Qualitative interviews for LAUGH EMPOWERED
Research type
Research Study
Full title
Qualitative interviews for LAUGH EMPOWERED PSCI (Ludic Artefacts Using Gesture and Haptics Evaluation and Making: Playful Objects for Wellbeing, Emotional Regulation and Engagement for Dementia and Post-Stroke Cognitive Impairment)
IRAS ID
273653
Contact name
Benjamin Jelley
Contact email
Sponsor organisation
Cardiff and Vale University Health Board
Duration of Study in the UK
0 years, 6 months, 0 days
Research summary
Research Summary
LAUGH Empowered research is a SmartExpertise research project funded by Welsh Government under the European Regional Development Fund (competitive research funding). It involves a collaboration between Cardiff Metropolitan University, NHS Stroke Rehabilitation Unit and Sunrise Senior Living, to design, develop and evaluate new hand-held playful and comforting devices for people living with dementia and post-stroke cognitive impairment. This IRAS application relates to a small qualitative study as part of the broader research.
Summary of Results
This report sets out the key findings from the qualitative interviews with NHS staff undertaken as part of the LAUGH EMPOWERED PSCI1 research between 2019-2021. This service improvement study focused on the implementation of HUG™ as a psychosocial wellbeing intervention within an NHS hospital context. Recipients of HUG™ were NHS patients with a diagnosis of post stroke cognitive impairment (PSCI) or dementia. The intervention involved the use of 20 HUGs™ by patients within the Stroke Rehabilitation Centre (SRC) and two dementia wards at Llandough Hospital, Cardiff and Vale University Health Board (C&VUHB). The study was led by Dr Ben Jelley, Consultant in Geriatric and Stroke Medicine, who was the NHS partner Chief Investigator (CI). The project was overseen by Academic Lead Investigator (ALI), Professor Cathy Treadaway, Cardiff Metropolitan University, who undertook all NHS participant interviews with Dr Abdul Seckam, Manager Stroke Hub Wales. The research commenced prior to the Covid 19 pandemic, with patients in the Stroke Rehabilitation Centre and continued through the pandemic with patients on the dementia wards. The academic research team had no physical access and little contact with NHS staff participants, nor the Chief Investigator during this difficult period. All NHS interviews took place (remotely via Microsoft Teams) once Covid lockdown restrictions were eased in April 2021. No face-to-face meetings were possible during the study, and it must be acknowledged that NHS staff were facing unprecedented pressures and stress during this period. The impact of Covid on the research was acknowledged by Welsh Government with several extensions to the project. The university research team deployed agile methods of responding to what was a very complex and difficult situation, using online platforms to ensure ethics approval, recruitment of participants and to undertake qualitative interviews with NHS staff.
Although not every patient who received a HUG™ responded positively, the device did have a significant positive impact on the quality of life and care of those who did. It is clear from this research that although HUG™ is not the right solution for every patient, it is a useful alternative to prescribed medication to be considered for someone who is anxious and distressed.
Key findings from the qualitative interviews study with NHS staff, highlight the following benefits of HUG™ as a psychosocial intervention in a hospital context, with people living with cognitive impairment as a result of stroke or dementia. HUG™ was found to be beneficial to patients by:
1. Providing comfort, reducing anxiety, agitation and giving reassurance
2. Improving communication and initiating conversations with staff
3. Providing company and a sense of purpose
4. Increasing oral intake: improving eating and drinking and taking prescribed medication
5. Providing an alternative to medication for anxiety (and lowering the risk of falls)
6. Enabling medical procedures and personal care to take place
7. Modifying distressing behaviours (tapping, shouting, crying)
8. Heightening proprioception and enabling a patient to feel ‘grounded’
Findings from this study reveal that HUG™ can be used successfully in a hospital context to improve patient wellbeing and reduce anxiety. However, to ensure best practice, staff need to understand:
· how a patient’s perception of the world is impacted by cognitive impairment, dementia and delirium
· how soothing and playful objects can assist in care
· the personal preferences of the patient
· to suspend their own personal views and be willing to try something new
· how to introduce care objects with compassion
Doctors interviewed in this study observed the positive benefits of using HUG™ with patients suffering from anxiety and agitation as a result of a stroke or dementia. The concept of ‘HUG™ on prescription’ was trialled in the study and it was considered, by those doctors interviewed, to be a useful, low-risk intervention, without the negative side effects that often accompany many of the drugs currently used.
REC name
Wales REC 4
REC reference
20/WA/0142
Date of REC Opinion
7 May 2020
REC opinion
Favourable Opinion