Motivational Interviewing (MI) can effectively stimulate motivation for health behavior change, but the active ingredients of MI are not well known. To help clinicians further stimulate motivation, they need to know the active ingredients of MI. A psychometrically sound instrument is required to identify those ingredients. The purpose of this study is to describe and evaluate the capability of existing instruments to reliably measure one or more potential active ingredients in the MI process between clients and MI-therapists.
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ABSTRACT Purpose: To gain insight into determinants of physical activity in wheelchair users with spinal cord injury or lower limb amputation, from the perspective of both wheelchair users and rehabilitation professionals. Methods: Seven focus groups were conducted: five with wheelchair users (n=25) and two with rehabilitation professionals (n¼11). The transcripts were analysed using a sequential coding strategy, in which the reported determinants of physical activity were categorized using the Physical Activity for people with a Disability (PAD) model. Results: Reported personal determinants of physical activity were age, general health status, stage of life, demotivation due to difficulty burning calories, available time and energy, balance in daily life, attitude, and history of a physically active lifestyle. Reported environmental determinants were professional guidance, inconvenient exercise times, accessibility of facilities, costs, transportation difficulties, equipment difficulties, and social support. Conclusions: Important, changeable determinants of physical activity that might be influenced in future lifestyle interventions for wheelchair users are: balance in daily life leading to more time and energy to exercise, attitude towards physical activity, professional guidance, accessibility of facilities (providing information on how and where to find accessible facilities), and social support (learning how to get this)
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Artikel proefschrift Jos Dobber verschenen in Frontiers in Psychiatry 24 maart 2020: Background: Trials studying Motivational Interviewing (MI) to improve medication adherence in patients with schizophrenia showed mixed results. Moreover, it is unknown which active MI-ingredients are associated with mechanisms of change in patients with schizophrenia. To enhance the effect of MI for patients with schizophrenia, we studied MI's active ingredients and its working mechanisms. Methods: First, based on MI literature, we developed a model of potential active ingredients and mechanisms of change of MI in patients with schizophrenia. We used this model in a qualitative multiple case study to analyze the application of the active ingredients and the occurrence of mechanisms of change. We studied the cases of fourteen patients with schizophrenia who participated in a study on the effect of MI on medication adherence. Second, we used the Generalized Sequential Querier (GSEQ 5.1) to perform a sequential analysis of the MI-conversations aiming to assess the transitional probabilities between therapist use of MI-techniques and subsequent patient reactions in terms of change talk and sustain talk. Results: We found the therapist factor “a trusting relationship and empathy” important to enable sufficient depth in the conversation to allow for the opportunity of triggering mechanisms of change. The most important conversational techniques we observed that shape the hypothesized active ingredients are reflections and questions addressing medication adherent behavior or intentions, which approximately 70% of the time was followed by “patient change talk”. Surprisingly, sequential MI-consistent therapist behavior like “affirmation” and “emphasizing control” was only about 6% of the time followed by patient change talk. If the active ingredients were embedded in more comprehensive MI-strategies they had more impact on the mechanisms of change. Conclusions: Mechanisms of change mostly occurred after an interaction of active ingredients contributed by both therapist and patient. Our model of active ingredients and mechanisms of change enabled us to see “MI at work” in the MI-sessions under study, and this model may help practitioners to shape their MI-strategies to a potentially more effective MI.
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Background: For patients with coronary artery disease (CAD), smoking is an important risk factor for the recurrence of a cardiovascular event. Motivational interviewing (MI) may increase the motivation of the smokers to stop smoking. Data on MI for smoking cessation in patients with CAD are limited, and the active ingredients and working mechanisms of MI in smoking cessation are largely unknown. Therefore, this study was designed to explore active ingredients and working mechanisms of MI for smoking cessation in smokers with CAD, shortly after a cardiovascular event. Methods: We conducted a qualitative multiple case study of 24 patients with CAD who participated in a randomized trial on lifestyle change. One hundred and nine audio-recorded MI sessions were coded with a combination of the sequential code for observing process exchanges (SCOPE) and the motivational interviewing skill code (MISC). The analysis of the cases consisted of three phases: single case analysis, cross-case analysis, and cross-case synthesis. In a quantitative sequential analysis, we calculated the transition probabilities between the use of MI techniques by the coaches and the subsequent patient statements concerning smoking cessation. Results: In 12 cases, we observed ingredients that appeared to activate the mechanisms of change. Active ingredients were compositions of behaviors of the coaches (e.g., supporting self-efficacy and supporting autonomy) and patient reactions (e.g., in-depth self-exploration and change talk), interacting over large parts of an MI session. The composition of active ingredients differed among cases, as the patient process and the MI-coaching strategy differed. Particularly, change talk and self-efficacy appeared to stimulate the mechanisms of change “arguing oneself into change” and “increasing self-efficacy/confidence.”
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E-Exercise is an effective 12-week blended intervention consisting of around five face-to-face physiotherapy sessions and a web-based application for patients with hip/knee osteoarthritis. In order to facilitate effective implementation of e-Exercise, this study aims to identify physiotherapists' experiences and determinants related to the usage of e-Exercise. Methods: An explanatory sequential mixed methods design embedded in a randomized controlled trial comparing e-Exercise with usual physiotherapy in patients with hip/knee osteoarthritis. Usage of e-Exercise was based on recruitment rates of 123 physiotherapists allocated to e-Exercise and objective web-based application usage data. Experiences and determinants related to e-Exercise usage were investigated with a questionnaire and clarified with semi-structured interviews. Results: Of the 123 physiotherapists allocated to e-Exercise, 54 recruited more than one eligible patient, of whom 10 physiotherapists continued using e-Exercise after the study period. Physiotherapists had mixed experiences with e-Exercise. Determinants related to intervention usage were appropriateness, added value, time, workload, professional autonomy, environmental factors, and financial consequences. Physiotherapists recommended to improve the ability to tailor e-Exercise to the individual needs of the patient patients' individual needs. Discussion: Determinants related to the usage of e-Exercise provided valuable information for the implementation of e-Exercise on broader scale. Most importantly, the flexibility of e-Exercise needs to be improved. Next, there is a need for education on how to integrate an online program within physiotherapy
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In this mixed methods study, a moderated mediation model predicting effects of leader-member exchange (LMX) and organizational citizenship behaviors (OCB) on innovative work behaviors, with employability as a mediator, has been tested. Multi-source data from 487 pairs of employees and supervisors working in 151 small and medium-sized enterprises (SMEs) supported our hypothesized model. The results of structural equation modelling provide support for our model. In particular, the benefits of close relationships and high-quality exchanges between employee and supervisor (LMX), and fostering individual development as a result of employees’ OCB have an indirect effect on innovative work behaviors through positive effects on workers’ employability. Innovative work behaviors depend on employees’ knowledge, skills, and expertise. In other words, enhancing workers’ employability nurtures innovative work behaviors. In addition, we found a moderation effect of organizational politics on the relationship between employability and innovative work behaviors. Secondly, qualitative methods focusing on experiences of the antecedents and outcomes of employability were used to complement our quantitative results. All in all, this study has important consequences for managerial strategies and practices in SMEs and call for an awareness of the dysfunctional effect of perceived organizational politics.
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This study theorizes on the sociomateriality of food in authority-building processes of partial organizations by exploring alternative food networks (AFNs). Through the construction of arenas for food provisioning, AFNs represent grassroots collectives that deliberately differentiate their practices from mainstream forms of food provisioning. Based on a sequential mixed-methods analysis of 24 AFNs, where an inductive chronological analysis is followed by a qualitative comparative analysis (QCA), we found that the entanglements between participants’ food provisioning practices and food itself shape how authority emerges in AFNs. Food generates biological, physiological and social struggles for AFN participants who, in turn, respond by embracing or avoiding them. As an outcome, most AFNs tend to bureaucratize over time according to four identified patterns while a few idiosyncratically build a more shared basis of authority. We conclude that the sociomateriality of food plays an important yet indirect role in understanding why and how food provisioning arenas re-organize and forge their forms of authority over time. Pascucci, S., Dentoni, D., Clements, J., Poldner, K., & Gartner, W. B. (2021). Forging Forms of Authority through the Sociomateriality of Food in Partial Organizations. Organization Studies, 42(2), 301-326. https://doi.org/10.1177/0170840620980232
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A new bookkeeping system called Jiskefet is being developed for A Large Ion Collider Experiment (ALICE) during Long Shutdown 2, to be in production until the end of LHC Run 4 (2029). Jiskefet unifies two function- alities: a) gathering, storing and presenting metadata associated with the oper- ations of the ALICE experiment and b) tracking the asynchronous processing of the physics data. It will replace the existing ALICE Electronic Logbook and AliMonitor, allowing for a technology refresh and the inclusion of new fea- tures based on the experience collected during Run 1 and Run 2. The front end leverages web technologies much in use nowadays such as TypeScript and NodeJS and is adaptive to various clients such as tablets, mobile devices and other screens. The back end includes an OpenAPI specification based REST API and a relational database. This paper will describe the organization of the work done by various student teams who work on Jiskefet in sequential and parallel semesters and how continuity is guaranteed by using guidelines on coding, documentation and development. It will also describe the current status of the development, the initial experience in detector stand-alone commissioning setups and the future plans.
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In bepaalde single-core configuraties met één processor, b.v. embedded control systems zoals robotic applications die uit vele korte processen bestaan, kunnen de context switches van een proces een aanzienlijke hoeveelheid van de beschikbare processing power verbruiken. Het verminderen van het aantal context switches vermindert de executietijd en verhoogt daardoor de prestaties van de toepassing. Bovendien is de end-to-end executietijd van de processen langer dan strict noodzakelijk, b.v. omdat de processen moeten wachten op controllers die een taak uitvoeren. Door de regels voor synchrone communicatie via kanalen in de procesalgebraïsche specificatietaal Communicating Sequential Processes te versoepelen, kunnen we de end-to-end executietijd verkorten. In ons onderzoek definiëren we verschillende graafproducten, bewijzen we dat deze producten een prestatiewinst opleveren (onder bepaalde voorwaarden) en we werken de numerieke en combinatorische aspecten van deze graafproducten uit.
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Generalists in palliative care and professionals with specialized expertise, including palliative care nurses, achieve high-quality palliative care. To strengthen their role, it is essential to understand the tasks palliative care nurses perform and their position within the organizations. We aim to accomplish this understanding and explore facilitators and barriers to taking on the role as specialized nurses from both the nurses’ and managers’ perspectives. A sequential mixed-method design combined an online survey, followed up by five focus groups. Analysis involved descriptive statistics and thematic coding. A total of 234 palliative care nurses across various care settings answered the survey. They primarily provided physical care (88%), with less focus on psychological (72%), social (68%), and spiritual (68%) domains, and were consulted for fewer than half of their activities. Having no job descriptions often occurred (from 78% in home care and nursing homes to 44% in hospitals). Hospital nurses were more involved in advisory teams (56%) than those in other settings (26% −28%). Nurses showed leadership by promoting generalists’ expertise, connecting partners, serving as role models, and advocating for palliative care. Focus groups with twelve nurses and nine managers identified facilitators and barriers that palliative care nurses and their managers encounter in embedding their roles and positions. These covered: (1) distinction between generalist and specialist palliative care, (2) collaboration, (3) job descriptions, (4) leadership, (5) visibility, (6) funding and reimbursement. Palliative care nurses fulfill an essential role but experience ambiguity about their role and position. They and their managers emphasized the importance of leadership and advocating for palliative care in their organizations. Visibility, funding, reimbursement, and collaboration are facilitators and barriers to their role and position. There are notable areas for improvement, including joining a palliative care advisory team, having a job description, and finding ways to demonstrate cost-effectiveness
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