Purpose: This study aimed to develop and pretest a systematic conversation approach for nurses to tailor aftercare to oncology patient's goals, unmet needs and wishes. Methods: We used an iterative developmental process for complex interventions: 1. Identifying problems 2. Identifying overall objectives 3. Designing the intervention 4. Pretesting and adapting the intervention. Results: The main results of the problem identification were: non-systematic and incomplete screening of potential issues, caveats in providing information, and shared decision-making. The overall objective formulated was: To develop a model for aftercare conversations based on shared goal-setting and decision-making. The conversation approach consists of four phases: 1. Preparation of the consultation including a questionnaire, 2. Shared goal-setting by means of a tool visualizing domains of life, and 3. Shared care planning by means of an overview of possible choices in aftercare, a database with health care professionals and a cancer survivorship care plan. 4. Evaluation. The results of the pretest revealed that the conversation approach needs to be flexible and tailored to the patient and practice setting, and embedded in the care processes. The conversation approach was perceived as enhancing patient-centeredness and leading to more in-depth consultations. Conclusion: The conversation approach was developed in co-creation with stakeholders. The results of the pretest revealed important implications and suggestions for implementation in routine care. The aftercare conversation approach can be used by nurses to provide tailored patient-centered evidence-based aftercare. Tailored aftercare should support oncology patient's goals, unmet needs and wishes. Further tailoring is needed.
DOCUMENT
Schön describes the way a designer engages with their materials as a “conversation”. In clothing design this typically involves tangible and situated actions such as draping, ripping, and cutting—actions that evoke responses from the fabric at hand. Dynamic fabrics—surface- changing fabrics that combine digital and physical states— are still novel fashion-design materials. When working with the digital, intangible qualities of these fabrics, how does a dialogue unfold for designers accustomed to working physically with fabrics? In this paper we examine the design process of Phem, a collection of garments that use dynamic fabrics that function similarly to augmented reality. We reflect upon the improvisations required to satisfy a productive dialogue with the digital forms of these materials. We conclude with a discussion that proposes revisiting Schön’s notion of a conversation in the context of digital forms, and use Ingold’s perspectives on making to inform this inquiry.
DOCUMENT
In this case study, we want to gain insights into how residents of three municipalities communicate about the new murder scenario of the cold case of Marianne Vaatstra and the possibility of a large-scale DNA familial searching. We investigate how stakeholders shape their arguments in conversation with each other and with the police. We investigate the repertoires that participants use to achieve certain effects in their interactions with others in three focus groups. The results show that the analyzed repertoires are strong normative orientated. We see two aspects emerge that affect the support for large-scale DNA familial searching. These are: 1. Cautious formulations: respondents showed restraint in making personal judgments and often formulated these on behalf of others. Participants would not fully express themselves, but adjusted to what seemed the socially desirable course. 2. Collective identity: respondents focused on the similarities between themselves and the needs, interests, and goals of other participants. Participants also tried in a discursive way to convince each other to participate in the large-scale familial searching. These two major discursive activities offered the communication discipline guidance for interventions into the subsequent communication strategy.
MULTIFILE
