Background: Patient participation and goal setting appear to be difficult in daily physiotherapy practice, and practical methods are lacking. An existing patient-specific instrument, Patient-Specific Complaints (PSC), was therefore optimized into a new Patient Specific Goal-setting method (PSG). The aims of this study were to examine the feasibility of the PSG in daily physiotherapy practice, and to explore the potential impact of the new method. Methods: We conducted a process evaluation within a non-controlled intervention study. Community-based physiotherapists were instructed on how to work with the PSG in three group training sessions. The PSG is a six-step method embedded across the physiotherapy process, in which patients are stimulated to participate in the goal-setting process by: identifying problematic activities, prioritizing them, scoring their abilities, setting goals, planning and evaluating. Quantitative and qualitative data were collected among patients and physiotherapists by recording consultations and assessing patient files, questionnaires and written reflection reports. Results: Data were collected from 51 physiotherapists and 218 patients, and 38 recordings and 219 patient files were analysed. The PSG steps were performed as intended, but the ‘setting goals’ and ‘planning treatment’ steps were not performed in detail. The patients and physiotherapists were positive about the method, and the physiotherapists perceived increased patient participation. They became aware of the importance of engaging patients in a dialogue, instead of focusing on gathering information. The lack of integration in the electronic patient system was a major barrier for optimal use in practice. Although the self-reported actual use of the PSG, i.e. informing and involving patients, and client-centred competences had improved, this was not completely confirmed by the objectively observed behaviour. Conclusion: The PSG is a feasible method and tends to have impact on increasing patient participation in the goal-setting process. However, its full potential for shared goal setting has not been utilized yet. More implementation effort is needed to achieve the required behaviour change and a truly client-centred attitude, to make physiotherapists totally ready for shared goal setting.
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Adaptive governance describes the purposeful collective actions to resist, adapt, or transform when faced with shocks. As governments are reluctant to intervene in informal settlements, community based organisations (CBOs) self-organize and take he lead. This study explores under what conditions CBOs in Mathare informal settlement, Nairobi initiate and sustain resilience activities during Covid-19. Study findings show that CBOs engage in multiple resilience activities, varying from maladaptive and unsustainable to adaptive, and transformative. Two conditions enable CBOs to initiate resilience activities: bonding within the community and coordination with other actors. To sustain these activities over 2.5 years of Covid-19, CBOs also require leadership, resources, organisational capacity, and network capacity. The same conditions appear to enable CBOs to engage in transformative activities. How-ever, CBOs cannot transform urban systems on their own. An additional condition, not met in Mathare, is that governments, NGOs, and donor agencies facilitate, support, and build community capacities. This is the peer reviewed version of the following article: Adaptive governance by community-based organisations: Community resilience initiatives during Covid‐19 in Mathare, Nairobi. which has been published in final form at doi/10.1002/sd.2682. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions
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This paper theorizes the spiritual processes of community entrepreneuring as navigating tensions that arise when community-based enterprises (CBEs) emerge within communities and generate socio-economic inequality. Grounded on an ethnographic study of a dairy CBE in rural Malawi, findings reveal that intra-community tensions revolve around the occurrence of ‘bad events’ – mysterious tragedies that, among their multiple meanings, are also framed as witchcraft. Community members prepare for, frame, cope and build collective sustenance from ‘bad events’ by intertwining witchcraft and mundane socio-material practices. Together, these practices reflect the mystery and the ambiguity that surround ‘bad events’ and prevent intra-community tensions from overtly erupting. Through witchcraft, intra-community tensions are channelled, amplified and tamed cyclically as this process first destabilizes community social order and then restabilizes it after partial compensation for socio-economic inequality. Generalizing beyond witchcraft, this spiritual view of community entrepreneuring enriches our understanding of entrepreneuring – meant as organization-creation process in an already organized world – in the context of communities. Furthermore, it sheds light on the dynamics of socio-economic inequality surrounding CBEs, and on how spirituality helps community members to cope with inequality and its effects.
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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.
In order to achieve much-needed transitions in energy and health, systemic changes are required that are firmly based on the principles of regard for others and community values, while at the same time operating in market conditions. Social entrepreneurship and community entrepreneurship (SCE) hold the promise to catalyze such transitions, as they combine bottom-up social initiatives with a focus on financially viable business models. SCE requires a facilitating ecosystem in order to be able to fully realize its potential. As yet it is unclear in which way the entrepreneurial ecosystem for social and community entrepreneurship facilitates or hinders the flourishing and scaling of such entrepreneurship. It is also unclear how exactly entrepreneurs and stakeholders influence their ecosystem to become more facilitative. This research programme addresses these questions. Conceptually it integrates entrepreneurial ecosystem frameworks with upcoming theories on civic wealth creation, collaborative governance, participative learning and collective action frameworks.This multidisciplinary research project capitalizes on a unique consortium: the Dutch City Deal ‘Impact Ondernemen’. In this collaborative research, we enhance and expand current data collection efforts and adopt a living-lab setting centered on nine local and regional cases for collaborative learning through experimenting with innovative financial and business models. We develop meaningful, participatory design and evaluation methods and state-of-the-art digital tools to increase the effectiveness of impact measurement and management. Educational modules for professionals are developed to boost the abovementioned transition. The project’s learnings on mechanisms and processes can easily be adapted and translated to a broad range of impact areas.
In the past decades, we have faced an increase in the digitization, digitalization, and digital transformation of our work and daily life. Breakthroughs of digital technologies in fields such as artificial intelligence, telecommunications, and data science bring solutions for large societal questions but also pose a new challenge: how to equip our (future)workforce with the necessary digital skills, knowledge, and mindset to respond to and drive digital transformation?Developing and supporting our human capital is paramount and failure to do so may leave us behind on individual (digital divide), organizational (economic disadvantages), and societal level (failure in addressing grand societal challenges). Digital transformation necessitates continuous learning approaches and scaffolding of interdisciplinary collaboration and innovation practices that match complex real-world problems. Research and industry have advocated for setting up learning communities as a space in which (future) professionals of different backgrounds can work, learn, and innovate together. However, insights into how and under which circumstances learning communities contribute to accelerated learning and innovation for digital transformation are lacking. In this project, we will study 13 existing and developing learning communities that work on challenges related to digital transformation to understand their working mechanisms. We will develop a wide variety of methods and tools to support learning communities and integrate these in a Learning Communities Incubator. These insights, methods and tools will result in more effective learning communities that will eventually (a) increase the potential of human capital to innovate and (b) accelerate the innovation for digital transformation
