Health professionals’ attitudes to substance abusers have been reported as suboptimal with potential adverse consequences for the quality of health care provided. Less is known about professionals working with addicted clients in mandated contexts. The aim of this study is to gain insight into forensic social professionals’ attitudes to substance use and examine differences between subgroups of professionals. An online survey including the Brief Substance Abuse Attitude Scale was completed by 314 Dutch forensic social professionals. Overall, forensic social professionals’ attitudes to substance use and treatability were positive, but there were differences regarding needed treatment interventions and ways of controlling substance use. Professionals who work within specialist addiction services had less moralistic and stereotypical attitudes. Professionals who have personal experiences with addiction reported to be more tolerant, but at the same time more convinced of strict control of substances use of their clients
In de afgelopen decennia is de visie op verslaving sterk veranderd. Het momenteel vigerende model in de wetenschap is het hersenziektemodel, maar dit model is momenteel onderhevig aan kritiek en lijkt vooral van toepassing op mensen met een ernstige vorm van verslaving. Wanneer de ideeën vanuit de herstelbenadering worden gelegd naast de visies op verslaving, dan valt op dat het biopsychosociale (BPS) het best passend is bij deze benadering. Tegelijkertijd valt op dat bij de herstelbenadering wordt gesproken over het begrip ’een zinvol bestaan’ en zingeving, maar dat dit begrip niet naar voren komt in het BPS model. In dit artikel wordt daarom gepleit voor toevoeging van een zingeving component aan het BPS model, waardoor een BPSZ model ontstaat. Daarbij bestaat nog wel de vraag of zingeving een vierde domein is of bovenliggend of onderliggend aan de andere drie domeinen. Betoogd wordt dat zingeving niet nieuw is binnen de verslavingszorg en dat toevoeging betekent dat met iedere persoon die zich aanmeldt voor zorg moet worden gezocht naar het persoonlijke verhaal achter de verslaving en de oplossing hiervan.
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Nationwide and across the globe, the quality, affordability, and accessibility of home-based healthcare are under pressure. This issue stems from two main factors: the rapidly growing ageing population and the concurrent scarcity of healthcare professionals. Older people aspire to live independently in their homes for as long as possible. Additionally, governments worldwide have embraced policies promoting “ageing in place,” reallocating resources from institutions to homes and prioritising home-based services to honour the desire of older people to continue living at home while simultaneously addressing the rising costs associated with traditional institutional care.Considering the vital role of district nursing care and the fact that the population of older people in need of assistance at home is growing, it becomes clear that district nursing care plays a crucial role in primary care. The aim of this thesis is twofold: 1) to strengthen the evidence base for district nursing care; and 2) to explore the use of outcomes for learning and improving in district nursing care. The first part of this thesis examines the current delivery of district nursing care and explores its challenges during the COVID-19 pandemic to strengthen the evidence base and get a better understanding of district nursing care. Alongside the goal of strengthening the evidence for district nursing care, the second part of this thesis explores the use of patient outcomes for learning and improving district nursing care. It focuses on nurse-sensitive patient outcomes relevant to district nursing care, their current measurement in practice, and what is needed to use outcomes for learning and improving district nursing practice.
Alcohol use disorder (AUD) is a major problem. In the USA alone there are 15 million people with an AUD and more than 950,000 Dutch people drink excessively. Worldwide, 3-8% of all deaths and 5% of all illnesses and injuries are attributable to AUD. Care faces challenges. For example, more than half of AUD patients relapse within a year of treatment. A solution for this is the use of Cue-Exposure-Therapy (CET). Clients are exposed to triggers through objects, people and environments that arouse craving. Virtual Reality (VRET) is used to experience these triggers in a realistic, safe, and personalized way. In this way, coping skills are trained to counteract alcohol cravings. The effectiveness of VRET has been (clinically) proven. However, the advent of AR technologies raises the question of exploring possibilities of Augmented-Reality-Exposure-Therapy (ARET). ARET enjoys the same benefits as VRET (such as a realistic safe experience). But because AR integrates virtual components into the real environment, with the body visible, it presumably evokes a different type of experience. This may increase the ecological validity of CET in treatment. In addition, ARET is cheaper to develop (fewer virtual elements) and clients/clinics have easier access to AR (via smartphone/tablet). In addition, new AR glasses are being developed, which solve disadvantages such as a smartphone screen that is too small. Despite the demand from practitioners, ARET has never been developed and researched around addiction. In this project, the first ARET prototype is developed around AUD in the treatment of alcohol addiction. The prototype is being developed based on Volumetric-Captured-Digital-Humans and made accessible for AR glasses, tablets and smartphones. The prototype will be based on RECOVRY, a VRET around AUD developed by the consortium. A prototype test among (ex)AUD clients will provide insight into needs and points for improvement from patient and care provider and into the effect of ARET compared to VRET.
Alcohol use disorder (AUD) is a pattern of alcohol use that involves having trouble controlling drinking behaviour, even when it causes health issues (addiction) or problems functioning in daily (social and professional) life. Moreover, festivals are a common place where large crowds of festival-goers experience challenges refusing or controlling alcohol and substance use. Studies have shown that interventions at festivals are still very problematic. ARise is the first project that wants to help prevent AUD at festivals using Augmented Reality (AR) as a tool to help people, particular festival visitors, to say no to alcohol (and other substances). ARise is based on the on the first Augmented Reality Exposure Therapy (ARET) in the world that we developed for clinical treatment of AUD. It is an AR smartphone driven application in which (potential) visitors are confronted with virtual humans that will try to seduce the user to accept an alcoholic beverage. These virtual humans are projected in the real physical context (of a festival), using innovative AR glasses. Using intuitive phone, voice and gesture interactions, it allows users to personalize the safe experience by choosing different drinks and virtual humans with different looks and levels of realism. ARET has been successfully developed and tested on (former) AUD patients within a clinical setting. Research with patients and healthcare specialists revealed the wish to further develop ARET as a prevention tool to reach people before being diagnosed with AUD and to extend the application for other substances (smoking and pills). In this project, festival visitors will experience ARise and provide feedback on the following topics: (a) experience, (b) awareness and confidence to refuse alcohol drinks, (c) intention to use ARise, (d) usability & efficiency (the level of realism needed), and (e) ideas on how to extend ARise with new substances.
Significant Others, family care, substance abuse, addiction, substance use disorder, Concerned significant others of a person with substance use disorder face psychological, social and financial problems caused by the subtance abuse of their loved one. Tradionally health care orginizations focus on the person with substance use disorder and pay less attention to their concerned significant other. In the Netherlands there is less information available about concerned significant others of persons with substance abuse. To develop a family care aproach for the significant other it's necessary to provide insight in the charasteristics of the concerned significant others of persons with substance use disorder.
