This chapter revisits the concept of internationalisation at home in light of the COVID pandemic and also of experiences and ongoing discourses on internationalisation. These include how internationalisation at home relates to diversity, inclusion and decolonisation of curricula. It discusses how the COVID pandemic has led to increased attention to internationalisation at home but also that confusion about terminology and the desire for physical mobility to be available to students may lead us to return to pre-COVID practices, in which internationalisation is mainly understood as mobility for a small minority of students and internationalisation of the home curriculum is a poor second best. A component of this chapter is how Virtual Exchange and Collaborative Online International Learning (COIL) have moved into the spotlight during the pandemic but were already in focus areas well before. This will be illustrated by some recent developments in internationalisation at home, mainly from non-Anglophone, European and particularly Dutch perspectives.
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Key summary points Aim To reach consensus on terminology, organisational aspects, and outcome domains of geriatric rehabilitation for older people living at home. Findings In three rounds, an international panel reached a consensus regarding the term “home-based geriatric rehabilitation” to distinguish it from inpatient rehabilitation. The panel also identifed key organisational aspects essential for its implementation and concluded that participation and activity are the primary outcome domains to focus on. Message The results of this International Delphi shows consensus of experts on various topics in home-based GR, which is important to further develop international collaboration, development and research on this topic. Abstract Purpose Internationally, many diferences are observed regarding the practice of geriatric rehabilitation for older people living at home. To improve international collaboration and research on this topic, we aimed to reach a consensus on terminology, organisational aspects, and outcome domains to focus on. Methods We conducted a three-round online Delphi study among 60 (Home-based) geriatric rehabilitation experts from 14 countries. In the frst round, we collected diverse perspectives and input through statements and questions. In the subsequent rounds, participants rated statements on a 5-point Likert scale. Each statement could be accompanied by written feedback. After each round, results were presented anonymously to the participants, and statements on which no consensus was reached were rephrased. Consensus was defned as 70% or more participants (fully) agreeing with a statement. Results Sixty, 52, and 46 experts completed rounds 1, 2 and 3, respectively. After two rounds, we reached a consensus on ten statements and on the remaining four in the last round. A consensus was reached on the terminology used (i.e., home-based geriatric rehabilitation) and on several organisational aspects (e.g., essential aspects to consider for starting home-based geriatric rehabilitation and the importance of a knowledgeable case manager). Lastly, experts agreed that participation and activity are the most important outcome domains to focus on. Conclusions Through an international Delphi study, we reached consensus on various important aspects of home-based geriatric rehabilitation. These outcomes provide a basis for further development of this emerging feld.
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Background The sense of home of nursing home residents is a multifactorial phenomenon which is important for the quality of living. This purpose of this study is to investigate the factors influencing the sense of home of older adults residing in the nursing home from the perspective of residents, relatives and care professionals. Methods A total of 78 participants (n = 24 residents, n = 18 relatives and n = 26 care professionals) from 4 nursing homes in the Netherlands engaged in a qualitative study, in which photography was as a supportive tool for subsequent interviews and focus groups. The data were analyzed based on open ended coding, axial coding and selective coding. Results The sense of home of nursing home residents is influenced by a number of jointly identified factors, including the building and interior design; eating and drinking; autonomy and control; involvement of relatives; engagement with others and activities; quality of care are shared themes. Residents and relatives stressed the importance of having a connection with nature and the outdoors, as well as coping strategies. Relatives and care professionals emphasized the role the organization of facilitation of care played, as well as making residents feel like they still matter. Conclusions The sense of home of nursing home residents is influenced by a multitude of factors related to the psychology of the residents, and the social and built environmental contexts. A holistic understanding of which factors influence the sense of home of residents can lead to strategies to optimize this sense of home. This study also indicated that the nursing home has a dual nature as a place of residence and a place where people are supported through numerous care strategies.
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Increasingly, internationalisation at home and internationalisation of the curriculum are adopted by universities across the globe but their systemic implementation is a complex process. For instance, academics and academic disciplines understand and approach internationalisation differently, as previous studies have shown. However, there is little research on the role of such disciplinary perspectives in relation to different internationalisation practices and interventions. Using the Becher-Biglan framework of academic tribes, this exploratory study compares 12 undergraduate programmes at a Dutch university of applied sciences and addresses the question if the different disciplinary approaches to internationalisation as identified in previous studies are also reflected in the choices of internationalisation at home activities. The findings show there is more variation in the range of activities rather than in the types of activities and that it is within the rationales underlying those choices where the influence of disciplinary perspectives is more visible.
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PurposeInternationally, many differences are observed regarding the practice of geriatric rehabilitation for older people living at home. To improve international collaboration and research on this topic, we aimed to reach a consensus on terminology, organisational aspects, and outcome domains to focus on.MethodsWe conducted a three-round online Delphi study among 60 (Home-based) geriatric rehabilitation experts from 14 countries. In the first round, we collected diverse perspectives and input through statements and questions. In the subsequent rounds, participants rated statements on a 5-point Likert scale. Each statement could be accompanied by written feedback. After each round, results were presented anonymously to the participants, and statements on which no consensus was reached were rephrased. Consensus was defined as 70% or more participants (fully) agreeing with a statement.ResultsSixty, 52, and 46 experts completed rounds 1, 2 and 3, respectively. After two rounds, we reached a consensus on ten statements and on the remaining four in the last round. A consensus was reached on the terminology used (i.e., home-based geriatric rehabilitation) and on several organisational aspects (e.g., essential aspects to consider for starting home-based geriatric rehabilitation and the importance of a knowledgeable case manager). Lastly, experts agreed that participation and activity are the most important outcome domains to focus on.ConclusionsThrough an international Delphi study, we reached consensus on various important aspects of home-based geriatric rehabilitation. These outcomes provide a basis for further development of this emerging field.
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Are you looking for some tips to stay focused on your studies, now that education has gone online? Have a read through the tips below from the Study Success research group. These tips have been compiled on the basis of scientific insight from cognitive psychology, neuropsychology and educational science, as well as our own studies into motivation, stress, enthusiasm and drop-out.
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Hospitals are encouraged to provide care closer to patients’ homes. This study investigates how patients, informal caregivers, and nurses experience home-based hospital-level care for decompensated heart failure. This mixed-methods study employed semi-structured interviews with 11 patients and 4 informal caregivers, a questionnaire administrated to 16 nurses from the intensive care, cardiac care, and general cardiology ward, and interviews with 4 nurses, supplemented by two group discussions. A convenience sample was utilized, member checks were performed, and two researchers analysed the patient interviews using thematic analysis based on the normalization process theory. Five overarching themes emerged: (i) Appreciation of personal environment, routines, and autonomy. (ii) Quality of care. (iii) Commitment to the treatment. (iv) Influence of personal characteristics. (v) Changing role of informal caregivers. Regarding nurse satisfaction, findings were mapped according to Proctor et al.’s implementation outcomes: acceptability: hospital-at-home care increases job satisfaction, through increased autonomy, personalized care, and patient satisfaction; appropriateness: hospital-at-home was perceived positively, although safety and adherence needed attention; adoption: hospital-at-home was not particularly challenging but offered a refreshing change; feasibility: on-call duty impacted personal commitments for some nurses; fidelity: information folders with clear protocols were deemed helpful. Patients, caregivers, and nurses generally favour home-based heart failure treatment over hospital-based treatment. Key conditions include comprehensive education on home treatment, adherence support like dietary restriction maintenance, prioritizing patient autonomy, recognizing caregiver burden, and exploring cost-effective strategies such as collaboration with home care organizations. Hoofdstuk in boek: https://www.techwijsinzorgenwelzijn.nl/
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To face the challenges of an ageing population, many Western countries nowadays stimulate an ageing in place policy to empower older adults to grow old in their own homes with the highest degree of self‐reliance. However, many community‐living older adults experience limitations in (instrumental) activities of daily living ((I)ADLs), which may result in a need for home‐care services. Unfortunately, home‐care workers often provide support by taking over tasks, as they are used to doing things for older adults rather than with them, which undermines their possibilities to maintain their self‐care capabilities. In contrast, reablement focuses on capabilities and opportunities of older adults, rather than on disease and dependency. Consequently, older adults are stimulated to be as active as possible during daily and physical activities. The 'Stay Active at Home' programme was designed to train home‐care workers to apply reablement in practice. To explore the experiences of home‐care workers with this programme an exploratory study was conducting in the Netherlands, between April and July, 2017. In total, 20 participants were interviewed: nine nurses (including a district nurse), 10 domestic support workers and the manager of the domestic support workers. The semi‐structured interviews focused on the experienced improvements with regard to knowledge, skills, self‐efficacy and social support. Furthermore, the most and least appreciated programme components were identified. The study has shown that home‐care workers perceived the programme as useful to apply reablement. However, they also need more support with mastering particular skills and dealing with challenging situations. Future implementation of the 'Stay Active at Home' programme can potentially benefit from small adaptions. Furthermore, future research is needed to examine whether the programme leads to more (cost‐) effective home care.
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What tips would you give to your fellow students or to your study programme? These can be tips relating to well-being, online education or studying at home. We asked this question in the international well-being questionnaire. All of the tips have been analysed and organised into tips for fellow students, teachers and bachelor programmes. On top of that, we compared the tips with our previous well-being survey from 2018. It is clear that, while many of the tips for students are the same, there is now a greater emphasis on mutual contact and studying together. Creating a fixed daily schedule was mentioned many times as well this time. For lecturers personal contact seems to be even more important now, especially amongst students in their final year. Other frequently mentioned topics include online interaction, flexibility and support with planning. For the bachelor programmes clarity and information were already important before, but these seem to be absolute necessities during the corona crisis.
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Background: According to the principles of Reablement, home care services are meant to be goal-oriented, holistic and person-centred taking into account the capabilities and opportunities of older adults. However, home care services traditionally focus on doing things for older adults rather than with them. To implement Reablement in practice, the ‘Stay Active at Home’ programme was developed. It is assumed that the programme leads to a reduction in sedentary behaviour in older adults and consequently more cost-effective outcomes in terms of their health and wellbeing. However, this has yet to be proven. Methods/ design: A two-group cluster randomised controlled trial with 12 months follow-up will be conducted. Ten nursing teams will be selected, pre-stratified on working area and randomised into an intervention group (‘Stay Active at Home’) or control group (no training). All nurses of the participating teams are eligible to participate in the study. Older adults and, if applicable, their domestic support workers (DSWs) will be allocated to the intervention or control group as well, based on the allocation of the nursing team. Older adults are eligible to participate, if they: 1) receive homecare services by the selected teams; and 2) are 65 years or older. Older adults will be excluded if they: 1) are terminally ill or bedbound; 2) have serious cognitive or psychological problems; or 3) are unable to communicate in Dutch. DSWs are eligible to participate if they provide services to clients who fulfil the eligibility criteria for older adults. The study consists of an effect evaluation (primary outcome: sedentary behaviour in older adults), an economic evaluation and a process evaluation. Data for the effect and economic evaluation will be collected at baseline and 6 and/or 12 months after baseline using performance-based and self-reported measures. In addition, data from client records will be extracted. A mixed-methods design will be applied for the process evaluation, collecting data of older adults and professionals throughout the study period. Discussion: This study will result in evidence about the effectiveness, cost-effectiveness and feasibility of the ‘Stay Active at Home’ programme.
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