Introduction: The notion of autonomy in Self-Determination Theory is at the core of intrinsically motivated learning, and fulfilment of the need for autonomy is essential for thriving at school. Therefore teacher-provided autonomy support has grown into a key concern in educational research. In the present study into primary school music education, the notion of creative autonomy support is introduced. Research into autonomy support is typically focused on verbal interaction. However, from an enactive perspective, teachers’ gesturing, bodily movement, facial expression, and musical action form an integral part of the socially situated interaction in music lessons, inherently involving autonomy support. In the present study, a distinction is made between creative verbal autonomy support and creative musical and non-verbal autonomy support.Methods: Applying a process-based time-serial methodology, rooted in a Complex Dynamic Systems and Enactive perspective, the effects of an intervention with Video Feedback Coaching for teachers were investigated. Video data of 105 music lessons of 18 teachers (intervention and control condition) from six primary schools was gathered, to examine teachers’ creative autonomy support at both the individual and group level.Results: The findings show that teachers in the intervention condition, compared to the control group, achieved a meaningful increase in their ability to offer creative autonomy support verbally. Teachers also showed development for the non-verbal and musical aspects of offering creative autonomy support. However, particularly for offering higher-level creative autonomy support in the non-verbal and musical mode, significant results were found for less than half of the intervention teachers.Discussion: These results underline the importance of embracing and studying the bodily dimension as an integral part of teacher autonomy support, aimed at emergence of students’ musical creativity, in primary school music education and in teacher training. We explain how these results might be relevant for autonomy enhancing musical activities in vulnerable groups.
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In primary music education a key question is what teachers can do to stimulate students’ musical creativity. For the answer, delving into teacher-student interaction during the creative processes in the naturalistic setting of primary music lessons is required. Twenty-six music lessons from thirteen teachers and their classes of seven Dutch schools were recorded to explore the relation between teachers’ autonomy support and students’ divergent and convergent thought & action. Quantitative sequential analysis and thematic analysis were combined to examine this relation, using a framework offered by Complex Dynamic Systems theory and Enaction theory. In contrast to classical correla-tional analysis, sequential analysis focuses on the dynamics, and thus on the temporal relation in classroom interaction. The results show that mostly lower-level autonomy support was offered. Es-pecially in creative lessons, higher-level autonomy support is more likely to lead to higher-level student divergent thought and action. For convergent thought and action, the results were less con-clusive. An implication of the findings is that (research into) music education could benefit from interventions aimed at enhancing autonomy support in primary school music.
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Most people with dementia (PwD) are cared for by unpaid family carers, many of whom must balance caring with paid work. This regularly entails dealing with care-related emergencies (CRE). This study aims to explore the impact of carers’ autonomy at work regarding breaks, schedule, and place on their ability to manage CRE, and use technology to that end. We conducted interviews with 16 working carers of PwD in Scotland. Data were analysed thematically to identify key themes. Autonomy at work appeared on a spectrum from no to complete autonomy. Carers’ position on this spectrum was often dynamic and determined by the nature of their work, their workplace culture and regulations, and their line managers’ support – or clients in the case of self-employed carers. Break autonomy allowed carers to use technology to be notified of and delegate the CRE response. Schedule autonomy allowed for an in-person response to CRE. Place autonomy allowed carers to work and care simultaneously, which enabled them to manage CRE immediately but presented them with additional challenges. Distance between workplace and PwD’s residence impacted carers’ ability to manage CRE, despite having complete autonomy. Implications for healthcare professionals, service providers, employers, policymakers, and technology developers are presented.
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Introduction: In 2011 5,3 million people had a chronic disease. Secondly patients want to have more influence in regulating their own disease. Self-management is increasingly being mentioned as a possible solution. However the practice learns that this involves ethical dilemmas, which nurses are often confronted with. Aim: ‘What factors are important for nurses who promote self-management in patient with a chronical disease to maintain a healthy lifestyle, while taking into account de patients’ autonomy?Method: a literature search was done in databases Pubmed and Cochrane. Inclusion criteria were: Qualitative research studies published after 2003 in English or Dutch language, concerning adult patients with a chronical disease and related to the nursing profession.Secondly a semi-structural interview was done with two dialysis care professionals and transcripted verbatim. Results: Six studies met the selection criteria and were used to answer the question. The literature data indicate five factors that influence self-management: (1) Professional attitude of nurses: nurses use their own values and convictions in ethical decisions which leads to moral conflicts (2) Shared-decision making: sharing knowledge as a professional with the patient is a significant component in giving the patient autonomy (3) Patient directed support contributes to the success of self-management (4) Change of the traditional relation as professional-patient into a professional cooperation (5) Reflection on ethical dilemmas.During the semi-structural interviews as most important aspects of self-management were mentioned that patients must be informed adequately and supported by making decisions. Patients autonomy must be central in the organization of care. Conclusion: Within self-management the patient should be in a central position. While performing self management care, nurses can be confronted with personal opinions that conflict with patients’ values. Shared decision making, patient directed support, professional attitude of the caregivers and reflection on ethical dilemmas, are key elements for effective self-management.
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Behaviour Change Support Systems (BCSS), already running for the 10th time at Persuasive Technology, is a workshop that builds around the concept of systems that are specifically designed to help and support behaviour change in individuals or groups. The highly multi-disciplinary nature of designing and implementing behaviour change strategies and systems for the strategies has been in the forefront of this workshop from the very beginning. The persuasive technology field is becoming a linking pin connecting natural and social sciences, requiring a holistic view on persuasive technologies, as well as multi-disciplinary approach for design, implementation, and evaluation. So far, the capacities of technologies to change behaviours and to continuously monitor the progress and effects of interventions are not being used to its full potential. The use of technologies as persuaders may shed a new light on the interaction process of persuasion, influencing attitudes and behaviours. Yet, although human- computer interaction is social in nature and people often do see computers as social actors, it is still unknown how these interactions re-shape attitude, beliefs, and emotions, or how they change behaviour, and what the drawbacks are for persuasion via technologies. Humans re-shape technology, changing their goals during usage. This means that persuasion is not a static ad hoc event but an ongoing process. Technology has the capacity to create smart (virtual) persuasive environments that provide simultaneously multimodal cues and psycho-physiological feedback for personal change by strengthening emotional, social, and physical presence. An array of persuasive applications has been developed over the past decade with an aim to induce desirable behaviour change. Persuasive applications have shown promising results in motivating and supporting people to change or adopt new behaviours and attitudes in various domains such as health and wellbeing, sustainable energy, education, and marketing. This workshop aims at connecting multidisciplinary researchers, practitioners and experts from a variety of scientific domains, such as information sciences, human-computer interaction, industrial design, psychology and medicine. This interactive workshop will act as a forum where experts from multiple disciplines can present their work, and can discuss and debate the pillars for persuasive technology.
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Abstract: Technological innovation in the healthcare sector is increasing, but integration of information technology (IT) in the care process is difficult. Healthcare workers are important agents in this IT integration. The purpose of this study is to explore factors that feed motivation to use IT. Self-determination theory (SDT) is applied to study how motivational factors impact effective IT use among frontline caregivers in residential care settings. As the team is very important to these caregivers, the team is our unit of analysis. In an embedded single case study design, interviews were conducted with all nine members of a team effectively using IT. All three basic psychological needs from SDT - autonomy, competence and relatedness - were found to have impact on effective IT use, though autonomy was primarily experienced at team level. Conversely, the effective use of an IT collaboration tool influences relatedness.
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Background The global nursing shortages exacerbated by the COVID-19 pandemic necessitated a drastic reorganization in nursing practices. Work routines, the composition of teams and subsequently mundane nursing practices were all altered to sustain the accessibility and quality of care. These dramatic changes demanded a reshaping of the nurses’ work environment. The aim of this study was to explore how nurses reshaped their work environment in the early stages of the COVID-19 pandemic. Methods A descriptive study comprising 26 semi-structured interviews conducted in a large Dutch teaching hospital between June and September 2020. Participants were nurses (including intensive care unit nurses), outpatient clinic assistants, nurse managers, and management (including one member of the Nurse Practice Council). The interviews were analysed with open, axial, and selective coding. Results We identified five themes: 1) the Nursing Staff Deployment Plan created new micro-teams with complementary roles to meet the care needs of COVID-19 infected patients; 2) nurse-led adaptations effectively managed the increased workload, thereby ensuring the quality of care; 3) continuous professional development ensured adequate competence levels for all roles; 4) interprofessional collaboration resulted in experienced solidarity, a positive atmosphere, and increased autonomy for nurses; and, 5) supportive managers reduced nurses’ stress and improved work conditions. Conclusions This study showed that nurses positively reshaped their work environment during the COVID-19 pandemic. They contributed to innovative solutions in an environment of equal interprofessional collaboration, which led to greater respect for their knowledge and competencies, enhanced their autonomy and improved management support.
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Background The global nursing shortages exacerbated by the COVID-19 pandemic necessitated a drastic reorganization in nursing practices. Work routines, the composition of teams and subsequently mundane nursing practices were all altered to sustain the accessibility and quality of care. These dramatic changes demanded a reshaping of the nurses’ work environment. The aim of this study was to explore how nurses reshaped their work environment in the early stages of the COVID-19 pandemic. Methods A descriptive study comprising 26 semi-structured interviews conducted in a large Dutch teaching hospital between June and September 2020. Participants were nurses (including intensive care unit nurses), outpatient clinic assistants, nurse managers, and management (including one member of the Nurse Practice Council). The interviews were analysed with open, axial, and selective coding. Results We identified five themes: 1) the Nursing Staff Deployment Plan created new micro-teams with complementary roles to meet the care needs of COVID-19 infected patients; 2) nurse-led adaptations effectively managed the increased workload, thereby ensuring the quality of care; 3) continuous professional development ensured adequate competence levels for all roles; 4) interprofessional collaboration resulted in experienced solidarity, a positive atmosphere, and increased autonomy for nurses; and, 5) supportive managers reduced nurses’ stress and improved work conditions. Conclusions This study showed that nurses positively reshaped their work environment during the COVID-19 pandemic. They contributed to innovative solutions in an environment of equal interprofessional collaboration, which led to greater respect for their knowledge and competencies, enhanced their autonomy and improved management support.
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This article describes a European project which was aimed at improving the situation of persons with psychiatric or learning disabilities with regard to social participation and citizenship. The project took place in three countries (Estonia, Hungary and the Netherlands) and four cities (Tallinn, Budapest, Amersfoort and Maastricht). The project included research and actions at the policy level, the organizational level and the practice level. At the policy level, the framework of the United Nations Convention on the Rights of Persons with Disabilities (United Nations, 2006) and the European Disability Strategy (European Commission, 2010) were used to look at national and local policies, at the reality of the lives of those with disabilities and at the support that professional services offer with regard to participation and inclusion. The project generated a number of insights, recommendations and methods by which to improve the quality of services and increase the number of opportunities for community engagement. In this article, we present some of the lessons learned from the meta-analysis. Although the circumstances in each country are quite different with regard to policy, culture and service systems, it is remarkable that people with disabilities face many of the same problems. The study shows that in all three countries, access to services could be improved. Barriers include bureaucratic procedures and a lack of services. The research identified that in every country and city there are considerable barriers regarding equal participation in the field of housing, work and leisure activities. In addition to financial barriers, there are the barriers of stigma and self-stigmatization. Marginalization keeps people in an unequal position and hinders their recovery and participation. In all countries, professionals need to develop a stronger focus on supporting the participation of their clients in public life and in the development of different roles pertaining to citizenship
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