Mechanisms that drive the intergenerational transmission of poverty have been studied widely, but to understand how these mechanisms are at work in real life we require studies on perspectives of families who themselves are living in poverty. In this study, we combine the perspectives of multiple generations of family households in a rural area in the Netherlands. We want to understand from their own perspective what prevents these families from escaping poverty. Twenty-three family households participated in intergenerational interviews. Results show that recurrent mechanisms were often perceived to relate to rearing practices, norm-setting and geographical mechanisms (immobility and perceived place-based stigma). Family habitus structures the mechanisms that prolong and perpetuate poverty.
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BACKGROUND: Informal care is an essential part of support provided in the homecare setting. To ensure effective healthcare provision, good communication and collaboration between informal and formal care providers are crucial. To achieve this aim, it is necessary to have a clear understanding of the perspectives of all stakeholders. In the scientific literature, limited knowledge is available regarding family members' opinions about their involvement in care. To date, no instruments have been developed that accurately measure these opinions. This study aims to elucidate the opinions of family members about their involvement in nursing care.METHODS: A cross-sectional survey approach was employed. The methodological steps in this study were (1) convert the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) from a nurses' perspective to a family perspective and thus develop the Families' Importance in Nursing Care-Families' Opinions (FINC-FO) and (2) measure families' opinions regarding their involvement in home nursing care. The questionnaire was sent to 3,800 patients with activated patient portals, which accounts for about 17% of the total patient base. Responses were received from 1,339 family members, a response rate of 35%.RESULTS: The developed FINC-FO questionnaire showed homogeneity and internal consistency. The results of the questionnaire indicate that family members consider it important to be involved in care and that they wish to be acknowledged as participants in discussions about care (planning) but are less inclined to actively participate in the provision of care by nurses. Family members expressed less explicit opinions about their own support needs. Factors such as level of education, type of partnership, and amount of care provided are seemingly associated with these opinions.CONCLUSIONS: Family members in the homecare setting wish to be involved in discussions about care (planning). The transition in care from primarily formal to more informal care necessitates an awareness and clear definition-on part of both healthcare professionals and families-of their respective roles in the provision of care. Communication about wishes, expectations, and the need for support in care is essential to ensure quality of care and that the family can sustain caregiving.
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BACKGROUND: In geriatric oncology, family members frequently accompany patients during medical consultations, providing emotional and practical support while participating in shared decision-making (SDM). Family involvement in SDM can facilitate the decision-making process but also pose challenges for healthcare professionals. Additionally, much of the SDM deliberation occurs outside the clinical setting, making it important to understand family dynamics to ensure treatment decisions align with the patient's values and preferences. Therefore this study aims to explore the experiences and perspectives of family members regarding their involvement in decision-making processes for older patients with cancer, and the subsequent impact on roles and family dynamics.METHODS: Qualitative open in-depth interviews were conducted with 16 family members of 11 patients with cancer of 70 years and older in the Netherlands. Qualitative data analysis was conducted using a thematic analysis approach.RESULTS: Four interconnected themes emerged. The first theme, "Roles" revealed that family members often provide both practical and informational support, and sometimes act as advocates for the patient. The second theme, "Family Values and Beliefs," highlighted a strong sense of unconditional and reciprocal support within families, emphasizing the core value of caring for one another. Third, "Family Dynamics," encompasses: keeping everyone informed, dividing caregiver tasks, dealing with disappointment and sadness, managing different opinions, and coping with uncertainty. Finally, "Dilemma's" describes: family members balancing their own opinions with the patient's preferences, reconciling hope and fear, weighing trust in medical professionals against their own judgment, and balancing caregiving responsibilities with their personal lives. These dilemmas were shaped by roles the family members assumed, the underlying values and beliefs, and family dynamics.CONCLUSION: The findings of this interview study provide valuable insights into the complex roles that family members of older patients with cancer play in medical consultations and treatment decision-making and their dilemma's. These roles are deeply influenced by family values and dynamics, which can significantly shape decision-making processes and outcomes. Understanding these factors can help healthcare professionals as it highlights the evolving responsibilities of family caregivers and the importance of supporting them in navigating the intricacies of treatment decisions while maintaining respect for patient autonomy.
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Effective collaboration between families and professionals in education and youth care is essential for supporting the development of children. Collaboration that centers on the child’s best interests benefits from the diverse perspectives of various stakeholders around a child. The Timeline helps to bring these perspectives together and discuss them, supporting better collaboration. The Timeline tool offers a visual representation of what is happening in a child’s life, both at home and at school. It is particularly useful when multiple professionals from youth care, education and parental support are involved. The Timeline tracks all events in chronological order from a child’s development, the support provided, to the quality of collaboration among those involved. By visually mapping the perspectives of parents and professionals, the tool facilitates open discussions. It also helps to reflect on past events and to plan what is needed to support the child’s ongoing development and education. This tool was developed based on the research project Around the Child.
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Family nursing conversations (FNC) are planned conversations between a care recipient, one or more family members, and a nurse. FNC, in the Netherlands, are intended to strengthen family functioning and family communication, improve collaboration between family and professional caregivers, and prevent overburden of family caregivers. This study aims to explore families’ experiences with FNC, and their perspectives on the benefits of FNC.Methods: A total of 26 participants (9 care recipients, 17 family members) from 11 families participated in a FNC and this qualitative study. Seven home health care nurses trained in FNC conducted these conversations as part of their daily practice. Four to six weeks after the FNC, care recipients and family members were interviewed about their experiences, and the perceived effects or benefits of the FNC. Interviews were semi-structured, face-to-face, and individual. Data collection continued until saturation had been reached. A grounded theory approach was used to analyze the data.Results: Participants experienced FNC as structured and open communication about the care situation. During the FNC, participants felt that they gained a clear overview of the care situation and that relationships among the FNC-participants improved. Participants reported that FNC decreased family members’ burden, and resulted in care that was more tailored to the care recipient’s needs.Conclusions: From the results of this study a model is proposed for families’ experiences with and perceived benefits of FNC. In a subsequent study, this model will be tested in a quantitative cost effectiveness study with a larger sample.
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Worldwide, schools implement social-emotional learning programs to enhance students' social-emotional skills. Although parents play an essential role in teaching these skills, knowledge about their perspectives on social-emotional learning is limited. In providing insight into the perspectives of parents from adolescent students this paper adds to this knowledge. An explorative qualitative study was conducted to gain insight into parents' perspectives on adolescent social-emotional learning. A broadly used professional framework for social emotional learning was used as a frame of reference in interviews with parents from diverse backgrounds. Within and across case analyses were applied to analyze the interviews. A conceptual model of four social-emotional skills constructs considered crucial learning by parents emerged from the data: respectful behavior, cooperation, self-knowledge and self-reliance. Parents' language, interpretations and orderings of skills indicate that the model underlying these constructs differs from skills embedded in the professional framework.
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Introduction: In March 2014, the New South Wales (NSW) Government (Australia) announced the NSW Integrated Care Strategy. In response, a family-centred, population-based, integrated care initiative for vulnerable families and their children in Sydney, Australia was developed. The initiative was called Healthy Homes and Neighbourhoods. A realist translational social epidemiology programme of research and collaborative design is at the foundation of its evaluation. Theory and Method: The UK Medical Research Council (MRC) Framework for evaluating complex health interventions was adapted. This has four components, namely 1) development, 2) feasibility/piloting, 3) evaluation and 4) implementation. We adapted the Framework to include: critical realist, theory driven, and continuous improvement approaches. The modified Framework underpins this research and evaluation protocol for Healthy Homes and Neighbourhoods. Discussion: The NSW Health Monitoring and Evaluation Framework did not make provisions for assessment of the programme layers of context, or the effect of programme mechanism at each level. We therefore developed a multilevel approach that uses mixed-method research to examine not only outcomes, but also what is working for whom and why.
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The evolving landscape of science communication highlights a shift from traditional dissemination to participatory engagement. This study explores Dutch citizens’ perspectives on science communication, focusing on science capital, public engagement, and communication goals. Using a mixed-methods approach, it combines survey data (n = 376) with focus group (n = 66) insights. Findings show increasing public interest in participating in science, though barriers like knowledge gaps persist. Trust-building, engaging adolescents, and integrating science into society were identified as key goals. These insights support the development of the Netherlands’ National Centre of Expertise on Science and Society and provide guidance for inclusive, effective science communication practices.
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Despite the many benefits of club-organized sports participation for children, sports participation is lower among children from low-income families than among those from middle- or high-income families. Social safety experienced by parents from low-income families is an important facilitator for parents to request financial support for their children’s sports participation. Therefore, the first aim of this study was to better understand parental social (un)safety in the context of acquiring financial support for children’s sports participation and how to create a safe social environment for low-income parents to request and receive this financial support. The second aim was to describe the co-creation process, which was organized to contribute to social safety solutions. To reach these goals, we applied a participatory action research method in the form of four co-creation sessions with professionals and an expert-by-experience, as well as a group interview with parents from low-income families. The data analysis included a thematic analysis of the qualitative data. The results showed that from the perspective of parents, social safety encompassed various aspects such as understandable information, procedures based on trust, and efficient referral processes. Sport clubs were identified as the primary source of information for parents. Regarding the co-creation process, the study found that stakeholders tended to overestimate parental social safety levels. Although the stakeholders enjoyed and learned from the sessions, differences in prior knowledge and a lack of a shared perspective on the purpose of the sessions made it challenging to collaboratively create solutions. The study’s recommendations include strategies for increasing parental social safety and facilitating more effective co-creation processes. The findings of this study can be used to inform the development of interventions that contribute to a social environment in which parents from low-income families feel safe to request and receive financial support for their children’s sports participation.
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Social and Emotional Learning programs, designed to enhance adolescents’ social and emotional skills, are implemented in schools worldwide. One of these programs is Skills4Life (S4L), for students in Dutch secondary education. To strengthen this program and adapt it to students’ needs, we conducted an exploratory study on their perspectives on their own social-emotional development, focusing on low-achieving students in prevocational education. We interviewed eleven boys and eleven girls in five focus groups on (1) their general school life experiences, (2) their perceptions and experiences regarding interactions with peers, the problems they encountered in these interactions, and (3) the strategies and skills they used to solve these problems. Driven by findings in related studies initial thematic analyzes were extended using a three-step approach: an inductive, data-driven process of open coding; axial coding; and selective coding, using the social-emotional skills comprised in an often-used SEL framework as sensitizing concepts. Overall, students were satisfied with their relationships with classmates and teachers and their ability to manage their daily interaction struggles. Their reflections on their interactions indicate that the skills they preferred to use mirror the social-emotional skills taught in many school programs. However, they also indicated that they did not apply these skills in situations they experienced as unsafe and uncontrollable, e.g., bullying and harassment. The insights into adolescents’ social-emotional skills perceptions and the problems they encountered with peers at school presented here can contribute to customizing school-based skills enhancement programs to their needs. Teacher training is required to help teachers gain insight into students’ perspectives and to use this insight to implement SEL programs tailored to their needs.
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