De vraag is of onderwijsinstellingen voorzien in leeromgevingen die verlangde competenties voor digitalisering versterken. Meerdere auteurs menen dat dit niet het geval is. Anders dan bij sectoren die eerder grensverleggende ICT-innovaties ondergingen, is het grootste deel van de processen in en rond leeromgevingen in het onderwijs, marginaal en niet fundamenteel door en voor de ICT-revolutie veranderd. Dat staat op gespannen voet met intensiteit en belang van ICT-gebruik in de samenleving, zoals bij jongeren. De dissertatie wil een bijdrage leveren aan het overbruggen van de kloof en een grotere verantwoordelijkheid van het onderwijs bereiken voor digitale competenties. Het onderzoek beperkt zich tot het hbo. De eerste twee hoofdstukken van de dissertatie bestaan uit literatuurverkenningen over de betekenis van ICT en digitale competenties. Voor het empirische deel werden leertheoretische uitgangspunten geformuleerd in vier categorieën: inhoud, drijfveren, interactie en omgeving. De onderzoeksopzet voorzag in een verkennende en een verdiepende studie bij de opleiding Small Business & Retail Management van Hogeschool Zuyd. De verkennende studie geeft een beeld van de opleiding vanuit drie perspectieven: 1) formuleringen in beleid en formeel beschreven, 2) percepties van docenten, management, beleidsmakers en instanties en 3) ervaringen van studenten. De verdiepende studie leidde tot 49 bevindingen. Deze resulteerden in 12 ontwerpprincipes voor leeromgevingen die betrekking hebben op besturende, primaire en ondersteunende processen. De principes kunnen vorm geven aan leeromgevingen die digitale competenties van hbo-studenten voor een gedigitaliseerde samenleving versterken. Zij kunnen er tevens aan bijdragen slagvaardigheid met ICT te vergroten.
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Objective: To gain insight into how communication vulnerable people and health-care professionals experience the communication in dialogue conversations, and how they adjust their conversation using augmentative and alternative communication (AAC) or other communication strategies. Methods: Communication vulnerable clients and health-care professionals in a long-term care institution were observed during a dialogue conversation (n = 11) and subsequently interviewed (n = 22) about their experiences with the conversation. The clients had various communication difficulties due to different underlying aetiologies, such as acquired brain injury or learning disorder. Results from the observations and interviews were analysed using conventional content analysis. Results: Seven key themes emerged regarding the experiences of clients and professionals: clients blame themselves for miscommunications; the relevance of both parties preparing the conversation; a quiet and familiar environment benefitting communication; giving clients enough time; the importance and complexity of nonverbal communication; the need to tailor communication to the client; prejudices and inexperience regarding AAC. The observations showed that some professionals had difficulties using appropriate communication strategies and all professionals relied mostly on verbal or nonverbal communication strategies. Conclusion: Professionals were aware of the importance of preparation, sufficient time, a suitable environment and considering nonverbal communication in dialogue conversations. However, they struggled with adequate use of communication strategies, such as verbal communication and AAC. There is a lack of knowledge about AAC, and professionals and clients need to be informed about the potential of AAC and how this can help them achieve equal participation in dialogue conversations in addition to other communication strategies.
The background and purpose of this paper is to investigate adherence, exercise performance levels and associated factors in head and neck cancer (HNC) patients participating in a guided home-based prophylactic exercise program during and after treatment [swallowing sparing intensity modulated radiation therapy (SW-IMRT)]. Fifty patients were included in the study. Adherence was defined as the percentage of patients who kept up exercising; exercise performance level was categorized as low: ≤1, moderate: 1–2, and high: ≥2 time(s) per day, on average. Associations between 6- and 12-week exercise performance levels and age, gender, tumour site and stage, treatment, intervention format (online or booklet), number of coaching sessions, and baseline HNC symptoms (EORTC-QLQ-H&N35) were investigated. Adherence rate at 6 weeks was 70% and decreased to 38% at 12 weeks. In addition, exercise performance levels decreased over time (during 6 weeks: 34% moderate and 26% high; during 12 weeks: 28% moderate and 18% high). The addition of chemotherapy to SW-IMRT [(C)SW-IMRT] significantly deteriorated exercise performance level. Adherence to a guided home-based prophylactic exercise program was high during (C)SW-IMRT, but dropped afterwards. Exercise performance level was negatively affected by chemotherapy in combination with SW-IMRT.
