Abstract Objective This was to elucidate the experiences and perceptions of people with severe mental illness (SMI) and their health care professionals with the SMILE (Severe Mental Illness Lifestyle Evaluation) group-based lifestyle intervention. SMILE focuses primarily on promoting healthy diet, physical activity and weight loss. Method A qualitative study with semi-structured interviews was conducted using purposive sampling. Interviews were conducted with 15 clients and 13 health care professionals (HCPs). Data were analysed according to a thematic analysis. Results Four overall themes were identified: interest in a lifestyle programme; group-based setting; changes in lifestyle behaviour; and preconditions for changing health behaviour. The results showed that clients valued the programme and were interested in the subject of lifestyle. The group-based setting was seen as a positive and important aspect of the intervention. Making lifestyle changes was acknowledged as difficult, especially in combination with the presence of psychiatric symptoms. Clients acquired an improved awareness of different aspects related to lifestyle behaviour. Irrespective of weight loss achieved, clients found their efforts successful with relatively ‘small’ changes. Some needed more support during the intervention than others. The practical activities in group sessions were regarded as most useful. HCPs were enthusiastic about the programme and their interactions with lifestyle improvements. Conclusions The results of this study shed light on different aspects that were considered important when delivering a lifestyle intervention to people with SMI. We recommend considering these aspects when implementing a lifestyle intervention in a mental health care setting for clients with SMI.
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The purpose of this study was to provide insight into the interplay between student perceptions of competence-based assessment and student self-efficacy, and how this influences student learning outcomes. Results reveal that student perceptions of the form authenticity aspect and the quality feedback aspect of assessment do predict student self-efficacy, confirming the role of mastery experiences and social persuasions in enhancing student self-efficacy as stated by social cognitive theory. Findings do not confirm mastery experiences as being a stronger source of self-efficacy information than social persuasions. Study results confirm the predictive role of students’ self-efficacy on their competence outcomes. Mediation analysis results indicate that student’s perceptions of assessment have an indirect effect on student’s competence evaluation outcomes through student’s self-efficacy. Study findings highlight which assessment characteristics, positively influencing students’ learning, contribute to the effectiveness of competence-based education. Limitations of the study and directions for future research are indicated.
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Aims and objectives: To gain insight into the experiences and perceptions of hospital and home care nurses regarding nutritional care for older adults to prevent and treat malnutrition. Background: In-depth knowledge about hospital and home care nurses’ experiences and perceptions can contribute to optimise nutritional care for older adults across the care continuum between hospital and home to prevent and treat malnutrition. Design: Multicentre cross-sectional descriptive study. Method: A validated questionnaire addressing malnutrition was used. A total of 1,135 questionnaires were sent to hospital and home care nurses. The STROBE statement was followed for reporting. Results: The response rate was 49% (n = 556). Of all the nurses, 37% perceived the prevalence of malnutrition among their care recipients between 10% and 25%. Almost 22% of the nurses neither agreed nor disagreed or disagreed with the statement that prevention of malnutrition is possible. More than 28% of the nurses reported that malnutrition is a small or no problem. Over 95% of the hospital nurses and 52.5% of the home care nurses stated they screened routinely for malnutrition. The nurses considered several interventions for treating malnutrition important. Over 81% of the nurses indicated they wanted to follow further training. Conclusion: Most hospital and home care nurses perceived that nutritional care for older adults to prevent and treat malnutrition was important. A fair group of nurses, however, had the opposite perception. Relevance to clinical practice: Raising the awareness of all hospital and home care nurses about the importance of nutritional care for older adults is pivotal to increase the chance of successfully providing nursing nutritional care. Nurses should follow training for consolidation of nutritional care. Nurses are well-positioned to take a leadership role to improve continuity and quality of nutritional care across the care continuum between hospital and home.
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Objective: Patients with chronic limb threatening ischemia (CLTI) are at high risk for amputation and other cardiovascular adverse events. Nutrition-related symptoms and malnutrition are common in the CLTI population, and lead to worse clinical outcomes. Understanding of the factors influencing nutritional intake is required to determine whether optimization of nutritional intake in this population requires interventions. Therefore, this study aimed to describe perceptions and experiences on nutrition of patients with CLTI, and to identify perceived barriers and facilitators influencing their nutritional intake.Methods: In this phenomenological qualitative study, individual semi-structured, face-to-face interviews were conducted with patients with CLTI who lived independently. Interviews were transcribed verbatim, and reflexive thematic analysis was performed.Results: Twelve participants were interviewed. Five themes were generated: (1) lack of nutritional risk perception, (2) role of nutrition for health, functioning and surviving, (3) multiple factors influencing nutritional intake, (4) limited nutritional advice, and (5) no intention to change current nutritional intake.Conclusion: Patients with CLTI perceive nutritional intake as a necessity to survive and function. Patients express limited risk perception regarding adequate nutritional intake and undernutrition. Nutritional intake is mainly based on non-health related factors, as habits and taste, and multiple barriers hinder nutritional intake. Patients received no or only limited nutritional advice. Together this leads to an expressed lack of intention to change nutritional intake. Findings of this study stress the urgency for patient-centered nutritional support, to increase nutrition-related knowledge and motivation, to prevent or treat undernutrition, and may improve clinical outcomes in patients with CLTI.
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ABSTRACT This study investigates how perceptions of radicalisation and co-occurring mental health issues differ between mental health care and the security domain, and how these perceptions affect intersectoral collaboration. It is generally thought that intersectoral collaboration is a useful strategy for preventing radicalisation and terrorism, especially when it concerns radicalised persons with mental health issues. It is not clear, however, what perceptions professionals have of radicalisation and collaboration with other disciplines. Data was obtained from focus groups and individual interviews with practitioners and trainers from mental health care and the security domain in the Netherlands. The results show a lack of knowledge about radicalisation in mental health care, whereas in the security domain, there is little understanding of mental health issues. This leads to a mad-bad dichotomy which has a negative effect on collaboration and risk management. Improvement of the intersectoral collaboration by cross-domain familiarization, and strengthening of trust and mutual understanding, should begin with the basic training of professionals in both domains. The Care and Safety Houses in the Netherlands offer a sound base for intersectoral collaboration. Future professionals from different domains ought to be familiarized with each other’s possibilities, limitations, tasks, and roles.
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In honours programmes, teachers face the task of designing courses in which students feel challenged and learn from accomplishing demanding assignments. The aim of this study was to investigate students’ and teachers’ perceptions of challenge and learning in an honours programme. From 2016 to 2019, students and teachers rated the learning activities during the programme and explained their ratings. The results showed that in the first two years, teachers estimated challenge and learning significantly higher than the students did. However, both students and teachers viewed the tasks as the factor with the strongest impact on challenge and learning. In the first year, students also identified group dynamics as challenging and a source for learning. Enhancing task complexity and supporting group dynamics are the main factors to adjust the level of challenge in an honours programme. Monitoring students’ and teachers’ perceptions can help to adapt the programme to improve students’ learning.
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Background: Shared decision-making plays an important role in ensuring value-based healthcare in cardiac surgery. However, the personal situations of patients in cardiac care have not been widely explored, and thus, little is known about the decision-making experiences of patients and their relatives before surgery.Objective: To explore the perceptions of patients indicated for cardiac surgery and their relatives during the decision-making process, as well as their experiences of a conversation aimed at achieving shared decision-making in the treatment trajectory.Methods: The data were collected through semi-structured in-depth interviews with patients aged ≥70 years who were indicated for cardiac surgery and their relatives until theme saturation. Both inductive and deductive analysis were conducted based on the principles of reflexive thematic analysis.Results: Interviews with 16 patients and 10 relatives provided in-depth insights into the experiences of patients and their relatives in terms of a shared decision-making process prior to surgery. Overall, 15 subthemes were identified, and these were divided into three themes. In general, the patients' experiences and perceptions were influenced by their (1) general daily functioning. The relatives were more concerned about (2) social expectations and (3) existential uncertainty.Conclusions: Patients eligible for cardiac surgery and their families have unique experiences and perceptions during the process of shared decision-making. The subthemes emerging from this study, such as the overestimation of potential medical outcomes by patients and their relatives, who experience fear about the current health situation of their loved one, require careful attention from healthcare professionals during decision-making conversations.
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Introduction: Nowadays the Western mental health system is in transformation to recovery-oriented and trauma informed care in which experiential knowledge becomes incorporated. An important development in this context is that traditional mental health professionals came to the fore with their lived experiences. From 2017 to 2021, a research project was conducted in the Netherlands in three mental health organizations, focussing on how service users perceive the professional use of experiential knowledge. Aims: This paper aims to explore service users’ perspectives regarding their healthcare professionals’ use of experiential knowledge and the users’ perceptions of how this contributes to their personal recovery. Methods: As part of the qualitative research, 22 service users were interviewed. A thematic analysis was employed to derive themes and patterns from the interview transcripts. Results: The use of experiential knowledge manifests in the quality of a compassionate user-professional relationship in which personal disclosures of the professional’s distress and resilience are embedded. This often stimulates users’ recovery process. Conclusions: Findings suggest that the use of experiential knowledge by mental health professionals like social workers, nurses and humanistic counselors, demonstrates an overall positive value as an additional (re)source.
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Objective To synthesise qualitative studies on women’s psychological experiences of physiological childbirth. Design Meta-synthesis. Methods Studies exploring women’s psychological experiences of physiological birth using qualitative methods were eligible. The research group searched the following databases: MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX and Psychology and Behavioural Sciences Collection. We contacted the key authors searched reference lists of the collected articles. Quality assessment was done independently using the Critical Appraisal Skills Programme (CASP) checklist. Studies were synthesised using techniques of meta-ethnography. Results Eight studies involving 94 women were included. Three third order interpretations were identified: ‘maintaining self-confidence in early labour’, ‘withdrawing within as labour intensifies’ and ‘the uniqueness of the birth experience’. Using the first, second and third order interpretations, a line of argument developed that demonstrated ‘the empowering journey of giving birth’ encompassing the various emotions, thoughts and behaviours that women experience during birth. Conclusion Giving birth physiologically is an intense and transformative psychological experience that generates a sense of empowerment. The benefits of this process can be maximised through physical, emotional and social support for women, enhancing their belief in their ability to birth and not disturbing physiology unless it is necessary. Healthcare professionals need to take cognisance of the empowering effects of the psychological experience of physiological childbirth. Further research to validate the results from this study is necessary.
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Internationalizing curricula. Needs and wishes of alumni and employers with regard to international competencies. Internationalization has become of great importance for universities acrossthe globe. The labour market is becoming international, with internationalopportunities and international competition. Emerging markets such as India, China and Russia are gaining economic power. Global challenges demand world-wide solutions. Production and marketing networks span the globe and various forms of migration have resulted in a large cultural diversity within nations. As a result, societies and labour markets are changing as well. In order to deal with these societal changes adequately and to succeed in today’s labour market, graduates need to be equipped with international competencies. In a survey among 500 chief executives, ICM Research (on behalf of Think Global and The British Council, 2011) showed that employers strongly value staff members who are able to work in an international and multicultural environment. Similar results were found in Diamond et al. (2011), in which ‘multicultural teamwork’ was considered most important. The Hague University of Applied Sciences seeks to prepare its students adequately for the world of tomorrow. The University’s development plans (e.g. HogeschoolOntwikkelingsPlan, HOP 7, 2009-2013 and HOP 8, 2014-2017) indicate that its vision is to train students to be globally-minded professionals with an international and multicultural perspective, who are world-citizens, interested in global issues and able to deal with diversity in a constructive manner. They are to be professionals, who possess the competencies to function well in an international and intercultural environment. Internationalization is therefore high on the agenda of The Hague University of Applied Sciences (THUAS) which is illustrated by the fact that, as of 2014, new students in all academies have to fill 12.5% (30 ECTS) of their four-year Bachelor program with international activities. These activities can range from an internship or semester abroad (student mobility) to participating in full programs of study or minors in which English is the medium of instruction, or an internationally themed minor (Internationalization at Home, IaH). And this is only the beginning. Internationalization is a means, not an end. All THUAS courses are looking into ways in which they can internationalize their curriculum. And in doing so, they need to be innovative (Leask, 2009) and keep in mind the specific needs and wishes of alumni and their employers with regard to international competences. The THUAS research group International Cooperation supports these internationalization policy objectives by investigating various aspects, such as: • The acquisition and development of international competencies among students. • The extent to which lecturers possess international competencies and what their needs and wishes are for further development. • The international competencies THUAS graduates have acquired as part of their degree and how THUAS has stimulated this development. • The international competencies that employers and alumni consider important. Although international competencies and employability have received growing attention in internationalization research, existing studies have mainly focused on: • The effects of study abroad on the development of international competence (cf. Hoven & Walenkamp, 2013). • The effects of an experience abroad (study, internship, voluntary work) on employability. • A more general analysis of the skills employers look for in prospective employees.
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