Schepen in moeilijkheden op zee leveren vaak besluitvormingsproblemen op tussen de scheepseigenaar/kapitein en de kuststaat. Kuststaten en met name de lokale overheden willen een probleem schip graag zo ver mogelijk weg sturen van hun gebied terwijl de eigenaar/kapitein zijn schip graag zo snel mogelijk naar de kust, een beschutte locatie of haven wil brengen. Het onderzoek geeft onderbouwing voor de besluitvorming rond schepen in moeilijkheden, zowel voor de zeescheepvaart als de betrokken besluitvormers van oeverstaten. Het product van het project is: een, op uitgewerkte scenario’s per scheepstype en lading gebaseerde besluitvormingsprocedure voor zeeschepen in moeilijkheden
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This study aimed to evaluate outcomes and support use in 12- to 25-year-old visitors of the @ease mental health walk-in centres, a Dutch initiative offering free counselling by trained and supervised peers.
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In the Netherlands, many parents of children with profound intellectual and multiple disabilities care for their children at home. Little is known about how parents and involved healthcare professionals share and align medical care for these children. This study aims to contribute to a better understanding of the dimensions that affect how medical care is shared and how healthcare professionals can align care with family needs. The study design was inspired by grounded theory. We analyzed in-depth interviews with 25 Dutch parents. The analysis identified five dimensions affecting how parents and professionals shared and aligned medical care: fragility, planned care, irregularities, interactions with providers, and parents’ choices. We recognized three distinctive ways these dimensions interplayed, characterizing scenarios of sharing care: dependent care, dialogical care, and autonomous care. The findings illuminated that parental distress decreased when parents could communicate about what they considered important for their child and family and its implications for sharing care. Parents developed their capacity to manage medical care and often evolved in their thinking about the quality of care and life. Sometimes this evolution was due to struggles with the care provided by professionals. Therefore, healthcare professionals may need to broaden the relational work of shared decision-making to include the sharing of medical care. Arrangements need to be continually reassessed as changes in the child’s and family’s situation trigger changes in preferred patterns of sharing care. Commitment to parents’ autonomy implies that healthcare professionals should be attentive to the parents’ emotional and relational needs.
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Introduction: Nowadays the Western mental health system is in transformation to recovery-oriented and trauma informed care in which experiential knowledge becomes incorporated. An important development in this context is that traditional mental health professionals came to the fore with their lived experiences. From 2017 to 2021, a research project was conducted in the Netherlands in three mental health organizations, focussing on how service users perceive the professional use of experiential knowledge. Aims: This paper aims to explore service users’ perspectives regarding their healthcare professionals’ use of experiential knowledge and the users’ perceptions of how this contributes to their personal recovery. Methods: As part of the qualitative research, 22 service users were interviewed. A thematic analysis was employed to derive themes and patterns from the interview transcripts. Results: The use of experiential knowledge manifests in the quality of a compassionate user-professional relationship in which personal disclosures of the professional’s distress and resilience are embedded. This often stimulates users’ recovery process. Conclusions: Findings suggest that the use of experiential knowledge by mental health professionals like social workers, nurses and humanistic counselors, demonstrates an overall positive value as an additional (re)source.
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Increasing attention has been paid to the ‘voice’ of people living with mild cognitive impairment (MCI) or dementia, but there is a lack of clarity about how everyday life is perceived from this insider’s perspective. This study aimed to explore the everyday life experiences, challenges and facilitators of individuals with MCI and dementia living at home. A scoping review of qualitative studies, guided by the Joanna Briggs Institute Reviewers Manual, was conducted. Eight databases were searched, resulting in 6345 records, of which 58 papers published between 2011 and 2021 were included. Analysis was carried out by descriptive content analysis. Findings were categorized into seven spheres of everyday life: experiences related to the condition, self, relationships, activities, environment, health and social care and public opinions. The results show many disruptions and losses in everyday life and how people try to accommodate these changes. In all areas of everyday life, people show a deep desire to have reciprocal relationships, stay engaged through participation in activities and have a sense of belonging in the community. However, more research is needed on the factors that promote and impede the sense of reciprocity and belonging.
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Background: Survivors of lymphoma experience multiple challenges after treatment. However, a lack of knowledge of in-depth experiences of lymphoma survivors in early aftercare persists. Objective: To gain an in-depth understanding of the experiences of lymphoma survivors in early aftercare who have received an aftercare consultation based on evidence-based guideline recommendations, with an advanced practice nurse. Methods: This study used a narrative design. We recruited lymphoma survivors after a best-practice aftercare consultationwith an advanced practice nurse. A total of 22 lymphoma survivors and 9 partners participated. Data were collected through narrative interviews and analyzed according to thematic narrative analysis. Results: Six themes emerged: living and dealing with health consequences, coping with work and financial challenges, having a positive outlook and dealing with uncertainty, deriving strength from and experiencing tensions in relationships, getting through tough times in life, and receiving support from healthcare professionals. Conclusions: The stories of lymphoma survivors in early aftercare revealed their experiences of how they coped with a range of challenges in their personal lives. Choosing an aftercare trajectory based on an aftercare consultation that encourages patients to think about their issues, goals, and possible aftercare options may be useful for their transition from treatment to survivorship. Implications for practice: Survivors’ social support and self-management capabilities are important aspects to be addressed in cancer care. An aftercare consultation involving shared goal setting and care planning may help nurses provide personalized aftercare.
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Background: Survivors of lymphoma experience multiple challenges after treatment. However, a lack of knowledge of in-depth experiences of lymphoma survivors in early aftercare persists. Objective: To gain an in-depth understanding of the experiences of lymphoma survivors in early aftercare who have received an aftercare consultation based on evidence-based guideline recommendations, with an advanced practice nurse. Methods: This study used a narrative design. We recruited lymphoma survivors after a best-practice aftercare consultation with an advanced practice nurse. A total of 22 lymphoma survivors and 9 partners participated. Data were collected through narrative interviews and analyzed according to thematic narrative analysis. Results: Six themes emerged: living and dealing with health consequences, coping with work and financial challenges, having a positive outlook and dealing with uncertainty, deriving strength from and experiencing tensions in relationships, getting through tough times in life, and receiving support from healthcare professionals. Conclusions: The stories of lymphoma survivors in early aftercare revealed their experiences of how they coped with a range of challenges in their personal lives. Choosing an aftercare trajectory based on an aftercare consultation that encourages patients to think about their issues, goals, and possible aftercare options may be useful for their transition from treatment to survivorship. Implications for practice: Survivors’ social support and self-management capabilities are important aspects to be addressed in cancer care. An aftercare consultation involving shared goal setting and care planning may help nurses provide personalized aftercare.
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Nursing Leadership is an important competence to develop in order to provide quality of care and prevent attrition of nurses. This research program looked into the perceptions and experiences of nurses on practising leadership. Next to that supporting the development of nursing leadership was addressed. The program has a mixed-method, action research design in which 75 in-depth interviews and 24 focus group interviews and quantitative data of 435 nurses form the backbone. According to hospital nurses, nursing leadership is related to proactiveness and voicing expertise in order to deliver good nursing care. Nevertheless, they do not feel fully competent and knowledge deficits were detected on aspects of the bachelor nursing profile, such as evidence based practice. Working-culture factors can either inhibit or encourage nursing leadership. The further awareness of unconsciously using expertise and knowledge deficits as well as team development towards a continuous safe learning environment are necessary steps for the enhancement of nursing leadership. A Nursing Leadership model was developed in which generic personal leadership competencies combined with expertise of the nurses' level of education and degrees form the essence of shared leadership in teams focussed on the realisation of good nursing care.
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Objectives The aim of this study was to examine the reciprocal association between work–family conflict and depressive complaints over time. Methods Cross-lagged structural equation modeling (SEM) was used and three-wave follow-up data from the Maastricht Cohort Study with six years of follow-up [2416 men and 585 women at T1 (2008)]. Work–family conflict was operationalized by distinguishing both work–home interference and home–work interference, as assessed with two subscales of the Survey Work–Home Interference Nijmegen. Depressive complaints were assessed with a subscale of the Hospital Anxiety and Depression scale. Results The results showed a positive cross-lagged relation between home–work interference and depressive complaints. The results of the χ 2 difference test indicated that the model with cross-lagged reciprocal relationships resulted in a significantly better fit to the data compared to the causal (Δχ 2 (2)=9.89, P=0.001), reversed causation model (Δχ 2 (2)=9.25, P=0.01), and the starting model (Δχ 2 (4)=16.34, P=0.002). For work–home interference and depressive complaints, the starting model with no cross-lagged associations over time had the best fit to the empirical data. Conclusions The findings suggest a reciprocal association between home–work interference and depressive complaints since the concepts appear to affect each other mutually across time. This highlights the importance of targeting modifiable risk factors in the etiology of both home–work interference and depressive complaints when designing preventive measures since the two concepts may potentiate each other over time.
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Research shows that victimization rates in forensic mental health care are high for both female and male patients. However, gender differences have been found in types and patterns of victimization (more sexual abuse and more complex trauma for women), cognitive appraisal, and response to traumatic events. Gender-responsive treatments focusing on trauma have been designed to adhere to these gender differences; however, despite promising research results, these interventions are yet to be introduced in many settings. This study examined how trauma is addressed in current clinical practice in Dutch forensic mental health care, whether professionals are knowledgeable of gender differences in trauma, and how gender-responsive factors such as self-esteem, self-efficacy, social relations, and coping skills are considered in treatment for female patients. We used a mixed-method design consisting of an online survey and 33 semi-structured interviews with professionals and patients. The results suggested that Dutch forensic mental health care could address trauma more structurally, and professionals could be more aware of gender differences and gender-responsive factors. Early start of trauma treatment was deemed important but was not current practice according to patients. Based on this study, guidelines were developed for gender-responsive, trauma-informed work in forensic mental health care.
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