Chapter 3 on ‘Presence’ offers a comprehensive assessment and exploration of the intervention as a form of contemporary non-pharmacologic medicine. While simulated presence appears to be a relatively novel intervention, studies already establish the technique as one that mitigates the levels of anxiety and behavioral disorders that impede effective treatment of persons with mental problems, especially dementia.
Presence as an intervention is based on psychological attachment concepts in medicine, which means the existence of qualitative assessments on how the approach establishes support for nurses and patients. Important in the chapter is the assertion that presence does not only cover the physical attendance by nurses and clinicians but rather methods that stimulate body senses and the spirit to alleviate anxiety and fear from the patient. Given the feasibility and high usability of presence, there is a need for more research on the non-pharmacologic method as a function of increasing adoption in various health facilities.
The problem is that there is a lack of information regarding presence and associated outcomes of this type of therapy. As asserted in the chapter, nurses normally document treatments and patient assessments done but rarely record presence and its impact on treatment. Regardless of the impediment arising from lack of knowledge, increasing awareness and demand for non-pharmacologic therapies provides a positive opportunity for nurses and clinicians to evaluate their working environment in order to derive ways of how best to integrate the approach. Given that presence includes strategies that stimulate auditory, visual and touch senses, review of the work environment should include the services of expert interior, system and information system designers in order to integrate virtual presence nicely within the hospital. Capture of virtual presence is imperative in order to ascertain nurses and clinicians do not waste time being physically present next to patients and their families.