Adoption of Artificial Intelligence-Enabled Robots in Long-Term Care Homes by Health Care Providers: Scoping Review.

BACKGROUND: Long-term care (LTC) homes face the challenges of increasing care needs of residents and a shortage of health care providers. Literature suggests that artificial intelligence (AI)-enabled robots may solve such challenges and support person-centered care. There is a dearth of literature exploring the perspectives of health care providers, which are crucial to implementing AI-enabled robots. OBJECTIVE: This scoping review aims to explore this scant body of literature to answer two questions: (1) what barriers do health care providers perceive in adopting AI-enabled robots in LTC homes? (2) What strategies can be taken to overcome these barriers to the adoption of AI-enabled robots in LTC homes? METHODS: We are a team consisting of 3 researchers, 2 health care providers, 2 research trainees, and 1 older adult partner with diverse disciplines in nursing, social work, engineering, and medicine. Referring to the Joanna Briggs Institute methodology, our team searched databases (CINAHL, MEDLINE, PsycINFO, Web of Science, ProQuest, and Google Scholar) for peer-reviewed and gray literature, screened the literature, and extracted the data. We analyzed the data as a team. We compared our findings with the Person-Centered Practice Framework and Consolidated Framework for Implementation Research to further our understanding of the findings. RESULTS: This review includes 33 articles that met the inclusion criteria. We identified three barriers to AI-enabled robot adoption: (1) perceived technical complexity and limitation; (2) negative impact, doubted usefulness, and ethical concerns; and (3) resource limitations. Strategies to mitigate these barriers were also explored: (1) accommodate the various needs of residents and health care providers, (2) increase the understanding of the benefits of using robots, (3) review and overcome the safety issues, and (4) boost interest in the use of robots and provide training. CONCLUSIONS: Previous literature suggested using AI-enabled robots to resolve the challenges of increasing care needs and staff shortages in LTC. Yet, our findings show that health care providers might not use robots because of different considerations. The implication is that the voices of health care providers need to be included in using robots. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-doi:10.1136/bmjopen-2023-075278.

A critical reflection on using the Patient Engagement In Research Scale (PEIRS) to evaluate patient and family partners' engagement in dementia research.

Introduction: Research involvement of people with lived experiences is increasing. Few tools are designed to evaluate their engagement in research. The Patient Engagement In Research Scale (PEIRS) is one of the few validated tools. Our team employed the PEIRS with patient and family partners with lived experiences of dementia every 6 months in a two-year telepresence robot project. This reflection paper reports our self-study on key learnings and proposes practical tips on using the PEIRS to evaluate patient and family partners' engagement in dementia research. It is the first to document a case using the PEIRS multiple times in a dementia research project. Methods: Guided by Rolfe et al.'s reflective model, we conducted three team reflective sessions to examine the team's experiences using the PEIRS to improve and evaluate patient and family partners' engagement in the research. We also reviewed our meeting notes and fieldnotes documented in the research journal. A reflexive thematic analysis was performed. Results: The team identified three key learnings: the values of using the PEIRS survey, the adaptations, and the factors influencing its implementation as an evaluation tool. Using the PEIRS provided significant benefits to the project, although some patient and family partners felt it was burdensome. The evaluation tool was enhanced with emojis and comment boxes based on suggestions from patient partners. The emojis introduced an element of fun, while the comment boxes allowed for personalized responses. Several factors influenced the PEIRS tool's effectiveness: the interviewer's identity, the confidentiality of responses and follow-ups, the timing and frequency of using the tool, and the presentation of the evaluations. These learnings led to the development of six practical tips,-"ENGAGE": Enjoyable and fun process, Never impose, Get prepared early, Adapt to the team's needs, Give people options, and Engage and reflect. Conclusion: With the emerging trend of including people with lived experiences in dementia research, there is a need for ongoing assessment of engagement from both patient and family partners and the research team strategies. Future research can further explore survey logistics, co-development of evaluation tools, and the use of tools with people living with dementia.

Understanding Elderly Chinese Cancer Patients in a Multicultural Clinical Setting: Embracing Mortality and Addressing Misperceptions of Vulnerability.

Chinese patients face higher risks of gastrointestinal (GI) cancers and greater cancer-related deaths than Canadian-born patients. The older population encounters barriers to quality healthcare, impacting their well-being and survival. Previous studies highlighted Chinese immigrant perceptions of not requiring healthcare support. During the COVID-19 pandemic, their underutilization of healthcare services garnered attention. The present study explores the experiences of older Chinese cancer patients to improve culturally sensitive cancer care. A total of twenty interviews carried out in Cantonese and Mandarin were conducted with Chinese immigrants, aged 60 or above, diagnosed with Stage 3 or 4 GI cancer. These interviews were transcribed verbatim, translated, and subjected to qualitative descriptive analysis. Among older Chinese immigrant patients, a phenomenon termed "Premature Acceptance: Normalizing Death and Dying" was observed. This involved four key themes: 1. acceptance and letting go, 2. family first, 3. self-sufficiency, and 4. barriers to supportive care. Participants displayed an early acceptance of their own mortality, prioritizing family prosperity over their own quality of life. Older Chinese patients normalize the reality of facing death amidst cancer. They adopt a pragmatic outlook, acknowledging life-saving treatments while willingly sacrificing their own support needs to ease family burdens. Efforts to enhance health literacy require culturally sensitive programs tailored to address language barriers and differing values among this population. A strengths-based approach emphasizing family support and practical aspects of care may help build resilience and improve symptom management, thereby enhancing their engagement with healthcare services.

Working with a robot in hospital and long-term care homes: staff experience.

Although there is a growing literature on the use of telepresence robots in institutional dementia care settings, limited research focused on the perspectives of frontline staff members who deliver dementia care. Our objective was to understand staff perspectives on using telepresence robots to support residents with dementia and their families. Guided by the Consolidated Framework for Implementation Research, we conducted four focus groups and 11 semi-structured interviews across four long-term care (LTC) homes and one hospital in Canada. We included 22 interdisciplinary staff members (e.g., registered nurses, social workers, occupational therapists, recreational therapists) to understand their experiences with telepresence robots. Thematic analysis identified three key themes: 1) Staff Training and Support; 2) Robot Features; 3) Environmental dynamics for Implementation. Our results underscore the imperative of structural support at micro-, meso- and macro-levels for staff in dementia care settings to effectively implement technology. This study contributes to future research and practice by elucidating factors facilitating staff involvement in technology research, integrating staff voices into technology implementation planning, and devising strategies to provide structural support to staff, care teams, and care homes.

Facilitators, barriers and impacts to implementing dementia care training for staff in long-term care settings by using fully immersive virtual reality: a scoping review protocol.

INTRODUCTION: The rapid growth of the ageing population underscores the critical need for dementia care training among care providers. Innovative virtual reality (VR) technology has created opportunities to improve dementia care training. This scoping review will specifically focus on the barriers, facilitators and impacts of implementing fully immersive VR training for dementia care among staff in long-term care (LTC) settings. METHODS AND ANALYSIS: We will follow the Joanna Briggs Institute's scoping review methodology to ensure scientific rigour. We will collect literature of all languages with abstracts in English from CINAHL, Medline, Scopus, Embase, Web of Science and ProQuest database until 31 December 2023. Grey literature from Google Scholar and AgeWell websites will be included. Inclusion criteria encompass papers involving paid staff (Population), fully immersive VR training on dementia care (Concept) and LTC settings (Context). Literature referring only to non-paid caregivers, non-fully immersive VR or other chronic diseases will be excluded. Literature screening, data extraction and analysis will be conducted by two reviewers separately. We will present a narrative summary with a charting table on the main findings. ETHICS AND DISSEMINATION: This work does not require ethics approval, given the public data availability for this scoping review. Through a comprehensive overview of the current evidence regarding impacts, barriers and facilitators on this topic, potential insights and practical recommendations will be generated to support the implementation of VR training to enhance staff competence in LTC settings. The findings will be presented in a journal article and shared with practitioners on the frontline.

Living with dementia: Exploring the intersections of culture, race, and dementia, stigma.

Research documents the presence of stigma and discrimination as key components in the lived experience of dementia. However, to date, there is limited understanding regarding how social location, particularly as it relates to culture and race, may shape this experience of stigma and discrimination. In this qualitative exploratory study, personal interviews were held with ten Chinese Canadians living with dementia focused on better understanding how culture, race, and dementia stigma influence their experiences. From the onset, themes related to stigma and discrimination were woven into the participants' stories about living with dementia. Consistent with other research, all participants described an increased sense of vulnerability and invisibility related to how both they and others responded to their diagnosis of dementia. Participants also provided examples of how this experience of stigma was compounded by culture, race, and immigration status. Importantly, these acts of stigma and discrimination were both externally and internally imposed, resulting in feelings of lack of safety and insecurity. This research draws attention to the increased vulnerability that accompanies a diagnosis of dementia and illustrates how this may be heightened by one's culture and racism.

Use of headphones for the delivery of music programs for people with dementia in long-term care homes: a scoping review protocol.

INTRODUCTION: Dementia affects the quality of life. Excessive noise in care environments can exacerbate stress and related symptoms. Headphone-based music interventions may help improve the quality of life for people with dementia in long-term care homes. This review aims to explore and synthesise research on headphone-based music interventions for people with dementia in long-term care homes, focusing on enablers and barriers to implementing headphone-based music interventions. METHODS AND ANALYSIS: Joanna Briggs Institute guidance for scoping review and Preferred Reporting Items for Scoping Reviews and Meta-analyses extension for Scoping Reviews will guide the review and report process. CINAHL, MEDLINE, Embase, Web of Science, Scopus, AgeLine, PsycINFO and ProQuest databases will be searched for relevant literature from June 2010 to January 2024, supplemented by hand searches and Google for grey literature. Two research assistants will independently screen citations, followed by a full-text review. Data will be extracted using a data extraction tool. We will present the data in a table with narratives that answer the questions of the scoping review. ETHICS AND DISSEMINATION: This scoping review does not require ethics approval and participation consent, as all data will be publicly available. The scoping review results will be disseminated through conference presentations and an open-access publication in a peer-reviewed journal. The findings will provide practical insights into the adoption and efficacy of headphone-based music programmes for dementia in long-term care homes, contributing to education, practice, policy and future research.

Facilitators and barriers to codesigning social robots with older adults with dementia: a scoping review protocol.

INTRODUCTION: Social robots including telepresence robots have emerged as potential support in dementia care. However, the effectiveness of these robots hinges significantly on their design and utility. These elements are often best understood by their end-users. Codesign involves collaborating directly with the end-users of a product during its development process. Engaging people with dementia in the design of social robots ensures that the products cater to their unique requirements, preferences, challenges, and needs. The objective of this scoping review is to understand the facilitators, barriers, and strategies in codesigning social robots with older adults with dementia. METHODS AND ANALYSIS: The scoping review will follow the Joanna Briggs Institute scoping review methodology and will be conducted from November 2023 to April 2024. The steps of search strategy will involve identifying keywords and index terms from CINAHL and PubMed, completing search using identified keywords and index terms across selected databases (Medline, CINAHL, PubMed, AgeLine, Web of Science, PsycINFO, Scopus, IEEE, and Google Scholar), and hand-searching the reference lists from chosen literature for additional literature. The grey literature will be searched using Google. Three research assistants will screen the titles and abstracts independently by referring to the inclusion criteria. Three researchers will independently assess the full text of literature following to the inclusion criteria. The data will be presented in a table with narratives that answers the questions of the scoping review. ETHICS AND DISSEMINATION: This scoping review does not require ethics approval because it collects data from publicly available resources. The findings will offer insights to inform future research and development of robots through collaboration with older people with dementia. In addition, the scoping review results will be disseminated through conference presentations and an open-access publication in a peer-reviewed journal.

The Perspective of Nurses and Healthcare Providers on the use of Television Videos with People with Moderate to Severe Dementia.

BACKGROUND: Nurses and healthcare providers need practical tools to deliver person-centred care in hospitals and long-term care homes. Few non-pharmacological interventions are designed to meet the needs of people with moderate to severe dementia. Dementia-friendly television videos (TV videos) offer a familiar stimulation with the potential for meaningful engagement in the relational space of technology. TV videos refer to moving visuals with audio that can be shown on TV and other devices. They can be used for different purposes for people with dementia, such as stimulating memories and facilitating expressions. PURPOSE: This study aims to understand the perspectives of nurses and healthcare providers on the potential function and practice considerations of using TV videos for people with moderate to severe dementia. METHODS: We conducted five focus groups with 23 nurses and healthcare providers in a long-term care home and a geriatric hospital unit. Data were analyzed using reflexive thematic analysis and guided by Kitwood's person-centred care model. RESULTS: Our analysis identified five themes about the use of TV videos: (1) calm the person with dementia who is in emotional distress, (2) form connections with the person with dementia, (3) bring people with dementia together, (4) facilitate the Person's Activities of Daily Living (ADLs), (5) help the person connect with their past. CONCLUSION: TV videos should be designed to match the person's cognitive abilities, interests, and cultural and linguistic backgrounds. Our findings supplemented Kitwood's model by identifying the person's cultural and language needs.

Facilitators and barriers to using AI-enabled robots with older adults in long-term care from staff perspective: a scoping review protocol.

INTRODUCTION: Assistive and service robots have been increasingly designed and deployed in long-term care (LTC) but little evidence guides their use. This scoping review synthesises existing studies on facilitators and barriers to using artificial intelligence (AI)-enabled robots with older adults in LTC settings. METHODS AND ANALYSIS: We will follow the Joanna Briggs Institute's scoping review methodology for the study, to be conducted from November 2023 to April 2024. We will focus on literature exploring the use of AI-enabled robots with older adults in an LTC setting from healthcare providers' perspectives. Three steps will be taken: (a) keywords and index terms will be identified from MEDLINE and CINAHL databases; (b) comprehensive searches will be conducted in MEDLINE, CINAHL, Embase, Web of Science, Scopus, AgeLine, PsycINFO, ProQuest and Google, using keywords and index terms identified in step (a); and (c) examining reference lists of the included studies and selecting items in the reference lists which meet the inclusion criteria. Searches for grey literature will also be conducted via Google. The results will be presented in a charting table and a narrative summary will be presented in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. ETHICS AND DISSEMINATION: Ethics approval and participation consent are not required because the data are publicly available. The results will be presented via a journal article and conference presentations.

Co-design of a digital app "WhatMatters" to support person-centred care: A critical reflection.

BACKGROUND: People with dementia often do not receive optimal person-centred care (PCC) in care settings. Family members can play a vital role as care partners to support the person with dementia with their psychosocial needs. Participatory research that includes the perspectives of those with lived experience is essential for developing high-quality dementia care and practices. OBJECTIVE: Throughout 2021-2022, a mobile app, called WhatMatters, was co-developed to provide easy-to-access and personalised support for people with dementia in hospitals and long-term care homes, with input from patients/residents, family partners and healthcare staff. This article discusses and critically reflects on the experiences of patients/residents, family partners, and healthcare staff involved in the co-design process. METHODS: For the app development, we applied a participatory co-design approach, guided by a User Experience (UX) model. The process involved co-design workshops and user testing sessions with users (patients/residents, family partners, healthcare staff) to co-develop the WhatMatters prototype. We also conducted focus groups and one on one interviews with staff and caregiver participants to explore their experiences. Our research team, which also included patient partners, took part in regular team meetings during the app's development, where we discussed and reflected on the co-design process. Reflexive thematic analysis was performed to identify themes that represent the challenges and rewarding experiences of the users involved in the co-design process, which guided our overall reflective process. FINDINGS: Our reflective analysis identified five themes (1) clarifying the co-design process, (2) ensuring inclusive collaborations of various users, and (3) supporting expression of emotion in a virtual environment, (4) feeling a sense of achievement and (5) feeling valued. IMPLICATIONS: WhatMatters offers potential for providing personally relevant and engaging resources in dementia care. Including the voices of relevant users is crucial to ensure meaningful benefits for patients/residents. We offer insights and lessons learned about the co-design process, and explore the challenges of involving people with lived experiences of dementia in co-design work, particularly during the pandemic.

Facilitators of and barriers to patient and public involvement in building learning health systems in community health services settings: a scoping review protocol.

INTRODUCTION: The development of learning health systems (LHSs) has often focused on optimally leveraging data. More attention should be paid to patient and public involvement or community engagement in forming learning communities that work together to build LHS. This scoping review aims to identify facilitators of and barriers to involving patients and the public in building LHSs in community health services settings. METHODS AND ANALYSIS: We will use the Joanna Briggs Institute's scoping review methodology. We will review literature in English published from 1 January 2007 to 31 December 2022. The databases that will be searched are MEDLINE, CINAHL, Embase, Web of Science, Scopus, AgeLine, PsycINFO and Web of Science. Key inclusion and exclusion criteria include the following: we will only consider a learning community in a community health services context (eg, home care, long-term care, primary care); we will exclude literature on acute care settings; and we will consider any research designs apart from big data analytics. We will review all sources, including university student theses and dissertations. The review will proceed in three steps: (1) we will identify keywords and index terms from the MEDLINE and CINAHL databases; (2) using the keywords and index terms identified in step (1), we will search other databases and (3) we will handsearch the reference lists of the selected literature and will search for grey literature using Google. Two research assistants will screen the titles and abstracts separately, with reference to the inclusion criteria. Two researchers will then assess the full text of selected studies, also in reference to the inclusion criteria. We will present the findings in a charting table and provide a narrative summary. ETHICS AND DISSEMINATION: This work does not require ethics approval because the data for this scoping review are publicly available. The findings will be presented in a journal article and at conferences.

Facilitators and Barriers to Using Virtual Reality and its Impact on Social Engagement in Aged Care Settings: A Scoping Review.

Aim: This scoping review aims to identify the facilitators and barriers to the implementation of VR technology in the aged-care setting. Background: Virtual reality (VR) offers the potential to reduce social isolation and loneliness through increased social engagement in aged-care settings. Methods and Analysis: This scoping review followed the Joanna Briggs Institute scoping review methodology and took place between March and August 2022. The review included a three-step search strategy: (1) identifying keywords from CINHAL, Embase, Medline, PsycInfo, Scopus, and Web of Science (2) conducting a second search using all identified keywords and index terms across selected databases; and (3) searching the reference lists of all included articles and reports for additional studies. Results: The final review included 22 articles. The analysis identified factors affecting the VR technology implementation in aged care settings to reduce isolation and loneliness: (a) key facilitators are local champions and staff training. (b) barriers include technological adaptability, video quality, and organizational culture. Conclusion: Existing evidence points to VR as a promising intervention to decrease loneliness and feelings of isolation and improve social engagement in older people living in aged-care settings.

Exploring experiences of loneliness among Canadian long-term care residents during the COVID-19 pandemic: A qualitative study.

BACKGROUND: The COVID-19 pandemic has significant impact on long-term care (LTC) residents' health and well-being. OBJECTIVES: This study investigated resident experiences of loneliness during the COVID-19 pandemic in Canadian LTC homes to offer lessons learned and implications. METHODS: 15 residents and 16 staff members were recruited from two large urban Canadian LTC homes with large outbreaks and fatalities. We used a telepresence robot to conduct one-on-one semi-structured interviews with participants remotely. We applied the Collaborative Action Research (CAR) methodology and report the early phase of CAR focused on collecting data and reporting findings to inform actions for change. Thematic analysis was performed to identify themes. RESULTS: Four themes were identified. The first two themes characterise what commonly generated feelings of loneliness amongst residents, including (1) social isolation and missing their family and friends and (2) feeling hopeless and grieving for lives lost. The second two themes describe what helped residents alleviate loneliness, including (3) social support and (4) creating opportunities for recreation and promoting positivity. CONCLUSIONS: Residents living in LTC experienced significant social isolation and grief during the pandemic that resulted in loneliness and other negative health consequences. IMPLICATIONS FOR PRACTICE: Promoting meaningful connection, safe recreational activities and a positive atmosphere in LTC homes during the pandemic may help mitigate residents' experiences of loneliness due to social isolation and/or grief and enhance their quality of life.

The perceptions of university students on technological and ethical risks of using robots in long-term care homes.

Introduction: The COVID-19 pandemic has disproportionately impacted long-term care (LTC) residents and exacerbated residents' risks of social isolation and loneliness. The unmet emotional needs of residents in LTC have driven researchers and decision-makers to consider novel technologies to improve care and quality of life for residents. Ageist stereotypes have contributed to the underuse of technologies by the older population. Telepresence robots have been found to be easy to use and do not require older adults to learn how to operate the robot but are remotely controlled by family members. The study aimed to understand the perspectives of multidisciplinary university students, including healthcare students, on using telepresence robots in LTC homes. The study would contribute to the future planning, implementation, and design of robotics in LTC. Methods: Between December 2021 and March 2022, our team conducted interviews with 15 multidisciplinary students. We employed a qualitative descriptive (QD) approach with semi-structured interview methods. Our study aimed to understand the perspectives of university students (under the age of 40) on using telepresence robots in LTC homes. Participants were invited to spend 15 min remotely driving a telepresence robot prior to the interview. A diverse team of young researchers and older adults (patient and family partners) conducted reflexive thematic analysis. Results: Six themes were identified: Robots as supplementary interaction; privacy, confidentiality, and physical harm; increased mental well-being and opportunities for interactions; intergenerational perspectives add values; staffing capacity; environmental and cultural factors influence acceptance. Conclusion: We identified a diverse range of perspectives regarding risk and privacy among participants regarding the implementation of telepresence robots in long-term care. Participants shared the importance of the voice of the resident and their own for creating more equitable decision-making and advocating for including this type of technology within LTC. Our study would contribute to the future planning, implementation, and design of robotics in LTC.

Future of digital health and community care: Exploring intended positive impacts and unintended negative consequences of COVID-19.

Response to COVID-19 has both intentionally and unintentionally progressed the digitization of health and community care, which can be viewed as a human rights issue considering that access to health and community care is a human right. In this article, we reviewed two cases of digitization of health and community care during the pandemic; one in Scotland, United Kingdom and another in British Columbia, Canada. An integrated analysis revealed that digitization of health and community care has intended positive and unintended negative consequences. Based on the analysis, we suggest five areas of improvement for equity in care: building on the momentum of technology advantages; education and digital literacy; information management and security; development of policy and regulatory frameworks; and the future of digital health and community care. This article sheds light on how health practitioners and leaders can work to enhance equity in care experiences amid the changing digital landscape.

Facilitators and barriers to using smart TV among older adults in care settings: a scoping review protocol.

INTRODUCTION: The objective of the scoping review is to understand what has been reported in the literature regarding facilitators and barriers to using smart television (smart TV) among older adults in care settings. METHODS AND ANALYSIS: The scoping review will adopt the Joanna Briggs Institute scoping review methodology. It will occur between March and August 2022. It will consider literature on using smart TV with older adults in care settings. A three-step search strategy will be applied: (1) to identify keywords and index terms from MEDLINE and CINAHL; (2) to do a search using identified keywords and index terms across chosen databases (MEDLINE, CINAHL, Embase, Web of Science, Scopus, AgeLine, PsycINFO, Web of Science, ProQuest and Google) and (3) to hand search the reference lists of all selected literature for additional literature. Further, we will search using Google for grey literature. Two research assistants will independently screen the titles and abstracts by referring to the inclusion criteria. After that, two researchers will independently assess the full text of selected literature by referring to the inclusion criteria. We will present the data in a table with narratives that answer the questions of the scoping review. ETHICS AND DISSEMINATION: The scoping review does not require ethics approval because it collects data from the publicly available literature. The findings will offer insights to inform the use of smart TV among older adults in care settings for education, practice, policy and future research. The scoping review results will also be disseminated through conference presentations and an open-access publication in a peer-reviewed journal.

Cultural adaptation in television technology for older adults with dementia in care settings.

Introduction: There is a lack of literature on the cultural adaptation of technologies for dementia care. This paper presents an example of the cultural adaptation of a television video about drinking water for older Chinese adults with dementia in care settings, in Vancouver, Canada. Method: We refer to the cultural adaptation process (CAP) model to guide the cultural adaptation process by collecting and incorporating feedback from different parties into the culturally adapted video, including Phase 1 local consultations and information gathering, phase 2 iterative testing and adaptation, and phase 3 finalizing adaptation. Results: We also referred to the Ecological Validity Model (EVM) to present the adjustments we made to the video from the cultural adaptation. We adjusted the video on seven domains suggested by the EVM: goal, context, content, language, people, concept, and method. Discussion: We draw attention to the opportunities and challenges of the cultural adaptation of technology into a new community. Based on our lessons, we outline concrete suggestions about what aspects of, and how, cultural adaptation can be made to promote cultural inclusivity in technology development and implementation.

How Do Social Workers Working in Long-term Care Understand Their Roles? Using British Columbia, Canada as an Example.

A common problem faced by social workers working in long-term care is that they are not given the opportunity to tell how they understand their roles and thus their roles are neither understood nor recognized by other professionals. There is a need for social workers to tell how they understand their roles so that their roles can be better understood and recognized. A research study was conducted in the province of British Columbia in Canada to explore how social workers working in long-term care understand their roles. Fourteen semi-structured interviews were conducted. Five themes were identified, including advocating for the most vulnerable, humanizing long-term care, balancing between self-determination and safety, dancing with the systems, and facilitating collaboration. The results reiterated but also supplemented the existing literature. This research study also proposes future research studies on the roles of social workers working in long-term care.

Perceived challenges in pediatric palliative care among doctors and nurses in Hong Kong.

This study aims to examine perceived challenges, including knowledge, skills, self, and work environment, of professionals in providing pediatric palliative care (PPC) in Hong Kong and the differences in perceived challenges between groups. A total of 680 pediatric doctors and nurses participated in the survey. They tended to perceive the provision of PPC as difficult and considered "advanced skills" (those dealing with death-related issues) challenging. Findings indicate that nurses, professionals who are less experienced, do not have children, and have not received palliative care training perceived a higher level of challenges in providing PPC. Implications for training and support are discussed.