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1 – 10 of 112A.J. Astell, B. Malone, G. Williams, F. Hwang and M.P. Ellis
The purpose of this paper is to present the self-described “journey” of a person with dementia (Brian; author 3) in his re-learning of old technologies and learning of new ones…
Abstract
Purpose
The purpose of this paper is to present the self-described “journey” of a person with dementia (Brian; author 3) in his re-learning of old technologies and learning of new ones and the impact this had on his life.
Design/methodology/approach
This is a single case study detailing the participant's experiences collaborating with a researcher to co-create methods of facilitating this learning process, which he documented in the form of an online blog and diary entries. These were analysed using NVivo to reveal the key themes.
Findings
Brian was able to relearn previously used technologies and learn two new ones. This lead to an overarching theme of positive outlook on life supported by person-centredness, identity and technology, which challenged negative perceptions about dementia.
Research limitations/implications
The paper provides an example of how learning and technology improved the life of one person with dementia. By sharing the approach the authors hope to encourage others to embrace the challenge of designing and developing innovative solutions for people with a dementia diagnosis by leveraging both current mainstream technology and creating novel bespoke interventions for dementia.
Originality/value
The personal perspective of a person with dementia and his experiences of (re-) learning provide a unique insight into the impact of technology on his life.
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Michael Sony, Jiju Antony and Olivia McDermott
The pandemic has reinforced the need for revamping the healthcare service delivery systems around the world to meet the increased challenges of modern-day illnesses. The use of…
Abstract
Purpose
The pandemic has reinforced the need for revamping the healthcare service delivery systems around the world to meet the increased challenges of modern-day illnesses. The use of medical cyber–physical system (MCPS) in the healthcare is one of the means of transforming the landscape of the traditional healthcare service delivery system. The purpose of this study is to critically examine the impact of MCPS on the quality of healthcare service delivery.
Design/methodology/approach
This paper uses an evidence-based approach, the authors have conducted a systematic literature review to study the impact of MCPS on healthcare service delivery. Fifty-four articles were thematically examined to study the impact of MCPS on eight characteristics of the healthcare service delivery proposed by the world health organisation.
Findings
The study proposes support that MCPS will positively impact (1) comprehensiveness, (2) accessibility, (3) coverage, (4) continuity, (5) quality, (6) person-centredness, (7) coordination, (8) accountability and (9) efficiency dimension of the healthcare service delivery. The study further draws nine propositions to support the impact of MCPS on the healthcare service delivery.
Practical implications
This study can be used by stakeholders as a guide point while using MCPS in healthcare service delivery systems. Besides, healthcare managers can use this study to understand the performance of their healthcare system. This study can further be used for designing effective strategies for deploying MCPS to be effective and efficient in each of the dimensions of healthcare service delivery.
Originality/value
The previous studies have focussed on technology aspects of MCPS and none of them critically analysed the impact on healthcare service delivery. This is the first literature review carried out to understand the impact of MCPS on the nine dimensions of healthcare service delivery proposed by WHO. This study provides improved thematic awareness of the resulting body of knowledge, allowing the field of MCPS and healthcare service delivery to progress in a more informed and multidisciplinary manner.
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Julie MacInnes, Jenny Billings, Alexandra Lelia Dima, Chris Farmer and Giel Nijpels
The purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the…
Abstract
Purpose
The purpose of this paper is to identify the range, type and outcomes of technological innovations aimed at supporting older people to maintain their independence within the context of integrated care at home. We also discuss key emergent themes relevant to the use of person-centred technology for older people in integrated care and propose recommendations for policy and practice.
Design/methodology/approach
An integrative review methodology was used to identify and describe recent scientific publications in four stages: problem identification, literature search, data evaluation and data analysis.
Findings
Twelve studies were included in the review. Three studies described remote consultations, particularly telemedicine; five studies described tools to support self-management; three studies described the use of healthcare management tools, and one study described both remote consultation and self-care management. Emergent themes were: acceptability, accessibility and use of digital technologies; co-ordination and integration of services; the implementation of digital technologies; and safety and governance. Several recommendations are proposed relevant to integrated care teams, technology developers and researchers.
Originality/value
This review uniquely considers the extent to which novel digital technologies used in integrated care for older people are person-centred.
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Kristina Rosengren, Sandra C. Buttigieg, Bárbara Badanta and Eric Carlstrom
This study aimed to describe facilitators and barriers in terms of regulation and financing of healthcare due to the implementation and use of person-centred care (PCC).
Abstract
Purpose
This study aimed to describe facilitators and barriers in terms of regulation and financing of healthcare due to the implementation and use of person-centred care (PCC).
Design/methodology/approach
A qualitative design was adopted, using interviews at three different levels: micro = hospital ward, meso = hospital management, and macro = national board/research. Inclusion criteria were staff working in healthcare as first line managers, hospital managers, and officials/researchers on national healthcare systems, such as Bismarck, Beveridge, and mixed/out-of-pocket models, to obtain a European perspective.
Findings
Countries, such as Great Britain and Scandinavia (Beveridge tax-based health systems), were inclined to implement and use person-centred care. The relative freedom of a market (Bismarck/mixed models) did not seem to nurture demand for PCC. In countries with an autocratic culture, that is, a high-power distance, such as Mediterranean countries, PCC was regarded as foreign and not applicable. Another reason for difficulties with PCC was the tendency for corruption to hinder equity and promote inertia in the healthcare system.
Research limitations/implications
The sample of two to three participants divided into the micro, meso, and macro level for each included country was problematic to find due to contacts at national level, a bureaucratic way of working. Some information got caught in the system, and why data collection was inefficient and ran out of time. Therefore, a variation in participants at different levels (micro, meso, and macro) in different countries occurred. In addition, only 27 out of the 49 European countries were included, therefore, conclusions regarding healthcare system are limited.
Practical implications
Support at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.
Originality/value
Fragmented health systems divided by separate policy documents or managerial roadmaps hindered local or regional policies and made it difficult to implement innovation as PCC. Therefore, support at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.
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The article describes the Five Dimensions of Person‐Centredness, an evaluation tool developed specifically to explore supported living and inclusion‐orientated organisations. It…
Abstract
The article describes the Five Dimensions of Person‐Centredness, an evaluation tool developed specifically to explore supported living and inclusion‐orientated organisations. It explores some of the learning gained from using the evaluation process with four organisations in Scotland, and includes identification of common themes that make the difference when personalising support.
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Joy M Rooney, Nadine Miles and Tom Barker
– The purpose of this paper is to explore patients’ experiences of intentional mental health peer support (PS).
Abstract
Purpose
The purpose of this paper is to explore patients’ experiences of intentional mental health peer support (PS).
Design/methodology/approach
Seven in-depth interviews were carried out by an independent researcher with individual inpatients who volunteered via a PS worker following leaflet and poster distribution explaining the research on the two wards. Each recorded interview of 13 questions was transcribed verbatim by the researcher and analysis identified common themes across the interviews.
Findings
An overarching theme of communication with patients was identified together with six main themes: person centredness, practical support, building connections, emotional support, modelling hope and recovery interventions. There were no negative comments expressed by interviewees.
Research limitations/implications
Small scale qualitative research allows in-depth exploration of experiences which is valuable in informing the further development of PS.
Originality/value
There are very few published reports of inpatient experiences of PS in inpatient settings.
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Kevin O’ Shanahan, James O’ Flynn, Declan McCarthy and Liam MacGabhann
This paper aims to describe a novel community development and how the synergies arising from the interaction of diverse perspectives (including arts and health, person centredness…
Abstract
Purpose
This paper aims to describe a novel community development and how the synergies arising from the interaction of diverse perspectives (including arts and health, person centredness, co-production and shared leadership) have led to a transformative initiative for individuals and a local community in the Republic of Ireland.
Design/methodology/approach
This is a descriptive case study. It includes the personal narrative of an expert by experience who is one of the co-authors. Links to short digital films are also included along with references to internal evaluation documents and published literature. Reflections from the nurses who contributed to the initiative and a university academic are also incorporated.
Findings
A space in the community built around the principles of relational practice has evolved into an alchemical space, enabling creativity, recovery and well-being. The benefits arising out of this network of social relationships have contributed to personal recovery, integration with the local community and generated social capital. This has enhanced mental health and well-being locally.
Practical implications
Statutory Irish health policy is reflective of developments in health care internationally, with an emphasis on greater delivery of care in the community. This views citizens as active partners in the maintenance of their health and well-being. This case study illustrates how this has unfolded in practice in a rural mental health community context.
Originality/value
This paper adds to the evidence base that demonstrates the potential benefits of participation in the arts to individual recovery journeys. In addition, it shows that when arts and health perspectives coalesce with the wider domain of relational practice, the synergies arising contribute positively to the health and well-being of local communities.
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Exploring subjective experiences of people living with dementia through qualitative research has become increasingly common in recent decades. Nonetheless, researchers have shared…
Abstract
Exploring subjective experiences of people living with dementia through qualitative research has become increasingly common in recent decades. Nonetheless, researchers have shared a number of ethical challenges in involving people living with dementia in research. A concept that has been influential in discussions about ethics within the field of dementia care, in particular, is person-centredness. A person-centred approach reflects values of respect for personhood and the rights of a person and of building mutual trust and understanding. This chapter presents my experience of adopting person-centred ethical practices in a sensory ethnographic study involving older adults living with dementia. I highlight person-centred ethical considerations at the design stage of my study and occasions during the conduct of my research when research methods and processes were adapted to further meet the needs of the participants. A person-centred approach required that I continually assessed the need to make ethical decisions in every aspect of the research process throughout its duration. Building and drawing on positive researcher–participant relationships to inform those decisions and an adaptable research design allowing research practices to be adapted in situ were therefore essential.
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Nick Zonneveld, Henk Nies, Elize van Wijk and Mirella Minkman
Mark Wilberforce, Jane Hughes, Paul Clarkson, David Whyte, Helen Chester, Sue Davies and David Challis
The purpose of this paper is to evaluate the implementation and potential value of an electronic referral system to improve integrated discharge planning for hospitalised older…
Abstract
Purpose
The purpose of this paper is to evaluate the implementation and potential value of an electronic referral system to improve integrated discharge planning for hospitalised older adults with complex care needs. This new technology formed part of the “Common Assessment Framework for Adults” policy in England.
Design/methodology/approach
Mixed methods were undertaken as part of a case study approach within an acute hospital in the North West of England. First, qualitative interviews were undertaken with practitioners to explore early experiences using the new technology. Second, routinely collected administrative data were analysed, comparing referrals made using the new technology and those made through the usual paper-based process.
Findings
Qualitative interviews found that an electronic discharge system has, in principle, the potential to improve the efficiency and suitability of integrated care planning. However, the implementation proved fragile to decisions taken elsewhere in the local care system, meaning its scope was severely curtailed in practice. Several “socio-technical” issues were identified, including the loss of valuable face-to-face communication by replacing manual with electronic referrals.
Research limitations/implications
The small number of patients referred during the implementation phase meant that patient outcomes could not be definitively judged. Research into the longer-term implications and value of electronic referral systems is needed.
Originality/value
There is concern that attempts to integrate health and social care are stymied by incompatible systems for recording service user information. This research explores a novel attempt to share assessment information and improve support planning across health and social care boundaries.
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