Care organising technologies and the post-phenomenology of care: An ethnographic case study

Shaw, Sara; Hughes, Gemma; Hinder, Susan; Carolan, Stephany; Greenhalgh, Trisha

doi:10.1016/j.socscimed.2020.112984

Cited by 18 publications

(13 citation statements)

References 32 publications

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“…Whilst telehealth has quickly become the norm in many contexts in pandemic era healthcare (see: Greenhalgh et al, 2020), the uptake of virtual technology in oncology has in some instances radically reconfigured caring relations for people living with cancer. But more than merely a question of telehealth and virtual consultation, swift moves in healthcare can dramatically shift the sense of connectedness and intimacy in care-based encounters (see: de la Bellacassa, 2017; Roberts et al, 2012; Shaw, Hughes, et al, 2020). This includes shifting to online service provision, no-longer running face-to-face clinics, limiting family visits in support of patients, the use of personal protective gear to minimize physical touch, or text-based discussions with potentially life-altering consequence.…”

Section: Introductionmentioning

confidence: 99%

Experiencing the SARS-CoV-2 Pandemic Whilst Living With Cancer

et al. 2022

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The SARS-CoV-2 pandemic has resulted in considerable consequences for many cancer patients, exacerbating pre-existing systemic health system limitations as well as creating new challenges. From socially distanced clinics and the widespread introduction of telehealth, to the halting of clinical trials and the reassessment of what constitutes “essential” treatment, care in oncology has abruptly changed. There is currently limited analysis of cancer patients’ experiences of the pandemic and its impacts on illness, wellness, and everyday life. Through semi-structured interviews with 54 people living with cancer during the 2020 phase of the SARS-CoV-2 pandemic in Australia, we explore how patients experience illness and care in reflecting upon a range of pandemic challenges, including delay, distance, and vulnerability. We find that in some cases, these pandemic conditions redefined the meaning of essential cancer care, reconfigured expectations around clinical trials, constructed new affective distances, and amplified dread and fear for people living with cancer.

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Section: Introductionmentioning

confidence: 99%

Experiencing the SARS-CoV-2 Pandemic Whilst Living With Cancer

et al. 2022

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“…Their results highlight the multistability of care technologies. Learning from their study was, that one size does not fit all [35]. Moerenhout et al [36] provide a postphenomenological view of electronic health records (EHR) and its impact on the clinical encounter.…”

Section: Related Workmentioning

confidence: 99%

‘It increases my ability to influence my ways of working’: A qualitative study on digitally mediated patient management in primary healthcare

Frennert

Erlingsdóttir

Muhic

et al. 2022

Scandinavian Caring Sciences

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Background: Digitally mediated primary healthcare is increasingly influencing working conditions, raising questions about how digitally mediated patient management is experienced. Aim:The aim of this study was to generate insights, through the lens of postphenomenology, into how digitally mediated primary healthcare affects the work and working environment, by gathering perspectives from primary healthcare professionals who regularly manage patient errands through a digital platform.Methods: Two rounds of interviews were conducted with a diversified sample of primary healthcare professionals at a primary healthcare centre. The first round of interviews was conducted during the initial phase of the deployment of a digital platform for patient management, with the second round conducted a year later (n = 24). The interview transcripts were analysed using reflexive thematic analysis.Results: Four themes relating to digitally mediated care work were identified: 'positive feelings towards digitally mediated primary healthcare', 'seeing a positive work atmosphere as a prerequisite for change', 'experiencing increased control over the pace of workflow' and 'reconfiguration of previous problems'. Conclusion and relevance to clinical practice:Building on postphenomenology, our study adds to the understanding of how material and symbolic aspects mutually affect the mediating role of a digital platform for patient management. Thus, the results indicate that the experience of using digitally mediated care processes is conditioned by the discourse towards digitalisation at the workplace and the management's approach to and inclusion of employees in the digital transition of primary healthcare, as well as the usefulness and usability of the digital platform. The findings can inform both practice and policy. Not applicable. According to the Swedish Ethical Review Act ([60]:460), research that involves the retrieval and handling of sensitive personal data or is likely to cause physical and psychological impact or in other ways harm the subjects is required to undergo ethical review. Data regarding participants' race, ethnic origin, political opinion, religious conviction and the like, is considered as having a sensitive character. For the study presented in this article no ethical approval is required according to the Swedish Ethical Review Act ([60]:460), as we do not ask interviewees about their own health or other sensitive topics (see above what is considered sensitive data).

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“…What we know from existing evidence is that the clinical encounter in oncology is not only an exchange of facts about disease, or a neutral forum for making decisions about treatment; rather, it also has social, moral, and ritual significance. As shown in the research examining clinical encounters, such dimensions do not simply translate without effort from face-toface to virtual realms (10,14,16). For medical oncologists during COVID-19, certain types of skills (e.g., rapport building) and treatment issues (e.g., diagnosis and the transition to palliative care) may be undermined because of the virtual medium of consultation (17,18).…”

Section: The Oncology Consultation During and Post-covid-19: The Virtmentioning

confidence: 99%

The Paradoxical Effects of COVID-19 on Cancer Care: Current Context and Potential Lasting Impacts

Broom

Kenny

Page

et al. 2020

Clinical Cancer Research

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Coronavirus disease 2019 (COVID-19) has fundamentally disrupted the practice of oncology, shifting care onto virtual platforms, rearranging the logistics and economics of running a successful clinical practice and research, and in some contexts, redefining what treatments patients with cancer should and can receive. Since the start of the pandemic in early 2020, there has been considerable emphasis placed on the implications for patients with cancer in terms of their vulnerability to the virus and potential exposure in healthcare settings. But little emphasis has been placed on the significant, and potentially enduring, consequences of COVID-19 for how cancer care is delivered. In this article, we outline the importance of a focus on the effects of COVID-19 for oncology practice during and potentially after the pandemic, focusing on key shifts that are already evident, including: the pivot to online consultations, shifts in access to clinical trial and definitions of "essential care," the changing economics of practice, and the potential legacy effects of rapidly implemented changes in cancer care. COVID-19 is reshaping oncology practice, clinical trials, and delivery of cancer care broadly, and these changes might endure well beyond the short-to mid-term of the active pandemic. Therefore, shifts in practice brought about by the pandemic must be accompanied by improved training and awareness, enhanced infrastructure, and evidence-based support if they are to harness the positives and offset the potential negative consequences of the impacts of COVID-19 on cancer care.

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Care organising technologies and the post-phenomenology of care: An ethnographic case study

Cited by 18 publications

References 32 publications

Experiencing the SARS-CoV-2 Pandemic Whilst Living With Cancer

Experiencing the SARS-CoV-2 Pandemic Whilst Living With Cancer

‘It increases my ability to influence my ways of working’: A qualitative study on digitally mediated patient management in primary healthcare

The Paradoxical Effects of COVID-19 on Cancer Care: Current Context and Potential Lasting Impacts

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