Bridging Bots and Bodies: A Techno-Anthropological Study of the Implementation of a Rehabilitation Robot at a Danish Stroke Ward Through Theories of Practice, Domestication, and Participation: A Techno-Anthropological Study of the Implementation of a Rehabilitation Robot at a Danish Stroke Ward Through Theories of Practice, Domestication, and Participation
Translated title
Bridging Bots and Bodies: A Techno-Anthropological Study of the Implementation of a Rehabilitation Robot at a Danish Stroke Ward Through Theories of Practice, Domestication, and Participation
Authors
Nicolas, Cleo Elsa Marika ; Fonsholt, Frederik Marinus Stougaard ; Madsen, Mia Theresa
Term
4. term
Education
Publication year
2023
Submitted on
2023-05-31
Pages
97
Abstract
Det danske sundhedsvæsen er under pres: der mangler personale, og der kommer flere ældre og mere syge borgere. Apopleksi (slagtilfælde) rammer mange, og nye teknologier som robotter bliver ofte foreslået som en hjælp. Dette studie undersøger, hvordan en rehabiliteringsrobot (ROBERT) påvirker arbejdet på en apopleksiafdeling, og hvordan antropologi-drevet samskabende design (participatory design) kan bruges til at udforme både lokale og mere generelle anbefalinger for implementering af sundhedsteknologi. Vi gennemførte etnografisk feltarbejde på afdelingen: deltagerobservation, følge af personale i deres arbejde og interviews med ergo- og fysioterapeuter, plejepersonale, en udviklingsterapeut og deres leder. Derudover afholdt vi en samskabelsesworkshop for at formulere lokale anbefalinger. Teoretisk kombinerede vi praksisteori, domestikationsteori og participatory design for at forstå hverdagspraksisser og hvordan den nye robot-praksis relaterer sig til dem, og for at bruge disse indsigter i en demokratisk designproces. Vi fandt, at robotten har udløst konflikter om korrekt brug og faglige grænser. Selvom teknologien opleves som lovende for patienterne, er det endnu ikke lykkedes at få den til at passe naturligt ind i eksisterende arbejdsgange eller at ændre arbejdsgangene, så de passer til robotten. Den afgørende barriere er selve implementeringsprocessen, som kræver flere ressourcer, end systemet stiller til rådighed; afdelingen mangler strukturel støtte til finansiering og facilitering af kompleks teknologi. Participatory design kan skabe lokalt meningsfulde principper for implementering, men metoden har også begrænsninger i et omskifteligt og presset felt som sundhedsvæsenet. Vi diskuterer, hvordan organisatoriske rammer under store forandringer ikke i tilstrækkelig grad rummer forskellige faglige identiteter, og hvordan design- og implementeringsforløb ofte overser brugernes reelle behov og praksisser. Vi peger også på mangel på tilgængelig viden og erfaringer om implementering som en barriere. Vi fremlægger anbefalinger om demokratisk engagement tæt på praksis, bedre videndeling i sundhedsvæsenet og nye måder at tænke forandring på. Konklusionen er, at implementering af ny sundhedsteknologi er meget kompleks og i dag ikke understøttes tilstrækkeligt af den viden, de strukturer og den organisatoriske støtte, som lokale enheder med specialiserede behov råder over. Det fører til ressourcespild, medarbejderfrustration og at de problemer, teknologien skulle løse, består. Vejen frem er at engagere og inddrage de lokale fagfolk, der skal få teknologien til at fungere i praksis.
The Danish healthcare system is under pressure: staff shortages and a growing, ageing, and sicker population. Stroke is common, and technologies like robots are often proposed to help. This study examines how a rehabilitation robot (ROBERT) affects work on a stroke ward, and how anthropology-driven participatory design can produce both local and more general recommendations for implementing healthcare technology. We conducted ethnographic fieldwork at a Danish stroke ward: participant observation, shadowing staff during their work, and interviews with occupational therapists, physiotherapists, care personnel, a development therapist, and their manager. We also ran a participatory design workshop to formulate local recommendations. Our framework combined practice theory, domestication theory, and participatory design to understand everyday practices and their relation to the new robot-related practice, and to use these insights in a democratic design process. We found that the robot sparked conflicts about proper use and professional boundaries. Although the technology is widely seen as promising for patients, it has not yet been integrated into existing routines, nor have routines been reshaped to fit the robot. The key barrier is the implementation process itself, which demands more resources than the wider system provides; the ward lacks structural support to fund and facilitate adoption of complex technology. Participatory design helps create locally meaningful principles for implementation, but it also has limitations in a fast-changing, pressured field like healthcare. We discuss how organizational structures during major changes do not fully accommodate diverse professional identities, and how design and implementation efforts often miss the real needs and practices of intended users. We also note the lack of available data and experience about such implementation processes. We present recommendations to address these issues through democratic, practice-level engagement with healthcare professionals, better knowledge sharing across the system, and new ways of conceptualizing change. We conclude that introducing new healthcare technologies is highly complex and not well supported by current knowledge, structures, and organizational backing at local sites with specialized needs, leading to wasted resources, staff frustration, and persistent problems. Addressing this complexity requires engaging and involving the local experts who must make new technologies work in practice.
[This summary has been rewritten with the help of AI based on the project's original abstract]
Keywords
Documents