In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient’s values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient’s values. The shared decision-making model seems to be helpful in the integration of the individual patient’s values in evidence-based practice. We aim to discuss the relevance of shared decision making in chronic care and to suggest how it can be integrated with evidence-based practice in nursing. We start by describing the following three possible approaches to guide the decision-making process: the paternalistic approach, the informed approach, and the shared decision-making approach. Implementation of shared decision making has gained considerable interest in cases lacking a strong best-treatment recommendation, and when the available treatment options are equivalent to some extent. We discuss that in chronic care it is important to always invite the patient to participate in the decision-making process. We delineate the following six attributes of health care interventions in chronic care that influence the degree of shared decision making: the level of research evidence, the number of available intervention options, the burden of side effects, the impact on lifestyle, the patient group values, and the impact on resources. Furthermore, the patient’s willingness to participate in shared decision making, the clinical expertise of the nurse, and the context in which the decision making takes place affect the shared decision-making process. A knowledgeable and skilled nurse with a positive attitude towards shared decision making – integrated with evidence-based practice – can facilitate the shared decision-making process. We conclude that nurses as well as other health care professionals in chronic care should integrate shared decision making with evidence- based practice to deliver patient-centred care.
The current study analyzed blogs written by four Dutch parents of children with profound intellectual and multiple disabilities, with the aim of deepening the understanding of the parents’ concerns. Thematic analysis was conducted and five main themes were identified: Dealing with uncertainties addressed the impact of unpredictability present in the everyday lives of parents, Love and loss described the complexity of concurrently cherishing the child and grieving various types of loss, Struggling with time, energy and finances detailed imbalances and struggles related to parents’ personal resources, Feeling included in communities and society specified social consequences, and Relating to professional care services reflected on stress and support associated with professional care delivery. The study findings demonstrate how care professionals should acknowledge parents’ vulnerabilities by being aware of their existential distress and empowering parents to exercise control of family thriving.
Nationwide and across the globe, the quality, affordability, and accessibility of home-based healthcare are under pressure. This issue stems from two main factors: the rapidly growing ageing population and the concurrent scarcity of healthcare professionals. Older people aspire to live independently in their homes for as long as possible. Additionally, governments worldwide have embraced policies promoting “ageing in place,” reallocating resources from institutions to homes and prioritising home-based services to honour the desire of older people to continue living at home while simultaneously addressing the rising costs associated with traditional institutional care.Considering the vital role of district nursing care and the fact that the population of older people in need of assistance at home is growing, it becomes clear that district nursing care plays a crucial role in primary care. The aim of this thesis is twofold: 1) to strengthen the evidence base for district nursing care; and 2) to explore the use of outcomes for learning and improving in district nursing care. The first part of this thesis examines the current delivery of district nursing care and explores its challenges during the COVID-19 pandemic to strengthen the evidence base and get a better understanding of district nursing care. Alongside the goal of strengthening the evidence for district nursing care, the second part of this thesis explores the use of patient outcomes for learning and improving district nursing care. It focuses on nurse-sensitive patient outcomes relevant to district nursing care, their current measurement in practice, and what is needed to use outcomes for learning and improving district nursing practice.
Vind jij het ook een uitdaging om onderwijsinnovaties om te zetten tot veranderingen in de onderwijspraktijk? Wil je niet alleen beter begrijpen wat onderwijsinnovatie zo moeilijk maakt, maar ook samen op zoek gaan naar oplossingen? Kom dan naar de innovatiewerkplaats, een project van lectoraat Organiseren van Verandering in Onderwijs en het Teaching and Learning Network. Open voor alle onderwijsprofessionals (binnen en buiten de HU).
Het kennisnetwerk “Leren en Ontwikkelen voor Toekomstgericht Onderwijs” richt zich op onderwijsvernieuwingsvraagstukken. Scholen staan voor complexe uitdagingen waaronder een toename in diversiteit aan leerlingen die maatwerk vragen, de hardnekkige kansenongelijkheidsproblematiek, de noodzaak nieuwe technologieën adequaat in te zetten, en de opdracht leerlingen nieuwe leerinhouden maar vooral nieuwe leervaardigheden aan te leren. Voor scholen leidt dit tot aanpassingen zoals afstappen van klassikaal werken, focussen op leerprocessen in plaats van leerproducten en inzetten op autonomievergroting bij leerlingen. Onafhankelijk van de sector kampen scholen met vergelijkbare (ontwikkel)vraagstukken zoals nieuwe (meer ontwerpende en coachende) rollen van leraren, het anders beoordelen en monitoren van leerlingen en nieuwe samenwerkingsvormen binnen teams. Ons kennisnetwerk omvat bestaande samenwerkingsverbanden van lerarenopleidingen en scholenclusters die ervaring hebben met gezamenlijk onderzoek doen, opleiden en professionaliseren. De lectoren kennen elkaar van gemeenschappelijke (praktijkgerichte) onderzoeksprojecten, professionaliseringsactiviteiten en onderwijsontwikkeling. In het kennisnetwerk brengen we de verschillende samenwerkingsverbanden fysiek samen doordat onderzoekers, (toekomstige) leraren en lerarenopleiders in kennislabs op een onderzoeksmatige manier werken aan praktische oplossingen voor eerdergenoemde vraagstukken. Daarbij wordt gebruik gemaakt van een methodiek voor hybride kennislabs, ontwikkeld door een van de lectoraten, samen met de OU. Binnen het netwerk is een kernteam verantwoordelijk voor enerzijds destillatie van prangende onderzoeksvragen en het doen van onderzoeksaanvragen en anderzijds de monitoring van zowel de leeropbrengsten als praktische opbrengsten (werkzame principes) van de kennislabs en de verfijning van de werkwijze binnen de kennislabs. Het uiteindelijke doel zijn kennislabs die zodanig regionaal verankerd zijn wat betreft de professionalisering van betrokkenen, kennisdeling, inspiratie en ondersteuning bij het ontwikkelen van toekomstgericht onderwijs en het aanvragen en uitvoeren van praktijkgericht onderzoek dat deze na vier jaar zonder subsidie kunnen worden voortgezet. Daarnaast vormen ze een onmisbaar onderdeel van een landelijke kennisinfrastructuur. We beogen een open netwerkorganisatie waarbij lerarenopleidingen, scholen en kennisinstellingen zich op basis van hun expertise kunnen aansluiten
How can European migration, between countries and within countries between regions, contribute to the development of vulnerable regions in Europe? This is the central question of project Premium_EU (Policy REcommendations to Maximise the beneficial Impact of Unexplored Mobilities in and beyond the European Union), which is financed by Horizon Europe.The key goal of Premium_EU is the development of a Regional Policy Dashboard for national and regional policy makers to help them in the formulation of new policies aimed at the potential of migration to enhance the development of vulnerable regions. The Dashboard combines all available knowledge of three domains in three modules: the Mobility Module, the Regional Development Effects Module, and the Policy Module.The Mobility Module includes both past trends and projections and scenarios, in addition to new mobility estimates based on data from social media usage, such as LinkedIn and Facebook. The module also includes qualitative information from case studies on specific types of mobility groups, such as Polish seasonal workers, or Turkish migrants to EU countries. These trends, projections and case studies will be summarized in a regional typology on the basis of the mobility profile of the region.In the Regional Development Effects Module all available data on regional development is summarized in a regional development typology, where regional development is interpreted much broader than economic development. Using causal models the role of regional mobility in regional development will be established.In the Policy Module all possible forms of regional policies will be collected and linked to the mobility- and regional development characteristics of the region.The Dashboard integrates these modules so that a policy maker, on the basis of the unique mobility and regional development profile of his or her region is able to make an evidence based choice out of a relevant set of policy options. Users of the Dashboard will also be able to add their experiences to the Dashboard, so that other users can benefit from their knowledge.
