Background and methodology

The survey was created by Professor Irena Papadopoulos and it stems from the findings of the previous International online survey on culturally competent compassion in Nursing [hyperlink]. The first survey revealed that a few participants (4.3%) felt that they were in receipt of compassion from their managers. This means that a staggering 95.7% of the sample of 1323 nurses and healthcare professionals were not receiving compassion from their managers [hyperlink to the two publications resulting from the first survey]. This is an important finding because the literature suggests that people who receive compassion are more likely to provide compassion. Therefore it can be inferred that if a nurse receives compassion from their manager he/she is more likely to be compassionate to patients.

Based on this result, this second study aimed to explore how managers view, define, recognize and practice compassion and whether they experience any barriers in practicing compassion. Informed by thirty year-long work on cultural competence and compassion in health and social care, this survey sought also to explore the cultural point of view, by looking for similarities and differences between countries.

The lead researcher recruited one to two volunteer co-researchers from each of the following participating countries:

1. Chile
2. Cyprus: a) Greek Cypriots, b)Turkish Cypriots
3. Colombia
4. Czech Republic
5. Greece
6. Hungary
7. Israel
8. Italy
9. Norway
10. Philippines
11. Poland
12. Slovakia
13. South Africa
14. Spain
15. Turkey
16. United Kingdom
17. USA

Recruitment was consecutive and snowball sampling was used. Each researcher/co-ordinator distributed the survey questionnaire to their network of managers in nursing. Participants were emailed a link and completed the survey in their home or place of work. The invitation letter informed potential participants of the aim of the survey, the name of the ethics committee/s which provided ethics approval for the study, and emphasised that their participation was anonymous, confidential and voluntary. The questionnaire data have been collected online using the Qualtrics survey software. In order to make the survey as accessible as possible, we will also provide the option for the survey to be done using pen and paper.

The role of the co-researchers included the translation and back translation of the questionnaire in their language to assure the quality and accuracy of the translation. In addition co-researchers were to translate the participant invitation/information letter, as well as the collected qualitative data.

Participants were eligible to take part in the study if they met the following criteria:

1. having a nursing/midwifery background (with a nursing or midwifery qualification)
2. having managerial responsibility for nurses or midwives.

We define a nurse/midwife manager as somebody with a nursing or midwifery background (and qualification) who has responsibility for overseeing or supervising nurses or midwives. This could be in a hospital setting or in the community. Data from each country have been included if a minimum of 50 respondents completed the questionnaire. The total number of respondents for this study is 1217.

After data collection, the responses to the open-ended questions were collated together and one of the co-researchers/co-ordinators from each country undertook the translation whilst the second one (where present) checked the translation for accuracy and meaning. All data were sent to the lead researcher for analysis.

 

Analysis

Data analysis for this study is still in process. As this survey contains open and closed questions the research team is using a mixture of quantitative and qualitative analysis.

• Qualitative analysis:Data were imported into NVivo software. Thematic analysis (Braun and Clarke, 2006) was used to analyse the data. One researcher coded the text piece by piece with initial descriptive codes. The codes were then grouped into themes and a coding manual was developed. The codes and themes were discussed with between the research team at Middlesex University and any discrepancies were discussed, and the coding scheme was re-adjusted. Each country was sent the analysis of their own data.

 

• Quantitative data:Data were entered onto SPSS and descriptive analysis was undertaken. The results of this analysis was sent to all countries.

Inferential analysis will also be conducted and a structural equation modelling approach used in order to investigate whether responses to one question would predict the response to another question on the survey.

 

The international on-line Compassion Questionnaire to Nursing Managers

Q1 Which country do you currently work in?

 

Q2. Please define your ethnic or cultural background

 

Q3. What type of setting do you work in? (Please click the statement that applies to you)

         Hospital

         Community care/ Primary care

         Nursing or Midwifery education

         Other (please specify)

 

Q4. What is your profession? (Please click the statement that applies to you)

         Nursing

         Midwifery

         Other (please specify)

 

Q5. What is your highest educational qualification?

         Bachelor Level or equivalent

         Master level

         Doctoral level

         Other  ____________________

 

Q6. What type of nursing/midwifery manager are you?

Please click on the statement that applies to you.

         Hospital nurse/midwifery manager

         Community/ primary care centre nurse/midwifery manager

         Departmental nurse/midwifery manager

         Ward nurse/midwifery manager

         Care home nursing/midwifery manager

         Joint nurse/midwifery education manager

         Other(please specify)

 

Q7. How many people do you manage?  Select your answer by clicking on one of the options below.

         1-5

         6-10

         11-20

         21-50

         More than 51

 

Q8. How many years of management experience do you have? Select your answer by clicking on one of the options below.

         1-5

         6-10

         More than 11

 

Q9. Please tick the relevant box. I am:

         Male

         Female

         Other(please specify)  ____________________

 

Q10. As a manager, do you feel that you have enough time to spend listening and talking to your staff? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q11. Please give an example of how you spend time listening and talking to your staff. Write your answer in the box below.

 

Q12. As a manager, do you feel that you advocate for your staff and defend their rights? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q13. If you answered yes to question 12 above, please give an example of how you would advocate for your staff and defend their rights. Write your answer in the box below.

 

Q14. As a manager, do you feel that you consider each staff member’s individual characteristics and culture when you interact with them? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q15. If you answered yes to question 14 above, give an example of how you would consider each staff member’s individual characteristics and culture when you interact with them. Write your answer in the box below.

 

Q16. In your opinion, is it necessary to be a compassionate manager? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q17. If you answered yes to question 16 above, please list in the box below the advantages of giving compassion to staff.

 

Q18. What actions and behaviours would indicate to you that a manager is giving compassion to his or her staff? Write your answer in the box below.

 

Q19. What, in your view, stops a manager giving compassion to his/her staff? Write your answer in the box below.

 

Q20. Do you think that front-line nurses and midwives receive compassion from their managers? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q21. If you answered yes to question 20, is this compassion too little, enough, or too much? Select your answer by clicking on one of the options below.

         too little

         enough

         too much

         none

 

Q22. How do you define compassion? Write your answer in the box below.

 

Q23. Who gives you compassion in your workplace? Write your answer in the box below.

 

Q24. Is receiving compassion important to you? Select your answer by clicking on one of the options below.

         Yes

         No

 

Q25. If you answered yes to question 24 above, can you explain why compassion is important to you?

 

Q26. Please add any comments/views regarding compassion and management.

 

Socially Assistive Robots in Health and Social Care – an online survey

Background and methodology

The current global landscape in health and social care is highly challenging, demanding innovative, effective actions. It is projected that by 2050 the world’s population over the age of 60 years will be about two billion, an increase of 900 million from 2015. Shortages of health care professionals and a growing ageing population place enormous pressures onto the health and social care systems of many countries.

The use of artificial intelligence (AI) and robotics provides an opportunity which may address some of the challenges related to the care needs of older adults. An advanced form of AI are Socially Assistive Humanoid Robots (SAHRs). SAHRs are robots who have an anthropomorphic appearance, for example have a head, eyes, and hands and can provide assistance to a user through social interaction, through the use of speech, gestures etc. Culturally competent humanoid socially assistive robots can provide culturally appropriate information and suggestions; they elicit information from the user and adapt to the user’s cultural preferences, are sensitive and use culturally appropriate verbal and non-verbal communication skills.

It has been argued that humanoid assistive robots will inevitably be part of the healthcare teams in the near future and the purpose of this survey is to elicit the views of nurses/midwives/social care workers from around the world on the following main research questions:

1. What functions are considered desirable and useful for a Socially Assistive Humanoid Robot to possess?
2. What outcomes do health and social care workers consider will have a positive impact on their work and their patients?

The lead researcher recruited one to two volunteer co-researchers from each of the following participating countries:

1. Australia
2. Austria
3. Chile
4. Cyprus: a) Greek Cypriots, b)Turkish Cypriots
5. Colombia
6. Czech Republic
7. Denmark
8. Germany
9. Greece
10. Hungary
11. Iran
12. Israel
13. Italy
14. Japan
15. Nepal
16. Norway
17. Philippines
18. Poland
19. Slovakia
20. South Africa
21. Spain
22. Thailand
23. Turkey
24. United Kingdom
25. USA

Recruitment is consecutive and snowball sampling will be used. Each researcher/co-ordinator is distributing the survey questionnaire to their network of nurses, social workers, and students. Participants are emailed a link and can complete the survey in their home or place of work. The invitation letter informs potential participants of the aim of the survey, the name of the ethics committee/s which provided ethics approval for the study, and emphasises that their participation is anonymous, confidential and voluntary. The questionnaire data are being collected online using the Qualtrics survey software. In order to make the survey as accessible as possible, we have also provided the option for the survey to be done using pen and paper.

The role of the co-researchers included the translation and back translation of the questionnaire in their language to assure the quality and accuracy of the translation. In addition co-researchers were to translate the participant invitation/information letter, as well as the collected qualitative data.

To be included in the study a participant must be a nurse/midwife/ social care worker who meets the following criteria:

1. Has a nursing/midwifery background (with a nursing or midwifery qualification)
2. Works in the health care sector or social care as a social care worker or practitioner or a nursing assistant or a healthcare assistant

Data from each country will be included if a minimum of 50 respondents completed the questionnaire.

After data collection, the responses to the open-ended questions will be collated together and one of the co-researchers/co-ordinators from each country will undertake the translation whilst the second one (where present) will check the translation for accuracy and meaning. All data will be sent to the lead researcher for analysis.

 

Analysis

Data analysis for this study has not yet started. As this survey contains open and closed questions the research team is using a mixture of quantitative and qualitative analysis.

• Qualitative analysis:Data will be imported into NVivo software. Thematic analysis (Braun and Clarke, 2006) will be used to analyse the data. One researcher will content code the text piece by piece with initial descriptive codes. The codes will then be grouped into themes and a coding manual will be developed. The codes and themes will be discussed between the research team at Middlesex University and any discrepancies will be solved with consensus, and the coding scheme will be re-adjusted accordingly. Each country will be sent the analysis of their own data.

 

• Quantitative data:Data will be entered onto SPSS and descriptive analysis will be undertaken. The results of this analysis will be sent to all countries. Inferential analysis will also be conducted and a structural equation modelling approach used in order to investigate whether responses to one question would predict the response to another question on the survey.

 

The international on-line survey on Socially Assistive Robots in Health and Social Care

Q1. Which country do you currently work in?

Q2. How many years have you lived in this country for? (Please click what applies to you)

         All my life  (1)

         Less than 5 years  (2)

         5-10 years  (3)

         More than 10 years  (4)

Q3. Do you identify with the culture of the country you currently live and work in? (Please click what applies to you)

         Yes  (1)

         No  (2)

Q4. Please define your ethnic or cultural background. (Please write your answer in the box below. It is very desirable that you provide an answer, however, if you feel this is difficult for you to answer, please just insert N/A)

Q5. Provide one example for each of the following categories that best represents the culture of the country you currently live and work in (Please, write one example in the space provide next to each category):

         Food  (1)__________________________________________

         Cultural customs/Events  (2)_______________________

         Religious festivals  (3)_______________________________

         Leisure  (4)_______________________________

         Hobbies/Sports  (5) _______________________________

Q6. What is your age? (Please click what applies to you)

         18-34  (2)

         35-44  (3)

         45-54  (4)

         55-64  (5)

         65+  (6)

Q7. What type of setting do you work in? (Please click what applies to you)

         Hospital  (1)

         Community care/ Primary care  (2)

         Nursing or Midwifery education  (3)

         Social Care/Care homes  (4)

         Other (please specify in the box below)  (5)

Q8. What is your profession? (Please click what applies to you)

         Nursing  (1)

         Midwifery  (2)

         Social care/Care home practitioner  (3)

         other (please specify in the box below)  (4)

Q9. What is your highest educational qualification? (Please click what applies to you)

         Vocational qualification  (1)

         Bachelor Level or equivalent  (2)

         Master level  (3)

         Doctoral level  (4)

         Other (please specify in the box below)  (5)

Q10. How many years of working experience do you have?  (Please click what applies to you)

         1-5  (1)

         6-10  (2)

         More than 11  (3)

Q11. Please tick the relevant box. I am:

         Male  (1)

         Female  (2)

         Other (please specify in the box below) (3)

Q12. As a nurse/midwife/ health and social care worker, do you have any experience with socially assistive robots? Have you used or have seen such technology in a care setting? (Please click what applies to you)

         Yes  (1)

         No  (2)

Q13. If you could design a socially assistive robot, what type of tasks/functions would you like it to undertake? (Please drag and drop ALL the following statements to rank them between 1 [extremely important] and 10 [not important at all])

• Measuring and monitoring (e.g. able to take measurements of weight and height, or monitoring blood pressure, temperature, etc.) (1)
• Increasing patient safety (e.g. used in fall prevention) (2)
• Helping with mobility (e.g. encourage movement and repositioning of the body to prevent pressure sores) (3)
• Provision of information (e.g. in a hospital provide information about departments or hospital visiting hours, wifi availability etc.) (4)
• Counselling and education (e.g. provide advice on healthy behaviours such as eating and exercising etc.) (5)
• Assisting in the collection of assessment type data such as person’s age, gender, spoken languages, religion, names of next of kin, food allergies, food choices, etc. (6)
• Providing culturally appropriate entertainment (e.g. music, tv, etc.) (7)
• Providing company to lonely patients (e.g. engaging in conversation etc.) (8)
• Motivating patients to engage in tasks/activities that promote cognitive stimulation/function (e.g. play a word search game) (9)
• Providing reminders (e.g. remind the user to have a glass of water) (10)

Q14. In the box below please tell us the reasons behind your ranking in the previous question and add any other tasks/functions which you would like a socially assistive robot to undertake.

Q15. In the box below please tell us what types of functions you would NOT WISH a robot to have and why?

Q16. What would you consider a benefit for nurses/midwives and health and social care workers from the use of socially assistive robots? (Please drag and drop ALL the following statements to rank them between 1 [extremely important] and 10 [not important at all]).

• Freeing time for human carers to increase communication and comforting of patients (1)
• Freeing time to improve communication between the members of the healthcare team (2)
• Freeing time to enable health and social care workers to reflect on the care they provide and share their successes and challenges with colleagues (3)
• Freeing time to invest in creating a culturally competent and compassionate working environment (4)
• Enhancing the quality of care (5)
• Saving time on hospital appointments for patients (e.g. help the patient to complete any necessary paperwork while waiting for the appointment) (6)
• Saving time on hospital discharge (e.g. provide the patient and family with relevant community information, or help the patient to arrange for transportation) (7)
• Provide a better hospital experience to patients (e.g. engage in conversation) (8)
• Provide a better hospital experience to visitors with various disabilities (e.g. giving directions to visitors with hearing/visual impairment) (9)
• Provide no benefit (10)

Q17. In the box below please tell us the reasons behind your ranking in the previous question and add any other benefits for nurses/midwives and health and social care workers from the use of socially assistive robots.

Q18. In the box below please  list  any  concerns you may have with the use of socially assistive robots in health care?

Q19. Imagine that two socially assistive robots will be deployed at your place of work in two-month time. What kind of training do you wish to have before the arrival of the robots?  (Please drag and drop ALL the following statements to rank them between 1 [extremely important] and 14 [not important at all]).

• The capabilities the robots have (1)
• The tasks the robots can undertake (2)
• How to turn the robot on and off (3) ­How to electrically charge the robot (4)
• How to clean the robot (5)
• How to upload specific information about the clinical/caring environment (6)
• How to enter and upload specific information about the patient/s (7)
• What information the robot is collecting (8)
• Where is the information collected by the robot stored and who has access to it (9)
• If I need to obtain the consent of the patient before a robot is assigned to him/her (10)
• What to do if the robot malfunctions (11)
• Who to contact if the robot malfunctions (12)
• What to do if the robot acts in ways which compromise the safety of the patient (13)
• How to deal with the relatives of the patients who have a robot involved in their care (14)

Q20. In the box below please tell us the reasons behind your ranking in the previous question and add any kind of training you would wish to have before the arrival of the robots, if applicable.

Q21. Please tick the answer you most agree with, in relation to the following statements:

Q22. What actions and behaviours would indicate to you that a robot is culturally competent? (Write your answer in the box below)

Q23. What actions and behaviours would indicate to you that a robot is being compassionate to a user?  (Write your answer in the box below)

Q24. How do you define compassion?  (Write your answer in the box below)

Q.25 We would appreciate any other comments or suggestions you could give us