9 research outputs found

    Strategies for implementing pet robots in care homes and nursing homes for residents with dementia: protocol for a modified Delphi study

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    Background: Pet robots are a type of technology-based innovation that have shown positive psychosocial benefts  for people with dementia in residential facilities, such as improving mood and social interaction and reducing agitation. Nevertheless, little is known about how pet robots can be implemented in care homes and nursing homes for  dementia care in real-world practice. The objectives of this study are to (1) identify contextualised implementation  strategies for implementing pet robots into care homes and nursing homes for dementia care and (2) achieve consensus on the most relevant strategies. Method: This study is informed by a preceding scoping review and qualitative study, which used the Consolidated  Framework of Implementation Research (CFIR) to identify multi-level determinants of implementation (i.e. barriers and  facilitators). We will use the CFIR-ERIC matching tool to identify relevant implementation strategies from the Expert  Recommendations for Implementing Change (ERIC) taxonomy to address these determinants. Data from the scoping review and qualitative study will be used to contextualise the generic ERIC strategies for our setting. After that,  a group of key stakeholders will be consulted to further contextualise and refne these strategies. Next, a two-round  modifed Delphi process will be conducted. Fifty-four international expert participants including healthcare professionals and organisational leaders from care homes and nursing homes and academic researchers will be recruited  through purposive sampling. During the frst Delphi round, participants will be invited to rate the relevance of each  implementation strategy on a 9-point Likert scale and provide comments or suggestions. Descriptive statistics will be  used to identify whether consensus has been obtained. Inductive qualitative content analysis will be used to analyse  and summarise textual responses for any new statements suggested by participants. Statements that do not reach  consensus and new statements suggested in round 1 will be taken to the next round, which will follow the same rating process. Discussion: This study will identify strategies for implementing pet robots in care homes and nursing homes for residents with dementia, which will have practical utility for clinicians, organisations and researchers. It will also demonstrate the practical application (and adaptation) of the CFIR-ERIC tool to identify and contextualise ERIC strategie </p

    Determinants of implementing pet robots in nursing homes for dementia care

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    Background: Pet robots have been employed as viable substitutes to pet therapy in nursing homes. Despite their  potential to enhance the psychosocial health of residents with dementia, there is a lack of studies that have investigated determinants of implementing pet robots in real-world practice. This study aims to explore the determinants of  implementing pet robots for dementia care in nursing homes, from the perspectives of healthcare professionals and  organisational leaders. Methods: A descriptive qualitative study, conceptualised and guided using the Consolidated Framework of Implementation Research (CFIR), was conducted. We conducted semi-structured interviews with healthcare professionals  and organisational leaders from nursing homes. Data was transcribed and analysed using Framework Analysis, based  on the CFIR as an a priori framework. Results: A total of 22 participants from eight nursing homes were included. Determinants were mapped to constructs from all fve CFIR domains. Determinants relating to the characteristics of pet robots include their design,  realisticness and interactivity, afordability, cleanability, perceived evidence strength and comparative advantages to live pets. Determinants relating to external infuences (outer setting) include national regulatory guidelines, funding  and networks with other organisations. With regards to characteristics of nursing homes (inner setting), determinants  include the relevance of pet robots in relation to the needs of residents with dementia, alignment with care processes, infection control mandates and their relative priority. In the domain characteristics of individuals, determinants  were associated with individuals beliefs on the role of technology, desires to enhance residents  quality of life, and  diferential attitudes on the use of robots. Finally, in the domain implementation process assessments and care planning were identifed as determinants. Conclusions: Overall, while sentiments around determinants within CFIR domains of pet robots characteristics, outer setting and implementation process were similar, participants opinions on the determinants within the ‘inner setting"  and characteristics of individuals’ were more varied. This could be due to diferent organisational structures, disciplinary diferences and personal experiences of using pet robots. Many determinants in diferent domains were interrelated. Findings provide a springboard for identifying and designing implementation strategies to guide the translation  of pet robots from research into real-world practice. </p

    Exploring barriers and facilitators to the implementation of pet robots for people with dementia in nursing homes: A qualitative research protocol

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    People living with dementia, especially those who live in nursing homes, are susceptible to social isolation and activity disengagement. Pet robots are technology-based substitutes to animal-assisted therapy that have demonstrated positive impacts on people with dementia in long term care settings, such as reducing agitation, improving mood and increasing social engagement. Nevertheless, knowledge about the issues influencing their implementation is lacking, as there is a scarcity of research that have explicitly investigated the barriers and facilitators influencing their implementation in real-world practice. The objective of this study is to understand the multi-level barriers and facilitators to the implementation of pet robots for people with living dementia in nursing homes, from the perspectives of key stakeholders. A qualitative study employing a descriptive qualitative approach will be used. The Consolidated Framework of Implementation Research (CFIR) will be used to guide the research process. Multi-level stakeholders, including people living with dementia, healthcare professionals and organisational decision makers in nursing homes, will be recruited for one-to-one interviews. Data will be analysed through framework analysis, using a combination of both deductive (based on the constructs and domains in the CFIR) and inductive approaches. To the best of our knowledge, this will be the first study to explore multi-level determinants to the implementation of pet robots in nursing homes for people living with dementia. Findings will be used to inform the identification of strategies that may be used to guide the implementation of pet robots for people living with dementia in nursing homes

    Social connectedness and the role of virtual reality: experiences and perceptions of people living with dementia and their caregivers

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    People living with dementia are often at increased risk of becoming socially disconnected due to dementia-related challenges. In recent years, digital technology has been designed to help address the social health of people living with dementia and provide opportunities to promote or maintain their social connectedness. This paper presents the findings from phase two of a participatory action research project, which explored people living with dementia and their caregiver’s experiences and perceptions of social connectedness and the potential role of Virtual Reality (VR) in promoting or maintaining same. People living with dementia (n = 8) and their informal caregivers (n = 8) participated in an individual, 1:1 online interview. Data analysis was guided by reflexive thematic analysis. The findings presented four themes: social connectedness: lived experiences and insights, facilitating social connectedness, barriers to social connectedness and the potential of multi-user VR for social connectedness. People living with dementia experienced a range of personal, community and societal connectedness. Facilitators of social connectedness included supportive, non-judgemental, and reciprocal relationships, technology adoption, and personal and contextual facilitators. Dementia-related difficulties and periods of disruption or change were considered barriers to social connectedness. Multi-user VR was perceived as useful for promoting and maintaining social connectedness. The perceived usefulness of multi-user VR for social connectedness indicates its potential for use with this population. Understanding the lived experiences, barriers, and facilitators of social connectedness will assist researchers and the human-computer interaction community to inform the design of future multi-user VR for social connectedness outcomes with people living with dementia and their caregivers. People living with dementia and their caregivers consider social connectedness a vital aspect of living well with dementia.People living with dementia experience social connectedness across personal, community and societal domains.Supportive, non-judgemental or reciprocal relationships, fostering technology, and personal and contextual factors facilitate social connectedness for people living with dementia.Dementia-related barriers and periods of disruption and change can negatively impact the social connectedness of people living with dementia.People living with dementia and their caregivers consider multi-user virtual reality a promising technology to promote and maintain their social connectedness. People living with dementia and their caregivers consider social connectedness a vital aspect of living well with dementia. People living with dementia experience social connectedness across personal, community and societal domains. Supportive, non-judgemental or reciprocal relationships, fostering technology, and personal and contextual factors facilitate social connectedness for people living with dementia. Dementia-related barriers and periods of disruption and change can negatively impact the social connectedness of people living with dementia. People living with dementia and their caregivers consider multi-user virtual reality a promising technology to promote and maintain their social connectedness.</p

    Perceptions and experiences of nursing students  communicating with people living with dementia: The  validation, emotion, reassure, activity (VERA) communication  skills framework

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    Background: There is an increased risk with advancing age that degenerative conditions such as dementia will affect a person's capacity to communicate. Thus, there is increased possibility that nursing students will be caring for this client group and will need to have the skills to communicate effectively. The Validation, Emotion, Reassure, Activity (VERA) framework is a communication tool developed for this purpose. Objectives: This pilot study explored nursing students' perceptions and experiences of communicating with people with dementia incorporating the VERA communication skills framework. Methods: Using a descriptive qualitative approach, second year undergraduate general nursing students were eligible for inclusion if they were assigned to complete their 4-week clinical placement in the designated research site and were willing to participate. Students allocated to the designated research site (n= 6) in semester 1 received standard communication skills as part of the undergraduate programme and students allocated (n= 10) in semester 2 received 2.5 h of additional communication skills based on the VERA framework. Data were analysed using framework analysis as described by Ritchie & Spencer. Results: The findings showed that students in both groups had initial reservations about communicating with people living with dementia. They employed several strategies including nonverbal techniques, distraction, reminiscence and life story work. However, students who received the VERA communication training felt more prepared to engage in these strategies because of the VERA training. Conclusion: With increasing numbers of people with dementia accessing health care, it is crucial that future nursing staff are equipped to meet the specific care needs of this population; which includes effective communication. The VERA framework can be useful to structure communication for nursing students. Implication for practice: The VERA training may be considered a useful framework for increasing undergraduate nursing students' knowledge and confidence in advance of clinical placements in older person's services. Nursing staff should continue to support students on clinical placements which involve caring for people with dementia and be cognisant of the trepidation students may have when first meeting this client group.</p

    Sexual counselling for patients with cardiovascular disease: protocol for a pilot study of the CHARMS sexual counselling intervention.

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    Introduction Sexual problems are common with cardiovascular disease, and can negatively impact quality of life. To address sexual problems, guidelines have identified the importance of sexual counselling during cardiac rehabilitation, yet this is rarely provided. The Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention aims to improve the provision of sexual counselling in cardiac rehabilitation in Ireland.Methods and analysis This is a multicentre pilot study for the CHARMS intervention, a complex, multilevel intervention delivered within hospital-based cardiac rehabilitation programmes. The intervention includes (1) training in sexual counselling for staff, (2) a staff-led patient education and support intervention embedded within the cardiac rehabilitation programme, (3) a patient information booklet and (4) an awareness raising poster. The intervention will be delivered in two randomly selected cardiac rehabilitation centres. In each centre 30 patients will be recruited, and partners will also be invited to participate. Data will be collected from staff and patients/partners at T1 (study entry), T2 (3-month follow-up) and T3 (6-month follow-up). The primary outcome for patients/partners will be scores on the Sexual Self-Perception and Adjustment Questionnaire. Secondary outcomes for patients/partners will include relationship satisfaction; satisfaction with and barriers to sexual counselling in services; sexual activity, functioning and knowledge; physical and psychological well-being. Secondary outcomes for staff will include sexuality-related practice; barriers to sexual counselling; self-ratings of capability, opportunity and motivation; sexual attitudes and beliefs; knowledge of cardiovascular disease and sex. Fidelity of intervention delivery will be assessed using trainer self-reports, researcher-coded audio recordings and exit interviews. Longitudinal feasibility data will be gathered from patients/partners and staff via questionnaires and interviews.Ethics and dissemination This study is approved by the Research Ethics Committee (REC) of the National University of Ireland, Galway. Findings will be disseminated to cardiac rehabilitation staff, patients/partners and relevant policymakers via appropriate publications and presentations

    The CHARMS pilot study: a multi-method assessment of the feasibility of a sexual counselling implementation intervention in cardiac rehabilitation in Ireland

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    Background: Many people living with cardiovascular disease (CVD) are affected by sexual problems associated with the condition. International guidelines recommend all patients with CVD should receive sexual counselling, yet this is rarely provided by health professionals. The current study piloted the Cardiac Health and Relationship Management and Sexuality (CHARMS) intervention, a complex multi-level intervention designed to increase the implementation of sexual counselling guidelines in hospital-based cardiac rehabilitation (CR) in Ireland. Methods: The CHARMS intervention, consisting of awareness training and skills development for staff, and education and support for patients, was implemented in two CR centres. Following a repeated measures design, quantitative and qualitative feasibility, fidelity, cost, and outcome data were collected from staff and patients at baseline (T1, pre-intervention), at 3 months post-baseline (T2, post-intervention), and at 6 months post-baseline (T3, postintervention). Data were organised according to a 14-point reporting framework of methodological issues that should be examined in pilot and feasibility studies. To inform a future definitive trial, potential solutions to identified feasibility issues were generated using the ADePT process for decision-making after pilot and feasibility trials. Results: Most elements of the study protocol were executed smoothly, and intervention implementation was successful. Patients’ (N = 42) responses to the intervention were positive. The reporting framework and the ADePT process facilitated the identification of two overarching feasibility problems, as well as solutions to be implemented in a definitive trial: (1) a high level of patient attrition in the pilot study, to be addressed through the use of financial incentives, reducing the length of the patient questionnaire, and providing a telephone survey option; and (2) negative staff perceptions, to be addressed through an augmented staff intervention, reframing ‘sexual counselling’ as ‘sexual education and support’ to fit with professional role perceptions, and reviewing all intervention terminology with a CR staff member to ensure acceptability. Conclusions: This article reports the successful piloting of a novel sexual counselling implementation intervention in cardiac rehabilitation. The utilisation of an extended reporting framework and the ADePT process facilitated the identification of adaptations necessary to ensure the feasibility of a definitive trial, thereby maximising methodological transparency
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