Most people with dementia (PwD) are cared for by unpaid family carers, many of whom must balance caring with paid work. This regularly entails dealing with care-related emergencies (CRE). This study aims to explore the impact of carers’ autonomy at work regarding breaks, schedule, and place on their ability to manage CRE, and use technology to that end. We conducted interviews with 16 working carers of PwD in Scotland. Data were analysed thematically to identify key themes. Autonomy at work appeared on a spectrum from no to complete autonomy. Carers’ position on this spectrum was often dynamic and determined by the nature of their work, their workplace culture and regulations, and their line managers’ support – or clients in the case of self-employed carers. Break autonomy allowed carers to use technology to be notified of and delegate the CRE response. Schedule autonomy allowed for an in-person response to CRE. Place autonomy allowed carers to work and care simultaneously, which enabled them to manage CRE immediately but presented them with additional challenges. Distance between workplace and PwD’s residence impacted carers’ ability to manage CRE, despite having complete autonomy. Implications for healthcare professionals, service providers, employers, policymakers, and technology developers are presented.
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Background The global nursing shortages exacerbated by the COVID-19 pandemic necessitated a drastic reorganization in nursing practices. Work routines, the composition of teams and subsequently mundane nursing practices were all altered to sustain the accessibility and quality of care. These dramatic changes demanded a reshaping of the nurses’ work environment. The aim of this study was to explore how nurses reshaped their work environment in the early stages of the COVID-19 pandemic. Methods A descriptive study comprising 26 semi-structured interviews conducted in a large Dutch teaching hospital between June and September 2020. Participants were nurses (including intensive care unit nurses), outpatient clinic assistants, nurse managers, and management (including one member of the Nurse Practice Council). The interviews were analysed with open, axial, and selective coding. Results We identified five themes: 1) the Nursing Staff Deployment Plan created new micro-teams with complementary roles to meet the care needs of COVID-19 infected patients; 2) nurse-led adaptations effectively managed the increased workload, thereby ensuring the quality of care; 3) continuous professional development ensured adequate competence levels for all roles; 4) interprofessional collaboration resulted in experienced solidarity, a positive atmosphere, and increased autonomy for nurses; and, 5) supportive managers reduced nurses’ stress and improved work conditions. Conclusions This study showed that nurses positively reshaped their work environment during the COVID-19 pandemic. They contributed to innovative solutions in an environment of equal interprofessional collaboration, which led to greater respect for their knowledge and competencies, enhanced their autonomy and improved management support.
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Background The global nursing shortages exacerbated by the COVID-19 pandemic necessitated a drastic reorganization in nursing practices. Work routines, the composition of teams and subsequently mundane nursing practices were all altered to sustain the accessibility and quality of care. These dramatic changes demanded a reshaping of the nurses’ work environment. The aim of this study was to explore how nurses reshaped their work environment in the early stages of the COVID-19 pandemic. Methods A descriptive study comprising 26 semi-structured interviews conducted in a large Dutch teaching hospital between June and September 2020. Participants were nurses (including intensive care unit nurses), outpatient clinic assistants, nurse managers, and management (including one member of the Nurse Practice Council). The interviews were analysed with open, axial, and selective coding. Results We identified five themes: 1) the Nursing Staff Deployment Plan created new micro-teams with complementary roles to meet the care needs of COVID-19 infected patients; 2) nurse-led adaptations effectively managed the increased workload, thereby ensuring the quality of care; 3) continuous professional development ensured adequate competence levels for all roles; 4) interprofessional collaboration resulted in experienced solidarity, a positive atmosphere, and increased autonomy for nurses; and, 5) supportive managers reduced nurses’ stress and improved work conditions. Conclusions This study showed that nurses positively reshaped their work environment during the COVID-19 pandemic. They contributed to innovative solutions in an environment of equal interprofessional collaboration, which led to greater respect for their knowledge and competencies, enhanced their autonomy and improved management support.
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Introduction: The notion of autonomy in Self-Determination Theory is at the core of intrinsically motivated learning, and fulfilment of the need for autonomy is essential for thriving at school. Therefore teacher-provided autonomy support has grown into a key concern in educational research. In the present study into primary school music education, the notion of creative autonomy support is introduced. Research into autonomy support is typically focused on verbal interaction. However, from an enactive perspective, teachers’ gesturing, bodily movement, facial expression, and musical action form an integral part of the socially situated interaction in music lessons, inherently involving autonomy support. In the present study, a distinction is made between creative verbal autonomy support and creative musical and non-verbal autonomy support.Methods: Applying a process-based time-serial methodology, rooted in a Complex Dynamic Systems and Enactive perspective, the effects of an intervention with Video Feedback Coaching for teachers were investigated. Video data of 105 music lessons of 18 teachers (intervention and control condition) from six primary schools was gathered, to examine teachers’ creative autonomy support at both the individual and group level.Results: The findings show that teachers in the intervention condition, compared to the control group, achieved a meaningful increase in their ability to offer creative autonomy support verbally. Teachers also showed development for the non-verbal and musical aspects of offering creative autonomy support. However, particularly for offering higher-level creative autonomy support in the non-verbal and musical mode, significant results were found for less than half of the intervention teachers.Discussion: These results underline the importance of embracing and studying the bodily dimension as an integral part of teacher autonomy support, aimed at emergence of students’ musical creativity, in primary school music education and in teacher training. We explain how these results might be relevant for autonomy enhancing musical activities in vulnerable groups.
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BACKGROUND:The number of workers who have previously undergone a cancer treatment is increasing, and possible late treatment effects (fatigue, physical and cognitive complaints) may affect work ability.OBJECTIVE:The aim of the study was to investigate the impact of late treatment effects and of job resources (autonomy, supportive leadership style, and colleagues’ social support) on the future work ability of employees living 2–10 years beyond a breast cancer diagnosis.METHODS:Data at T1 (baseline questionnaire) and at T2 (9 months later) were collected in 2018 and 2019 (N = 287) among Dutch-speaking workers with a breast cancer diagnosis 2–10 years ago. Longitudinal regression analyses, controlling for years since diagnosis, living with cancer (recurrence or metastasis), other chronic or severe diseases, and work ability at baseline were executed.RESULTS:Higher levels of fatigue and cognitive complaints at baseline predicted lower future work ability. The three job resources did not predict higher future work ability, but did relate cross-sectionally with higher work ability at baseline. Autonomy negatively moderated the association between physical complaints and future work ability.CONCLUSIONS:Fatigue and cognitive complaints among employees 2–10 years past breast cancer diagnosis need awareness and interventions to prevent lower future work ability. Among participants with average or high levels of physical complaints, there was no difference in future work ability between medium and high autonomy. However, future work ability was remarkably lower when autonomy was low.
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Purpose: The aim of this study was to investigate the occupational well-being among employees with chronic diseases, and the buffering effect of four job resources, possibly offering targets to enhance occupational well-being.Method: This cross-sectional study (N = 1951) was carried out among employees in educational and (semi-)governmental organizations in the Netherlands. The dimensions of the survey were chronic diseases (i.e., physical, mental, or both physical and mental), occupational well-being (i.e., work ability, burnout complaints, and work engagement), and job resources (i.e., autonomy, social support by colleagues, supportive leadership style, and open and communicative culture). First, it was analyzed if chronic diseases were associated with occupational well-being. Second, it was analyzed if each of the four job resources would predict better occupational well-being. Third, possible moderation effects between the chronic disease groups and each job resource on occupational well-being were examined. Regression analyses were used, controlling for age.Results: Each chronic disease group was associated with a lower work ability. However, higher burnout complaints and a lower work engagement were only predicted by the group with mental chronic diseases and by the group with both physical and mental chronic disease(s). Furthermore, all four job resources predicted lower burnout complaints and higher work engagement, while higher work ability was only predicted by autonomy and a supportive leadership style. Some moderation effects were observed. Autonomy buffered the negative relationship between the chronic disease groups with mental conditions (with or without physical conditions) and work ability, and the positive relationship between the group with both physical and mental chronic disease(s) and burnout complaints. Furthermore, a supportive leadership style is of less benefit for occupational well-being among the employees with mental chronic diseases (with or without physical chronic diseases) compared to the group employees without chronic diseases. No buffering was demonstrated for social support of colleagues and an open and communicative organizational culture.Conclusion: Autonomy offers opportunities to reinforce occupational well-being among employees with mental chronic diseases. A supportive leadership style needs more investigation to clarify why this job resource is less beneficial for employees with mental chronic diseases than for the employees without chronic diseases.
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Robots are increasingly used in a variety of work environments, but surprisingly little attention has been paid to how robots change work. In this comparative case study, we explore how robotization changed the work design of order pickers and order packers in eight logistic warehouses. We found that all warehouses robotized tasks based on technological functionality to increase efficiency, which sometimes created jobs consisting of ‘left-over tasks’. Only two warehouses used a bottom-up approach, where employees were involved in the implementation and quality of work was considered important. Although the other warehouses did not, sometimes their work design still benefitted from robotization. The positive effects we identified are reduced physical and cognitive demands and opportunities for upskilling. Warehouses that lack attention to the quality of work may risk ending up with the negative effects for employees, such as simplification and intensification of work, and reduced autonomy. We propose that understanding the consequences of robots on work design supports HR professionals to help managing this transition by both giving relevant input on a strategic level about the importance of work design and advocating for employees and their involvement.
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In primary music education a key question is what teachers can do to stimulate students’ musical creativity. For the answer, delving into teacher-student interaction during the creative processes in the naturalistic setting of primary music lessons is required. Twenty-six music lessons from thirteen teachers and their classes of seven Dutch schools were recorded to explore the relation between teachers’ autonomy support and students’ divergent and convergent thought & action. Quantitative sequential analysis and thematic analysis were combined to examine this relation, using a framework offered by Complex Dynamic Systems theory and Enaction theory. In contrast to classical correla-tional analysis, sequential analysis focuses on the dynamics, and thus on the temporal relation in classroom interaction. The results show that mostly lower-level autonomy support was offered. Es-pecially in creative lessons, higher-level autonomy support is more likely to lead to higher-level student divergent thought and action. For convergent thought and action, the results were less con-clusive. An implication of the findings is that (research into) music education could benefit from interventions aimed at enhancing autonomy support in primary school music.
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The central aim of this thesis was to increase understanding of designing vocational learning environments at the school–work boundary. Four studies were conducted, focusing on learning environment designs at the school–work boundary and on design considerations of the actors involved in their construction, both from the world of school and the world of work.
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