The professional growth of midwives, essential for optimizing midwifery leadership globally, can be enhanced through twinning collaborations. How twinning promotes growth is unclear. This case study explores how professional growth is affected by cultural differences between twins. We used a longitudinal qualitative design including data from open-ended questionnaires and focus groups. These data were analyzed using a content analysis. Our findings show that cultural differences were capable of both hindering and facilitating professional growth. Within the complex dynamics of twinning, professional growth was facilitated by twins’ preparedness to bridge cultural differences. Common goals positively influenced this process. Friction was more likely, and professional growth was hindered, when midwives were unprepared to bridge cultural differences. To optimize professional growth through twinning, we recommend a clear focus on common goals and consideration of the interaction between the length of a project and the extent of the cultural differences between twins.
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In Nurse Academy verscheen het volgende artikel met Martine Lammertink van PsyQ / Parnassia Groep als eerste auteur:Lammertink, M. & van Meijel, B. (2014). Het cultureel interview. Nurse Academy GGZ, 3, 32 - 35. Ook Robert Meijburg, opleider Parnassia Groep, en Diana Polhuis, Hoofdopleider GGZ-VS, leverden een bijdrage aan dit artikel, waarvoor dank. Nurse Academy hanteert echter als beleid dat er max twee auteur aan een artikel worden gekoppeld. In de geestelijke gezondheidszorg in Nederland zien hulpverleners steeds meer mensen van verschillende etnische en culturele achtergronden. In deze gevalsbeschrijving wordt bekeken hoe de hulpverlener door middel van het zogeheten ‘cultureel interview’ de culturele achtergrond van de patiënt ziet en vanuit dit perspectief de behandeling kan vormgeven. Na het lezen van dit artikel kunt/weet u: – het belang van aandacht voor en kennis over de culturele achtergrond van de patiënt – het belang van cultureel interview – de opbouw van het cultureel interview
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De publicatielijst bevat alle publicaties waar Robbert Gobbens aan bijgedragen heeft in de periode 2005 - 2020
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Een Duits verzorgingstehuis nodigde recent aangekomen vluchtelingen uit die geïnteresseerd waren in werken in de ouderenzorg. Het doel van deze studie was om inzicht te krijgen in hoe gevestigde zorgverleners en eerstegeneratie immigranten nieuwkomers sleutelden aan waarden om de zorg voor mensen met dementie vorm te geven. Deze etnografische studie omvatte 200 uur observatie, 24 diepte-interviews en twee focusgroepinterviews met zes immigranten van de eerste generatie en zes gevestigde personeelsleden. De gevestigde zorgverleners en immigranten van de eerste generatie toonden zich bereid en in staat om te sleutelen aan situaties waarin verschillende waarden een rol speelden. Wanneer de werklast echter te zwaar wordt, kunnen medewerkers uit beide groepen gevoelens van machteloosheid, onverschilligheid en demotivatie ervaren. Institutionele beperkingen hebben een negatieve invloed op de interactie tussen gevestigde zorgverleners en immigranten van de eerste generatie die nieuwkomers zijn en beïnvloeden hun uitvoering van de zorg voor geriatrische bewoners met dementie. In dergelijke situaties wordt het cruciaal voor het personeel om een ondersteunende supervisor te hebben die hen kan helpen om te gaan met de dagelijkse stressfactoren van hun praktijk.
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Many visitor studies make social background variables the central point of departure to explain participation patterns. How the past is 'staged', however, also has an influence on those to whom it appeals. This relational perspective calls for new conceptual tools to grasp empirical reality. Inspired by the historical philosophy of Georg Simmel and the literary theory of Mikhail Bakhtin a number of concepts which enable us to grasp the subtle relationship between museum presentations and visitors are presented. Bakhtin's notion of chronotopy serves as a key concept. By linking museum presentations and visitor perceptions with each other, it is also possible to identify certain tendencies within the contemporary museum landscape.
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The aim of this study was to assess the predictive ability of the frailty phenotype (FP), Groningen Frailty Indicator (GFI), Tilburg Frailty Indicator (TFI) and frailty index (FI) for the outcomes mortality, hospitalization and increase in dependency in (instrumental) activities of daily living ((I)ADL) among older persons. This prospective cohort study with 2-year follow-up included 2420 Dutch community-dwelling older people (65+, mean age 76.3±6.6 years, 39.5% male) who were pre-frail or frail according to the FP. Mortality data were obtained from Statistics Netherlands. All other data were self-reported. Area under the receiver operating characteristic curves (AUC) was calculated for each frailty instrument and outcome measure. The prevalence of frailty, sensitivity and specifcity were calculated using cutoff values proposed by the developers and cutoff values one above and one below the proposed ones (0.05 for FI). All frailty instruments poorly predicted mortality, hospitalization and (I)ADL dependency (AUCs between 0.62–0.65, 0.59–0.63 and 0.60–0.64, respectively). Prevalence estimates of frailty in this population varied between 22.2% (FP) and 64.8% (TFI). The FP and FI showed higher levels of specifcity, whereas sensitivity was higher for the GFI and TFI. Using a different cutoff point considerably changed the prevalence, sensitivity and specifcity. In conclusion, the predictive ability of the FP, GFI, TFI and FI was poor for all outcomes in a population of pre-frail and frail community-dwelling older people. The FP and the FI showed higher values of specifcity, whereas sensitivity was higher for the GFI and TFI.
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Abstract Introduction: More and more researchers are convinced that frailty should refer not only to physical limitations but also to psychological and social limitations that older people may have. Such a broad, or multidimensional, definition of frailty fits better with nursing, in which a holistic view of human beings, and thus their total functioning, is the starting point. Purpose: In this article, which should be considered a Practice Update, we aim at emphasizing the importance of the inclusion of other domains of human functioning in the definition and measurement of frailty. In addition, we provide a description of how district nurses view frailty in older people. Finally, we present interventions that nurses can perform to prevent or delay frailty or its adverse outcomes. We present, in particular, results from studies in which the Tilburg Frailty Indicator, a multidimensional frailty instrument, was used. Conclusion: The importance of a multidimensional assessment of frailty was demonstrated by usually satisfactory results concerning adverse outcomes of mortality, disability, an increase in healthcare utilization, and lower quality of life. Not many studies have been performed on nurses’ opinions about frailty. Starting from a multidimensional definition of frailty, encompassing physical, psychological, and social domains, nurses are able to assess and diagnose frailty and conduct a variety of interventions to prevent or reduce frailty and its adverse effects. Because nurses come into frequent contact with frail older people, we recommend future studies on opinions of nurses about frailty (e.g., screening, prevention, and addressing).
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Purpose: To examine the development of multidimensional frailty, including physical, psychological and socialcomponents, over a period of seven years. To determine the effects of sociodemographic factors (gender, age, marital status, education, income) on the development of frailty. Methods: : This longitudinal study was conducted in sample of 479 community-dwelling people aged ≥ 75 years living in the municipality of Roosendaal, the Netherlands. The Tilburg Frailty Indicator (TFI), a self-report questionnaire, was used to collect data about frailty. Frailty was assessed annually. Results: : Frailty increased significantly over seven years among the people who completed the entire TFI all years (n = 121), the average score was 3.75 (SD 2.80) at baseline and 5.05 (SD 3.18) after seven years. Regarding frailty transitions, most participants remained unchanged from their baseline status. The transition from non-frail to frail was present in 8.3% to 12.6% of the participants and 5.1% to 10.7% made a transition from frail to nonfrail. Gender (woman), age (≥80 years), marital status (not married/cohabiting), high level of education, and incomes from €601-€1800 were significantly associated with a higher frailty score. Conclusion: : This study showed that multidimensional frailty, assessed with the TFI, increased among Dutch community-dwelling people aged ≥75 years using a follow-up of seven years. Gender, age, marital status, education, and income were associated with frailty transitions. These findings provide healthcare professionals clues to identify people at increased risk of frailty, and target interventions which aim to prevent or delay frailty and its adverse outcomes, such as disability and mortality.
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Background: Over the years, a plethora of frailty assessment tools has been developed. These instruments can be basically grouped into two types of conceptualizations – unidimensional, based on the physical–biological dimension – and multidimensional, based on the connections among the physical, psychological, and social domains. At present, studies on the comparison between uni- and multidimensional frailty measures are limited. Objective: The aims of this paper were: 1) to compare the prevalence of frailty obtained using a uni- and a multidimensional measure; 2) to analyze differences in the functional status among individuals captured as frail or robust by the two measures; and 3) to investigate relations between the two frailty measures and disability.
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Objective: The Tilburg Frailty Indicator (TFI) is a self-report user-friendly questionnaire for assessing multidimensional frailty among community-dwelling older people. The main aim of this study is to re-evaluate the validity of the TFI, both cross-sectionally and longitudinally, focusing on the predictive value of the total TFI and its physical, psychological, and social domains for adverse outcomes disability, indicators of healthcare utilization, and falls. Methods: The validity of the TFI was determined in a sample of 180 Dutch communitydwelling older people aged 70 years and older. The participants completed questionnaires including the TFI, the Groningen Activity Restriction Scale (GARS) for assessing disability, and questions with regard to health care utilization and falls in 2016 and again one year later. Results: The physical and psychological domains of the TFI were significantly correlated as expected with adverse outcomes disability, many indicators of healthcare utilization, and falls. Regression analyses showed that physical frailty was mostly responsible for the effect of frailty on the adverse outcomes. The cross-sectional and longitudinal predictive validity of total frailty with respect to disability and receiving personal care was excellent, evidenced by Areas Under the Curves (AUCs) >0.8. In most cases, using the cut-off point 5 for total frailty ensured the best values for sensitivity and specificity. Conclusion: The present study provided new, additional evidence for the validity of the TFI for assessing frailty in Dutch community-dwelling older people aiming to prevent or delay adverse outcomes, including disability.
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