Eind 2009 publiceerden Ghislain Verstraete en Rik Pinxten een bundel essays onder de titel 'Doe-het-zelfdemocratie'. Een boek over 'mensen en hun rol in de samenleving' (Verstraete & Pinxten, 2009). Uit de titel wordt al duidelijk dat Verstraete en Pinxten een pleidooi houden voor nieuwe vormen van actief burgerschap. Gedaan met consumentisme en leunen op de overheid. Leve de actieve burger die de handen uit de mouwen steekt en zijn steentje bijdraagt aan de samenleving. Het boek bevat zeven hoofdstukken waarin telkens de burger als producent op een bepaald terrein beschreven wordt. Helaas ontbreekt een hoofdstuk over de zorgende mens: de burger die zorg draagt voor zichzelf maar vooral voor andere 'kwetsbare' burgers. In deze tekst willen we een aanzet geven tot zo'n hoofdstuk over de mens als zorger. We doen dat door de recente ontwikkelingen in de Nederlandse sociale sector te beschrijven en meer specifiek de Wet maatschappelijke ondersteuning. Na een korte toelichting en update over deze wet komen we terecht bij het werk van Hans Achterhuis. Elders in dit nummer van ALERT komt hij ook aan bod, onder meer naar aanleiding van zijn boek over geweld. Wij komen bij Achterhuis terecht omwille van zijn werk over utopieën (Achterhuis, 1998, 2010). Bij het overzien van de Wmo en de eerste jaren werking van het nieuwe sociaal beleid dringt zich immers snel de vraag op of er geen sprake is van een bundel beleidsutopieën. Maar ook de vraag of dat erg is, en of het wel te vermijden is.
Background: The importance of clarifying goals and providing process feedback for student learning has been widely acknowledged. From a Self-Determination Theory perspective, it is suggested that motivational and learning gains will be obtained because in well-structured learning environments, when goals and process feedback are provided, students will feel more effective (need for competence), more in charge over their own learning (need for autonomy) and experience a more positive classroom atmosphere (need for relatedness). Yet, in spite of the growing theoretical interest in goal clarification and process feedback in the context of physical education (PE), little experimental research is available about this topic. Purpose: The present study quasi-experimentally investigated whether the presence of goal clarification and process feedback positively affects students’ need satisfaction and frustration. Method: Twenty classes from five schools with 492 seventh grade PE students participated in this quasi-experimental study. Within each school, four classes were randomly assigned to one of the four experimental conditions (n = 121, n = 117, n = 126 and n = 128) in a 2 × 2 factorial design, in which goal clarification (absence vs. presence) and process feedback (absence vs. presence) were experimentally manipulated. The experimental lesson consisted of a PE lesson on handstand (a relatively new skill for seventh grade students), taught by one and the same teacher who went to the school of the students to teach the lesson. Depending on the experimental condition, the teacher either started the lesson explaining the goals, or refrained from explaining the goals. Throughout the lesson the teacher either provided process feedback, or refrained from providing process feedback. All other instructions were similar across conditions, with videos of exercises of differential levels of difficulty provided to the students. All experimental lessons were observed by a research-assistant to discern whether manipulations were provided according to a condition-specific script. One week prior to participating in the experimental lesson, data on students’ need-based experiences (i.e. quantitatively) were gathered. Directly after students’ participation in the experimental lesson, data on students’ perceptions of goal clarification and process feedback, need-based experiences (i.e. quantitatively) and experiences in general (i.e. qualitatively) were gathered. Results and discussion: The questionnaire data and observations revealed that manipulations were provided according to the lesson-scripts. Rejecting our hypothesis, quantitative analyses indicated no differences in need satisfaction across conditions, as students were equally satisfied in their need for competence, autonomy and relatedness regardless of whether the teacher provided goal clarification and process feedback, only goal clarification, only process feedback or none. Similar results were found for need frustration. Qualitative analyses indicated that, in all four conditions, aspects of the experimental lesson made students feel more effective, more in charge over their own learning and experience a more positive classroom atmosphere. Our results suggest that under certain conditions, lessons can be perceived as highly need-satisfying by students, even if the teacher does not verbally and explicitly clarify the goals and/ or provides process feedback. Perhaps, students were able to self-generate goals and feedback based on the instructional videos.
Background: Joint bleeds are the hallmark of hemophilia, leading to a painful arthritic condition called as hemophilic arthropathy (HA). Exercise programs are frequently used to improve the physical functioning in persons with HA. As hemophilia is a rare disease, there are not many physiotherapists who are experienced in the field of hemophilia, and regular physiotherapy sessions with an experienced physiotherapist in the field of hemophilia are not feasible for persons with HA. Blended care is an innovative intervention that can support persons with HA at home to perform the advised physical activities and exercises and provide self-management information. Objective: The aim of this study was to develop a blended physiotherapy intervention for persons with HA. Methods: The blended physiotherapy intervention, namely, e-Exercise HA was developed by cocreation with physiotherapists, persons with HA, software developers, and researchers. The content of e-Exercise HA was compiled using the first 3 steps of the Center for eHealth Research roadmap model (ie, contextual inquiry, value specification, and design), including people with experience in the development of previous blended physiotherapy interventions, a literature search, and focus groups. Results: A 12-week blended intervention was developed, integrating face-to-face physiotherapy sessions with a web-based app. The intervention consists of information modules for persons with HA and information modules for physiotherapists, a graded activity program using a self-chosen activity, and personalized video-supported exercises. The information modules consist of text blocks, videos, and reflective questions. The patients can receive pop-ups as reminders and give feedback on the performance of the prescribed activities. Conclusions: In this study, we developed a blended physiotherapy intervention for persons with HA, which consists of information modules, a graded activity program, and personalized video-supported exercises.
LINK
