Some patients in psychiatric treatment are considered extremely difficult to treat because of the disruptive nature of their relationships with treatment staff. In this paper, we describe and evaluate a specialist inpatient treatment program for these patients. Data were collected from medical records and daily reports of patients (n = 108). Pretest-posttest measurements were used to evaluate the treatment. The main treatment method consists of the provision of safety, structure, and cooperation. Treatment results show statistically significant changes from admittance to discharge. The collaborative and consistent manner in which nurses approach the patients is crucial for quality of care.
Purpose of review: To summarize the latest research on the risks and consequences of the burden that may be imposed on informal carers of persons living and dying with advanced heart failure.Recent findings: A systematic search in PubMed over the period 2013–2014 ultimately revealed 24 original articles included in this review. From this research update it can be concluded that the body of knowledge increased with more studies focusing on caregivers of patients with advanced heart failure.Summary: Caregivers are important partners in care and their lives are seriously affected by the condition of advanced heart failure. Studies on the longitudinal effects of the caregiving role on caregiver's quality of life and on caregiver contributions to patient outcomes is still scarce. Focus of current research is moving towards relationship aspects. Dyadic-care typologies and the concept of incongruence within dyads in terms of conflicting perspectives on how to manage the heart failure are new and important concepts presented in studies presented in this review. Heart failure patients and their caregivers still lack sufficient palliative care and communication on prognosis and end-of-life care. More research is needed to determine the optimal time to start palliative interventions to support caregivers of patients with advanced heart failure.
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The impact of organized youth sport on youth development depends on various conditions in the pedagogical climate, such as how sport is delivered by youth sport coaches. While this is broadly acknowledged and provides a basis to improve youth sport and its developmental outcomes, little is known about the pedagogical perspectives of youth coaches on their practice. This study uses semi-structured interviews with 32 youth sport coaches in diverse youth sport contexts in the Netherlands. Reflexive data analysis is employed to garner insights into coaches’ role perceptions, coaching goals, and underlying values. The findings show that while youth coaches focus on sport-centered activities, many foreground non-sport dimensions such as life mentoring and working towards social inclusion as critical elements of their work, reflected in five pedagogically-oriented goals: discipline, autonomy, resilience, social abilities, and aspirations. Underlying these goals are pedagogical values such as building and maintaining caring relationships with participants. These goals and values echo scientific literature on pedagogical sport climate conditions (e.g. positive youth development), and challenge notions of youth sport as a performance-oriented and uncaring setting. The results contribute to existing knowledge about youth coaches’ pedagogical orientations, and inform the development of strategies to stimulate positive sport practices and developmental outcomes for participants.
