This thesis describes an Action Research (AR) project aimed at the implementation of Evidence Based Practice in a mental health nursing setting in the Netherlands. The main research question addressed in this thesis is: In what way is Action Research with an empowering appropriate to implement Evidence Based Practice in a mental health nursing setting in the Netherlands and what is the effect of this implementation on the care experienced by the client, the nursing interventions and the context in this setting compared to a comparative setting? To answer this main research question, the following questions derived from it were addressed: What is Evidence Based Practice? What is known about implementing evidence-based practice in nursing through Action Research? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be more successful? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be successful? How is EBP implemented through AR with an empowering intent and what are the outcomes for the use of evidence, the context and the facilitation in the setting? What is the effect of the implementation of EBP in mental health nursing using AR with an empowering intent on the care experienced by the client, the nursing interventions and the context compared to a comparison setting? The first two questions were answered by a search of the literature while the remaining questions were answered during the AR study conducted in two mental health organisations in the Netherlands.
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Accessible Summary What is known on the subject? • Mentalizing is the capacity to understand both one‘s own and other people‘s behaviour in terms of mental states, such as, for example, desires, feelings and beliefs. • The mentalizing capacities of healthcare professionals help to establish effective therapeutic relationships and, in turn, lead to better patient outcomes. What this paper adds to existing knowledge? • The personal factors positively associated with the mentalizing capacities of healthcare professionals are being female, greater work experience and having a more secure attachment style. Psychosocial factors are having personal experience with psychotherapy, burnout, and in the case of female students, being able to identify with the female psychotherapist role model during training. There is limited evidence that training programmes can improve mentalizing capacities. • Although the mentalization field is gaining importance and research is expanding, the implications for mental health nursing have not been previously reviewed. Mental health nurses are underrepresented in research on the mentalizing capacities of healthcare professionals. This is significant given that mental health nurses work closest to patients and thus are more often confronted with patients‘ behaviour compared to other health care professionals, and constitute a large part of the workforce in mental healthcare for patients with mental illness. What are the implications for practice? • Given the importance of mentalizing capacity of both the patient and the nurse for a constructive working relationship, it is important that mental health nurses are trained in the basic principles of mentalization. Mental health nurses should be able to recognize situations where patients‘ lack of ability to mentalize creates difficulties in the interaction. They should also be able to recognize their own difficulties with mentalizing and be sensitive to the communicative implications this may have.
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Background Running-related injuries (RRIs) can be considered the primary enemy of runners. Most literature on injury prediction and prevention overlooks the mental aspects of overtraining and under-recovery, despite their potential role in injury prediction and prevention. Consequently, knowledge on the role of mental aspects in RRIs is lacking. Objective To investigate mental aspects of overtraining and under-recovery by means of an online injury prevention programme. Methods and analysis The ‘Take a Mental Break!’ study is a randomised controlled trial with a 12 month follow-up. After completing a web-based baseline survey, half and full marathon runners were randomly assigned to the intervention group or the control group. Participants of the intervention group obtained access to an online injury prevention programme, consisting of a running-related smartphone application. This app provided the participants of the intervention group with information on how to prevent overtraining and RRIs with special attention to mental aspects. The primary outcome measure is any self-reported RRI over the past 12 months. Secondary outcome measures include vigour, fatigue, sleep and perceived running performance. Regression analysis will be conducted to investigate whether the injury prevention programme has led to a lower prevalence of RRIs, better health and improved perceived running performance. Ethics and dissemination The Medical Ethics Committee of the University Medical Center Utrecht, the Netherlands, has exempted the current study from ethical approval (reference number: NL64342.041.17). Results of the study will be communicated through scientific articles in peer-reviewed journals, scientific reports and presentations on scientific conferences.
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Digital transformation has been recognized for its potential to contribute to sustainability goals. It requires companies to develop their Data Analytic Capability (DAC), defined as their ability to collect, manage and analyze data effectively. Despite the governmental efforts to promote digitalization, there seems to be a knowledge gap on how to proceed, with 37% of Dutch SMEs reporting a lack of knowledge, and 33% reporting a lack of support in developing DAC. Participants in the interviews that we organized preparing this proposal indicated a need for guidance on how to develop DAC within their organization given their unique context (e.g. age and experience of the workforce, presence of legacy systems, high daily workload, lack of knowledge of digitalization). While a lot of attention has been given to the technological aspects of DAC, the people, process, and organizational culture aspects are as important, requiring a comprehensive approach and thus a bundling of knowledge from different expertise. Therefore, the objective of this KIEM proposal is to identify organizational enablers and inhibitors of DAC through a series of interviews and case studies, and use these to formulate a preliminary roadmap to DAC. From a structure perspective, the objective of the KIEM proposal will be to explore and solidify the partnership between Breda University of Applied Sciences (BUas), Avans University of Applied Sciences (Avans), Logistics Community Brabant (LCB), van Berkel Logistics BV, Smink Group BV, and iValueImprovement BV. This partnership will be used to develop the preliminary roadmap and pre-test it using action methodology. The action research protocol and preliminary roadmap thereby developed in this KIEM project will form the basis for a subsequent RAAK proposal.
Due to the existing pressure for a more rational use of the water, many public managers and industries have to re-think/adapt their processes towards a more circular approach. Such pressure is even more critical in the Rio Doce region, Minas Gerais, due to the large environmental accident occurred in 2015. Cenibra (pulp mill) is an example of such industries due to the fact that it is situated in the river basin and that it has a water demanding process. The current proposal is meant as an academic and engineering study to propose possible solutions to decrease the total water consumption of the mill and, thus, decrease the total stress on the Rio Doce basin. The work will be divided in three working packages, namely: (i) evaluation (modelling) of the mill process and water balance (ii) application and operation of a pilot scale wastewater treatment plant (iii) analysis of the impacts caused by the improvement of the process. The second work package will also be conducted (in parallel) with a lab scale setup in The Netherlands to allow fast adjustments and broaden evaluation of the setup/process performance. The actions will focus on reducing the mill total water consumption in 20%.
This PD project aims to gather new knowledge through artistic and participatory design research within neighbourhoods for possible ways of addressing and understanding the avoidance and numbness caused by feelings of vulnerability, discomfort and pain associated with eco-anxiety and chronic fear of environmental doom. The project will include artistic production and suitable forms of fieldwork. The objectives of the PD are to find answers to the practice problem of society which call for art that sensitises, makes aware and helps initiate behavioural change around the consequences of climate change. Rather than visualize future sea levels directly, it will seek to engage with climate change in a metaphorical and poetic way. Neither a doom nor an overly techno-optimistic scenario seem useful to understand the complexity of flood risk management or the dangers of flooding. By challenging both perspectives with artistic means, this research hopes to counter eco-anxiety and create a sense of open thought and susceptibility to new ideas, feelings and chains of thought. Animation and humour, are possible ingredients. The objective is to find and create multiple Dutch water stories, not just one. To achieve this, it is necessary to develop new methods for selecting and repurposing existing impactful stories and strong images. Citizens and students will be included to do so via fieldwork. In addition, archival materials will be used. Archives serve as a repository for memory recollection and reuse, selecting material from the audiovisual archive of the Institute of Sound & Vision will be a crucial part of the creative work which will include two films and accompanying music.
Lectorate, part of NHL Stenden Hogeschool
