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Presentation on http://spironto.de at ARTEL 2013 Workshop on Awareness & Reflection at ECTEL 2013, Paphos, Cyprus, September 17, 2013
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SpirOnto: Semantically Enhanced
Patient Records for Reflective Learning on Spiritual Care in
Palliative Care
ARTEL Workshop 2013, Paphos, Cyprus
Christine Kunzmann, Traugott Roser, Andreas Schmidt, Tanja
Stiehl
http://spironto.de 2Sep 2013
Motivation
Palliative care is a multi-professional environment Doctors Nurses Chaplains/Spiritual caregivers Social workers
Patient record as „boundary object“ Information store and basis for decision making Foundation for reflection („Supervision“) Gaining evidence and insight into spirtual care
http://spironto.de 3
Reflective practice
Demanding nature of child palliative care
Regular reflective practice in informal group sessions Narratives about individual patients Development of a deep and rich understanding of
their work
At longer time intervals: institutionalized supervision
Sep 2013
http://spironto.de 4
Spiritual care
Sep 2013
Culturally sensitive spiritual care is as important as medical and care in palliative situation
Currently, however, spiritual care is not seen as a systematic approach with observable effects (as medicine or care)
For a basis for a systematic approach, an concept network („ontology“) was created which was derived from existing documentation
Facilitates finding gaps and possibilities for action beyond one‘s own profession
http://spironto.de 5
Ontology development
Ontology developed based on 143 existing patient records (on paper, years 2004-2009)
Qualitative analysis
Formative evaluation of the resulting ontology with staff members with various backgrounds
Sep 2013
http://spironto.de 6
Full ontology
Sep 2013
http://spironto.de 7
Ontology
Facts about a patient or its social environment, demographics, disease/care status, cultural background
Observations that led to the identification of the facts (timestamp and a possibly rich description)
Spiritual concepts that interpret facts, such as eternity and finiteness, eternal love, guilt, purity, powerlessness vs. almightiness, or autonomy context-dependent interpretations
Spiritual interventions are possible spiritual care activities, e.g., support, meaningful silence, pastoral interviews, practical consultancy, or rituals.
Sep 2013
Sep 2013
http://spironto.de 10
The System
Phased development
Summer 2013: First initial prototype developed for Windows Notebooks and Tablets
Intended as a proof of concept for getting feedback Testing planned Further development and larger scale evaluation
planned for 2014
Sep 2013
http://spironto.de 11Sep 2013
Sep 2013
Screenshot
Sep 2013
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Conclusions
Spiritual care is often belittled as lacking evidence of its effectiveness
Development of the ontology has already shown that spiritual care follows a systematic approach. made visible through the general structure of the
ontology: observations/facts, spiritual concepts as interpretations, and spiritual care interventions.
Workshops with physicians, social workers, and carers: can act as a boundary object between the disciplines and can create awareness about spiritual care and its relevance
First prototype with editing capabilities about to be tested, analysis and visualization planned for 2014
Also applicable in related fields, such as elderly care, or care for handicapped people
Sep 2013
http://spironto.de 15
Team
Christine Kunzmann, Pontydysgu, UKkontakt@christine-kunzmann.de
Traugott Roser, University of Münster, Germanytraugott.roser@uni-muenster.de
Andreas P. Schmidt, Karlsruhe University of Applied Sciences, Germanyandreas_peter.schmidt@hs-karlsruhe.de
Tanja Stiehl, Center of Pediatric Palliative Care, LMU Munich, Germanytanja.stiehl@med.uni-muenchen.de
Sep 2013
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