Background: Transmural palliative care interventions aim to identify older persons with palliative care needs and timely provide advance care planning, symptom management, and coordination of care. Nurses can have an important role in these interventions; however, their expertise is currently underused. A new transmural care pathway with a central role for the community care registered nurse in advance care planning aims to contribute to the quality of palliative care for older persons. Objective: To examine the perspectives of community nurses on the feasibility of a new transmural care pathway for advance care planning for older persons. Design: A qualitative study design using semi-structured interviews. Setting(s): Interviews were performed with community nurses of three participating homecare organizations in the Netherlands between March and May 2023. Participants: 19 community nurses. Methods: A topic guide was based on (1) challenges in advance care planning identified from the literature and (2) concepts that are important in assessing the feasibility of complex healthcare interventions provided by the Normalisation Process Theory framework. A combined inductive and deductive thematic analysis was performed. Results: Four themes were identified: views on the transmural care pathway, community nurses’ needs to fulfil their role, key points regarding implementation, and evaluation of the new practice. In general, community nurses were positive about the feasibility of the new practice as it provided a more structured work process that could facilitate interprofessional collaboration and improve the quality of palliative care. Overall, the feasibility of the new practice, from community nurses perspective, was determined by (1) clear roles and responsibilities in the transmural care pathway, (2) standardized registration of advance care planning, and (3) close involvement of community nurses in the whole implementation process. Conclusions: We highlighted important factors, from the perspectives of community nurses, that need to be considered in the implementation of a new transmural care pathway for advance care planning. A clear division of roles and responsibilities, standardized registration of advance care planning, and involvement of community nurses during the whole implementation process were mentioned as important enabling factors. This knowledge might contribute to successful implementation of a transmural care pathway that aims to enhance the quality of palliative care for older persons. Tweetable abstract: Community nurses’ perspectives on the feasibility of a transmural care pathway for advance care planning for older persons.
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The transition taking place within the Dutch healthcare system has been a central theme in politics and public debate for decades. The recent changes again demand the full attention of researchers and educators in the field. In this article, we reflect on the current ideology and goals of the transition and link these to the range of ideas that lie behind the ideal of “community care”. Additionally, we pose the question of what these changes may mean for research and education within the social care domain in general and for our research group in particular. The AUAS Community Care Research Group covers a variety of research topics that are clustered into three “streams”: informal care, social inclusion and network strengthening. Within these streams, we focus on care by society and link this to professional caregiving. We will also explain why our research interests are specifically relevant in the context of the transition of the healthcare system, as this transition explicitly accentuates the importance of a “caring society” and thus a change in role for the care professional. We will also reflect on how we can best translate our research results into the curriculum of education programmes for students who will soon work as professionals in the social and/or care domains.
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Community care is becoming increasingly important. In the Netherlands, the percentage of people over the age of 65 is expected to increase to 22% by 2025, leading to more elderly patients, often with long-term and complex health problems (multimorbidity). Because many of these patients continue to live at home until a very old age, nurses are increasingly working outside of institutions. The 17 Dutch Bachelor nursing programmes responded to this development with a new national education profile 'Bachelor Nursing 2020 (BN2020)’ with more elements of community care. However, despite the increase in extramural care, the Dutch labour market has a shortage of community nurses with higher professional education qualifications, partly because most nursing students focus on the general hospital setting as the environment for their future career. Whether this is based on a perception of community care that deters making this choice has never been systematically investigated. It is also unclear whether a more community-oriented curriculum will better equip students for working in community care. In response to these issues, the nursing programme at the Amsterdam University of Applied Sciences (AUAS) redesigned its curriculum to include more elements of community care. Three perspectives were chosen for the redesign: (1) the influence of lecturers as role models, (2) positive placement experiences, and (3) five new ‘community-based’ themes in education. These new themes are as follows: patient self-management, shared decision-making, collaboration with the patients’ social system, healthcare technology, and allocation of care. The redesign also includes a ‘paved way’ into community care in the form of a coherent and attractive programme for interested students.This thesis describes whether and how the curriculum-redesign within higher professional education in nursing can be effective in terms of (1) stimulating a positive perception of community care and (2) realising a form of community care in line with the new themes in BN2020. In other words, that students will base choices in their actions/nursing interventions on these new themes in the education profile.
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As the Dutch population is aging, the field of music-in-healthcare keeps expanding. Healthcare, institutionally and at home, is multiprofessional and demands interprofessional collaboration. Musicians are sought-after collaborators in social and healthcare fields, yet lesser-known agents of this multiprofessional group. Although live music supports social-emotional wellbeing and vitality, and nurtures compassionate care delivery, interprofessional collaboration between musicians, social work, and healthcare professionals remains marginal. This limits optimising and integrating music-making in the care. A significant part of this problem is a lack of collaborative transdisciplinary education for music, social, and healthcare students that deep-dives into the development of interprofessional skills. To meet the growing demand for musical collaborations by particularly elderly care organisations, and to innovate musical contributions to the quality of social and healthcare in Northern Netherlands, a transdisciplinary education for music, physiotherapy, and social work studies is needed. This project aims to equip multiprofessional student groups of Hanze with interprofessional skills through co-creative transdisciplinary learning aimed at innovating and improving musical collaborative approaches for working with vulnerable, often older people. The education builds upon experiential learning in Learning LABs, and collaborative project work in real-life care settings, supported by transdisciplinary community forming.The expected outcomes include a new concept of a transdisciplinary education for HBO-curricula, concrete building blocks for a transdisciplinary arts-in-health minor study, innovative student-led approaches for supporting the care and wellbeing of (older) vulnerable people, enhanced integration of musicians in interprofessional care teams, and new interprofessional structures for educational collaboration between music, social work and healthcare faculties.
Samenvatting Mensen met een beperking (psychiatrisch, verstandelijk, lichamelijk) wonen tegenwoordig vaker zelfstandig en doen voor hun ondersteuning daarom vaker een beroep op mensen in de buurt waar zij wonen. Dit betekent voor de professionele hulpverleners dat zij een steeds grotere taak krijgen in het versterken van het sociale netwerk van mensen met een beperking, en het (op deze wijze) bevorderen van inclusie in de buurt. In hun werk merken zorg- en welzijnsprofessionals op dat, soms relatief spontaan ingezette of kleine initiatieven succesvol kunnen zijn, maar soms ook niet. De professionals hebben wel ideeën over wat goed werkt en wat niet, maar dit is niet op één centrale plek vastgelegd, en daarbij soms onduidelijk en afhankelijk van de context. Zij vragen zich af hoe ze de informatie die ze elk hebben kunnen bundelen en tot meer inzicht kunnen komen in wat werkt, in welke situatie en in welke context. In het project wordt samengewerkt door de Hogeschool van Amsterdam (AKMI / Lectoraat Community Care), de Sociaal Werkopleidingen van de HvA, de Afdeling onderwijs, jeugd en zorg van de Gemeente Amsterdam, GGD Amsterdam, Cliëntenbelang Amsterdam, Centrum voor Cliëntervaringen (i.s.m. VuMcAmsterdam), De Regenbooggroep, Cordaan en Stichting Prisma. In dit onderzoek zullen drie verschillende buurtgerichte interventies worden getoetst aan de hand van de ‘what works’ principes (wwp). De interventies gericht op het bevorderen van de sociale inclusie van mensen met beperkingen in de buurt worden geëvalueerd door cliënten/ ervaringsdeskundigen, zorg- en welzijnsprofessionals en buurtbewoners. Voor dit onderzoek is gekozen voor ‘realis evaluation’, waarin niet het effect op zich wordt onderzocht, maar de werkzame elementen van een interventie. Belangrijke opbrengsten van het project zijn: 1) het determineren en beschrijven van werkzame elementen die leidend kunnen zijn voor het bedenken en/of beoordelen van initiatieven om de netwerken van mensen met een beperking in de buurt te versterken; 2) op basis daarvan een handreiking bieden voor professionals.
Dutch society faces major future challenges putting populations’ health and wellbeing at risk. An ageing population, increase of chronic diseases, multimorbidity and loneliness lead to more complex healthcare demands and needs and costs are increasing rapidly. Urban areas like Amsterdam have to meet specific challenges of a growing and super divers population often with a migration background. The bachelor programs and the relating research groups of social work and occupational therapy at the Amsterdam University of Applied Sciences innovate their curricula and practice-oriented research by multidisciplinary and cross-domain approaches. Their Centres of Expertise foster interprofessional research and educational innovation on the topics of healthy ageing, participation, daily occupations, positive health, proximity, community connectedness and urban innovation in a social context. By focusing on senior citizens’ lives and by organizing care in peoples own living environment. Together with their networks, this project aims to develop an innovative health promotion program and contribute to the government missions to promote a healthy and inclusive society. Collaboration with stakeholders in practice based on their urgent needs has priority in the context of increasing responsibilities of local governments and communities. Moreover, the government has recently defined social base as being the combination of citizen initiatives, volunteer organizations , caregivers support, professional organizations and support of vulnerable groups. Kraktie Foundations is a community based ethno-cultural organization in south east Amsterdam that seeks to research and expand their informal services to connect with and build with professional care organizations. Their aim coincides with this project proposal: promoting health and wellbeing of senior citizens by combining intervention, participatory research and educational perspectives from social work, occupational therapy and hidden voluntary social work. With a boundary crossing innovation of participatory health research, education and Kraktie’s work in the community we co-create, change and innovate towards sustainable interventions with impact.
