Nursing and Midwifery (Scholarly Articles)

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  • Publication
    Strategies to implement pet robots in long-term care facilities for dementia care: A modified Delphi study
    (Elsevier, 2023-01-03) Koh, Wei Qi; Hoel, Viktoria; Casey, Dympna; Toomey, Elaine
    Objectives Pet robots are technology-based substitutes for live animals that have demonstrated psychosocial benefits for people living with dementia in long-term care. However, little research has been conducted to understand how pet robots should be implemented in routine care. This study aims to identify, contextualize, and achieve expert consensus on strategies to implement pet robots as part of dementia care in long-term care facilities. Design A 2-round modified Delphi study. Settings and Participants An international panel of 56 experts from 14 countries, involving care professionals, organizational leaders, and researchers. Methods A list of potentially relevant strategies was identified, contextualized, and revised using empirical data and through stakeholder consultations. These strategies constituted statements for Round 1. Experts rated the relative importance of each statement on a 9-point scale, and free-text fields allowed them to provide justifications. Consensus was predefined as ≥75% agreement. Statements not reaching an agreement were brought forward to Round 2. Quantitative data were analyzed using descriptive statistics, and textual data were analyzed using inductive content analysis. Results Thirteen strategies reached consensus; 11 were established as critical: (1) assess readiness and identify barriers and facilitators, (2) purposely reexamine the implementation, (3) obtain and use residents' and their family's feedback, (4) involve residents and their family, (5) promote adaptability, (6) conduct ongoing training, (7) conduct educational meetings, (8) conduct local consensus discussions, (9) organize clinician implementation team meetings, (10) provide local technical assistance, and (11) access new funding. Other strategies received differing extents of agreement. Reasons for variations included contextual differences, such as resource availability, organizational structures, and staff turnover. Conclusions and Implications This study identified the most relevant strategies that can be used by technology developers, care providers, and researchers to implement pet robots in long-term care facilities for dementia care. Further development, specification, and testing in real-world settings are needed.
  • Publication
    Examining the utility of the DESCARTE model for case study research
    (Slack, 2021-03-01) Whelan, Sally; Casey, Dympna
    The DESCARTE model aims to guide health care researchers on the design, conduct, and reporting of case studies. The current article critically appraises the utility of the model and provides an example of its application to a multiple case study that examined the effect of MARIO, a social robot, on the resilience of people with dementia. The DESCARTE model is explained, and its strengths and the challenges encountered during its application are discussed. DESCARTE provides a structured framework that promotes quality in case study research by requiring the researcher to articulate philosophical cohesiveness, ethical considerations, reflexivity, and the strategies used during data integration and throughout data analysis. However, the model does not prompt the development of research questions or methods to promote rigor and reflexivity throughout the case study. A task list and additional guiding questions are provided to address these deficits and to improve the utility of the DESCARTE model.
  • Publication
    The perceptions of people with dementia and key stakeholders regarding the use and impact of the social robot MARIO
    (MDPI, 2020-11-20) Casey, Dympna; Barrett, Eva; Kovačič, Tanja; Sancarlo, Daniele; Ricciardi, Francesco; Murphy, Kathy; Koumpis, Adamantios; Santorelli, Adam; Gallagher, Niamh; Whelan, Sally; Horizon 2020
    People with dementia often experience loneliness and social isolation. This can result in increased cognitive decline which, in turn, has a negative impact on quality of life. This paper explores the use of the social robot, MARIO, with older people living with dementia as a way of addressing these issues. A descriptive qualitative study was conducted to explore the perceptions and experiences of the use and impact of MARIO. The research took place in the UK, Italy and Ireland. Semi-structured interviews were held in each location with people with dementia (n = 38), relatives/carers (n = 28), formal carers (n = 28) and managers (n = 13). The data was analyzed using qualitative content analysis. The findings revealed that despite challenges in relation to voice recognition and the practicalities of conducting research involving robots in real-life settings, most participants were positive about MARIO. Through the robot’s user-led design and personalized applications, MARIO provided a point of interest, social activities, and cognitive engagement increased. However, some formal carers and managers voiced concern that robots might replace care staff.
  • Publication
    Interventions for the management of obesity in people with bipolar disorder
    (Cochrane Collaboration, 2018-04-12) Tully, Agnes; Murphy, Edel; Smyth, Siobhan; Conway, Yvonne; Geddes, John; Devane, Declan; Kelly, John P.; Jordan, Fionnuala
    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effectiveness of interventions for the management of obesity in people with bipolar disorder. © 2018 The Cochrane Collaboration.
  • Publication
    A qualitative evidence synthesis of users experience of mobile health applications in the self-management of type 2 diabetes
    (SAGE Publications, 2021-02-14) O’Neill, Margaret; Houghton, Catherine; Crilly, Geraldine; Dowling, Maura
    Aim The aim of this qualitative evidence synthesis was to identify and synthesise qualitative research relating to experiences of using mobile health (mHealth) applications to aid self-management of Type 2 Diabetes. Methods Using a systematic search strategy, 11 databases were searched (Medline, CINAHL, PsychInfo, PubMed, Web of Science, Embase, Cochrane Library, Scopus, ProQuest A&1, ProQuest UK & Ireland, Mednar). “Best fit” framework synthesis was used guided by the Health Information Technology Acceptance Model (HITAM). Assessment of methodological limitations was conducted using Critical Appraisal Skills Programme (CASP) and confidence in the review findings were guided by GRADE-CERQual. Results Fourteen eligible studies were included in the synthesis (7 qualitative and 5 mixed methods). Key themes identified under the health, information and technology zones of the HITAM revealed the benefits of mHealth apps, barriers to their use, their perceived usefulness and ease of use. Discussion Most people used the apps for feedback on their self-management and found them helpful in their communication with health care providers. Some embraced the technology and found it easy to use while others found mHealth apps to be counterintuitive.
  • Publication
    Palliative care nurses' experiences of clinical supervision: a qualitative evidence synthesis
    (Mark Allen Healthcare, 2020-12-17) Keane, Sinéad; Ryan, Aoife; Adams, Niamh; Dowling, Maura
    Background: Clinical supervision provides support and facilitates professional and personal development. Aim: To identify and synthesise all available qualitative research on palliative care nurses' experiences of clinical supervision. Methods: Guided by the 'enhancing transparency in reporting the synthesis of qualitative research' (ENTREQ) statement, eight databases were searched using a systematic search strategy (Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, Medline, Web of Science, ProQuest, Embase, Psychological and Behavioural Sciences). The findings of all included studies were analysed guided by Thomas and Harden's approach. Confidence in the review findings was determined guided by Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). Findings: Nine qualitative studies were included in this synthesis and four analytic themes were identified: negative experiences and misunderstandings of clinical supervision; clinical supervision needs structure and clarity; supervisor needs to be a conductor and a producer; finding your 'inner supervisor'. Conclusion: The review illuminates the benefits of clinical supervision as a renewal process for palliative care (PC) nurses, but also highlights the challenges in its provision. Organisations should provide designated time and opportunities for PC nurses to attend clinical supervision sessions during working hours.
  • Publication
    Estimating the health-care costs of wound care in Ireland
    (Mark Allen Healthcare, 2019-06-05) Gillespie, Paddy; Carter, Laura; McIntosh, Caroline; Gethin, Georgina
    Objective: To estimate the cost of wound care to the Irish health-care system.Methods: A bottom-up, prevalence-based analysis was undertaken using a decision analytic model to estimate costs. Health-care resource activity was identified from a recently published study from the UK and was valued using unit cost data for Ireland.Results: The base case analysis estimated the total annual health-care cost of wound care to be (sic)629,064,198 (95% Confidence interval (CI): (sic)452,673,358 to (sic)844,087,124), accounting for 5% (95% CI: 3% to 6%) of total public health expenditure in Ireland in 2013.The average cost per patient was (sic)3,941 ( 95% CI: (sic)2,836 to (sic)5,287). However, this study is subject to many limitations and plausible changes in the model's inputs showed that the total annual health-care cost of wound care could range from (sic)281,438,970 to (sic)844,316,912.Conclusion: Caring for wounds places a substantial burden on the Irish health-care system. In light of growing pressures to finance an already resource-constrained health-care system, these results provide useful information for those charged with future wound care service design and provision in Ireland and elsewhere.
  • Publication
    “Stuck between a rock and a hard place”: How mental health nurses’ experience psychosocial interventions in Irish mental health care settings
    (Wiley, 2020-10-19) Smyth, Siobhan; De Vries, Jan M. A.; Rossetti, Jeanette; McCann, Edward; School of Nursing and Midwifery, National Univeristy of Ireland Galway; Nursing Midwifery Planning Development Unit (NMPDU) HSE West; Martha McMenamin Memorial Scholarship; Sigma Theta Tau International (STTI)
    4.1 Description The paper will report on the interview data of trained MHNs experiences of using PSI within the Irish context. This observational data will be reported elsewhere (Smyth et al. 2020 under review). 4.2 Introduction This research is conducted when the current reform of Irish mental health governance demands clarification of key psychosocial skills (PSI) required for mental health nurses (MHNs) to embrace recovery‐orientated ways of working. There is limited evidence about this important topic in Ireland and across countries. 4.3 Aim To explore PSI‐trained MHNs experiences of using PSI within Ireland. 4.4 Method A multiple case study methodology was used and situated within an interpretive paradigm. Data were gathered using semi‐structured interviews with 40 PSI‐trained MHNs. 4.5 Findings Three overarching themes developed from the analysis. These included (a) PSI‐trained MHNs understanding and use of PSI; (b) facilitating factors supporting the use of PSI by PSI‐trained MHNs; and (c) obstacles limiting the use of PSI by PSI‐trained MHNs. 4.6 Discussion MHNs recognize that regular clinical supervision is required to increase their confidence, along with PSI guidelines for the offering of these skills across practice settings. MHNs also need work release to attend supplementary training on PSI so that they can do their job adequately. 4.7 Implications for practice This study suggests that MHNs are often stuck between a rock and a hard place when delivering PSI in practice. MHNs need to be aware that this can affect client outcomes. 4.8 Relevance statement This research identified a gap in knowledge within the Irish context but also across the world on this important topic. MHNs need access to regular clinical supervision, PSI guidelines and ongoing PSI training to feel confident in order to keep abreast of the changes happening in mental health practice and research.
  • Publication
    Barriers and facilitators to seasonal influenza vaccination uptake among nurses: A mixed methods study
    (Wiley, 2020-03-23) Flanagan, Paula; Dowling, Maura; Gethin, Georgina
    Aim To identify the barriers and facilitators to seasonal influenza vaccination uptake among nurses.Background Seasonal influenza causes significant mortality and morbidity among older people and high-risk groups. Vaccinating nurses against influenza is an essential public health measure to reduce the burden of disease. Yet despite annual recommendations, nurses' influenza vaccine uptake rates remain low.Design An explanatory sequential mixed methods study design.Data Sources Qualified nurses attending mandatory training in two large acute hospitals in Ireland.Methods A paper-based questionnaire assessing nurses' knowledge, risk perception, health beliefs and influenza vaccination practices was distributed to a convenience sample of qualified nurses (N = 462) between September 2017 - February 2018. A self-selected sample of 35 nurses who completed the questionnaire participated in five focus groups to explore in depth the barriers and facilitating factors associated with their vaccination practices between September 2018 - October 2018. The questionnaire data were analysed statistically and thematic analysis was applied to the qualitative data. The quantitative and qualitative findings were integrated using the Pillar Integration Process.Results Seven themes emerged: (a) the influence of nurses' knowledge on vaccine uptake; (b) dissemination of information; (c) vaccine fears and concerns; (d) protection, risk and vulnerability: self and others; (e) influencers; (f) accessibility; and (g) organizational pressure.Conclusion Achieving high vaccine uptake rates among nurses through voluntary vaccination programmes remains a challenge. Multi-faceted influenza campaigns based on the HBM should be prioritized to address dissemination of evidence-based knowledge, accessibility, and external cues to action.Impact Low influenza vaccine uptake among nurses compromises patient safety and contributes to a significant burden on health services. This study identified factors associated with vaccine practices among nurses and will inform the development of specific tailored interventions for nurses.
  • Publication
    The profile of patients with venous leg ulcers: A systematic review and global perspective
    (Elsevier, 2020-08-13) Gethin, Georgina; Vellinga, Akke; Tawfick, Wael; O'Loughlin, Aonghus J.; McIntosh, Caroline D.; Mac Gilchrist, C.; Murphy, Louise; Ejiugwo, M.; O'Regan, Marion; Cameron, Adam; Ivory, John D.
    A holistic profile that includes demographic, medical history and wound characteristics of individuals with venous leg ulceration is lacking. Lack of such a profile negatively impacts the ability to develop interventions to improve patient outcomes. To describe the profile of the patient population with venous leg ulceration from published observational (non-interventional) studies and to identify gaps in the knowledge base for future research in this area. A systematic review of observational studies that included more than 50 patients, from any world region, of any age and in any care setting. twenty studies, involving 3395 patients, from all world regions met our criteria. Demographic characteristics were well reported and showed a female to male ratio of 1.2:1, average age of 47-65 years, high levels of co-morbidities including hypertension (53-71%) and diabetes (16-20%), and only one study reporting ethnicity. When reported, approximately 4-30% had high levels of depression. The average wound size was 18.6-43.39 cm2; mean wound duration was 13.8-65.5 months, mean number of recurrences was four. No study reported on demographic factors plus medical history plus wound characteristics together. a comprehensive, holistic profile of the population with VLU is lacking. There is a critical need for more comprehensive profiling to enable the development of targeted interventions to improve outcomes.
  • Publication
    Fostering the resilience of people with dementia: A narrative literature review
    (Frontiers Media, 2020-02-25) Whelan, Sally; Teahan, Áine; Casey, Dympna; College of Medicine, Nursing and Health Sciences, National University of Ireland Galway
    Background: Resilience is a process through which people use resources to adapt to adversity. Interventions aiming to support resilience in people with dementia have been developed. However, the optimal content, structure and impact of these interventions is unclear. This literature review explores the factors through which interventions foster resilience in people with dementia and examines their efficacy. Methods: Eight databases were searched systematically, for literature published from 2000 to 2019. Following the removal of duplicate articles, the titles and abstracts of 6,749 articles were screened. Articles were selected if they: reported empirical studies in English; focused on resilience; involved people with dementia and psychosocial interventions. The full text of 53 articles were examined and three studies, reported in six papers, were included in the final review. Data were systematically extracted, and two authors critiqued the studies using the Critical Appraisal Skills Programme check lists. The studies were examined to determine how resilience was defined and operationalized and their findings were synthesized using the theoretical resilience framework. Results: Five interventions aiming to foster resilience were identified: Dementia Advisors; Peer Support Network Services; Visual Arts Enrichment Activities; Memory Makers; and Early-Stage and Beyond Community Activities. All studies defined resilience as a process and most involved people with mild dementia who had family carers. The interventions impacted resilience by reducing the adversity of stigma and social isolation; increasing personal and social resources, providing stigma-free space and reciprocal support. Interventions empowered people with dementia, increasing their self-esteem and self-worth. Resilience can be fostered both during, and after interventions. However, the efficacy of interventions could not be determined because the research designs utilized did not measure efficacy. Conclusions: Interventions need facilitators to ensure they are strength-based, person-centered and they enable reciprocal social interactions. Future research needs to develop interventions that aim to foster the resilience of people with dementia who lack family carers and/or have more advanced dementia through meaningful activities that are identified by people with dementia as important to their resilience. Robust methodologies, including randomized controlled trials should be used to measure effectiveness and explore the impact of interventions regarding the: interplay between individual and community resources; the importance of reciprocity; and temporal aspects of resilience.
  • Publication
    The effects of MARIO, a social robot, on the resilience of people with dementia: A multiple case study
    (International Society for Gerontechnology, 2020-08) Whelan, Sally; Burke, Megan; Barrett, Eva; Mannion, Arlene; Kovačič, Tanja; Santorelli, Adam; Luz Oliveira, Barbara; Gannon, Louise; Shiel, Edel; Casey, Dympna
    Background: Resilience is a process of adapting to stress. For people with dementia, resilience is enhanced through having positive social relationships. Social robots, such as MARIO, can facilitate social engagement. However, the effect of social robots on resilience has not yet been determined. Objective: To investigate how MARIO, a social robot, affects the resilience of people with dementia. Method: Multiple case study methodology was used to explore the resilience of people with dementia during and after they used MARIO in 12 facilitated sessions. Data collection was conducted using: dementia care mapping; semi-structured interviews with people with dementia (n=10), caregivers (n=6), and relatives (n=7); and questionnaires including the Quality of Life in Alzheimer’s disease and The Resilience Scale. During sessions, data was collected using the Observational Measure of Engagement. Data analysis was guided by framework analysis. Qualitative and quantitative data were analysed in NVIVO 12 and SPSS respectively. Then, all data was triangulated in a matrix, analysed for similarities and differences within and across cases, and themes were developed. Results: The cross-case analysis produced four themes: Resilience changes minute to minute; Initiating and maintaining readiness; Active co-creation of meaningful activity; Impact on resilience. The findings revealed that people with dementia required skilled facilitation to use MARIO. During interactions with MARIO, the resilience of eight out of ten people was supported. Sessions with MARIO increased the wellbeing of people with dementia by providing a meaningful activity that re-enforced their positive self-concept. Conclusion: Social robots need to have greater capability to interpret and respond to the emotional needs of users if they are to benefit the resilience of people with dementia without the presence of a supportive facilitator. Future research should explore how strength-based strategies can empower people with dementia to create a meaningful activity using social robots.
  • Publication
    Nurses are research leaders in skin and wound care
    (Wiley, 2020-08-24) Gethin, Georgina; Probst, Sebastian; Weller, Carolina; Kottner, Jan; Beeckman, Dimitri
    The World Health Assembly declared 2020, the International Year of the Nurse and the Midwife. Recent editorials and commentaries support the leading role of nurses and midwives as frontline caregivers emphasizing the need to invest in the nursing workforce worldwide to meet global health needs. Today nurses are also leaders in research and one example is skin and wound care. In order to reflect on the contribution of nurses as researchers we conducted a systematic review of published articles in five international leading wound care journals in the years 1998, 2008 and 2018. We aimed to determine the type of research publication and percentage of nurses as first, second or senior authors. The place in the authorship was selected as indicative of leadership as it implies responsibility and accountability for the published work. Across the years 1998, 2008 and 2018, 988 articles were published. The overall proportion of nurse-led articles was 29% (n = 286). The total numbers of articles increased over time and so too did the nurse-led contributions. Nurse-led research was strongest in the design categories 'cohort studies' (46%, n = 44), 'systematic reviews' (46%, n = 19), and 'critically appraised literature and evidence-based guidelines' (47%, n = 55).Results of this review indicate that, in addition to the crucial clinical roles, nurses also have a substantial impact on academia and development of the evidence base to guide clinical practice. Our results suggest that nurse led contributions were particularly strong in research summarizing research to guide skin and wound care practice.
  • Publication
    Niven and Scott (2003): Sixteen years of hindsight
    (Wiley, 2019-05-28) Scott, P Anne
    This paper revisits a 2003 publication in Nursing Philosophy: The need for accurate perception and informed judgement in determining the appropriate use of the nursing resource: hearing the patient's voice. The author suggests that the basic ideas and focus of this 16-year-old paper are still topical and relevant in considerations of nursing care. However, it is also suggested that greater attention to the importance of the nurse-patient relationship in considerations of resource allocation, and potential rationing of nursing care, would have strengthened the original paper.
  • Publication
    Visibility of nursing in policy documents related to health care priorities
    (Wiley, 2020-02-09) Tønnessen, Siri; Christiansen, Karin; Hjaltadóttir, Ingibjörg; Leino‐Kilpi, Helena; Scott, Philomena Anne; Suhonen, Riitta; Öhlén, Joakim; Halvorsen, Kristin
    Aim To explore the visibility of nursing in policy documents concerning health care priorities in the Nordic countries.Background Nurses at all levels in health care organisations set priorities on a daily basis. Such prioritization entails allocation of scarce public resources with implications for patients, nurses and society. Although prioritization in health care has been on the political agenda for many years, prioritization in nursing seems to be obscure in policy documents.Methodology Each author searched for relevant documents from their own country. Text analyses were conducted of the included documents concerning nursing visibility.Results All the Nordic countries have published documents articulating values and criteria relating to health care priorities. Nursing is seldom explicitly mentioned but rather is included and implicit in discussions of health care prioritization in general.Conclusion There is a need to make priorities in nursing visible to prevent missed nursing care and ensure fair allocation of limited resources.Implications for nursing management To highlight nursing priorities, we suggest that the fundamental need for nursing care and what this implies for patient care in different organisational settings be clarified and that policymakers explicitly include this information in national policy documents.
  • Publication
    Safe and competent nursing care: An argument for a minimum standard?
    (SAGE Publications, 2020-05-18) Tønnessen, Siri; Scott, Anne; Nortvedt, Per
    There is no agreed minimum standard with regard to what is considered safe, competent nursing care. Limited resources and organizational constraints make it challenging to develop a minimum standard. As part of their everyday practice, nurses have to ration nursing care and prioritize what care to postpone, leave out, and/or omit. In developed countries where public healthcare is tax-funded, a minimum level of healthcare is a patient right; however, what this entails in a given patient's actual situation is unclear. Thus, both patients and nurses would benefit from the development of a minimum standard of nursing care. Clarity on this matter is also of ethical and legal concern. In this article, we explore the case for developing a minimum standard to ensure safe and competent nursing care services. Any such standard must encompass knowledge of basic principles of clinical nursing and preservation of moral values, as well as managerial issues, such as manpower planning, skill-mix, and time to care. In order for such standards to aid in providing safe and competent nursing care, they should be in compliance with accepted evidence-based nursing knowledge, based on patients' needs and legal rights to healthcare and on nurses' codes of ethics. That is, a minimum standard must uphold a satisfactory level of quality in terms of both professionalism and ethics. Rather than being fixed, the minimum standard should be adjusted according to patients' needs in different settings and may thus be different in different contexts and countries.
  • Publication
    Resource allocation and rationing in nursing care: A discussion paper
    (SAGE Publications, 2018-04-01) Scott, P Anne; Harvey, Clare; Felzmann, Heike; Suhonen, Riitta; Habermann, Monika; Halvorsen, Kristin; Christiansen, Karin; Toffoli, Luisa; Papastavrou, Evridiki
    Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource.
  • Publication
    Clinical research nurses’ expectations and realities of their role: A qualitative evidence synthesis
    (Wiley, 2019-12-17) Hernon, Orlaith; Dalton, Rachael; Dowling, Maura
    Aims To synthesise the available body of qualitative studies relating to clinical research nurses’ experiences of their role. Methods A systematic search of the literature in five databases was undertaken: CINAHL, MEDLINE, EMBASE, PubMed and ProQuest. Thomas and Harden's three‐stage approach to thematic analysis was followed using the ENTREQ statement for reporting. Results Nineteen studies reported in 20 papers (with a total of 232 nurses) were included in the synthesis. Three analytical themes with six subthemes were identified as follows: “identity”; “meeting targets”; and “patient advocate.” Conclusions Clinical research nurses experience isolation, and contributing to this is their perception of nonresearch nurses’ lack of understanding for their role. This can result in difficulties when recruiting study participants. Clinical research nurses can experience internal conflict between being a patient advocate and adhering to a trial protocol. Relevance to clinical practice Training is needed to help research nurses develop skills to face challenges in order to ensure safe and ethical care is provided to research participants while also ensuring high‐quality data collected for the study.
  • Publication
    Evaluation of a companion robot for individuals with dementia: Quantitative findings of the MARIO Project in an Irish residential care setting
    (Slack, 2019-06-25) Barrett, Eva; Burke, Megan; Santorelli, Adam; Luz Oliveira, Barbara; Cavallo, Filippo; Dröes, Rose-Marie; Hopper, Louise; Fawcett-Henesy, Ainna; Meiland, Franka J.M.; Mountain, Gail; Moyle, Wendy; Raciti, Massimiliano; Pegman, Geoff; Teare, Aimee; Sancarlo, Daniele; Riccardi, Francesco; Russo, Alessandro; Bleaden, Andy; Greco, Antonio; Casey, Dympna; Horizon 2020; Irish Research Council
    The current study focuses on the short-term effect of MARIO, a social robot, on quality of life, depression, and perceived social support in persons with dementia (PWD) and evaluates their acceptability of MARIO. Ten PWD in one nursing home took part in a 4-week pilot study, where each participant had up to 12 sessions with MARIO. Sessions comprised engagement in music, news, reminiscence, games, and calendar applications. Standardized questionnaires were administered before and after the 4-week period. Participants had a sustained interest in MARIO during their interactions and an acceptance of MARIO's appearance, sound, and applications. Consequently, participants spent more time socially engaged. No statistically significant differences were found in quality of life, depression, and perceived social support. PWD can engage with a social robot in a real-world nursing home. Future research should incorporate a larger sample and longer intervention period.
  • Publication
    Critical care nurses experiences of providing care for adults in a highly technological environment: A qualitative evidence synthesis
    (Wiley, 2019-08-20) Crilly, Geraldine; Dowling, Maura; Delaunois, Isabelle; Flavin, Mary; Biesty, Linda
    Abstract Aims To synthesise the available body of qualitative evidence relating to nurses' perceptions and experiences of care provision in adult critical care environments. Methods The study adhered to ENTREQ (Confidence in Evidence of Reviews of Qualitative Research) guidelines. See Supplemental File 1. A systematic search of the literature in nine databases was undertaken: CINAHL, Web of Science, Medline, Embase, PsycINFO, Campbell Collaboration, Proquest A & I, DART, Lenus. Blind screening to select relevant studies was undertaken and each selected study was assessed for quality using the Critical Appraisal Skills Programme framework (CASP). Guided by Thomas and Harden's three‐stage approach to thematic analysis, line‐by‐line coding of participants' verbatim accounts and the researchers' interpretations in the selected studies' findings was undertaken and then organised into higher order analytical themes. Confidence in the findings were reviewed using GRADE‐CERQual. Results Twelve studies reported in thirteen papers, including 122 nurses were selected in the final sample for synthesis. Three analytical themes were identified: 1) sometimes machines get all the attention 2) with experience the patient becomes the focus, and 3) technology can't save everybody. Conclusions Providing care for adult patients in a highly technological environment is challenging particularly for novice nurses, who face the potential of technology drawing all their attention. Experienced critical care nurses learn to keep technology in abeyance and deliver person‐centred care within the bounds of a technological environment. Relevance to clinical practice The review supports Locsin's theory of technological competence and highlights that providing care in critical care requires nurses to actively balance attention for the person while managing machines. Experienced nurses achieve this balance and can offer support to novice nurses. Critical care nurse orientation programmes should be underpinned by a holistic approach which addresses the dualism of technology and care.