1
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Empowerment in structures. Practical-ethical considerations of the preconditions for technology-assisted dementia care in Germany based on an expert-interview study

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Intelligent assistive technologies (IAT) have become more common in dementia care. Ethical reflection on technology-assisted dementia care (TADC) has focused so far mainly on individual and interpersonal implications (e.g., self-determination, (in)dependence, safety or privacy issues, caregivers’ support and cost-efficiency). From an empowerment-sensitive perspective, however, the societal, political, economic and technological preconditions for TADC should be more deeply analyzed in terms of their accelerating or inhibiting effects on technology development, implementation and usage. Therefore, the aim of this study was to explore these preconditions in the German context and so to contribute to more empowerment-sensitive structures.

          Methods

          Semi-structured interviews were conducted with 20 German-speaking experts from health care, health policy and the fields contributing to IAT (e.g., computer science, engineering). Thematic content analysis was used to analyze the data.

          Findings

          The experts’ assessments of the current preconditions for TADC in Germany were starkly ambivalent. In the field of „society”, they identified digitalization, a change in mentality towards IAT and demographic change as accelerators, unequally distributed digital literacy, misleading perceptions and a lack of affinity as inhibitors. In the field “politics - regulation - economy”, experts identified scarcity of public resources, growing private wealth and regulatory progress as accelerators and unclear financing options, an uncertain market, data protection and ethical challenges as inhibitors. In the field “technology”, they identified progress in basic technical research and improved customizability and interconnectivity as accelerators, while deficient digital infrastructure, a lack of user participation, dementia-specific challenges and challenges regarding data collection and security were seen as inhibitors.

          Conclusions

          TADC promises an empowerment of persons with dementia, e.g. by enhancing their self-determination, increasing their independence from social control and by allowing more social participation. Yet its societal, political, economic and technological environments preconfigure the likelihood of successful empowerment as a socio-technical practice within TADC. Accelerators in the fields of society, politics-regulation-economy and technology need to be consolidated and strengthened. Inhibitors need to be mitigated, e.g. by with new educational, political and market economic policies. We make policy recommendations based on these conclusions.

          Related collections

          Most cited references47

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          A simple method to assess and report thematic saturation in qualitative research

          Data saturation is the most commonly employed concept for estimating sample sizes in qualitative research. Over the past 20 years, scholars using both empirical research and mathematical/statistical models have made significant contributions to the question: How many qualitative interviews are enough? This body of work has advanced the evidence base for sample size estimation in qualitative inquiry during the design phase of a study, prior to data collection, but it does not provide qualitative researchers with a simple and reliable way to determine the adequacy of sample sizes during and/or after data collection. Using the principle of saturation as a foundation, we describe and validate a simple-to-apply method for assessing and reporting on saturation in the context of inductive thematic analyses. Following a review of the empirical research on data saturation and sample size estimation in qualitative research, we propose an alternative way to evaluate saturation that overcomes the shortcomings and challenges associated with existing methods identified in our review. Our approach includes three primary elements in its calculation and assessment: Base Size, Run Length, and New Information Threshold. We additionally propose a more flexible approach to reporting saturation. To validate our method, we use a bootstrapping technique on three existing thematically coded qualitative datasets generated from in-depth interviews. Results from this analysis indicate the method we propose to assess and report on saturation is feasible and congruent with findings from earlier studies.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Patient empowerment, patient participation and patient-centeredness in hospital care: A concept analysis based on a literature review.

            The concepts of patient empowerment, patient participation and patient-centeredness have been introduced as part of the trend towards a more participatory health care and have largely been used interchangeably. Although these concepts have been discussed for a number of years, their exact meaning in hospital care remains somewhat unclear. This absence of theoretical and conceptual clarity has led to (1) poor understanding and communication among researchers, health practitioners and policy makers and (2) problems in measurement and comparison between studies across different hospitals.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Self-management: Enabling and empowering patients living with cancer as a chronic illness.

              With recent improvements in the early detection, diagnosis, and treatment of cancer, people with cancer are living longer, and their cancer may be managed as a chronic illness. Cancer as a chronic illness places new demands on patients and families to manage their own care, and it challenges old paradigms that oncology's work is done after treatment. As a chronic illness, however, cancer care occurs on a continuum that stretches from prevention to the end of life, with early detection, diagnosis, treatment, and survivorship in between. In this article, self-management interventions that enable patients and families to participate in managing their care along this continuum are reviewed. Randomized controlled trials of self-management interventions with cancer patients and families in the treatment, survivorship, and end-of-life phases of the cancer care continuum are reviewed, and the Chronic Care Model is presented as a model of care that oncology practices can use to enable and empower patients and families to engage in self-management. It is concluded that the need for a common language with which to speak about self-management and a common set of self-management actions for cancer care notwithstanding, oncology practices can now build strong relationships with their patients and formulate mutually agreed upon care plans that enable and empower patients to care for themselves in the way they prefer.
                Bookmark

                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2002853Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/177655Role: Role: Role:
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                10 January 2025
                2024
                : 15
                : 1437967
                Affiliations
                [1] Department of Medical Ethics and History of Medicine, University Medical Center Göttingen , Göttingen, Germany
                Author notes

                Edited by: Sagit Lev, Bar-Ilan University, Israel

                Reviewed by: Jodi Sturge, University of Twente, Netherlands

                Tenzin Wangmo, University of Basel, Switzerland

                *Correspondence: Johannes Welsch, johannes.welsch@ 123456med.uni-goettingen.de
                Article
                10.3389/fpsyt.2024.1437967
                11757930
                cffaa961-2dd5-4c34-a00f-3cbc25341223
                Copyright © 2025 Welsch and Schicktanz

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 24 May 2024
                : 18 November 2024
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 50, Pages: 12, Words: 7234
                Funding
                Funded by: Bundesministerium für Bildung und Forschung , doi 10.13039/501100002347;
                Award ID: 01GP1901
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The current study was carried out within the context of the EIDEC (Ethical and Social Implications of Co-Intelligent Monitoring and Assistive Systems in Dementia Care) project. This work was funded by the Federal Ministry of Education and Research (funding code: 01GP1901). Furthermore, we acknowledge support by the Open Access Publication Funds of the Göttingen University.
                Categories
                Psychiatry
                Original Research
                Custom metadata
                Aging Psychiatry

                Clinical Psychology & Psychiatry
                empowerment,dementia,intelligent assistive technology,digitalization,exogenous preconditions,policy recommendations

                Comments

                Comment on this article