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Rozzano Locsin

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Papers by Rozzano Locsin

Theory-Based Nursing Practice in the World of Anthropomorphic Intelligent Machines

How will human nurses practice nursing with advancing technologies particularly involving anthrop... more How will human nurses practice nursing with advancing technologies particularly involving anthropomorphic intelligent machines? Nursing as an expression of caring in nursing is oftentimes appreciated as acts of endearment or TLC (Tender loving care) by nurses towards persons who are in situations craving for human-to-human contact. Such situations often define nursing as demanding for nurses’ emotion. However, if feelings or emotions is the criterion that makes the ‘caring’ live meaningfully in nursing situations, in the future, how will caring be expressed when nursing engagements in practice will be primarily with anthropomorphic intelligent machines? Contemporary understandings of ‘humanness’ may be obsolete and human-to-human contact as we know it today may consequently remain imaginary. The realities of nursing care perpetuate increasing dependence on technology, and interactions between persons and intelligent machines will need to be redefined. The theory of Technological Com...

The Co-Existence of Technology and Caring in the Theory of Technological Competency as Caring in Nursing

The Journal of Medical Investigation, 2017

The coexistence of technology and caring is best exemplified in nursing. The theory of Technologi... more The coexistence of technology and caring is best exemplified in nursing. The theory of Technological Competency as Caring in Nursing illuminates this coexistence as the essence of technology in health care premised on machine technologies as a generic concept of objects or things that are mechanical, organic, and electronic. With its timely development these technologies are continually imbued with artificial general intelligence. As such, the ultimate expression of machine technologies in nursing turns out to be autonomous robots (ARs) with future potentials of functions comparable to human persons. While theory-based nursing practice is essential to nursing care practice, quality human care, particularly with technologies assuming indispensable practice process mechanisms is critical. Some practice-based questions informing ARs and human person engagements in nursing care practice include, "Will ARs which are imbued with artificial intelligence replace nurses in their practice?" "What contributions to quality human health care will autonomous and artificially intelligent robots provide?" While these questions may reflect far-reaching ramifications of technologies in health care, it must also be acknowledged that these technologies are fundamental to the delivery of quality human health care now, and in the future.

Nurses’ Awareness and Actual Nursing Practice Situation of Stroke Care in Acute Stroke Units: A Japanese Cross-Sectional Web-Based Questionnaire Survey

International Journal of Environmental Research and Public Health, 2021

The awareness of care provided by stroke care unit (SCU) nurses in Japan to patients with an acut... more The awareness of care provided by stroke care unit (SCU) nurses in Japan to patients with an acute cerebrovascular accident (CVA) and the characteristic differences in their actual nursing practice were evaluated. A cross-sectional web-based questionnaire survey was administered to 1040 SCU nurses. Data collection and reporting procedures followed the STROBE Statement Checklist for cross-sectional studies. Exploratory factor analysis, using 52 observation items, identified eight factors with a factor loading > 0.4. For all factors, the actual practice was significantly lower than the awareness of the importance of nursing care for patients with acute CVA. Awareness and actual practice of recognition of patients’ physical changes (RPPCs) were high. The actual practice of RPPCs and preventing the worsening of acute stroke and related symptoms varied, depending on years of experience in acute phase stroke care. RPPCs in actual practice had a significantly higher score among certifie...

Comparative Examination between the Perceived Inventory of Technological Competency as Caring in Nursing (PITCCN) and the Technological Competency as Caring in Nursing Instrument (TCCNI)

International Journal of Nursing & Clinical Practices, 2017

Background: Technological Competency as Caring in Nursing Instrument (TCCNI) was developed by Roz... more Background: Technological Competency as Caring in Nursing Instrument (TCCNI) was developed by Rozzano Locsin (2013) to determine the expression of "technological competency" as caring in nursing among practicing nurses. While the TCCNI was translated into other languages, no instrument measuring the 'technological competency as caring in nursing' among Japanese nurses was developed and tested. Considering culture and social background influencing measurement of the phenomena, Kato et al. (2016) re-envisioned the TCCNI to focus on caring behaviors of nurses in acute care settings. The Perceived Inventory of Technological Competency of Caring in Nursing (PITCCN) was developed. Aim: The aim of this study is to perform comparative examination between the PITCCN and the TCCNI. Methods: The authors developed the Japanese version of the TCCNI from its original instrument subjecting this to reverse translation using a professional English-to-Japanese-to-English translator who clearly confirmed the accuracy of the translations. In this study, the contents of the item configurations were analyzed and discussed regarding instruments, and the summary of the similarities and differences among researchers who had been involved in the research of caring. The difference between the item configuration of PITCCN and TCCNI was clearly illustrated by a comparative table, and in the case where there was no corresponding item, it was left blank. Results: The commonality between the TCCNI and PITCCN was the holistic focus on patients using information obtained through technologies. Different question items were included to provide highquality outcomes for the PITCCN. Conclusion: Considered useful in order to perform high quality practice in using technology, and to provide high quality nursing. Measured Technological Competency as Caring in Nursing might be able to utilizing for in-service education of hospitals or formalized education in nursing universities.

Assessing the Psychometric Properties of the Technological Competency as Caring in Nursing Instrument-Revised

International Journal for Human Caring, 2021

The Technological Competency as Caring in Nursing Instrument-Revised (TCCNI-R) was developed from... more The Technological Competency as Caring in Nursing Instrument-Revised (TCCNI-R) was developed from the Technological Competency as Caring in Nursing theory. To assess the psychometric properties, a four-factor questionnaire comprised the TCCNI-R. Only 590 of 1,322 online questionnaire responses by nurses in 11 general hospitals in Chugoku-Shikoku, Japan, were analyzed and interpreted. Exploratory factor analysis and confirmatory factor analysis via SEM justified construct validity, and Cronbach's alpha coefficient established reliability. Goodness of fit was rejected; however fit index value was accepted. Root mean square of error approximation showed reasonable approximation error. The TCCNI-R showed content validity and reliability in measuring technological competency as expression of caring in nursing.

Issues in the Development of Conversation Dialog for Humanoid Nursing Partner Robots in Long-Term Care

Information Systems - Intelligent Information Processing Systems, Natural Language Processing, Affective Computing and Artificial Intelligence, and an Attempt to Build a Conversational Nursing Robot, 2021

The purpose of this chapter is to explore the issues of development of conversational dialog of r... more The purpose of this chapter is to explore the issues of development of conversational dialog of robots for nursing, especially for long-term care, and to forecast humanoid nursing partner robots (HNRs) introduced into clinical practice. In order to satisfy the required performance of HNRs, it is important that anthropomorphic robots act with high-quality conversational dialogic functions. As for its hardware, by allowing independent range of action and degree of freedom, the burden of quality exerted in human-robot communication is reduced, thereby unburdening nurses and professional caregivers. Furthermore, it is critical to develop a friendlier type of robot by equipping it with non-verbal emotive expressions that older people can perceive. If these functions are conjoined, anthropomorphic intelligent robots will serve as possible instructors, particularly for rehabilitation and recreation activities of older people. In this way, more than ever before, the HNRs will play an active...

Perceptions of nurse managers and staff nurses regarding Technological Competency as Caring in Nursing theory in general hospitals in Japan

Belitung Nursing Journal, 2021

Background: Nurses as primary healthcare providers demonstrate quality nursing care through compe... more Background: Nurses as primary healthcare providers demonstrate quality nursing care through competencies with healthcare technologies, while nurse managers assume the primacy of managing quality healthcare in their respective care settings. However, little is known about perceptions of the influence of care technologies on their nursing practice. Objective: This study aimed to determine managers’ and staff nurses’ perceptions regarding the Technological Competency as Caring in Nursing (TCCN) theory in general hospitals in Japan. Methods: This study employed a cross-sectional survey design, with 421 participants selected using a stratified sampling method. Technological Competency as Caring in Nursing Instrument–Revised (TCCNI-R) was used for online data collection using Survey Monkey©. Data were analyzed using Welch’s t-test and ANOVA. Results: Nurses with years of experience within the range of 20 to less than 30 years showed the highest TCCNI-R scores among the two groups. Nurses ...

Are Indonesian Nurses Ready for Healthcare Robots During the COVID-19 Pandemic?

Belitung Nursing Journal, 2020

Healthcare robots are used in Indonesia and other countries to combat COVID-19 pandemic. This art... more Healthcare robots are used in Indonesia and other countries to combat COVID-19 pandemic. This article was aimed to describe a perspective about healthcare robots, and to recommend ways for Indonesian nurses to engage with healthcare robots during the COVID-19 pandemic. One view hindering healthcare robot appreciation as partners of nurses is its threat to their practice. However, with the current environment of COVID-19 ‘frontline’ situations, increasing infections of patients with SARS COV2, limited personal protective equipment, and the fastidious nature of maintaining social distancing and mask-wearing, it may be best to view healthcare robots as significant partners to facilitate safety, and ease the demands of nursing care activities in order to safeguard human lives while enhancing human well-being. Educating healthcare practitioners about healthcare robot programming and assurance of its safe and secure use can advance robot appreciation as partners in healthcare. These goals...

Consideration of Safety Management When Using Pepper, a Humanoid Robot for Care of Older Adults

Intelligent Control and Automation, 2020

Pepper, a humanoid robot, is 1.2 m in height and is designed to move its limbs. There are risks o... more Pepper, a humanoid robot, is 1.2 m in height and is designed to move its limbs. There are risks of the older adults experiencing falling and collision accidents when they interact with Pepper. When physical interaction happens between a humanoid robot and human beings, potential harmful physical contact might occur. The aim of this report was to examine the safety management aspects when using Pepper, a humanoid robot for the care of older adults. The older adults' reactions to Pepper's functions cannot be predicted. Hence, it is necessary to clarify methods to guarantee its safety in advance and to increase the safety and properties of the robots. The benefits of introducing support robots such as Pepper for aging medical and nursing care settings are obvious. Therefore, engagement in robot development while considering both the risks and benefits is critical. Our academic initiatives have just begun. Through information exchange among researchers, users, engineers, and law specialists, we need to identify latent and prominent risks in situations where Pepper and the older adults interact and deepen our examination of measures against such risks.

The Intermediary Roles of Public Health Nurses (PHNs) in Utilizing Communication Robots (CRs) in Community Health Care Practice

Health, 2019

Robot technology is expected to reduce the burden of medical professionals, a concern in the supe... more Robot technology is expected to reduce the burden of medical professionals, a concern in the super-aged society. The aim of this article is to determine the intermediary roles of Public Health Nurses (PHNs) in using Communication Robots (CRs) in Community Health care. It is necessary to consider who will manage, and how to draw lines of responsibility when a problem occurs when using robots in the future. Regarding the mediator or intermediary role of PHNs in the use of CRs, PHNs are expected to be cognizant of varieties of robots for use with persons of diverse ages and health levels, as well as of robot performances. As one of the community healthcare workers who service the elderly living in the community, the role of PHNs as mediators or intermediaries is to pay attention to ethical and moral issues while working with CRs to manage the health of the community. Lack of understanding of the intermediary role might create possible ethico-moral issues in the future. Therefore, it is critical for PHNs to understand their role as intermediaries. In doing so, it is expected that older people at home will be able to live peaceful lives, as well as be physically and mentally healthy.

A novel in-service nursing education optimizing theory of technological competency as caring in nursing

Journal of Nursing Education and Practice, 2019

Contemporary and future nursing practices are increasingly being designed with nursing theories a... more Contemporary and future nursing practices are increasingly being designed with nursing theories as to its foundation. The aim of this article is to describe an in-service education program for nursing administrators centered on the theory of Technological Competency as Caring in Nursing (TCCN). This theory is framed chiefly within the concepts of technology, caring, nursing, and technological competency. Influencing the significance of in-service education is theory-based practice with advancing technologies in human caring. The in-service education program was organized as a five-month, one-hour a month lecture and discussion series. In each session, educational contents are focused on the nursing process as caring based on the theory of TCCN. This education is a plan that will gradually educate the nurse manager group, the mid-level nursing staff group, and finally to the staff nurse group. This hierarchically organized in-service educational plan aims to systematically improve th...

Criterion-related Validity of the Perceived Inventory of Technological Competency as Caring in Nursing (PITCCN) in Acute Care Settings

The Journal of Medical Investigation, 2019

Characteristics of Transactive Relationship Phenomena among Older adults, Care Workers as Intermediaries, and the Pepper Robot with Care Prevention Gymnastics Exercises

The Journal of Medical Investigation, 2019

In this research, participatory action research method was used (11), and researchers continuousl... more In this research, participatory action research method was used (11), and researchers continuously discussed and analyzed the recoded data. The transactions were focused/analyzed as to how Pepper-CPGE led the exercises, and how care workers intervened during physical exercise of the older adults. Analyzed scenes were physical exercises with Pepper-CPGE. Recorded videos were analyzed only during (1) upper limb motor functions exercise, and (2) exercises using Radio Gymnastics the First (Rajio Taiso Dai-ichi), a program that is well-known and wellpracticed by most Japanese citizens. Pepper-CPGE instructs the older adults to perform gymnastics activities while viewing the video monitor.

Perceptions of Self of Persons with Visible Artificial Devices : A Review of the Literature

The Journal of Medical Investigation, 2019

ending in 2017! Each full-text article that met the inclusion criteria was read, reread, and anal... more ending in 2017! Each full-text article that met the inclusion criteria was read, reread, and analyzed as recommended in the six phases described by Braun and Clarke (8). Data items were derived from the retrieved abstracts of each article and classified according to themes. From the data extracts, data sets were identified as Key Themes. Table I exhibits the thematic data analysis as Braun and Clarke described. Establishing Inter-Rater Reliability : Using the Databases Four co-authors participated in the search and analysis of pertinent articles using a specific database source. For example, coauthor (YM) searched the CINAHL database for articles that met the inclusion criteria. This effort distribution ensured that all of the co-authors contributed valuable and appropriate effort towards collecting findings as legitimate co-authors of the study. Each of the four co-authors analyzed articles which were retrieved from search engines or databases assigned to them individually. Each coauthor identified and listed the data extracts, or themes, and subsequently cross-referenced them against the identified data extracts from the other three authors' lists. Deliberations regarding these extracted themes based on the data items, namely the abstracts or summaries, of each article were made for the purpose of achieving a thematic consensus! With the CINAHL database, the keywords 'perception AND prosthesis AND limb' were used. The search yielded only twelve articles. To increase the likelihood of retrieving more pertinent articles, the keywords 'body-image AND prosthesis AND artificial AND limb AND perception' were used for SCOPUS, in addition to the original three keywords. Nevertheless, only fourteen articles were found. Of these, however, only twelve full-text articles were available even with the assistance of the Florida Atlantic University (FAU) Library System. For the IEEE database, the keywords 'Prosthesis/Limb/Self Perception/Psychological/Human/Life' were used, in addition to the keywords used for CINAHL and SCOPUS. Even with these keywords used singly, or in various configurations, only ten relevant articles were found. It is important to note here that the IEEE database seemed to contain more research studies pertaining to or focused on the design and development of artificial devices. Regardless, only seven full-text published articles were found through the Florida Atlantic University (FAU) Library system. With PubMed, the keywords 'Prosthesis/Limb/Perception/ Emotion' were used. Nine relevant articles were found, with one article eliminated as it duplicated an article retrieved through CINAHL. Of the remaining articles, only five full-text articles were made available using the FAU library system.

Can humanoid nurse robots replace human nurses?

Journal of Nursing, 2018

Background: The certainty of future technological developments in robotics and artificial intelli... more Background: The certainty of future technological developments in robotics and artificial intelligence can alter how nursing is practiced today and in the future. In 1992, Peck argued that while advancing technologies will take over the predictive and prescriptive health care practice, the future of nursing will rest on the irreplaceable human touch, specifically "Tender Loving Care." Discussion: If nursing is the expression of TLC, and the science of caring supports this expression as nursing, is it true that contemporary nursing practice is the engagement of human beings with caring as its core? Is the practice of nursing grounded in caring? With recent advances in robot technologies and artificial super intelligence (ASI) will there be Humanoid Nurse Robots (HNRs) 'nurse' persons with TLC? Conclusion: As fundamental to nursing practice grounded in the theory of Technological Competency as Caring in Nursing, the ultimate purpose of technological competency as caring in nursing is to know persons as caring who are participants in their care, rather than simply objects of care. The process of 'knowing persons as caring' in nursing is communicated as technological knowing, mutual designing and participative engaging.

Recommended Design and Direction of Development for Humanoid Nursing Robots Perspective from Nursing Researchers

Intelligent Control and Automation, 2017

The purpose of this article is to describe recommendations towards the design and direction of de... more The purpose of this article is to describe recommendations towards the design and direction of development for Humanoid Nursing Robots (HNRs) from the standpoint of researchers of nursing care practice. Efforts to introduce robot technologies in nursing practice and to use them in elderly and high-tech healthcare environments have begun in developed countries like Japan. Companies are developing various types of robots, although their types and functionalities continue to require a clear identification and definition. Regardless, robot developments for health care purposes are progressing well to meet universal technological demands. While human caring has been a human-to-human relationship, in a nonhuman-to-human relationship in the case of HNRs, it is essential to consider ethical concerns and human safety. If HNRs are to support patients directly, they must be required to have the same level of comprehensive judgment ability and responsiveness as that of human nurses. This includes abilities to genuinely observe, judge, rapidly respond, and conduct human caring practice emphasizing individuality. If HNRs support patients independently, abilities which are much like those of humans will be required of them in addition to the appropriate intelligence and skillfulness to do so. A low level robot nurse exerts work that should be called non-nursing or as a medical aid assistant no matter who thinks and what these technologies can do. Similarly, a higher level HNR with higher level artificial intelligence is expected to exceed the capabilities of human beings. As such, current discourse and debate also include the concern that HNRs may now become one's superior or rather that the HNR is a subordinate thereby requiring human management.

Availability of Thickness Estimation of the Subcutaneous Fat by Using the Near-infrared Ray Measuring Device

International Journal of Nursing & Clinical Practices, 2016

Gluteal intramuscular injection requires accurate needle insertion into the specific muscle area ... more Gluteal intramuscular injection requires accurate needle insertion into the specific muscle area for accurate, safe, and efficacious delivery of medication for long-acting anti-psychiatric drugs. With ultrasonography, accurate evaluation of the "Distance from the Epidermis to the Under-Fascia (DEUF)" can be determined. However, a nurse in the clinical settings, ultrasonographic measurements during intramuscular injection is impractical and difficult. The purpose of this study was to estimate the thickness of subcutaneous fat by using a near-infrared ray measuring device.This study was approved by the Ethics Committee of Tokushima University Hospital. There were 39 subjects (21 men and 18 women) aged 20 to 60 years (Mean ± SD: 44.97 ± 15.20 years old). Bilateral DEUF at Ventrogluteal and Dorsogluteal sites (AVIUS: Hitachi-Aloka Medical Co.) were evaluated on B-mode scan as the gold standard. At the same sites, the thickness of the subcutaneous fatty tissue was measured using the PoccoStick (HORIC: smallsize instrument measuring the thickness of the subcutaneous fat with a near-infrared ray device). The right Ventrogluteal site thickness of the fatty tissue was significantly overestimated by PoccoStick (15.18 ± 8.77 mm) measurements, as compared to the ultrasonography (12.42 ± 5.26 mm) (p<0.01) results. The left-side Ventrogluteal site and both the right and left Dorsogluteal sites measurements did not show significant differences. This illustrated and supported the credible use of inexpensive devices such as the PoccoStick in estimating the DEUF. The development of a more highly accurate small-sized instrument is recommended.

Characteristics of Psychiatric Hospital Work Environment Found Attractive by Professional Nurse Administrators in Japan

International Journal of Nursing & Clinical Practices, 2016

Purpose: The purpose of this study is to identify characteristics of work environments in psychia... more Purpose: The purpose of this study is to identify characteristics of work environments in psychiatric hospitals which are appealing to nurses. Understanding characteristics of work environments of psychiatric hospital nurses can lead to attracting nurses to work in this environment, thereby increasing human resources and alleviating nurse-staffing problems. Methods: Questionnaire copies focusing on staffing shortages of nurses in psychiatric hospitals were provided to 277 psychiatric hospital nurse administrators in Japan from May-April 2016. Data analyses included descriptive and multivariate statistics. Factor analysis together with the Kaiser-Meyer-Olkin and the Bartlett's test of Sphericity were used to assess adaptive validity. Factor loadings were set at 0.4 or more for the configuration of items, while internal consistency and reliability of the assessment data scores were done using Cronbach's alpha coefficient. Mean factor points were calculated and student's t-test and one-way analysis of variance were performed. Significance probability level was set at 0.001. Results: Factor analysis revealed nine factors: (1) Educational system, (2) Reputation at hospitals, (3) Support system for acquisition of certificate of clinical nurse specialist/certified nurse, (4) Reputation at hospitals as places of employment, (5) Knowledge of nursing philosophy and of culture of working places, (6) Reputation of teaching for students' clinical practice, (7) Working hours and leave privileges, (8) Salary and other allowances, (9) Support system for license acquisition. Data revealed that nurse administrators who employed new graduate registered nurses found their hospitals' attractive points were: educational system, support system to acquire certificate of clinical nurse specialist, reputation of hospital as place of employment, knowledge of nursing philosophy and culture of working places, teaching students' clinical practice, and salary and other allowances. Conclusion: Nurse administrators who have no difficulty recruiting nursing staff recognized that their hospital environments were considered appealing based on working hours and leave privileges.

Relationship between Lifestyle, Quality of Sleep, and Daytime Drowsiness of Nursing Students of University A

Open Journal of Psychiatry, 2017

The harmful effects of technological devices, including smart phones have been increasingly suspe... more The harmful effects of technological devices, including smart phones have been increasingly suspected among university students; bedtimes have become increasingly later at night, and leisure activities often extend through the night. Likewise, availability and need of increasing part-time job hours have been considered. The purpose of this research was to determine the relationship among lifestyles, quality of sleep, and daytime drowsiness of nursing students of University A. The research was conducted in June 2015, when student life rhythms were considered stable after two months of lectures. Responses with missing values or with inappropriate answers were excluded. Of the data collected from 96 respondents, only 71 were acceptable. The survey focused on lifestyle, daytime sleepiness (using ESS: Epworth Sleepiness Scale) and quality of subjective sleep (using the PSQI: Pittsburgh Sleep Quality Index). Approval was obtained from the Research Ethics Committee of Shikoku University. While in this study, more than half (63.4%) of the students had poor quality of sleep, however, there was no relationship between their quality of sleep and daytime drowsiness, or between their lifestyles and the quality of sleep. These findings suggest that while university students' use of technological devices is suspected to influence on sleep deprivation and consequent daytime drowsiness, the findings did not provide the evidence.

Development of the Diabetes Oral Health Assessment Tool © for Nurses

Health, 2015

Although some studies have suggested a bidirectional relationship between diabetes and periodonta... more Although some studies have suggested a bidirectional relationship between diabetes and periodontal disease, there were no appropriate tools for nurses to evaluate oral status and oral health behaviors in patients with diabetes. Therefore, the Diabetes Oral Health Assessment Tool (DiO-HAT©) was developed with items contributed by health care professionals (diabetologists, periodontal specialists, a preventive dentist, a Certified Nurse in Diabetes Nursing, a national registered dietitian, registered nurses, a dental hygienist, and nursing researchers) who were involved in the medical care of patients with diabetes. Subsequently, a survey of 700 Diabetes Nurse Specialists (DNS) was conducted to determine their score of recognition and implementation of the DiOHAT©, however, 304 participants (43.4%) responded. Constructive concept validation and the Cronbach's alpha coefficient for all assessment items was 0.932, indicating high reliability: Factor 1, Patient's oral health status (α = 0.874); Factor 2, Implementation of oral health behaviors (α = 0.890); Factor 3, Information transmission regarding dental visits (α = 0.862); and Factor 4, Perceptions and knowledge of oral health behaviors (α = 0.793). Although the mean score of recognition of DiOHAT© was 3.5 ± 0.4 points, the mean value of the implementation score was 1.5 ± 0.5 Y. Kuwamura et al. 1711 points (obtained using a 4-grade scale). The implementation scores were significantly lower than the recognition scores for all items (p < 0.001). The findings suggested that the DNS were not inclined to implement all items of DiOHAT©, despite recognizing their importance.

Theory-Based Nursing Practice in the World of Anthropomorphic Intelligent Machines

How will human nurses practice nursing with advancing technologies particularly involving anthrop... more How will human nurses practice nursing with advancing technologies particularly involving anthropomorphic intelligent machines? Nursing as an expression of caring in nursing is oftentimes appreciated as acts of endearment or TLC (Tender loving care) by nurses towards persons who are in situations craving for human-to-human contact. Such situations often define nursing as demanding for nurses’ emotion. However, if feelings or emotions is the criterion that makes the ‘caring’ live meaningfully in nursing situations, in the future, how will caring be expressed when nursing engagements in practice will be primarily with anthropomorphic intelligent machines? Contemporary understandings of ‘humanness’ may be obsolete and human-to-human contact as we know it today may consequently remain imaginary. The realities of nursing care perpetuate increasing dependence on technology, and interactions between persons and intelligent machines will need to be redefined. The theory of Technological Com...

The Co-Existence of Technology and Caring in the Theory of Technological Competency as Caring in Nursing

The Journal of Medical Investigation, 2017

The coexistence of technology and caring is best exemplified in nursing. The theory of Technologi... more The coexistence of technology and caring is best exemplified in nursing. The theory of Technological Competency as Caring in Nursing illuminates this coexistence as the essence of technology in health care premised on machine technologies as a generic concept of objects or things that are mechanical, organic, and electronic. With its timely development these technologies are continually imbued with artificial general intelligence. As such, the ultimate expression of machine technologies in nursing turns out to be autonomous robots (ARs) with future potentials of functions comparable to human persons. While theory-based nursing practice is essential to nursing care practice, quality human care, particularly with technologies assuming indispensable practice process mechanisms is critical. Some practice-based questions informing ARs and human person engagements in nursing care practice include, "Will ARs which are imbued with artificial intelligence replace nurses in their practice?" "What contributions to quality human health care will autonomous and artificially intelligent robots provide?" While these questions may reflect far-reaching ramifications of technologies in health care, it must also be acknowledged that these technologies are fundamental to the delivery of quality human health care now, and in the future.

Nurses’ Awareness and Actual Nursing Practice Situation of Stroke Care in Acute Stroke Units: A Japanese Cross-Sectional Web-Based Questionnaire Survey

International Journal of Environmental Research and Public Health, 2021

The awareness of care provided by stroke care unit (SCU) nurses in Japan to patients with an acut... more The awareness of care provided by stroke care unit (SCU) nurses in Japan to patients with an acute cerebrovascular accident (CVA) and the characteristic differences in their actual nursing practice were evaluated. A cross-sectional web-based questionnaire survey was administered to 1040 SCU nurses. Data collection and reporting procedures followed the STROBE Statement Checklist for cross-sectional studies. Exploratory factor analysis, using 52 observation items, identified eight factors with a factor loading > 0.4. For all factors, the actual practice was significantly lower than the awareness of the importance of nursing care for patients with acute CVA. Awareness and actual practice of recognition of patients’ physical changes (RPPCs) were high. The actual practice of RPPCs and preventing the worsening of acute stroke and related symptoms varied, depending on years of experience in acute phase stroke care. RPPCs in actual practice had a significantly higher score among certifie...

Comparative Examination between the Perceived Inventory of Technological Competency as Caring in Nursing (PITCCN) and the Technological Competency as Caring in Nursing Instrument (TCCNI)

International Journal of Nursing & Clinical Practices, 2017

Background: Technological Competency as Caring in Nursing Instrument (TCCNI) was developed by Roz... more Background: Technological Competency as Caring in Nursing Instrument (TCCNI) was developed by Rozzano Locsin (2013) to determine the expression of "technological competency" as caring in nursing among practicing nurses. While the TCCNI was translated into other languages, no instrument measuring the 'technological competency as caring in nursing' among Japanese nurses was developed and tested. Considering culture and social background influencing measurement of the phenomena, Kato et al. (2016) re-envisioned the TCCNI to focus on caring behaviors of nurses in acute care settings. The Perceived Inventory of Technological Competency of Caring in Nursing (PITCCN) was developed. Aim: The aim of this study is to perform comparative examination between the PITCCN and the TCCNI. Methods: The authors developed the Japanese version of the TCCNI from its original instrument subjecting this to reverse translation using a professional English-to-Japanese-to-English translator who clearly confirmed the accuracy of the translations. In this study, the contents of the item configurations were analyzed and discussed regarding instruments, and the summary of the similarities and differences among researchers who had been involved in the research of caring. The difference between the item configuration of PITCCN and TCCNI was clearly illustrated by a comparative table, and in the case where there was no corresponding item, it was left blank. Results: The commonality between the TCCNI and PITCCN was the holistic focus on patients using information obtained through technologies. Different question items were included to provide highquality outcomes for the PITCCN. Conclusion: Considered useful in order to perform high quality practice in using technology, and to provide high quality nursing. Measured Technological Competency as Caring in Nursing might be able to utilizing for in-service education of hospitals or formalized education in nursing universities.

Assessing the Psychometric Properties of the Technological Competency as Caring in Nursing Instrument-Revised

International Journal for Human Caring, 2021

The Technological Competency as Caring in Nursing Instrument-Revised (TCCNI-R) was developed from... more The Technological Competency as Caring in Nursing Instrument-Revised (TCCNI-R) was developed from the Technological Competency as Caring in Nursing theory. To assess the psychometric properties, a four-factor questionnaire comprised the TCCNI-R. Only 590 of 1,322 online questionnaire responses by nurses in 11 general hospitals in Chugoku-Shikoku, Japan, were analyzed and interpreted. Exploratory factor analysis and confirmatory factor analysis via SEM justified construct validity, and Cronbach's alpha coefficient established reliability. Goodness of fit was rejected; however fit index value was accepted. Root mean square of error approximation showed reasonable approximation error. The TCCNI-R showed content validity and reliability in measuring technological competency as expression of caring in nursing.

Issues in the Development of Conversation Dialog for Humanoid Nursing Partner Robots in Long-Term Care

Information Systems - Intelligent Information Processing Systems, Natural Language Processing, Affective Computing and Artificial Intelligence, and an Attempt to Build a Conversational Nursing Robot, 2021

The purpose of this chapter is to explore the issues of development of conversational dialog of r... more The purpose of this chapter is to explore the issues of development of conversational dialog of robots for nursing, especially for long-term care, and to forecast humanoid nursing partner robots (HNRs) introduced into clinical practice. In order to satisfy the required performance of HNRs, it is important that anthropomorphic robots act with high-quality conversational dialogic functions. As for its hardware, by allowing independent range of action and degree of freedom, the burden of quality exerted in human-robot communication is reduced, thereby unburdening nurses and professional caregivers. Furthermore, it is critical to develop a friendlier type of robot by equipping it with non-verbal emotive expressions that older people can perceive. If these functions are conjoined, anthropomorphic intelligent robots will serve as possible instructors, particularly for rehabilitation and recreation activities of older people. In this way, more than ever before, the HNRs will play an active...

Perceptions of nurse managers and staff nurses regarding Technological Competency as Caring in Nursing theory in general hospitals in Japan

Belitung Nursing Journal, 2021

Background: Nurses as primary healthcare providers demonstrate quality nursing care through compe... more Background: Nurses as primary healthcare providers demonstrate quality nursing care through competencies with healthcare technologies, while nurse managers assume the primacy of managing quality healthcare in their respective care settings. However, little is known about perceptions of the influence of care technologies on their nursing practice. Objective: This study aimed to determine managers’ and staff nurses’ perceptions regarding the Technological Competency as Caring in Nursing (TCCN) theory in general hospitals in Japan. Methods: This study employed a cross-sectional survey design, with 421 participants selected using a stratified sampling method. Technological Competency as Caring in Nursing Instrument–Revised (TCCNI-R) was used for online data collection using Survey Monkey©. Data were analyzed using Welch’s t-test and ANOVA. Results: Nurses with years of experience within the range of 20 to less than 30 years showed the highest TCCNI-R scores among the two groups. Nurses ...

Are Indonesian Nurses Ready for Healthcare Robots During the COVID-19 Pandemic?

Belitung Nursing Journal, 2020

Healthcare robots are used in Indonesia and other countries to combat COVID-19 pandemic. This art... more Healthcare robots are used in Indonesia and other countries to combat COVID-19 pandemic. This article was aimed to describe a perspective about healthcare robots, and to recommend ways for Indonesian nurses to engage with healthcare robots during the COVID-19 pandemic. One view hindering healthcare robot appreciation as partners of nurses is its threat to their practice. However, with the current environment of COVID-19 ‘frontline’ situations, increasing infections of patients with SARS COV2, limited personal protective equipment, and the fastidious nature of maintaining social distancing and mask-wearing, it may be best to view healthcare robots as significant partners to facilitate safety, and ease the demands of nursing care activities in order to safeguard human lives while enhancing human well-being. Educating healthcare practitioners about healthcare robot programming and assurance of its safe and secure use can advance robot appreciation as partners in healthcare. These goals...

Consideration of Safety Management When Using Pepper, a Humanoid Robot for Care of Older Adults

Intelligent Control and Automation, 2020

Pepper, a humanoid robot, is 1.2 m in height and is designed to move its limbs. There are risks o... more Pepper, a humanoid robot, is 1.2 m in height and is designed to move its limbs. There are risks of the older adults experiencing falling and collision accidents when they interact with Pepper. When physical interaction happens between a humanoid robot and human beings, potential harmful physical contact might occur. The aim of this report was to examine the safety management aspects when using Pepper, a humanoid robot for the care of older adults. The older adults' reactions to Pepper's functions cannot be predicted. Hence, it is necessary to clarify methods to guarantee its safety in advance and to increase the safety and properties of the robots. The benefits of introducing support robots such as Pepper for aging medical and nursing care settings are obvious. Therefore, engagement in robot development while considering both the risks and benefits is critical. Our academic initiatives have just begun. Through information exchange among researchers, users, engineers, and law specialists, we need to identify latent and prominent risks in situations where Pepper and the older adults interact and deepen our examination of measures against such risks.

The Intermediary Roles of Public Health Nurses (PHNs) in Utilizing Communication Robots (CRs) in Community Health Care Practice

Health, 2019

Robot technology is expected to reduce the burden of medical professionals, a concern in the supe... more Robot technology is expected to reduce the burden of medical professionals, a concern in the super-aged society. The aim of this article is to determine the intermediary roles of Public Health Nurses (PHNs) in using Communication Robots (CRs) in Community Health care. It is necessary to consider who will manage, and how to draw lines of responsibility when a problem occurs when using robots in the future. Regarding the mediator or intermediary role of PHNs in the use of CRs, PHNs are expected to be cognizant of varieties of robots for use with persons of diverse ages and health levels, as well as of robot performances. As one of the community healthcare workers who service the elderly living in the community, the role of PHNs as mediators or intermediaries is to pay attention to ethical and moral issues while working with CRs to manage the health of the community. Lack of understanding of the intermediary role might create possible ethico-moral issues in the future. Therefore, it is critical for PHNs to understand their role as intermediaries. In doing so, it is expected that older people at home will be able to live peaceful lives, as well as be physically and mentally healthy.

A novel in-service nursing education optimizing theory of technological competency as caring in nursing

Journal of Nursing Education and Practice, 2019

Contemporary and future nursing practices are increasingly being designed with nursing theories a... more Contemporary and future nursing practices are increasingly being designed with nursing theories as to its foundation. The aim of this article is to describe an in-service education program for nursing administrators centered on the theory of Technological Competency as Caring in Nursing (TCCN). This theory is framed chiefly within the concepts of technology, caring, nursing, and technological competency. Influencing the significance of in-service education is theory-based practice with advancing technologies in human caring. The in-service education program was organized as a five-month, one-hour a month lecture and discussion series. In each session, educational contents are focused on the nursing process as caring based on the theory of TCCN. This education is a plan that will gradually educate the nurse manager group, the mid-level nursing staff group, and finally to the staff nurse group. This hierarchically organized in-service educational plan aims to systematically improve th...

Criterion-related Validity of the Perceived Inventory of Technological Competency as Caring in Nursing (PITCCN) in Acute Care Settings

The Journal of Medical Investigation, 2019

Characteristics of Transactive Relationship Phenomena among Older adults, Care Workers as Intermediaries, and the Pepper Robot with Care Prevention Gymnastics Exercises

The Journal of Medical Investigation, 2019

In this research, participatory action research method was used (11), and researchers continuousl... more In this research, participatory action research method was used (11), and researchers continuously discussed and analyzed the recoded data. The transactions were focused/analyzed as to how Pepper-CPGE led the exercises, and how care workers intervened during physical exercise of the older adults. Analyzed scenes were physical exercises with Pepper-CPGE. Recorded videos were analyzed only during (1) upper limb motor functions exercise, and (2) exercises using Radio Gymnastics the First (Rajio Taiso Dai-ichi), a program that is well-known and wellpracticed by most Japanese citizens. Pepper-CPGE instructs the older adults to perform gymnastics activities while viewing the video monitor.

Perceptions of Self of Persons with Visible Artificial Devices : A Review of the Literature

The Journal of Medical Investigation, 2019

ending in 2017! Each full-text article that met the inclusion criteria was read, reread, and anal... more ending in 2017! Each full-text article that met the inclusion criteria was read, reread, and analyzed as recommended in the six phases described by Braun and Clarke (8). Data items were derived from the retrieved abstracts of each article and classified according to themes. From the data extracts, data sets were identified as Key Themes. Table I exhibits the thematic data analysis as Braun and Clarke described. Establishing Inter-Rater Reliability : Using the Databases Four co-authors participated in the search and analysis of pertinent articles using a specific database source. For example, coauthor (YM) searched the CINAHL database for articles that met the inclusion criteria. This effort distribution ensured that all of the co-authors contributed valuable and appropriate effort towards collecting findings as legitimate co-authors of the study. Each of the four co-authors analyzed articles which were retrieved from search engines or databases assigned to them individually. Each coauthor identified and listed the data extracts, or themes, and subsequently cross-referenced them against the identified data extracts from the other three authors' lists. Deliberations regarding these extracted themes based on the data items, namely the abstracts or summaries, of each article were made for the purpose of achieving a thematic consensus! With the CINAHL database, the keywords 'perception AND prosthesis AND limb' were used. The search yielded only twelve articles. To increase the likelihood of retrieving more pertinent articles, the keywords 'body-image AND prosthesis AND artificial AND limb AND perception' were used for SCOPUS, in addition to the original three keywords. Nevertheless, only fourteen articles were found. Of these, however, only twelve full-text articles were available even with the assistance of the Florida Atlantic University (FAU) Library System. For the IEEE database, the keywords 'Prosthesis/Limb/Self Perception/Psychological/Human/Life' were used, in addition to the keywords used for CINAHL and SCOPUS. Even with these keywords used singly, or in various configurations, only ten relevant articles were found. It is important to note here that the IEEE database seemed to contain more research studies pertaining to or focused on the design and development of artificial devices. Regardless, only seven full-text published articles were found through the Florida Atlantic University (FAU) Library system. With PubMed, the keywords 'Prosthesis/Limb/Perception/ Emotion' were used. Nine relevant articles were found, with one article eliminated as it duplicated an article retrieved through CINAHL. Of the remaining articles, only five full-text articles were made available using the FAU library system.

Can humanoid nurse robots replace human nurses?

Journal of Nursing, 2018

Background: The certainty of future technological developments in robotics and artificial intelli... more Background: The certainty of future technological developments in robotics and artificial intelligence can alter how nursing is practiced today and in the future. In 1992, Peck argued that while advancing technologies will take over the predictive and prescriptive health care practice, the future of nursing will rest on the irreplaceable human touch, specifically "Tender Loving Care." Discussion: If nursing is the expression of TLC, and the science of caring supports this expression as nursing, is it true that contemporary nursing practice is the engagement of human beings with caring as its core? Is the practice of nursing grounded in caring? With recent advances in robot technologies and artificial super intelligence (ASI) will there be Humanoid Nurse Robots (HNRs) 'nurse' persons with TLC? Conclusion: As fundamental to nursing practice grounded in the theory of Technological Competency as Caring in Nursing, the ultimate purpose of technological competency as caring in nursing is to know persons as caring who are participants in their care, rather than simply objects of care. The process of 'knowing persons as caring' in nursing is communicated as technological knowing, mutual designing and participative engaging.

Recommended Design and Direction of Development for Humanoid Nursing Robots Perspective from Nursing Researchers

Intelligent Control and Automation, 2017

The purpose of this article is to describe recommendations towards the design and direction of de... more The purpose of this article is to describe recommendations towards the design and direction of development for Humanoid Nursing Robots (HNRs) from the standpoint of researchers of nursing care practice. Efforts to introduce robot technologies in nursing practice and to use them in elderly and high-tech healthcare environments have begun in developed countries like Japan. Companies are developing various types of robots, although their types and functionalities continue to require a clear identification and definition. Regardless, robot developments for health care purposes are progressing well to meet universal technological demands. While human caring has been a human-to-human relationship, in a nonhuman-to-human relationship in the case of HNRs, it is essential to consider ethical concerns and human safety. If HNRs are to support patients directly, they must be required to have the same level of comprehensive judgment ability and responsiveness as that of human nurses. This includes abilities to genuinely observe, judge, rapidly respond, and conduct human caring practice emphasizing individuality. If HNRs support patients independently, abilities which are much like those of humans will be required of them in addition to the appropriate intelligence and skillfulness to do so. A low level robot nurse exerts work that should be called non-nursing or as a medical aid assistant no matter who thinks and what these technologies can do. Similarly, a higher level HNR with higher level artificial intelligence is expected to exceed the capabilities of human beings. As such, current discourse and debate also include the concern that HNRs may now become one's superior or rather that the HNR is a subordinate thereby requiring human management.

Availability of Thickness Estimation of the Subcutaneous Fat by Using the Near-infrared Ray Measuring Device

International Journal of Nursing & Clinical Practices, 2016

Gluteal intramuscular injection requires accurate needle insertion into the specific muscle area ... more Gluteal intramuscular injection requires accurate needle insertion into the specific muscle area for accurate, safe, and efficacious delivery of medication for long-acting anti-psychiatric drugs. With ultrasonography, accurate evaluation of the "Distance from the Epidermis to the Under-Fascia (DEUF)" can be determined. However, a nurse in the clinical settings, ultrasonographic measurements during intramuscular injection is impractical and difficult. The purpose of this study was to estimate the thickness of subcutaneous fat by using a near-infrared ray measuring device.This study was approved by the Ethics Committee of Tokushima University Hospital. There were 39 subjects (21 men and 18 women) aged 20 to 60 years (Mean ± SD: 44.97 ± 15.20 years old). Bilateral DEUF at Ventrogluteal and Dorsogluteal sites (AVIUS: Hitachi-Aloka Medical Co.) were evaluated on B-mode scan as the gold standard. At the same sites, the thickness of the subcutaneous fatty tissue was measured using the PoccoStick (HORIC: smallsize instrument measuring the thickness of the subcutaneous fat with a near-infrared ray device). The right Ventrogluteal site thickness of the fatty tissue was significantly overestimated by PoccoStick (15.18 ± 8.77 mm) measurements, as compared to the ultrasonography (12.42 ± 5.26 mm) (p<0.01) results. The left-side Ventrogluteal site and both the right and left Dorsogluteal sites measurements did not show significant differences. This illustrated and supported the credible use of inexpensive devices such as the PoccoStick in estimating the DEUF. The development of a more highly accurate small-sized instrument is recommended.

Characteristics of Psychiatric Hospital Work Environment Found Attractive by Professional Nurse Administrators in Japan

International Journal of Nursing & Clinical Practices, 2016

Purpose: The purpose of this study is to identify characteristics of work environments in psychia... more Purpose: The purpose of this study is to identify characteristics of work environments in psychiatric hospitals which are appealing to nurses. Understanding characteristics of work environments of psychiatric hospital nurses can lead to attracting nurses to work in this environment, thereby increasing human resources and alleviating nurse-staffing problems. Methods: Questionnaire copies focusing on staffing shortages of nurses in psychiatric hospitals were provided to 277 psychiatric hospital nurse administrators in Japan from May-April 2016. Data analyses included descriptive and multivariate statistics. Factor analysis together with the Kaiser-Meyer-Olkin and the Bartlett's test of Sphericity were used to assess adaptive validity. Factor loadings were set at 0.4 or more for the configuration of items, while internal consistency and reliability of the assessment data scores were done using Cronbach's alpha coefficient. Mean factor points were calculated and student's t-test and one-way analysis of variance were performed. Significance probability level was set at 0.001. Results: Factor analysis revealed nine factors: (1) Educational system, (2) Reputation at hospitals, (3) Support system for acquisition of certificate of clinical nurse specialist/certified nurse, (4) Reputation at hospitals as places of employment, (5) Knowledge of nursing philosophy and of culture of working places, (6) Reputation of teaching for students' clinical practice, (7) Working hours and leave privileges, (8) Salary and other allowances, (9) Support system for license acquisition. Data revealed that nurse administrators who employed new graduate registered nurses found their hospitals' attractive points were: educational system, support system to acquire certificate of clinical nurse specialist, reputation of hospital as place of employment, knowledge of nursing philosophy and culture of working places, teaching students' clinical practice, and salary and other allowances. Conclusion: Nurse administrators who have no difficulty recruiting nursing staff recognized that their hospital environments were considered appealing based on working hours and leave privileges.

Relationship between Lifestyle, Quality of Sleep, and Daytime Drowsiness of Nursing Students of University A

Open Journal of Psychiatry, 2017

The harmful effects of technological devices, including smart phones have been increasingly suspe... more The harmful effects of technological devices, including smart phones have been increasingly suspected among university students; bedtimes have become increasingly later at night, and leisure activities often extend through the night. Likewise, availability and need of increasing part-time job hours have been considered. The purpose of this research was to determine the relationship among lifestyles, quality of sleep, and daytime drowsiness of nursing students of University A. The research was conducted in June 2015, when student life rhythms were considered stable after two months of lectures. Responses with missing values or with inappropriate answers were excluded. Of the data collected from 96 respondents, only 71 were acceptable. The survey focused on lifestyle, daytime sleepiness (using ESS: Epworth Sleepiness Scale) and quality of subjective sleep (using the PSQI: Pittsburgh Sleep Quality Index). Approval was obtained from the Research Ethics Committee of Shikoku University. While in this study, more than half (63.4%) of the students had poor quality of sleep, however, there was no relationship between their quality of sleep and daytime drowsiness, or between their lifestyles and the quality of sleep. These findings suggest that while university students' use of technological devices is suspected to influence on sleep deprivation and consequent daytime drowsiness, the findings did not provide the evidence.

Development of the Diabetes Oral Health Assessment Tool © for Nurses

Health, 2015

Although some studies have suggested a bidirectional relationship between diabetes and periodonta... more Although some studies have suggested a bidirectional relationship between diabetes and periodontal disease, there were no appropriate tools for nurses to evaluate oral status and oral health behaviors in patients with diabetes. Therefore, the Diabetes Oral Health Assessment Tool (DiO-HAT©) was developed with items contributed by health care professionals (diabetologists, periodontal specialists, a preventive dentist, a Certified Nurse in Diabetes Nursing, a national registered dietitian, registered nurses, a dental hygienist, and nursing researchers) who were involved in the medical care of patients with diabetes. Subsequently, a survey of 700 Diabetes Nurse Specialists (DNS) was conducted to determine their score of recognition and implementation of the DiOHAT©, however, 304 participants (43.4%) responded. Constructive concept validation and the Cronbach's alpha coefficient for all assessment items was 0.932, indicating high reliability: Factor 1, Patient's oral health status (α = 0.874); Factor 2, Implementation of oral health behaviors (α = 0.890); Factor 3, Information transmission regarding dental visits (α = 0.862); and Factor 4, Perceptions and knowledge of oral health behaviors (α = 0.793). Although the mean score of recognition of DiOHAT© was 3.5 ± 0.4 points, the mean value of the implementation score was 1.5 ± 0.5 Y. Kuwamura et al. 1711 points (obtained using a 4-grade scale). The implementation scores were significantly lower than the recognition scores for all items (p < 0.001). The findings suggested that the DNS were not inclined to implement all items of DiOHAT©, despite recognizing their importance.