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Designing chatbots for training professionals in child and youth social care

Introduction:Various subjects in child and youth social care, such as sexuality and sexual violence, are quite sensitive, and professionals may experience a certain reluctance to discuss these subjects with their clients (e.g., the young people they work with, as well as their families) and colleagues. An example of such a subject is sexual abuse and unacceptable behavior that may occur with their clients, whether at home, at the youth care institution or somewhere else.It is essential that youth care professionals do not shy away from such a sensitive subject as sexual abuse and know how to talk about it with their clients in a healthy way. Professionals in child and youth social care should dare to educate on this topic, and be trained to deal with the enormous diversity of young people and parents they encounter in their work.Research on application of trained methods shows that receiving training on itself is often not enough to develop strong applicable competences about subjects like sexual abuse and to continue to apply these acquired practical skills in the field in the long term. In order to be able to apply ‘what is learned’ successfully, it is necessary to practice the learned skills in a safe environment, and to regularly refresh those skills. In order to create an opportunity for practicing skills in a safe environment, we have explored the extent to which innovative chatbot technologies can be used to better equip (future) professionals to apply and practice their skills.

Effects of the Caregiver Interaction Profile Training on Caregiver-Child Interactions in Dutch Child Care Centers

Relationship between the presence of baccalaureate-educated RNs and quality of care

BACKGROUND: Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities. METHODS: We conducted a cross-sectional study among 282 wards and 6,145 residents from 95 Dutch long-term care facilities. The relationship between the presence of BRNs in wards and quality of care was assessed, controlling for background characteristics, i.e. ward size, and residents' age, gender, length of stay, comorbidities, and care dependency status. Multilevel logistic regression analyses, using a generalized estimating equation approach, were performed. RESULTS: 57% of the wards employed BRNs. In these wards, the BRNs delivered on average 4.8 min of care per resident per day. Among residents living in somatic wards that employed BRNs, the probability of experiencing a fall (odds ratio 1.44; 95% CI 1.06-1.96) and receiving antipsychotic drugs (odds ratio 2.15; 95% CI 1.66-2.78) was higher, whereas the probability of having an indwelling urinary catheter was lower (odds ratio 0.70; 95% CI 0.53-0.91). Among residents living in psychogeriatric wards that employed BRNs, the probability of experiencing a medication incident was lower (odds ratio 0.68; 95% CI 0.49-0.95). For residents from both ward types, the probability of suffering from nosocomial pressure ulcers did not significantly differ for residents in wards employing BRNs. CONCLUSIONS: In wards that employed BRNs, their mean amount of time spent per resident was low, while quality of care on most wards was acceptable. No consistent evidence was found for a relationship between the presence of BRNs in wards and quality of care outcomes, controlling for background characteristics. Future studies should consider the mediating and moderating role of staffing-related work processes and ward environment characteristics on quality of care.

Quality of care in the intensive care unit from the perspective of patient's relatives

BACKGROUND: The quality standards of the Dutch Society of Intensive Care require monitoring of the satisfaction of patient's relatives with respect to care. Currently, no suitable instrument is available in the Netherlands to measure this. This study describes the development and psychometric evaluation of the questionnaire-based Consumer Quality Index 'Relatives in Intensive Care Unit' (CQI 'R-ICU'). The CQI 'R-ICU' measures the perceived quality of care from the perspective of patients' relatives, and identifies aspects of care that need improvement.METHODS: The CQI 'R-ICU' was developed using a mixed method design. Items were based on quality of care aspects from earlier studies and from focus group interviews with patients' relatives. The time period for the data collection of the psychometric evaluation was from October 2011 until July 2012. Relatives of adult intensive care patients in one university hospital and five general hospitals in the Netherlands were approached to participate. Psychometric evaluation included item analysis, inter-item analysis, and factor analysis.RESULTS: Twelve aspects were noted as being indicators of quality of care, and were subsequently selected for the questionnaire's vocabulary. The response rate of patients' relatives was 81% (n = 455). Quality of care was represented by two clusters, each showing a high reliability: 'Communication' (α = .80) and 'Participation' (α = .84). Relatives ranked the following aspects for quality of care as most important: no conflicting information, information from doctors and nurses is comprehensive, and health professionals take patients' relatives seriously. The least important care aspects were: need for contact with peers, nuisance, and contact with a spiritual counsellor. Aspects that needed the most urgent improvement (highest quality improvement scores) were: information about how relatives can contribute to the care of the patient, information about the use of meal-facilities in the hospital, and involvement in decision-making on the medical treatment of the patient.CONCLUSIONS: The CQI 'R-ICU' evaluates quality of care from the perspective of relatives of intensive care patients and provides practical information for quality assurance and improvement programs. The development and psychometric evaluation of the CQI 'R-ICU' led to a draft questionnaire, sufficient to justify further research into the reliability, validity, and the discriminative power of the questionnaire.

The impact of in-service professional development on the quality of teacher-child interactions in early education and care

High-quality interactions between young children and teachers in early childhood education and care (ECEC) are the cornerstone of educational quality. International findings suggest that the quality of interactions that support emotions and classroom organization is at a medium to high level, but the quality of instructional support is at a lower level. Within the “Teaching Through Interactions” framework developed by Hamre and colleagues (2013), several efforts were made to evaluate and improve key teacher-child interactions through in-service training. Our review includes experimental studies that evaluate professional development using the Classroom Assessment Scoring System measures. The systematic literature search and coding of studies was carried out by two independent reviewers. Our review includes 15 recent studies with 18 treatments. The meta-analysis (random effect model) showed an overall statistically significant professional development effect of g = 0.39 (SE = .08), i.e. close to a medium-size effect. In addition, effect sizes were almost equal for interactions related to emotional support, classroom organization, and instructional support (g= 0.35, 0.30, and 0.43, respectively). The quality of experimental studies and professional development was at a high level (e.g., individual component, feedback, or modeling) and experimental findings were generally positive. Our meta-analysis indicates that high-quality in-service programs have the strength to improve teacher-child interactions and pedagogical quality across all three domains.

Caregiver-child relationships in after-school care

Affective teacher–child relationships have frequently been investigated in school settings, but less attention has been devoted to these relationships in after-school care. This study explored caregiver- (N = 90) and child-informed reports (N = 90) of the affective caregiver–child relationship (N = 180 dyads) in Dutch after-school care, exploring gender differences at caregiver and child level and the relationship with a gender match between children and caregivers. The caregivers and children reported relatively high levels of closeness and relatively low level of conflict and dependency/autonomy support, irrespective of gender. Multilevel regression analyses revealed that a gender match between child and caregiver was associated with teacher-reported closeness: levels were highest in female-girl dyads and lowest in male-boy dyads. Further, boys indicated the highest levels of autonomy in male-boy dyads, whereas girls indicated the lowest levels in female-girl dyads. Masculinity of staff was associated with more child-reported autonomy support, whereas femininity predicted caregiver-reported closeness in the relationship.