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可能影响养老院技术实施的条件和伦理挑战:一项定性研究。

Conditions and ethical challenges that could influence the implementation of technologies in nursing homes: A qualitative study.

作者信息

Bourbonnais Anne, Rousseau Jacqueline, Lalonde Marie-Hélène, Meunier Jean, Lapierre Nolwenn, Gagnon Marie-Pierre

机构信息

Faculty of Nursing, Université de Montréal, Montréal, QC, Canada.

Research Centre of the Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada.

出版信息

Int J Older People Nurs. 2019 Dec;14(4):e12266. doi: 10.1111/opn.12266. Epub 2019 Sep 1.

Abstract

AIM

To explore the conditions that may influence the implementation of an interactive mobile application (app) and an intelligent videomonitoring system (IVS) in nursing homes (NHs) and the ethical challenges of their use.

BACKGROUND

There is a lack of knowledge about implementing technologies in NHs and the ethical challenges that might arise. In past studies, nursing care teams expressed the need for technologies offering clinical support. Technologies like an IVS and an app could prove useful in NHs to prevent and manage falls and responsive behaviours.

DESIGN

An exploratory qualitative study was conducted with care managers, family caregivers and formal caregivers in five NHs.

METHODS

Each participant was shown a presentation of a potential app and a short video on an IVS. It was followed by an individual semi-structured interview. A conventional content analysis was performed.

FINDINGS

Potential users found it would be possible to implement these technologies in NHs even if resistance could be expected. To facilitate adoption and achieve clinical benefits, the implementation of technologies should be pilot-tested, and coaching activities should be planned. Ethical risks were considered already present in NHs even without technologies, for example, risks to privacy. Strategies were proposed, for instance, to adapt the code of ethics and procedures. Some potential prejudices about the interest and abilities of older staff, nurses' aides, and family caregivers to use technology were identified.

CONCLUSIONS

Through rigorous and ethical implementation, technologies supporting clinical care processes could benefit older people living in NHs, as well as their relatives and the staff.

IMPLICATIONS FOR PRACTICE

Various strategies are proposed to successfully implement technologies. Effort should be made to avoid prejudices during implementation, and procedures should be adapted to mitigate possible ethical challenges.

摘要

目的

探讨可能影响在养老院实施交互式移动应用程序(应用程序)和智能视频监控系统(IVS)的条件,以及使用这些技术所面临的伦理挑战。

背景

对于在养老院实施技术以及可能出现的伦理挑战,人们缺乏相关了解。在过去的研究中,护理团队表示需要能提供临床支持的技术。诸如IVS和应用程序之类的技术可能在养老院预防和管理跌倒及应激行为方面很有用。

设计

对五家养老院的护理经理、家庭护理人员和正式护理人员进行了一项探索性定性研究。

方法

向每位参与者展示了一个潜在应用程序的演示文稿和一段关于IVS的短视频。随后进行了个人半结构化访谈。进行了常规内容分析。

结果

潜在用户发现,即使预计会有阻力,在养老院实施这些技术也是可行的。为促进技术采用并实现临床效益,技术实施应进行试点测试,并应规划指导活动。即使没有这些技术,养老院也被认为已经存在伦理风险,例如隐私风险。提出了一些策略,例如调整道德准则和程序。还发现了一些对老年员工、护士助理和家庭护理人员使用技术的兴趣和能力的潜在偏见。

结论

通过严谨且符合伦理的实施过程,支持临床护理流程的技术可以使住在养老院的老年人及其亲属和工作人员受益。

对实践的启示

提出了各种策略以成功实施技术。在实施过程中应努力避免偏见,并应调整程序以减轻可能出现的伦理挑战。

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