cases.
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Affiliation(s)
- J Beaver
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2RD, United Kingdom. https://twitter.com/Jessica_Beaver
| | - S E Goldberg
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2RD, United Kingdom. https://twitter.com/se_goldberg
| | - A Edgley
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2RD, United Kingdom
| | - R H Harwood
- School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2RD, United Kingdom. https://twitter.com/RowanHarwood
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Nakanishi M, Ziylan C, Bakker T, Granvik E, Nägga K, Nishida A. Facilitators and barriers associated with the implementation of a Swedish psychosocial dementia care programme in Japan: a secondary analysis of qualitative and quantitative data. Scand J Caring Sci 2020; 35:430-441. [PMID: 32285513 DOI: 10.1111/scs.12854] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/17/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND A psychosocial dementia care programme for challenging behaviour (DEMBASE® ) was developed in collaboration with a Swedish BPSD-registry team for in-home care services use in Japan. The programme consisted of a web-based tool for the continued assessment of challenging behaviours and interdisciplinary discussion meetings. Effectiveness of the adapted programme was verified through a cluster-randomised controlled trial. The Tokyo Metropolitan Government provided municipal funding to introduce the programme into daily practice beginning in April 2018. OBJECTIVES To investigate both facilitators and barriers associated with programme implementation. DESIGN A secondary analysis of qualitative and quantitative data. SETTINGS Data were collected in naturalistic long-term care settings from April 2018 to March 2019. PARTICIPANTS A total of 138 professionals and 157 people with dementia participated in the programme. METHODS Challenging behaviour in persons with dementia was assessed by professionals using a total Neuropsychiatric Inventory score. Data on expected facilitators and barriers were extracted for qualitative analysis from a debriefing meeting between professionals. RESULTS Of the 157 persons with dementia, 81 (51.6%) received follow-up behavioural evaluations by March 2019. The average level of challenging behaviour was significantly reduced for 81 persons from baseline to their most recent follow-up evaluations. Facilitators included 'programme available for care managers', 'visualised feedback on professionals' work', 'affordable for providers and professionals' and 'media coverage'. Barriers included 'professionals from different organisations', 'unpaid work', 'operation requirement for municipalities' and 'conflict with daily benefit-oriented framework'. CONCLUSIONS A follow-up evaluation was not fully achieved. Further strategies to address barriers may include the development of a benefit-rewarding scheme for interdisciplinary discussion meetings, an e-learning system capable of substituting training course portions and a cross-municipality training course.
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Affiliation(s)
- Miharu Nakanishi
- Mental Health and Nursing Research Team, Mental Health Promotion Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Canan Ziylan
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Ton Bakker
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands.,Stichting Wetenschap Balans, Rotterdam, the Netherlands
| | - Eva Granvik
- Center of excellence in dementia, university hospital, Malmö, Sweden
| | - Katarina Nägga
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.,Department of Acute Internal Medicine and Geriatrics, Linköping University, Linköping, Sweden
| | - Atsushi Nishida
- Mental Health Promotion Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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First-person Video Analysis for Evaluating Skill Level in the Humanitude Tender-Care Technique. J INTELL ROBOT SYST 2019. [DOI: 10.1007/s10846-019-01052-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Henriques LVL, Dourado MDARF, Melo RCCPD, Tanaka LH. Implementation of the Humanitude Care Methodology: contribution to the quality of health care. Rev Lat Am Enfermagem 2019; 27:e3123. [PMID: 30698221 PMCID: PMC6336364 DOI: 10.1590/1518-8345.2430-3123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 10/28/2018] [Indexed: 11/26/2022] Open
Abstract
Objective: to evaluate the contribution of the implementation of the Humanitude Care
Methodology to the quality of health care in a Continuing Care Unit. Method: an action-research study with a non-probability convenience sampling,
involving 34 health professionals from one unit in Portugal. Data was
collected through a questionnaire and an observation worksheet for the
Structured Sequence of Humanitude Care Procedures. We used data content
analysis with the Statistical Package for Social Science, version 17.0. Results: health professionals demonstrated difficulties to provide care for people who
are agitated, confused, disoriented, aggressive and who refuse care, and to
communicate with patients who do not communicate verbally. The professionals
valued the accomplishment of the stages of the observation worksheet. There
were discrepancies between the perception of accomplishment and the actual
practice. Throughout the implementation of the methodology, there was an
increase in the practical application of the procedures, with positive
repercussion for the patients and for the professionals. Conclusion: the results allowed to perceive the contribution of the process of
implementation of the methodology, through the positive transformations in
health care delivery.
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Affiliation(s)
| | | | | | - Luiza Hiromi Tanaka
- Universidade Federal São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
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