Background Clients facing decision-making for long-term care are in need of support and accessible information. Construction of preferences, including context and calculations, for clients in long-term care is challenging because of the variability in supply and demand. This study considers clients in four different sectors of long-term care: the nursing and care of the elderly, mental health care, care of people with disabilities, and social care. The aim is to understand the construction of preferences in real-life situations. Method Client choices were investigated by qualitative descriptive research. Data were collected from 16 in-depth interviews and 79 client records. Interviews were conducted with clients and relatives or informal caregivers from different care sectors. The original client records were explored, containing texts, letters, and comments of clients and caregivers. All data were analyzed using thematic analysis. Results Four cases showed how preferences were constructed during the decision-making process. Clients discussed a wide range of challenging aspects that have an impact on the construction of preferences, e.g. previous experiences, current treatment or family situation. This study describes two main characteristics of the construction of preferences: context and calculation. Conclusion Clients face diverse challenges during the decision-making process on long-term care and their construction of preferences is variable. A well-designed tool to support the elicitation of preferences seems beneficial.
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Data is widely recognized as a potent catalyst for advancing healthcare effectiveness, increasing worker satisfaction, and mitigating healthcare costs. The ongoing digital transformation within the healthcare sector promises to usher in a new era of flexible patient care, seamless inter-provider communication, and data-informed healthcare practices through the application of data science. However, more often than not data lacks interoperability across different healthcare institutions and are not readily available for analysis. This inability to share data leads to a higher administrative burden for healthcare providers and introduces risks when data is missing or when delays occur. Moreover, medical researchers face similar challenges in accessing medical data due to thedifficulty of extracting data from applications, a lack of standardization, and the required data transformations before it can be used for analysis. To address these complexities, a paradigm shift towards a data-centric application landscape is essential, where data serves as the bedrock of the healthcare infrastructure and is application agnostic. In short, a modern way to think about data in general is to go from an application driven landscape to a data driven landscape, which will allow for better interoperability and innovative healthcare solutions.In the current project the research group Digital Transformation at Hanze University of Applied Sciences works together with industry partners to build an openEHR implementation for a Groningen-based mental healthcare provider.
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Hoe kan het onderwijs worden vormgegeven zodat mbo-jongeren worden gestimuleerd om te gaan stemmen? In dit onderzoek laten we de resultaten zien van een exploratieve evaluatie van drie sets met evidence-informed leermiddelen met als doel de stemintentie van jongeren te verhogen. De leermiddelen richten zich op (1) informatie over het stemproces, (2) in gesprek gaan over wel of niet stemmen en (3) gesprekken over maatschappelijke onderwerpen in combinatie met het invullen van een stemadviesapplicatie. De leermiddelen zijn gegeven door negen docenten en geëvalueerd door middel van docentinterviews en studentvragenlijsten (N = 172). Uit de resultaten kan worden opgemaakt dat docenten en studenten positief zijn over de praktische benadering in de leermiddelen. Tevens blijkt uit de resultaten dat de leermiddelen studenten inzicht geven in hun politieke voorkeur en dat zij leren het gesprek over stemmen met elkaar aan te gaan. Dit stimuleert mogelijk politiek zelfvertrouwen. Deze resultaten scheppen positieve verwachtingen voor de mogelijke effectiviteit van de lessen die kan worden getoetst in vervolgonderzoek.--How can education be designed to encourage students in vocational education to vote? We present the results of an explorative evaluation of three evidence-informed lessons aimed at increasing young people’s intention to vote. The three lessons focus on (1) information about the voting process, (2) engaging in discussions about whether or not to vote, and (3) discussions about socio-political issues combined with the use of a voting advice application. The lessons were taught by nine teachers and evaluated through teacher interviews and student questionnaires (N = 172). The results indicate that both teachers and students responded positively to the practical approach of the teaching materials. Additionally, the materials provided students with insight into their political preferences and helped them engage in discussions about voting. This potentially fosters political self-efficacy. These findings create positive expectations regarding the lessons’ potential effectiveness, which can be examined in follow-up research.
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Purpose: Collaborative deliberation comprises personal engagement, recognition of alternative actions, comparative learning, preference elicitation, and preference integration. Collaborative deliberation may be improved by assisting preference elicitation during shared decision-making. This study proposes a framework for preference elicitation to facilitate collaborative deliberation in long-term care consultations. Methods: First, a literature overview was conducted comprising current models for the elicitation of preferences in health and social care settings. The models were reviewed and compared. Second, qualitative research was applied to explore those issues that matter most to clients in long-term care. Data were collected from clients in long-term care, comprising 16 interviews, 3 focus groups, 79 client records, and 200 online client reports. The qualitative analysis followed a deductive approach. The results of the literature overview and qualitative research were combined. Results: Based on the literature overview, five overarching domains of preferences were described: “Health”, “Daily life”, “Family and friends”, ”Living conditions”, and “Finances”. The credibility of these domains was confirmed by qualitative data analysis. During interviews, clients addressed issues that matter in their lives, including a “click” with their care professional, safety, contact with loved ones, and assistance with daily structure and activities. These data were used to determine the content of the domains. Conclusion: A framework for preference elicitation in long-term care is proposed. This framework could be useful for clients and professionals in preference elicitation during collaborative deliberation.
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Financially vulnerable consumers are often associated with suboptimal financial behaviors. Evaluated financial education programs so far show difficulties to effectively reach this target population. In our attempt to solve this problem, we built a behaviorally informed financial education program incorporating insights from both motivational and behavioral change theories. In a quasi-experimental field study among Dutch financially vulnerable people, we compared this program with both a control group and a traditional program group. In comparison with the control group, we found robust positive effects of the behaviorally informed program on financial skills and knowledge and self-reported financial behavior, but not on other outcomes. Additionally, we did not find evidence that the behaviorally informed program performed better than the traditional program. Finally, we discuss the findings and limitations of this study in light of the financial education literature and provide implications for policymaking and directions for future research.
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Background: The majority of patients diagnosed with early-stage breast cancer are in a position to choose between having a mastectomy or lumpectomy with radiation therapy (breast-conserving therapy). Since the long-term survival rates for mastectomy and for lumpectomy with radiation therapy are comparable, patients’ informed preferences are important for decision-making. Although most clinicians believe that they do include patients in the decision-making process, the information that women with breast cancer receive regarding the surgical options is often rather subjective, and does not invite patients to express their preferences. Shared decision-making (SDM) is meant to help patients clarify their preferences, resulting in greater satisfaction with their final choice. Patient decision aids can be very supportive in SDM. We present the protocol of a study to β test a patient decision aid and optimise strategies for the implementation of SDM regarding the treatment of early-stage breast cancer in the actual clinical setting. Methods/design: This paper concerns a preimplementation and post-implementation study, lasting from October 2014 to June 2015. The intervention consists of implementing SDM using a patient decision aid. The intervention will be evaluated using qualitative and quantitative measures, acquired prior to, during and after the implementation of SDM. Outcome measures are knowledge about treatment, perceived SDM and decisional conflict. We will also conduct face-to-face interviews with a sample of these patients and their care providers, to assess their experiences with the implementation of SDM and the patient decision aid.
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In this study we investigate, through a questionnaire, in-service student-teachers’ needs and preferences in a master program for a course about learning with technology. Results show that about half of the student-teachers would like to have such a course and about one third has doubts about it. The reasons provided by students with different needs and their preferences for the content, learning activities and teacher support are discussed in this paper, as well implications for the design of teacher preparation programs
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In this paper the first phase of a descriptive research project on musical preferences and music listening habits of first year’s conservatoire students is presented. The paper presents the background of the research project, the construction of a survey and the first results of this survey, which indicate that musical preferences and music listening habits of first year’s conservatoire students are highly varied. Possible refinements for the survey are discussed.The paper ends with first notions on how to not only use the findings for descriptive ends but also put them in the broader perspective of more general research on musical preferences.
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Background: Despite increasing shortages of highly educated community nurses, far too few nursing students choose community care. This means that a strong societal problem is emerging that desperately needs resolution.Objectives: To acquire a solid understanding of the causes for the low popularity of community care by exploring first-year baccalaureate nursing students' perceptions of community care, their placement preferences, and theassumptions underlying these preferences.Design: A quantitative cross-sectional design.Settings: Six universities of applied sciences in the Netherlands.Participants: Nursing students in the first semester of their 4-year programme (n =1058).Methods: Data were collected in September–December 2014. The students completed the ‘Scale on Community Care Perceptions’ (SCOPE), consisting of demographic data and three subscales measuring the affective componentof community care perception, perceptions of a placement and a profession in community care, and students' current placement preferences. Descriptive statistics were used.Results: For a practice placement, 71.2% of first-year students prefer the general hospital and 5.4% community care, whereas 23.4% opt for another healthcare area. Students consider opportunities for advancement and enjoyable relationships with patients as most important for choosing a placement. Community care is perceived as a ‘low-status-field’ with many elderly patients, where students expect to find little variety in caregiving and few opportunities for advancement. Students' perceptions of the field are at odds with things they believe to be important for their placement.Conclusion: Due to misconceptions, students perceive community care as offering them few challenges. Strategies to positively influence students' perceptions of community nursing are urgently required to halt thedissonance between students' preference for the hospital and society's need for highly educated community nurses.
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The aim of this study was to describe patients' experiences of, and preferences for, surgical wound care discharge education and how these experiences predicted their ability to self-manage their surgical wounds. A telephone survey of 270 surgical patients was conducted across two hospitals two weeks after discharge. Patients preferred verbal (n = 255, 94.8%) and written surgical wound education (n = 178, 66.2%) from medical (n = 229, 85.4%) and nursing staff (n = 211, 78.7%) at discharge. The most frequent education content that patients received was information about follow-up appointments (n = 242, 89.6%) and who to contact in the community with wound care concerns (n = 233, 86.6%). Using logistic regression, patients who perceived that they participated in surgical wound care decisions were 6.5 times more likely to state that they were able to manage their wounds at home. Also, patients who agreed that medical and/or nursing staff discussed wound pain management were 3.1 times more likely to report being able to manage their surgical wounds at home. Only 40% (107/270) of patients actively participated in wound-related decision-making during discharge education. These results uncovered patient preferences, which could be used to optimise discharge education practices. Embedding patient participation into clinical workflows may enhance patients' self-management practices once home.
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