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- Convenors:
-
Alfonso Otaegui
(Pontifical Catholic University of Chile)
Marilia Duque (UCL ESPM)
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- Formats:
- Panels
- Sessions:
- Friday 24 July, -, -
Time zone: Europe/Lisbon
Short Abstract:
In this panel we approach formal and informal channels of communication within medical environments, with special focus on the role of mediators (nurses, community health workers) and the creative appropriation of mobile technologies in daily informal care (e.g. use of WhatsApp for medical purposes)
Long Abstract:
Based on ethnographic findings, we propose that communication based on empathy will still be the fundamental part of the ecosystem of care in the future. We are particularly interested in discussing how people and health practitioners are using ordinary communication apps and functionalities (such as Facebook, WhatsApp, WeChat, SMS) to improve health in formal and informal ways. We also confront Deloitte last report on the future of Medtech and its prediction that "medtech companies should consider partnering with consumer-focused technology and specialized digital health companies to stay relevant in the future of health" because, for them, data will be the key factor in medical care. Much of those arguments are based in a customer-centric approach. This panel proposes to challenge this very notion of a (global or commodified) customer willing to engage with bespoken technology for health purposes. We aim to highlight how cultural context can result in other kinds of "consumers" that are not ready to comply with medtech industry but are already reinventing care practices on creative ways. We would like to invite contributions that address (but need not be limited to): the role of mediators within medical environments; creative uses of mobile technologies in formal and informal care; Googling for health and its consequences; development of social media support groups; and coordination of care at a distance through mobile devices.
Accepted papers:
Session 1 Friday 24 July, 2020, -Paper short abstract:
This paper analyses the utilisation of the safety phone service among the practical nurses and their senior customers who live alone at home in Finland. By describing the unexpected usages of this service and recent update with its monitoring device, the meaning of emergency and the consequence of the neoliberal welfare reform would be examined.
Paper long abstract:
In Finland, the safety phone service is a mean to ensure the life of
senior citizens who live alone at home. It has been designed as a device
to call in help without reaching a handset in times such as falling or
having a heart attack. The operators, who are practical nurses with
smartphones, are supposed to answer these calls and respond immediately.
Although this service is meant for extreme health emergencies, there are
many unexpected calls such as to ask for toilet assistance or daily
health check-ups. Practical nurses handle those calls with empathy, try
to meet their unexpected needs as flexible as possible. However, the
recent update for this service with more monitoring technology and the
neoliberal change on the tariff system had severe impacts on care
workers’ spontaneity and their depth of communication with service users.
Therefore, this paper examines the utilisations of the safety phone
service, based on the fieldwork in a municipality in south-western
Finland from 2013 onwards. By describing the extensive list of emergency
calls and the operators’ daily interaction with the safety phone users,
the meaning of emergency for older adults and their subjective
definition of quality of life would be examined. Furthermore, the
ethnographic account of the instalment of the latest version of the
safety phone in care homes would reveal the governmentality of the new
monitoring technology and the consequence of the neoliberal welfare
reform on the local eldercare sector.
Paper short abstract:
Drawing on ethnography and audio recordings, this study examines palliative care professionals' use of cellphone/smartphone communication in their work of articulating very different people and contexts, while also looking at their negotiations of (smart)phone use within the team.
Paper long abstract:
At the hospital, medical professionals carry out a considerable part of their work through telecommunication devices. In palliative care, where keeping constant contact with the involved parties is crucial for managing end-of-life trajectories, professionals routinely use such devices for making sense of symptoms and events, adjusting medication with patients and relatives, and for sharing information about procedures and decisions with other professionals within the team, the hospital and other institutions. Based on (ongoing) ethnography and recordings in a hospital palliative care team in Portugal, our study shows that professionals use their own smartphones and wifi connections, important resources for real-time communication within the team and with other professionals, sharing new information through voice and text, searching the internet for updated guidelines or information on the geographical availability of services for patients and families, while work cellphones are mostly used for taking/making calls from/to patients and relatives, as well as from/to other health institutions. This appears to be related to the hospital's endorsement of professionals' use of telecommunication technologies while restricting the use of their full potentialities: most cellphones provided by the hospital receive calls and messages but do not allow to call or write back, and security measures limit internet access in hospital computers. Besides, although generally treated as contributing to tasks at hand, (smart)phone use within the team is treated, in some occasions, as problematic for the normal accomplishment of work, leading to negotiations of its temporary restriction (e.g. in weekly team meetings).
Paper short abstract:
Among psychiatrists and psychologists, cell phones work as a mental health care device for highly transient patients arriving from the world over. This study aims to show how Italian psychiatrists and psychologists take advantage of cell phones to not only provide care but also meet with refugees.
Paper long abstract:
In the last ten years, refugees have been coming to Italy from all over the world, often en route to other destinations in Europe, like Germany or Sweden. The problem among psychiatrists and psychologists is how to provide appropriate mental health services to this migrant population.
Because of their broad cultural diversity and mobility, it is almost impossible to deliver services for refugees based on sufficient cross-cultural communication, or to promote their mental well-being through social inclusion. Thus, the consulting room becomes a place of encounter with "others," who may likewise elude their understanding. In dealing with such patients, many therapists try to communicate via mobile phones. Exchanging messages has become an indispensable medium for delivering mental health service for refugees.
This study discusses how therapists in Italy take advantage of mobile phones for refugees' mental health care. Forty-three therapists (13 psychiatrists and 30 psychologists) were recruited for the study, which comprised semi-structured interviews. The findings suggest that mobile phones can function as a useful device to not only deliver appropriate care anytime and anywhere, but also to trace each refugee's history and experience by means of its applications and data collection capacities, so that therapists can consult with transient and elusive "others."
Paper short abstract:
Providing WhatsApp access implies extra time and effort from health practitioners. This paper discusses this dilemma and presents examples on how WhatsApp can positively impact health and care practices considering the perspective of nurses, doctors and patients in the health ecosystem in Sao Paulo.
Paper long abstract:
WhatsApp has been largely appropriated for health and care purposes in Sao Paulo. Institutions started providing services based on the app in order to optimize resources. In these cases, nurses assume a key role in the interaction with patient in order to save time spent with doctors. But there are also the cases, mainly for those working in independent offices, when doctors are directly requested to provide their WhatsApp. While some consider this kind of support as an unpaid work, others prioritize its benefits for patients.
This paper addresses this discussion considering both perspective: from health practitioners and patients. It brings examples of WhatsApp best practices for Health in Sao Paulo and highlights how WhatsApp is perceived as a distinction factor by patients in their consumption of health services and how they behave to preserve this channel of communication when it is provided. Ethnography conducted with older people in Sao Paulo shows a concern to not to burden the doctors. For this reason, patients start using WhatsApp to ask their doctors and nurses friends and friends of friends to seek for health advice. This practice creates informal health networks, mediated by WhatsApp, that work in the renegotiation of resources and time in the Health ecosystem in Sao Paulo.
Paper short abstract:
This paper examines the impact of digital visual communication via smartphones on health and care in China. It demonstrates how the sharing of short videos (China) and visual messaging are part of emerging visual cultures and shifting practices of filial piety and peer-support.
Paper long abstract:
Understanding health and care in the digital age is critical given the challenges posed by the massive ageing population in China. This paper examines the impact of digital visual communication via smartphones upon health and care practices in China. The research informing this paper is drawn from long-term (Feb 2018 - June 2019) ethnography conducted as part of the ASSA project.
In Shanghai (China), sharing health-related short videos (duan shi pin) has gained popularity among retirees, not only as part of a daily practice of traditional Chinese 'body cultivation' (Yang sheng), but also as a popular way of expressing care among family and friends. Forms of care at a distance are practiced through the exchange of messages, photos, emojis and stickers (illustrated messages), and also through video calling.
With particular reference to everyday digital health and self-care practices among older people in China, this paper suggests that digital visual communication practices not only facilitate informal care and enabling new practices of peer-learning and peer-support in China, but also play an increasing important role in the medical communication between medical practitioners, older people and their families.
Paper short abstract:
The visibility of posts on digital social networks toguether with the use of smatphones indicates that the role of mediation of nutricionists is a creative possibility to resizes and guides actions of food and nutrition education on digital social media platforms concerning healthy eating practices.
Paper long abstract:
The Digital Laboratory of Food Education and Humanities (LADIGE / UFRJ) deals with studies that relate Commensality and Communication and Information Technologies. In this paper, we propose a debate on new roles for nutritionists in their interaction on social networks. The hypothesis is that the daily use of smatphones resizes and guides healthy eating practices with the mediation of this professional in actions of food and nutrition education on digital social media platforms. The objective of this study was to evaluate the potential for visibility of posts on digital social networks about the promotion of healthy eating. The methodology compared two content analyzes on digital media: 90 posts (July 2019) from a set of mothers' profiles on Instagran (stories, feeds and hastags), and 5 cooking video classes by digital influencer Rita Lobo, on Panelinha channel on the Youtube platform, with 510 thousand subscribers (November 2019). In the first analysis, it was observed how guidance on food introduction for children after weaning was published in the form of a diary with tips, recipes and methods of preparation. In the channel, the video classes amplified the 'New food classification' by blaming the ultra-processed food. We understand that the Nutrition content follows the principles of the Healthy Eating Guides for the Brazilian adult and child population as a consumption trend, implying a mediation by the nutritionist as a creative of medical care.
Paper short abstract:
Estudo acadêmico sobre o "Grupo de Apoio à mulheres com miomas e infertilidade - GAMMI" no Facebook. O paper discute as redes virtuais como oportunidade de autoconhecimento e exercício da sororidade num contexto de desconfiança em relação às vias de cuidado tradicionais.
Paper long abstract:
Este trabalho acadêmico consiste em um estudo sobre o "Grupo de Apoio à mulheres com miomas e infertilidade - GAMMI" pertencente à rede social Facebook. O grupo brasileiro, que conta atualmente com a participação de 12.636 mulheres, é um espaço de intercâmbio de experiências, pedidos de ajuda, oferta de apoio e solidariedade entre as participantes que enfrentam esse problema. O estudo se desenvolve a partir da análise de conteúdo de 100 publicações, suas respetivas reações e interações.
O objetivo da análise é compreender como se estabelecem essas redes de suporte, bem como a relação com o contexto em que o grupo opera: mediante a desconfiança sobre os tratamentos propostos, a falta de preparo dos médicos e um sistema de saúde precário. Dessa forma se pretende iniciar uma discussão sobre possibilidades de fluxos distintos de poder e informação, tendo as redes virtuais como oportunidade de autoconhecimento, exercício da sororidade e autonomia de mulheres em relação aos seus corpos.
O texto faz parte de uma pesquisa mais ampla sobre grupos de apoio entre mulheres nas redes sociais no Brasil e na Espanha, mais especificamente na rede social Facebook.
Paper short abstract:
This paper presents an ethnography of nurse navigators in a public hospital in Chile, and discusses how this model may improve productivity in other low income areas, as these oncological nurses help their patients deal with both medical and bureaucratical complexities of their treatment.
Paper long abstract:
With the aim of highlighting mediators' role in healthcare environments, this paper presents an ethnography of nurse navigators in a public hospital in Chile. The navigator nurses work as mediators between oncological patients and the medical and bureaucratical system of a public hospital in a low-income area. Cancer treatments mean two complexities for the patient: the medical complexity of the treatment and the bureaucracy of the public health system. Given the high number of patients, oncologists do not have the time to explain all the details of the treatment. The nurses working at the chemotherapy room face the same problem, as they try to fit in as many patients on a day as possible. The nurse navigators then, fill in this gap by educating the patient on the details of the disease and its treatment and mediate between the patient and the complex bureaucratical system of public healthcare in Chile. These dedicated nurses constitute a human factor in healthcare that no app can replace. The nurse navigators, however, do use an app that is the most commonly used messaging app amongst patients: WhatsApp. We will explore the uses of WhatsApp by nurses and patients and the protocols that have evolved in the usage of this app. With the aim of building a model scalable to other low-income hospitals in Chile, we will explore the perspective of patients on this nurse model of healthcare and the advantages of using a messaging app already adopted by the target population.