Implementation of robotic devices in nursing care. Barriers and facilitators: an integrative review.

BACKGROUND: Robots in healthcare are gaining increasing attention; however, their implementation is challenging due to the complexity of both interventions themselves and the contexts in which they are implemented. The objective of this integrative review is to identify barriers to and facilitators of the implementation of robotic systems in nursing. METHODS: Articles published from 2002 to 2019 reporting on projects to implement robotic devices in nursing care were searched on Medline (via PubMed), CINAHL and databases on funded research projects (Community Research and Development Information Services and Technische Informationsbibliothek) and in journals for robotic research in November 2017 and July 2019 for an update. No restrictions regarding study designs were imposed. All included articles underwent quality assessments with design-specific critical appraisal tools. Barriers to and facilitators of implementation were classified using the Context and Implementation of Complex Interventions framework. RESULTS: After removing all duplicates, the search revealed 11 204 studies, of which 17 met the inclusion criteria and were included in the synthesis. The majority of the studies dealt with the implementation of robots designed to support individuals, either living at home or in nursing homes (n=11). The studies were conducted in Europe, the USA and New Zealand and were carried out in nursing homes, individual living environments, hospital units and laboratories. The quality of reporting and quality of evidence were low in most studies. The most frequently reported barriers were in socioeconomic and ethical domains and were within the implementation outcomes domain. The most frequently reported facilitators were related to the sociocultural context, implementation process and implementation strategies. DISCUSSION: This review identified barriers to and facilitators of the implementation of robotic devices in nursing within different dimensions. The results serve as a basis for the development of suitable implementation strategies to reduce potential barriers and promote the integration of elements to facilitate implementation. PROSPERO REGISTRATION NUMBER: CRD42018073486.

Flexible work arrangements in open workspaces and relations to occupational stress, need for recovery and psychological detachment from work.

BACKGROUND: The trend is going into the direction of flexible work arrangements in open workspaces in which employees can decide where and when to work. The aim of this study was to analyze effects of a transition to open workspaces including Activity Based Working (ABW) on employees' working conditions and their levels of occupational stress, need for recovery and psychological detachment from work. METHODS: Employees of a large technology company responded to a baseline and two follow-up measurements over one year. Data were collected via online survey assessing the employees' mental demands, workload, job autonomy, support from supervisor, team collaboration, satisfaction with communication climate and three well-being outcomes (occupational stress, need for recovery and psychological detachment from work). Descriptive statistical analyses, analyses of variance and regression analyses were applied to test the hypotheses. RESULTS: Significant differences in working conditions were found after the transition, e.g. reduced mental demands, but an increased workload. Job autonomy, team collaboration and satisfaction with communication climate increased. Levels of occupational stress decreased significantly over time. Regression analyses revealed substantial associations between flexible work arrangements, job resources and occupational stress. CONCLUSION: The results contribute to the current knowledge on flexible work arrangements in open work spaces. They can be used to design future work settings aimed at increasing employees' well-being and job performance. Further practical implications and recommendations for future research are discussed.

Effectiveness of a complex intervention to improve participation and activities in nursing home residents with joint contractures (JointConEval): study protocol of a multicentre cluster-randomised controlled trial [DRKS-ID:DRKS00015185].

BACKGROUND: Nursing home residents are frequently affected by joint contractures, which impacts their participation and daily activities. A complex intervention, the Participation Enabling Care in Nursing (PECAN), was previously developed and pilot tested to address their needs. Its effectiveness and safety will be evaluated in the present study. METHODS/DESIGN: This multicentre cluster-randomised controlled trial will be conducted in 32 nursing homes spread over two regions of Germany. A total of 578 residents over 65 years old with joint contractures will be included. To compare the effect of the PECAN intervention with optimised standard care (usual care and an information session), randomisation will take place at a cluster level. The individually tailored intervention was designed using the biopsychosocial model in the International Classification of Functioning, Disability and Health (ICF) to reduce activity limitations and participation restrictions resulting from existing joint contractures by addressing barriers and by strengthening supportive factors on an individual level and an organisational level. The implementation strategy comprises a facilitators' workshop, a peer mentoring approach including a peer mentor visit and telephone peer counselling, an in-house information event, an information session for the nursing team and a training session on collegial consultation for the facilitators. The in-house information event will also take place in the nursing homes of the control group. The primary outcome is the residents' participation and activities after 12 months of follow-up as assessed using the PaArticular Scales. The secondary outcome is the residents' quality of life. A cost-effectiveness analysis (costs per additional resident who experienced a decrease of ten points in the participation or activities subscale of the PaArticular Scales) and a cost-utility analysis (costs per additional quality adjusted life year) will be conducted. We will investigate barriers and facilitators in a comprehensive process evaluation. DISCUSSION: We expect a clinically relevant improvement of participation and activities in residents with joint contractures. Our findings will provide important insights regarding participation in the situation of the affected individuals. TRIAL REGISTRATION: DRKS, DRKS00015185 . Registered on 1 August 2018. Universal Trial Number U1111-1218-1555. Registered on 26 July 2018.

Working in a cocoon: (Co)working conditions of office nomads - a health related qualitative study of shared working environments.

BACKGROUND: The flexible working and business model of coworking spaces inherits the provision of workspace and further the construction of a network for entrepreneurs, creative and knowledge workers. Until now, research on coworking spaces is scarce in the field of health sciences. OBJECTIVE: This study investigated reasons and motives for working in coworking spaces and working conditions under health related aspects. Demands and resources while working in coworking spaces were analyzed according to a theoretical model for (Job-demands-resources model - JDR) perceived working conditions. METHODS: Twenty semi-structured qualitative interviews were conducted with coworkers (n = 14) and coworking operators (n = 6) in Berlin, Hamburg, and Munich. Participants were asked to describe the reasons and motivations for working in coworking spaces and their perceived working conditions. Transcripts were analyzed according to content analysis. RESULTS: The most mentioned reason for using coworking spaces were the community aspect (n = 15) followed by the alternative to home office (n = 12). Negative job demands seem to result from unfavorable ergonomic conditions, working disruptions, miscommunications and missing privacy. Time flexibility, social surrounding and increased productivity were interpreted as job resources. CONCLUSIONS: These results can be seen as a basis for further quantitative research in order to generalize these findings, by testing hypotheses and develop workplace-related concepts for health management.