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.
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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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Objectives To determine nurse-sensitive outcomes in district nursing care for community-living older people. Nurse-sensitive outcomes are defined as patient outcomes that are relevant based on nurses’ scope and domain of practice and that are influenced by nursing inputs and interventions. Design A Delphi study following the RAND/UCLA Appropriateness Method with two rounds of data collection. Setting District nursing care in the community care setting in the Netherlands. Participants Experts with current or recent clinical experience as district nurses as well as expertise in research, teaching, practice, or policy in the area of district nursing. Main outcome measures Experts assessed potential nurse-sensitive outcomes for their sensitivity to nursing care by scoring the relevance of each outcome and the ability of the outcome to be influenced by nursing care (influenceability). The relevance and influenceability of each outcome were scored on a nine-point Likert scale. A group median of 7 to 9 indicated that the outcome was assessed as relevant and/or influenceable. To measure agreement among experts, the disagreement index was used, with a score of <1 indicating agreement. Results In Delphi round two, 11 experts assessed 46 outcomes. In total, 26 outcomes (56.5%) were assessed as nurse-sensitive. The nurse-sensitive outcomes with the highest median scores for both relevance and influenceability were the patient’s autonomy, the patient’s ability to make decisions regarding the provision of care, the patient’s satisfaction with delivered district nursing care, the quality of dying and death, and the compliance of the patient with needed care. Conclusions This study determined 26 nurse-sensitive outcomes for district nursing care for community-living older people based on the collective opinion of experts in district nursing care. This insight could guide the development of quality indicators for district nursing care. Further research is needed to operationalise the outcomes and to determine which outcomes are relevant for specific subgroups.
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In 2019, the first "Atelier Book" was published . Since then, a few years have passed and numerous new Ateliers have emerged. With this new atelier book, through more than 30 portraits, the richness and variety of ateliers within our college are shown. The portraits are divided as follows: ateliers at the NHL Stenden locations, external ateliers and ateliers which the facilities are a strong determinant. These portraits show which issues are being worked on, how they cooperate with the field and researchers and what the added value of the Ateliers is. This atelier book also contains a number of in-depth articles that talk about working and learning in ateliers. The contribution in chapter 1 is about: what NHL Stenden aims at with ateliers, where do the ateliers differ and some experiences with ateliers. After the portraits in chapter 2, chapter 3 presents the 'Atelier Value Creation Model' and a model with design dimensions. Both provide tools for designing and evaluating ateliers. Chapter 4 zooms in on the effects of physical space on learning. Then, Chapter 5 discusses the outcomes of (current) research on ateliers.
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This article is based on ethnographic research over recent years in eight Dutch police teams. It focuses on the othering process in which police officers define ‘crooks’ as the Other and chase, catch and arrest them. Catching crooks is perceived as an assignment as well as a game. Street cops construct detailed subcategories of the crook which influence their daily practices. They select crooks by recognition (the permanent suspects), by abnormalization (out of placeness) and by profiling (regardless of place). In addition to the discussion on ethnic profiling, we argue that profiling is a contextual practice. The contents of the profiles depend on the demographic characteristics of the district in which a police team operates. Interacting mediaframes of both the crook and the police reinforce the mutual caricatures and tense relationships.
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This project builds upon a collaboration which has been established since 15 years in the field of social work between teachers and lecturers of Zuyd University, HU University and Elte University. Another network joining this project was CARe Europe, an NGO aimed at improving community care throughout Europe. Before the start of the project already HU University, Tallinn Mental Health Centre and Kwintes were participating in this network. In the course of several international meetings (e.g. CARe Europe conference in Prague in 2005, ENSACT conferences in Dubrovnik in 2009, and Brussels in April 2011, ESN conference in Brussels in March 2011), and many local meetings, it became clear that professionals in the social sector have difficulties to change current practices. There is a great need to develop new methods, which professionals can use to create community care.
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Bundeling van vijf essays, geschreven door hbo-studenten Social Work. Zij volgden in studiejaar 2023/2024 een half jaar de minor Inclusiviteit in de stad aan de Haagse Hogeschool. In die minor zoomen we in op hedendaagse uitsluitingsmechanismen die bepaalde groepen in onze samenleving extra hard treffen. Het centrale thema van de essays is inclusiviteit. In elk essay is te zien hoe belangrijk dit onderwerp is voor de nieuwe generatie. De auteurs gaan in op de verschillende dimensies van inclusiviteit, variërend van uitsluiting door armoede, door culturele verschillen maar ook door het kiezen van het beroep sekswerk. Uitsluiting heeft een diep effect op het welzijn van mensen, op toegankelijkheid tot instituties en op sociale rechtvaardigheid.
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In Amsterdam, the phenomenon of overcrowding is increasing, and tourism is one of the causes. Both the public debate and the municipal authorities are pointing to an increasing need for more expertise and knowledge regarding ways of achieving a healthy balance for various stakeholders. This article focuses on the stakeholder role of city residents and discusses their attitudes to tourists and tourism-related developments in their own neighbourhood and in the rest of the city. The term “attitude” can be divided into three components: feeling, behaviour and thinking. The results of this study are based on both quantitative and qualitative fieldwork (surveys and semi-structured interviews) and on desk research. It can be concluded that, for the most part, residents have a positive attitude to tourists and tourism. Differences in attitude are mostly determined by the city district where respondents live and by personal feelings and thinking. Follow-up research in the coming years will examine the complexity of the issue of overcrowding in more depth.
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Considering the challenges on sustainable agriculture in the district, different institutions join hands to overcome these issues and respond to the felt need of working more integrative both in the agricultural sector and environmental knowledge system. Adding a sense of urgency due to COVID-19 into problem analysis, these institutions accelerated the ambition to develop a Digital Farmer Field School (DFFS). This paper elaborates on the co-construction of principles for the design of a Digital Farmer Field School (DFFS) by the local stakeholders in Enrekang district. The local design team design of the DFFS Enrekang is composed of a transdisciplinary team from relevant government institutions and research institutions. The design principles of DFFS are built around inclusive design principles, concepts of interface usability based on different type of access to digital technology models, responsible innovation criteria and learning principles of farmer field school (FFS). The DFFS Enrekang design principles serve as guiding principles and shared value among the collaborating institutions to combine ambition, inspiration, and accountability in the DFFS management and development processes. This tablet based digital learning platform aims to provide an alternative for farmers to access information on sustainable agricultural and environmental practices.
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This article describes a European project which was aimed at improving the situation of persons with psychiatric or learning disabilities with regard to social participation and citizenship. The project took place in three countries (Estonia, Hungary and the Netherlands) and four cities (Tallinn, Budapest, Amersfoort and Maastricht). The project included research and actions at the policy level, the organizational level and the practice level. At the policy level, the framework of the United Nations Convention on the Rights of Persons with Disabilities (United Nations, 2006) and the European Disability Strategy (European Commission, 2010) were used to look at national and local policies, at the reality of the lives of those with disabilities and at the support that professional services offer with regard to participation and inclusion. The project generated a number of insights, recommendations and methods by which to improve the quality of services and increase the number of opportunities for community engagement. In this article, we present some of the lessons learned from the meta-analysis. Although the circumstances in each country are quite different with regard to policy, culture and service systems, it is remarkable that people with disabilities face many of the same problems. The study shows that in all three countries, access to services could be improved. Barriers include bureaucratic procedures and a lack of services. The research identified that in every country and city there are considerable barriers regarding equal participation in the field of housing, work and leisure activities. In addition to financial barriers, there are the barriers of stigma and self-stigmatization. Marginalization keeps people in an unequal position and hinders their recovery and participation. In all countries, professionals need to develop a stronger focus on supporting the participation of their clients in public life and in the development of different roles pertaining to citizenship
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