Background: Older cardiac patients are at high risk of readmission and mortality. Transitional care interventions (TCIs) might contribute to the prevention of adverse outcomes. The Cardiac Care Bridge program was a randomized nurse-coordinated TCI combining case management, disease management and home-based rehabilitation for hospitalized frail older cardiac patients. This qualitative study explored the experiences of patients’ participating in this study, as part of a larger process evaluation as this might support interpretation of the neutral study outcomes. In addition, understanding these experiences could contribute to the design and application of future transitional care interventions for frail older cardiac patients. Methods: A generic qualitative approach was used. Semi-structured interviews were performed with 16 patients ≥70 years who participated in the intervention group. Participants were selected by gender, diagnosis, living arrangement and hospital of inclusion. Data were analysed using thematic analysis. In addition, quantitative data about intervention delivery were analysed. Results: Three themes emerged from the data: 1) appreciation of care continuity; 2) varying experiences with recovery and, 3) the influence of an existing care network. Participants felt supported by the transitional care intervention as they experienced post-discharge support and continuity of care. The perceived contribution of the program in participants’ recovery varied. Some participants reported physical improvements while others felt impeded by comorbidities or frailty. The home visits by the community nurse were appreciated, although some participants did not recognize the added value. Participants with an existing healthcare provider network preferred to consult these providers instead of the providers who were involved in the transitional care intervention. Conclusion: Our results contribute to an explanation of the neutral study of a nurse-coordinated transitional care intervention. For future purpose, it is important to identify which patients might benefit most from TCIs. Furthermore, the intensity and content of TCIs could be more personalized by tailoring interventions to older cardiac patients’ needs, considering their frailty, self-management skills and existing formal and informal caregiver networks.
With the emergence of education for sustainable development (ESD), robust literature on ethics and ESD has emerged; however, ecocentric perspective developed within environmental ethics is marginalized in current ESDebate. The questions discussed in this article are as follows: Why is the distinction between anthropocentric and ecocentric view of environment salient to ESD? How can this distinction be operationalized and measured? Until now, little has been done to address complement quantitative studies of environmental attitudes by qualitative studies, exploring the sociocultural context in which ecocentric or anthropocentric attitudes are being formed. Neither of existing scales engaged with the interface between environmental ethics and sustainable development. This article will discuss ESD in the context of environmental ethics and present the results of the case study conducted with the Dutch Bachelor-level students. Results of qualitative evaluation of the scale measuring ecocentric and anthropocentric attitudes will be presented, and the new Ecocentric and Anthropocentric Attitudes toward the Sustainable Development (EAATSD) scale will be proposed.
The study of moral reasoning in relation to sustainable development is an emerging field within environmental education (EE) and education for sustainable development (ESD). The vignette method was used to evaluate the perception of the relationship between environmental and social issues in the Dutch upper elementary school children. This case study is placed within two broad areas of tension, namely between the need to address urgent environmental problems and to promote pluralistic democratic learning; and between the value of environment as an economic asset and deep ecology perspective. Results of this study indicate that the children are able to critically think about the moral dilemmas inherent in sustainable development and distinguish between different values in relation to environment. https://doi.org/10.1016/j.stueduc.2013.12.004 https://www.linkedin.com/in/helenkopnina/
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