The unexpected death of a child is one of the most challenging losses as it fractures survivors’ sense of parenthood and other layers of identity. Given that not all the bereaved parents who have need for support respond well to available treatments and that many have little access to further intervention or follow-up over time, online interventions featuring therapeutic writing and peer support have strong potential. In this article we explore how a group of bereaved mothers experienced the process of participating in an online course in therapeutic writing for the integration of grief. Our research questions were: How do parents who have lost a child experience being part of an online course in therapeutic writing? What are the perceived benefits and challenges of writing in processing their grief? We followed an existential phenomenological approach and analyzed fieldwork notes (n = 13), qualitative data from the application and assessment surveys (n = 35; n = 21), excerpts from the journals of some participants (n = 3), and email correspondence with some participants (n = 5). We categorized the results in three meaning units: (1) where does my story begin? The “both and” of their silent chaos; (2) standing on the middle line: a pregnancy that does not end; (3) closures and openings: “careful optimism” and the need for community support. Participants experienced writing as an opportunity for self-exploration regarding their identities and their emotional world, as well as a means to develop and strengthen a bond with their children. They also experienced a sense of belonging, validation, and acceptance in the online group in a way that helped them make sense of their suffering. Online writing courses could be of benefit for bereaved parents who are grieving the unexpected death of a child, but do not replace other interventions such as psychotherapy. In addition to trauma and attachment informed models of grief, identity informed models with a developmental focus might enhance the impact of both low-threshold community interventions and more intensive clinical ones. Further studies and theoretical development in the area are needed, addressing dialogical notions such as the multivoicedness of the self. Lehmann OV, Neimeyer RA, Thimm J, Hjeltnes A, Lengelle R and Kalstad TG (2022) Experiences of Norwegian Mothers Attending an Online Course of Therapeutic Writing Following the Unexpected Death of a Child. Front. Psychol. 12:809848. doi: 10.3389/fpsyg.2021.809848
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Development process of an online educational module on ‘eHealth based lifestyle-interventions’: experiences of teachers
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Abstract: Combined lifestyle interventions (CLI) are focused on guiding clients with weight-related health risks into a healthy lifestyle. CLIs are most often delivered through face-to-face sessions with limited use of eHealth technologies. To integrate eHealth into existing CLIs, it is important to identify how behavior change techniques are being used by health professionals in the online and offline treatment of overweight clients. Therefore, we conducted online semi-structured interviews with providers of online and offline lifestyle interventions. Data were analyzed using an inductive thematic approach. Thirty-eight professionals with (n = 23) and without (n = 15) eHealth experience were interviewed. Professionals indicate that goal setting and action planning, providing feedback and monitoring, facilitating social support, and shaping knowledge are of high value to improve physical activity and eating behaviors. These findings suggest that it may be beneficial to use monitoring devices combined with video consultations to provide just-in-time feedback based on the client’s actual performance. In addition, it can be useful to incorporate specific social support functions allowing CLI clients to interact with each other. Lastly, our results indicate that online modules can be used to enhance knowledge about health consequences of unhealthy behavior in clients with weight-related health risks.
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De COVID-19-pandemie heeft het belang duidelijk gemaakt van continuïteit van zorgverlening binnen de GGZ. Online behandeling is een veelbelovende oplossing daarvoor. Vaktherapie is een vaak ingezette behandeling voor psychiatrische aandoeningen. Vaktherapie is ervaringsgericht en bestaat uit beeldende, dans-, drama-, muziek-, psychomotorische en/of speltherapie. Vaktherapie wordt tot dusverre nog niet online aangeboden. Virtual Reality (VR) is een innovatieve manier om vaktherapie online aan te bieden. Eerder is een innovatieve online vaktherapieruimte ontwikkeld, de VR Health Experience (VRhExp). Hierdoor konden cliënten online vanuit huis aan vaktherapie deelnemen. De VRhExp werd door vaktherapeuten als veelbelovend beschouwd. Tegelijkertijd gaven vaktherapeuten aan specifieke interventies te missen. Het ´ARts and psychomotoR Interventions for Virtual rEality (ARRIVE)´ project stelt zich ten doel om vaktherapeutische VR-interventies te ontwikkelen en te bouwen voor de VRhExp. Vervolgens worden de VR-interventies in pilots onderzocht. Dit wordt gedaan door IT-technici, vaktherapeuten en onderzoekers met behulp van de Design Thinking methode. De VR-interventies worden Open Access beschikbaar gesteld. Door het opnemen van VR-interventies in de VRhExp wordt deze daadwerkelijk bruikbaar voor het aanbieden van online vaktherapie. Dit praktijkonderzoek wordt uitgevoerd door de lectoraten ‘Vaktherapie bij Persoonlijkheidsstoornissen’ en ‘Innovatie in de Care’ van de Hogeschool van Arnhem en Nijmegen in samenwerking met twee vaktherapeutische praktijken (MKB) en GGNet (Centrum voor Geestelijke Gezondheid). De onderzoeksresultaten worden geïmplementeerd in het onderwijs en het werkveld.
Zelfstandig wonende oudere volwassenen kunnen verschillende problemen hebben die hun levenskwaliteit beïnvloeden. Zo hebben veel oudere volwassenen slechte voedingsgewoontes en bewegen onvoldoende. Dit kan leiden tot spierverlies, verminderde mobiliteit en een hoger risico op vallen. Deze problemen zijn nog groter bij mensen met beperkte gezondheidsvaardigheden. Juist deze groep is vaak minder ontvankelijk voor het bespreken van gezondheidskwesties, daarnaast zijn ze minder goed bereikbaar. Dit kan komen doordat deze groep andere problemen heeft die leefstijl niet op de eerste plaats zet, zoals zorgen over geldzaken, huisvesting en andere zaken die meer onmiddellijke aandacht vereisen. Het is bekend dat een wijkgerichte aanpak meer impact oplevert in het bereiken van resultaten. Om deze groep te bereiken en te stimuleren hun leefstijl blijvend te verbeteren willen wij i.s.m. lokale partners een keuzetool (WP1) en leefstijlloket (WP2) ontwikkelen in de wijk Amsterdam Nieuw-West. Binnen dit loket zal een prototype van een online keuze instrument worden gebruikt om vraag en aanbod beter op elkaar af te stemmen. Het leefstijlloket inclusief keuzetool (TRL 4) wordt in een kleinschalige lab opstelling getest en doorontwikkelt (WP3). Het onderzoek levert nieuwe kennis op over hoe we (technisch) de kenmerken van ouderen kunnen matchen met verschillende leefstijlactiviteiten en hoe professionals met de (blended –online en offline begeleiding) keuzetool ouderen beter kunnen ondersteunen in de keuze van leefstijlactiviteiten. Goed aansluitende leefstijlactiviteiten verminderen de kans op vroegtijdig stoppen met de activiteiten. Het leefstijlloket zal samenwerken met lokale partners, zoals bewonersorganisaties, welzijnsorganisaties, huisartsen, fysiotherapeuten en diëtisten om de diensten te leveren die nodig zijn om deze groep te ondersteunen en resultaten te boeken. Het leefstijlloket kan al deze partners ondersteunen. Bovendien geeft studenten en docent-onderzoekers de kans vragen op te halen en te leren in de praktijk en wijkbewoners, professionals en stakeholders te profiteren van de nieuwe kennis en kunde binnen de Hogescholen.
communicative participation, language disordersOBJECTIVE(S)/RESEARCH QUESTION(S) Speech and language therapists (SLTs) are the primary care professionals to treat language and communication disorders. Their treatment is informed by a variety of outcome measures. At present, diagnosis, monitoring of progress and evaluation are often based on performance-based and clinician-reported outcomes such as results of standardized speech, language, voice, or communication tests. These tests typically aim to capture how well the person can produce or understand language in a controlled situation, and therefore only provide limited insight in the person’s challenges in life. Performance measures do not incorporate the unobservable feelings such as a patient's effort, social embarrassment, difficulty, or confidence in communication. Nor do they address language and communication difficulties experienced by the person themselves, the impact on daily life or allow patients to set goals related to their own needs and wishes. The aim of our study is give our patients a voice and empower SLTs to incorporate their patient's perspective in planning therapy. We will Aangemaakt door ProjectNet / Generated by ProjectNet: 08-12-2020 12:072Subsidieaanvraag_digitaal / Grant Application_digitaalDossier nummer / Dossier number: 80-86900-98-041DEFINITIEFdevelop a valid and reliable patient-reported outcome measure that provides information on communicative participation of people with communication disorders and integrate this item bank in patient specific goal setting in speech and language therapy. Both the item bank and the goal setting method will be adapted in cocreation with patients to enable access for people with communication difficulties.STUDY DESIGN Mixed methods research design following the MRC guidance for process evaluation of complex interventions, using PROMIS methodology including psychometric evaluation and an iterative user-centered design with qualitative co-creation methods to develop accessible items and the goal setting method.RESEARCH POPULATION Children, adolescents and adults with speech, language, hearing, and voice disorders.OUTCOME MEASURES An online patient-reported outcome measure on communicative participation, the Communicative Participation Item Bank (CPIB), CPIB items that are accessible for people with language understanding difficulties, a communicative-participation person-specific goal setting method developed with speech and language therapists and patients and tested on usability and feasibility in clinical practice, and a course for SLTs explaining the use of the goal-setting method in their clinical reasoning process.RELEVANCE This study answers one of the prioritized questions in the call for SLTs to systematically and reliably incorporate the clients’ perspective in their daily practice to improve the quality of SLT services. At present patient reported outcomes play only a small role in speech and language therapy because 1) measures (PROMS) are often invalid, not implemented and unsuitable for clinical practice and 2) there is a knowledge gap in how to capture and interpret outcomes from persons with language disorders.
