Purpose: To gain a rich understanding of the experiences and opinions of patients, healthcare professionals, and policymakers regarding the design of OGR with structure, process, environment, and outcome components. Methods: Qualitative research based on the constructive grounded theory approach is performed. Semi-structured interviews were conducted with patients who received OGR (n=13), two focus groups with healthcare professionals (n=13), and one focus group with policymakers (n=4). The Post-acute Care Rehabilitation quality framework was used as a theoretical background in all research steps. Results: The data analysis of all perspectives resulted in seven themes: the outcome of OGR focuses on the patient’s independence and regaining control over their functioning at home. Essential process elements are a patient-oriented network, a well-coordinated dedicated team at home, and blended eHealth applications. Additionally, closer cooperation in integrated care and refinement regarding financial, time-management, and technological challenges is needed with implementation into a permanent structure. All steps should be influenced by the stimulating aspect of the physical and social rehabilitation environment. Conclusion: The three perspectives generally complement each other to regain patients’ quality of life and autonomy. This study demonstrates an overview of the building blocks that can be used in developing and designing an OGR trajectory.
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PURPOSE: To gain a rich understanding of the experiences and opinions of patients, healthcare professionals, and policymakers regarding the design of OGR with structure, process, environment, and outcome components.METHODS: Qualitative research based on the constructive grounded theory approach is performed. Semi-structured interviews were conducted with patients who received OGR ( n = 13), two focus groups with healthcare professionals ( n = 13), and one focus group with policymakers ( n = 4). The Post-acute Care Rehabilitation quality framework was used as a theoretical background in all research steps. RESULTS: The data analysis of all perspectives resulted in seven themes: the outcome of OGR focuses on the patient's independence and regaining control over their functioning at home. Essential process elements are a patient-oriented network, a well-coordinated dedicated team at home, and blended eHealth applications. Additionally, closer cooperation in integrated care and refinement regarding financial, time-management, and technological challenges is needed with implementation into a permanent structure. All steps should be influenced by the stimulating aspect of the physical and social rehabilitation environment.CONCLUSION: The three perspectives generally complement each other to regain patients' quality of life and autonomy. This study demonstrates an overview of the building blocks that can be used in developing and designing an OGR trajectory.
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This article reports on qualitative research among 48 social professionals, managers and policymakers and their perceptions of activating citizenship, social work roles and responsibilities, carried out in Utrecht and Tartu. Professionals from both countries agreed to the idea of activating citizenship but stressing the perspective of personalised or lived citizenship, each person to his own capacities and embedded in the personal context. Nearly all respondents were critical about the recognition of social workers as a full profession, about the new management way of steering social work and about cooperation between different groups of professionals and services. Although both countries have quite different historical and cultural backgrounds, the authors found many similarities among social workers regarding their ideas on support, participation and commitment to the people they work for and work with. International research projects contribute to a more strongly recognised social work theory and social work practice by getting a better understanding, in particular of the way social work adapts to different contexts but from a highly recognisable international discourse within social work.
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Expectations are high for digital technologies to address sustainability related challenges. While research into such applications and the twin transformation is growing rapidly, insights in the actual daily practices of digital sustainability within organizations is lacking. This is problematic as the contributions of digital tools to sustainability goals gain shape in organizational practices. To bridge this gap, we develop a theoretical perspective on digital sustainability practices based on practice theory, with an emphasis on the concept of sociomateriality. We argue that connecting meanings related to sustainability with digital technologies is essential to establish beneficial practices. Next, we contend that the meaning of sustainability is contextspecific, which calls for a local meaning making process. Based on our theoretical exploration we develop an empirical research agenda.
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Rationale, aims and objective: Primary Care Plus (PC+) focuses on the substitution of hospital-based medical care to the primary care setting without moving hospital facilities. The aim of this study was to examine whether population health and experience of care in PC+ could be maintained. Therefore, health-related quality of life (HRQoL) and experienced quality of care from a patient perspective were compared between patients referred to PC+ and to hospital-based outpatient care (HBOC). Methods: This cohort study included patients from a Dutch region, visiting PC+ or HBOC between December 2014 and April 2018. With patient questionnaires (T0, T1 and T2), the HRQoL and experience of care were measured. One-to-two nearest neighbour calliper propensity score matching (PSM) was used to control for potential selection bias. Outcomes were compared using marginal linear models and Pearson chi-square tests. Results: One thousand one hundred thirteen PC+ patients were matched to 606 HBOC patients with well-balanced baseline characteristics (SMDs <0.1). Regarding HRQoL outcomes, no significant interaction terms between time and group were found (P > .05), indicating no difference in HRQoL development between the groups over time. Regarding experienced quality of care, no differences were found between PC+ and HBOC patients. Only travel time was significantly shorter in the HBOC group (P ≤ .001). Conclusion: Results show equal effects on HRQoL outcomes over time between the groups. Regarding experienced quality of care, only differences in travel time were found. Taken as a whole, population health and quality of care were maintained with PC+ and future research should focus more on cost-related outcomes.
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Health and social well-being depend on many contextual facets which are interdependent in a complex way and are all but limited to the field of cure and care. Publications of the World Health Organization and the Dutch Ministry of Health show that good health also depends on socioeconomic aspects such as stable living conditions and (pre-emptive) debt counselling. Inspired by these findings, many programs have been launched that aim for an integrated approach of health and social issues. Although these programs enjoy a lot of sympathy, the implementation proves to be difficult. Among many obstacles, more than once the financing of the program is a stumbling block. The hesitation to invest is prompted by the uncertainties of the benefits these programs aim at. These uncertainties relate to both size and distribution. The intended results are mostly long term and not always easy to monetize. Moreover, the benefits may distribute among other stakeholders than those who bore the costs of the program, the so-called ‘wrong pocket problem’. To overcome the hesitation to invest, a social cost-benefit analysis offers a remedy. Social Cost-Benefit Analysis (SCBA): A SCBA assesses the impact of an investment on society by estimating all relevant costs and revenues – both financial and non-financial – and their (re)distributions amongst stakeholders. From this perspective, this type of analysis is an important contribution to policy development. Publications of public planning and research agencies in the Netherlands underline the contribution of SCBA’s to policymaking in the field of public health and social welfare.
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Understanding the decision-making process of a boardroom is one of the most fascinating parts of organizational research. We are all interested in power games, team dynamics and how the external environment could influence the decision of directors. One of the important buzzwords of today is “good governance” and many boards face a lot of societal pressure to implement best practices of governance. It goes beyond regulatory requirements and boards need to take a different perspective on integrating governance codes and best practices in their organizations. In this study, we focused on the role of individual directors in developing organizational responses to that pressure. More specifically, we looked at how directors’ own cognitive frames of governance influence the way boards choose best practices.
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Current research on data in policy has primarily focused on street-level bureaucrats, neglecting the changes in the work of policy advisors. This research fills this gap by presenting an explorative theoretical understanding of the integration of data, local knowledge and professional expertise in the work of policy advisors. The theoretical perspective we develop builds upon Vickers’s (1995, The Art of Judgment: A Study of Policy Making, Centenary Edition, SAGE) judgments in policymaking. Empirically, we present a case study of a Dutch law enforcement network for preventing and reducing organized crime. Based on interviews, observations, and documents collected in a 13-month ethnographic fieldwork period, we study how policy advisors within this network make their judgments. In contrast with the idea of data as a rationalizing force, our study reveals that how data sources are selected and analyzed for judgments is very much shaped by the existing local and expert knowledge of policy advisors. The weight given to data is highly situational: we found that policy advisors welcome data in scoping the policy issue, but for judgments more closely connected to actual policy interventions, data are given limited value.
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This article analyses four of the most prominent city discourses and introduces the lens of urban vitalism as an overarching interdisciplinary concept of cities as places of transformation and change. We demonstrate the value of using urban vitalism as a lens to conceptualize and critically discuss different notions on smart, inclusive, resilient and sustainable just cities. Urban vitalism offers a process-based lens which enables us to understand cities as places of transformation and change, with people and other living beings at its core. The aim of the article is to explore how the lens of vitalism can help us understand and connect ongoing interdisciplinary academic debates about urban development and vice versa, and how these ongoing debates inform our understanding of urban vitalism.
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Aims and Objectives: To identify and synthesise empirical evidence on the perspectives of nurses regarding factors that enable and/or obstruct the delivery of compassionate care. Methodological Design and Justification: A scoping review was chosen for its capacity to perform a broad exploration of the available literature. Ethical Issues: This scoping review raises no ethical issues. Research Methods: This review includes studies that report enablers and barriers of compassionate care. Both qualitative and quantitative designs were included. The quality of each study was assessed using the Mixed Method Appraisal Tool (MMAT). A narrative synthesis was employed to summarise the results. Instruments: A search was conducted in the electronic databases of MEDLINE and CINAHL (1975–2021). Outcome Measures: Barriers and enablers to compassionate care from nurses' perspectives. Results: Fifteen empirical studies were included in this review. Four themes of enablers and barriers to compassionate care emerged: (1) personal characteristics, (2) professional characteristics, (3) patient-related factors, and (4) workplace-related factors. Main facilitators were a strong motivation to deliver compassionate care, the managements' support of compassion as a nursing value and operating in a healthy team culture. Main barriers were the absence of education and/or role models for compassionate care, heavy workloads, and the managements' prioritisation of task-centred care. Study Limitations: This study is limited by the inclusion of qualitative studies with small samples and the absence of data from Northern Europe and North America. Conclusions: The findings indicate that policymakers, healthcare leaders, and nursing management play an important role in nurses' ability to provide compassionate care. Through leadership that centralises compassion as a core nursing value, nurses receive greater support in prioritising compassion in patient care. This support is further enhanced by ensuring adequate staffing and manageable schedules, offering comprehensive training in compassionate care skills, and providing resources to support nurses' wellbeing. Trial Registration: PROSPERO: CRD42022324955 https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=324955.
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