This thesis describes an Action Research (AR) project aimed at the implementation of Evidence Based Practice in a mental health nursing setting in the Netherlands. The main research question addressed in this thesis is: In what way is Action Research with an empowering appropriate to implement Evidence Based Practice in a mental health nursing setting in the Netherlands and what is the effect of this implementation on the care experienced by the client, the nursing interventions and the context in this setting compared to a comparative setting? To answer this main research question, the following questions derived from it were addressed: What is Evidence Based Practice? What is known about implementing evidence-based practice in nursing through Action Research? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be more successful? Which factors have to be dealt with in a mental health nursing setting, so the implementation of EBP with AR with an empowering intent will be successful? How is EBP implemented through AR with an empowering intent and what are the outcomes for the use of evidence, the context and the facilitation in the setting? What is the effect of the implementation of EBP in mental health nursing using AR with an empowering intent on the care experienced by the client, the nursing interventions and the context compared to a comparison setting? The first two questions were answered by a search of the literature while the remaining questions were answered during the AR study conducted in two mental health organisations in the Netherlands.
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Background: Community learning is one approach to promote research competencies and to involve nurses and nursing students in research. This study examines the impact of community learning according to participants-both those inside and outside the community-in a joint nursing research project at a hospital. Method: A qualitative design was se-lected using a participatory approach. Data were col-lected through semistructured interviews, reflections, conversations, and patient input during 2 academic years. Results: Thematic analysis showed 11 themes, which were organized into three clusters: realization, transformation, and influencing factors. Participants perceived changes in practice and described how their perspectives have changed on care, education, and research. Reconsiderations led to some new or revised strategies, and influencing factors were associated with the contemporary context, degree of in-volvement, and design/facilitation. Conclusion: The impact of community learning emerged and extended beyond community boundaries, and the indicated influencing factors must be taken into account.
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Aim: to identify: (1) nursing competencies for FCC in a hospital setting; and (2) to explore perspectives on these competencies among Dutch and Australian professionals including lecturers, researchers, Registered Nurses and policy makers. Design: A multinational cross-sectional study using Q-methodology. Methods: First, an integrative review was carried out to identify known competencies regarding FCC and to develop the Q-set (search up to July 2018). Second, purposive sampling was used to ensure stakeholder involvement. Third, participants sorted the Q-set using a web-based system between May and August 2019. Lastly, the data were analysed using a by-person factor analysis. The commentaries on the five highest and lowest ranked competencies were thematically analysed. Results: The integrative review identified 43 articles from which 72 competencies were identified. In total 69 participants completed the Q-sorting. We extracted two factors with an explained variance of 24%. The low explained variance hampered labelling. Based on a post-hoc qualitative analysis, four themes emerged from the competencies that were considered most important, namely: (a) believed preconditions for FCC; (b) promote a partnership between nurses, patients and families; (c) be a basic element of nursing; and (d) represent a necessary positive attitude and strong beliefs of the added value of FCC. Three themes appeared from the competencies that were considered least important because they: (a) were not considered a specific nursing competency; (b) demand a multidisciplinary approach; or (c) require that patients and families take own responsibility. Conclusions: Among healthcare professionals, there is substantial disagreement on which nursing competencies are deemed most important for FCC. Impact: Our set of competencies can be used to guide education and evaluate practicing nurses in hospitals. These findings are valuable to consider different views on FCC before implementation of new FCC interventions into nursing practice.
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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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This research investigates the integration of stakeholders' values into the digital frameworks of Collective Management Organizations (CMOs) within the Dutch music copyright system. Utilizing Q methodology, the study captures diverse perspectives from composers, lyricists, publishers, and CMO representatives on values, value tensions, norms, and system requirements. A pilot study with four experts tested data collection methods and refined the study design for a larger, follow-up study involving 30 participants. Preliminary findings, based on factor analysis of participant rankings of 30 statements, reveal two distinct perspectives: one focused on "Fairness and Accountability," emphasizing trust-building and equitable treatment, and the other on "Technological Efficiency and Transparency," prioritizing clear information, verification mechanisms, and advanced IT systems. Qualitative insights from participant interviews provide nuanced understanding, highlighting the importance of transparency in royalty processes, balanced application of technology, and equitable royalty distribution in the digital age. This research contributes to the modernization of copyright management systems offering a conceptual model adaptable to other creative (Intellectual Property) industries
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Objective: To obtain insight into (a) the prevalence of nursing staff–experienced barriers regarding the promotion of functional activity among nursing home residents, and (b) the association between these barriers and nursing staff–perceived promotion of functional activity. Method: Barriers experienced by 368 nurses from 41 nursing homes in the Netherlands were measured with the MAastrIcht Nurses Activity INventory (MAINtAIN)-barriers; perceived promotion of functional activities was measured with the MAINtAIN-behaviors. Descriptive statistics and hierarchical linear regression analyses were performed. Results: Most often experienced barriers were staffing levels, capabilities of residents, and availability of resources. Barriers that were most strongly associated with the promotion of functional activity were communication within the team, (a lack of) referral to responsibilities, and care routines. Discussion: Barriers that are most often experienced among nursing staff are not necessarily the barriers that are most strongly associated with nursing staff–perceived promotion of functional activity.
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Background: The aim of this study is to validate a newly developed nurses' self-efficacy sources inventory. We test the validity of a five-dimensional model of sources of self-efficacy, which we contrast with the traditional four-dimensional model based on Bandura's theoretical concepts. Methods: Confirmatory factor analysis was used in the development of the newly developed self-efficacy measure. Model fit was evaluated based upon commonly recommended goodness-of-fit indices, including the χ2 of the model fit, the Root Mean Square Error of approximation (RMSEA), the Tucker-Lewis Index (TLI), the Standardized Root Mean Square Residual (SRMR), and the Bayesian Information Criterion (BIC). Results: All 22 items of the newly developed five-factor sources of self-efficacy have high factor loadings (range .40-.80). Structural equation modeling showed that a five-factor model is favoured over the four-factor model. Conclusions and implications: Results of this study show that differentiation of the vicarious experience source into a peer- and expert based source reflects better how nursing students develop self-efficacy beliefs. This has implications for clinical learning environments: a better and differentiated use of self-efficacy sources can stimulate the professional development of nursing students.
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There is a wide range of literature suggesting that implicit learning is more effective than explicit learning when acquiring motor skills. However, the acquisition of nursing skills in educational settings continues to rely heavily on detailed protocols and explicit instructions. This study aimed to examine the necessity for comprehensive protocols in the acquisition of nursing skills. In the context of bandaging techniques, three studies were conducted to investigate whether students who practiced with an instruction card containing minimal instructions (implicit group) performed comparably to the students who practiced with a protocol containing step-by-step instructions (explicit group). Study 1 was designed to determine whether both groups performed equally well in applying a bandage during training. Study 2 and 3 were designed to determine if both groups performed equally well during a retention and transfer (multitasking) test, administered after a series of three training sessions. In comparison with the explicit group, the implicit group demonstrated comparable performance with their practice attempts in Study 1 and performed equally well during the retention and transfer test in Study 2. Furthermore, several results from Study 3 indicated better performance of the implicit group. In conclusion, the use of protocols with explicit step-by-step instructions may not be essential for the acquisition of nursing skills. Instead, instructional methods that facilitate implicit learning may be preferable, as students in the implicit group demonstrated at least comparable performance in all studies and tended towards greater consistency when multitasking.
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The rising global demand for district nursing care necessitates effective strategies to support evidence-based decision-making. Despite the extensive development of nursing guidelines, adherence by district nursing teams remains suboptimal, revealing a gap between guideline development and daily practice. The Learning And Reflection for Nurses (LEARN) programme aims to bridge this gap by enhancing guideline use and fostering a learning attitude among district nursing teams. This protocol outlines the programme’s development, components and evaluation approach.
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Nursing Leadership is an important competence to develop for providing quality of care and preventing attrition of nurses. This study looked into the perceptions and experiences of nurses on practising leadership related to performing bachelor nursing competencies. Next to that awareness of the development of nursing leadership was addressed.
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