The development of an integrated ethical or normative model to design housing for persons with impairments and diseases, focusing on older persons with dementia.
Purpose: When designing a nursing home, architects and planners need to consider ways to provide patients and caregivers with a feeling of a natural setting and being a part of the outdoor world as well as considering themes such as having accessible gardens that take the total well-being of its residents1. A substantial mountain of evidence suggests that participating in green and gardening activities for people with dementia provides a positive response in such patients2-5. Experiencing the natural world and relaxing in fresh air and daylight are considered beneficial to well-being and health. The limitations of people with dementia often mean they are dependent on the people around them to provide them with opportunities to access a green environment as described above. This study focuses on the essential design needed for gardens to be enjoyed by people with dementia as part of an enriched living environment. Method: First, literature and studies providing evidence of the beneficial effect of gardening and gardens on persons with dementia were reviewed. The analysis focused on (i) the accessibility of nursing home gardens, (ii) ways we can entice people with dementia to go into the garden (independently), and (iii) ways we can motivate these people to want to stay in the garden, once they enter it. Results & Discussion: A green area offers nursing home patients, their families and caregivers many opportunities to socialize, to reminiscence and to regain an increased sense of autonomy. Therefore, encouraging people with dementia to stay in a green area more often and to participate in gardening and other activities is desirable. Caregivers can also benefit from the positive effects, such as improvements in mood and stress levels. Only limited evidence is available based on the effects of green environments on the quality of life of people with dementia, because of research limitations, small samples sizes and a lack of appropriate measurement instruments, as well as the researcher's inability to specify and define factors influencing the results, etc. Qualitative research data provide the initial guidelines for providing increased attention to the design of garden spaces and related activities. Despite the positive aspects of a garden, many Dutch nursing homes have gardens that suffer from poor accessibility. We also find that people with dementia often want to go back inside a nursing home once they enter an outdoor environment.
"Objectives: Research on what matters most to people with dementia is crucial for developing tailored interventions and support. This study explored how people with dementia experience their everyday lives, providing insight into what is important to them to live the best they can at home. Methods: Inspired by a phenomenological approach, open interviews were conducted with 15 people with dementia, supplemented by home tours and walking interviews. Data collection included one to three sessions per participant. Data were analysed using descriptive content analysis and followed the phases of open, axial, and selective coding. A co‐researcher group of seven people with dementia was consulted during the analysis to help interpret the emergent findings. Findings: Six dimensions of what matters most in everyday life were identified: 1) Engaging in meaningful activities, which included routines, household chores, leisure, day activities, and volunteering or work; 2) Keeping a sense of connection, in relationships within the home, with family, friends, groups, and the neighbourhood; 3) Having a sense of belonging, which included attachments inside and outside the home, and to cherished objects; 4) Connecting to self, which included the ability to reflect on past experiences, live in the present moment and anticipate the future; 5) Adjusting to ongoing changes, which included alterations in sensory perceptions, perceptions of the physical environment, and navigating shifts in interpersonal dynamics; 6) Being open to help and support, from professionals, community and society. Conclusions: For people with dementia, everyday life is a continuous balancing act between what matters most and what can be achieved daily. This is not only related to dementia but is also embedded in the wider perspective of life history, relational networks, and the physical environment. This study highlights the importance of identifying what matters most to people with dementia to provide person‐centred support."
Wat dragen creatieve onderzoeksmethodes bij aan vernieuwing binnen de zorg? We onderzoeken dit binnen tien projecten van het Create Health-programma van ZonMw. In deze projecten wordt kennis ontwikkeld over de toegevoegde waarde van creatieve manieren van werken bij e-health innovatie. Informatie over de onderzoeksresultaten is te vinden op de website: husite.nl/creatieve-onderzoeksmethodes en het artikel: CHIWaWA maakt samenwerking in create-health onderzoek inzichtelijk | Hogeschool Utrecht (hu.nl)Doel Het Create Health programma heeft tot doel om bij te dragen aan maatschappelijke uitdagingen rondom gezond en actief ouder worden. CHIWaWA werkt daarbij toe naar een conceptueel model dat manieren van werken in kaart brengt in create health projecten – gekoppeld aan theorie over boundary crossing en research impact – met betrekking tot projectuitkomsten en kennis-, persoonlijke-, en systeemontwikkeling van betrokken actoren. Resultaten onderzoek Kennis die zowel online als offline te raadplegen is, in een boek, in wetenschappelijke artikelen en op een website. Deze kennis bevat: Inzicht in kansen om impact van e-health innovatie in ‘create health’-samenwerking te vergroten; Projectnarratieven met ‘best practices’ voor interdisciplinaire samenwerking waarbij onderzoekers, creatieve industrie en zorgprofessionals betrokken zijn; Guidelines voor ontwikkelaars van e-health applicaties m.b.t. samenwerking met de creatieve industrie; Guidelines voor beleidsmakers m.b.t. het stimuleren van samenwerking tussen zorg en creatieve industrie en het gebruik van creatieve manieren van werken om onderzoek naar de praktijk te krijgen; Aanpak Vanuit een service-dominant logic perspectief wordt bekeken hoe toegepaste kennis en skills worden gedeeld tussen actoren die betrokken zijn bij de verschillende ‘create health’-projecten, wat de meerwaarde daarvan is en wat actoren van die uitwisseling – als proces – leren. De focus ligt op co-creatie van waarde, die door samenwerking en uitwisseling tot stand komt. Door middel van procesonderzoek wordt er toegewerkt naar bijdragen aan theorieontwikkeling op het gebied van boundary crossing en contribution mapping. Resultaten Eindpublicatie: Create Health: Samenwerking tussen zorg, wetenschap en creatieve industrie (2023) Boek: Create Ways of Working. Insights from ten ehealth Innovation research projects (2022) Website www.creatieveonderzoeksmethodes.nl (2022) Bijdragen aan conferenties en symposia Co-design in de anderhalvemetermaatschappij (whitepaper), Dutch Design Week 2020. Download de presentatieslides. Collaborating in complexity. Strategies for interdisciplinary collaboration n design work, Design4Health conference 2020 Grounding Practices. How researchers ground their work in create-health collaborations for designing e-health solutions, Design4Health conference 2020 Seven ways to foster interdisciplinary collaboration in research involving healthcare and creative research disciplines, DementiaLab conference 2019 Posterpresentatie: Health x Design, DementiaLab conference 2019 Meer informatie over het Create Health programma Het ZonMw programma Create Health heeft als doel om bij te dragen aan de maatschappelijke uitdaging rondom gezond en actief ouder worden. Binnen het programma worden activiteiten uitgezet waarbij de samenwerking tussen de creatieve industrie en zorg en welzijn voorop staat. Het gaat hierbij om publiek-private samenwerking (PPS).
Met het onderzoek Co-creatie, kunst & media en kwetsbare ouderen wil Saskia van de Ree de voorwaarden van het co-creatieve proces van participatieve kunst & mediaprojecten duiden. Als casus is gekozen voor het project Domweg gelukkig in Groningen van Samen in Beeld-TV. Dit Groningse mediaproject maakt televisie met, voor en door ouderen om eenzaamheid aan te pakken. Door de benadering van het werkproces vanuit het meervoudige perspectief van onderliggende ethische, economische, artistieke en sociale aspecten, toetst onderzoeker Saskia van de Ree een door haar ontworpen hybride theoretisch kader op deze concrete participatieve kunst & media- praktijk. Het onderzoek belicht de meervoudigheid van waardecreatie in de sociaal artistieke praktijk en duidt de werkwijze in termen van : 1) de empowerment van kwetsbare groepen 2) waardering van het project in termen van draagvlak en borging 3) kunst en media als ontmoeting/katalysator en 4) co-creatie als een vorm van samen werken en leren. Het onderzoek valt onder de onderzoekslijn Art & Dementia van het lectoraat Image in Context (Academie Minerva, Hanzehogeschool Groningen) en wordt begeleid door dr Anke Coumans.
Pre-eclampsia (PE) is a common and severe pregnancy complication and is associated with substantial perinatal morbidity and mortality in mothers and infants. The disease is often characterized by a non-specific presentation which makes it challenging for physician to diagnose PE during regular pregnancy check-ups. To date, there are no diagnostic tests on the market for detection of PE early in pregnancy (first trimester). In this project, we will develop a platform to sensitively analyse calcium-binding proteins (CBPs) which will unlock the full potential of CBPs as predictive PE markers. The technology will also be applicable for other diseases (e.g., dementia and cancer) where CBPs are also known to play a key role in disease pathophysiology. We will develop with phage display antibodies that can recognize calcium binding to specific motifs in proteins. To this end we will synthesize peptide motifs with and without calcium to select antibodies that are specific for calcium bound proteins. These antibodies will be validated for their clinical use. For this goal we will use serum samples from the Improved studie (EU subsidised study) to determine if we can recognize pre-eclampsia in a very early stage. This knowledge can lead to a better treatment of pregnant women suffering from this disease and also will probably increase the well-being for the baby born and the development further in life.
