OBJECTIVE: Loneliness and social isolation are pressing issues that can seriously impact the mental health and well-being of older adults. Interacting with nature can stimulate a feeling of connectedness. However, for older adults, access to nature is often troublesome because of physical limitations and mobility restrictions.METHODS: In the present mixed-method study, 37 older adults (62-99 years old) with varying care needs and mobility restrictions watched a video presenting a walkthrough of a simulated digital nature landscape.RESULTS: Quantitative results show a significant increase in social connectedness scores and enhanced peacefulness after experiencing a digital nature. Qualitative results stress the importance of variations in nature scenery and highlight the influence of contextual and person-related factors including nature experiences throughout the life span and mobility constraints that older adults may face.CONCLUSION: These findings testify to the potential of using digital nature as a complementary strategy when interactions with outdoor nature become increasingly difficult due to old age.
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Abstract: Self-management interventions (SMIs) may fail if they misalign with the local context. To optimize the implementation of SMIs in Chinese people with chronic lung disease (CLD), the local context was identified in Chinese primary care (PC) and secondary care (SC). A mixed-method study using semi-structured interviews and quantitative surveys was conducted on people with CLD and healthcare professionals (HCPs). The qualitative data was collected until data saturation was reached, and participants were invited to complete the survey after the interview. The qualitative data—analyzed with the framework approach—was triangulated with the quantitative data. A total of 52 participants completed the interviews, and 48 also finished the survey. Four themes were identified; (a) illness perceptions (e.g., patients had poor CLD knowledge and SM, inadequate resources lead to suboptimal disease control in PC); (b) self-management skills (e.g., most patients delayed exacerbation recognition and action, and some were admitted at the crisis point); (c) factors influencing self-management skills (e.g., (in)adequate disease knowledge and medical expenditure affordability); and (d) needs for self-management (e.g., increased disease knowledge, individualized self-management plan, eHealth, (healthcare insurance) policy support). Identified themes were dependent on each other and should be leveraged when implementing SMIs. Ultimately, such SMIs can optimize patient health outcomes.
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Background: The need for effective continuing education is especially high in in-hospital geriatric care, as older patients have a higher risk of complications, such as falls. It is important that nurses are able to prevent them. However, it remains unknown which interventions change the behavior of nurses. Therefore, the aim of this study is to identify intervention options to change the behavior of hospital nurses regarding fall prevention among older hospitalized patients. Methods: This study used a mixed method design. The Behavior Change Wheel (BCW) was used to identify intervention functions and policy categories to change the behavior of nurses regarding fall prevention. This study followed the eight steps of the BCW and two methods of data collection were used: five focus groups and three Delphi rounds. The focus groups were held with hospital nurses (n = 26). Geriatric experts (n = 11), managers (n = 13) and educators (n = 13) were included in the Delphi rounds. All data were collected within ten tertiary teaching hospitals in the Netherlands. All participants were included based on predefined in- and exclusion criteria and availability. Results: In Geriatric experts’ opinions interventions targeting behavior change of nurses regarding fall prevention should aim at ‘after-care’, ‘estimating fall risk’ and ‘providing information’. However, in nurses’ opinions it should target; ‘providing information’, ‘fall prevention’ and ‘multifactorial fall risk assessment’. Nurses experience a diversity of limitations relating to capability, opportunity and motivation to prevent fall incidents among older patients. Based on these limitations educational experts identified three intervention functions: Incentivisation, modelling and enablement. Managers selected the following policy categories; communication/marketing, regulation and environmental/social planning. Conclusions: The results of this study show there is a discrepancy in opinions of nurses, geriatric experts, managers and educators. Further insight in the role and collaboration of managers, educators and nurses is necessary for the development of education programs strengthening change at the workplace that enable excellence in nursing practice. DOI: https://doi.org/10.1186/s12912-021-00598-z
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The shortage for ICT personal in the EU is large and expected to increase. The aim of this research is to contribute to a better understanding of the roles and competences needed, so that education curricula can be better aligned to evolving market demand by answering the research question: Which competence gaps do we need to bridge in order to meet the future need for sufficiently qualified personnel in the EU Software sector? In this research, a mixed method approach was executed in twelve European countries, to map the current and future needs for competences in the EU. The analyses shows changes in demand regarding technical skills, e.g. low-code and a stronger focus on soft skills like communication and critical thinking. Besides this, the research showed educational institutes would do well to develop their curricula in a practical way by integration of real live cases and work together with organizations.
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Objectives: Promoting unstructured outside play is a promising vehicle to increase children’s physical activity (PA). This study investigates if factors of the social environment moderate the relationship between the perceived physical environment and outside play. Study design: 1875 parents from the KOALA Birth Cohort Study reported on their child’s outside play around age five years, and 1516 parents around age seven years. Linear mixed model analyses were performed to evaluate (moderating) relationships among factors of the social environment (parenting influences and social capital), the perceived physical environment, and outside play at age five and seven. Season was entered as a random factor in these analyses. Results: Accessibility of PA facilities, positive parental attitude towards PA and social capital were associated with more outside play, while parental concern and restriction of screen time were related with less outside play. We found two significant interactions; both involving parent perceived responsibility towards child PA participation. Conclusion: Although we found a limited number of interactions, this study demonstrated that the impact of the perceived physical environment may differ across levels of parent responsibility.
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Background: During hospitalization patients frequently have a low level of physical activity, which is an important risk factor for functional decline. Function Focused Care (FFC) is an evidencebased intervention developed in the United States to prevent functional decline in older patients. Within FFC, nurses help older patients optimally participate in functional and physical activity during all care interactions. FFC was adapted to the Dutch Hospital setting, which led to Function Focused Care in Hospital (FFCiH). FFCiH consists of four components: (1) ‘Environmental and policy assessment’; (2) ‘Education’; (3) ‘Goal setting with the patient’ and (4) ‘Ongoing motivation and mentoring’. The feasibility of FFCiH in the Dutch hospital setting needs to be assessed. Objective: Introduce FFCiH into Dutch hospital wards, to assess the feasibility of FFCiH in terms of description of the intervention, implementation, mechanisms of impact, and context. Design: Mixed method design Setting(s): A Neurological and a Geriatric ward in a Dutch Hospital. Participants: 56 Nurses and nursing students working on these wards. Methods: The implementation process was described and the delivery was studied in terms of dose, fidelity, adaptions, and reach. The mechanisms of impact were studied by the perceived facilitators and barriers to the intervention. Qualitative data were collected via focus group interviews, observations, and field notes. Quantitative data were collected via evaluation forms and attendance/participation lists. Results: A detailed description of FFCiH in terms of what, how, when, and by whom was given. 54 Nurses (96.4%) on both wards attended at least 1 session of the education or participated in bedside teaching. The nurses assessed the content of the education sessions with a mean of 7.5 (SD 0.78) on a 0–10 scale. The patient files showed that different short and long-term goals were set. Several facilitators and barriers were identified, which led to additions to the intervention. An important facilitator was that nurses experienced FFCiH as an approach that fits with the principles underpinning their current working philosophy. The experienced barriers mainly concern the implementation elements of the FFCiH-components ‘Education’ and ‘Ongoing motivation and mentoring’. Optimizing the team involvement, improving nursing leadership during the implementation, and enhancing the involvement of patients and their family were activities added to FFCiH to improve future implementation. Conclusions: FFCiH is feasible for the Dutch hospital setting. Strong emphasis on team involvement, nursing leadership, and the involvement of patients and their families is recommended to optimize future implementation of FFCiH in Dutch hospitals.
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In the present study, the role of five categories of characteristics of a reciprocal peer coaching context was studied in relation to teacher learning. Both self-reports and student perceptions were used to measure teacher learning. Data were gathered on 28 secondary school teachers (14 coaching dyads). A mixed-method approach was adopted combining quantitative and qualitative data. To study the associations between five categories of characteristics of a peer coaching context (independent variable) and teacher learning (dependent variable), questionnaire results (quantitative data) and digital diaries (qualitative data) were examined. It was found that teachers learn when they are intrinsically motivated to take part in professional development programs; when they feel a certain pressure toward experimenting with new instructional methods; and when they are able to discuss their experiences within a safe, constructive, and trustworthy reciprocal peer coaching environment.
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When examining enrollment and graduation grades, higher education remains less accessible for first-generation students. Dutch first-generation students are also less likely to attend honors talent programs. However, not much is known what is driving these effects. First-generation honors students might face identity-related and psychological challenges, such as identity incompatibility, which is associated with low levels of sense of belonging and self-efficacy. This study investigates what identity-related psychological obstacles first-generation students experience in honors talent programs through three studies using a mixed-method approach. Results showed that psychological identity factors are obstacles for first-generation students in honors talent programs, though these obstacles vary over time. First-generation students in honors talent programs experience more identity incompatibility than their continuing-generation peers. However, identity incompatibility does not influence their reasons for not participating in honors programs; instead, (lack of) self-efficacy does. Moreover, quantitative data showed that higher levels of identity incompatibility before and during the honors talent program relate to lower levels of (anticipated) sense of belonging and self-efficacy. However, the qualitative part of the study showed that students generally report relatively high levels of sense of belonging and self-efficacy in the honors talent program. Together, these results show that even though the honors talent program can be a warm and welcoming safe space for first-generation students, there also is a need for honors educators in The Netherlands and abroad to become more aware of the struggles of first-generation students and actively invest in recruiting and supporting this group of students in honors talent programs.
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The ageing of people with intellectual disabilities, with associated morbidity like dementia, calls for new types of care. Person-centered methods may support care staff in providing this, an example being Dementia Care Mapping (DCM). DCM has been shown to be feasible in ID-care. We examined the experiences of ID-professionals in using DCM. We performed a mixed-methods study, using quantitative data from care staff (N = 136) and qualitative data (focus-groups, individual interviews) from care staff, group home managers and DCM-in-intellectual disabilities mappers (N = 53). ageing, dementia, Dementia Care Mapping, intellectual disability, mixed-methods, personcentred care
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How to provide health clubs the possibility of offering distinctive services in an increasingly stronger and rapidly changing competitive environment? This was the issue raised by the Dutch fitness industry, which in recent years has grown markedly. Our study represents an extension of the dynamic capabilities framework, by exploring and suggesting a mixed method approach to operationalize the capability of customer focus. We have adapted emerging generative user research methods from the field of design as we feel that the most commonly used models and methods in marketing do not answer to the new demands of the market In our contribution we discuss the need for new methods for arriving at a customer-driven marketing approach. We demonstrate how we have transferred this to the health club industry in a study among n=5,000 customers of health clubs. We will discuss how the approach spurred new insights through multidisciplinary collaboration.
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