Zoekresultaten

A conversation approach based on shared goal-setting and shared decision-making for nurses in cancer aftercare

Purpose: This study aimed to develop and pretest a systematic conversation approach for nurses to tailor aftercare to oncology patient's goals, unmet needs and wishes. Methods: We used an iterative developmental process for complex interventions: 1. Identifying problems 2. Identifying overall objectives 3. Designing the intervention 4. Pretesting and adapting the intervention. Results: The main results of the problem identification were: non-systematic and incomplete screening of potential issues, caveats in providing information, and shared decision-making. The overall objective formulated was: To develop a model for aftercare conversations based on shared goal-setting and decision-making. The conversation approach consists of four phases: 1. Preparation of the consultation including a questionnaire, 2. Shared goal-setting by means of a tool visualizing domains of life, and 3. Shared care planning by means of an overview of possible choices in aftercare, a database with health care professionals and a cancer survivorship care plan. 4. Evaluation. The results of the pretest revealed that the conversation approach needs to be flexible and tailored to the patient and practice setting, and embedded in the care processes. The conversation approach was perceived as enhancing patient-centeredness and leading to more in-depth consultations. Conclusion: The conversation approach was developed in co-creation with stakeholders. The results of the pretest revealed important implications and suggestions for implementation in routine care. The aftercare conversation approach can be used by nurses to provide tailored patient-centered evidence-based aftercare. Tailored aftercare should support oncology patient's goals, unmet needs and wishes. Further tailoring is needed.

A generational approach to female entrepreneurship in Europe

Female entrepreneurship is still a limited phenomenon in European countries and its promotion ranks high on the EU policy agenda. Various frameworks have been offered to explain the main structural differences in entrepreneurship between men and women, emphasizing a variety of underlying factors. With a novel approach, this paper argues that due to a process of generation renewal the numerical difference between male and female entrepreneurship will diminish. Generation replacement is seen by sociologists and other social scientists as the motor behind cultural renewal. Our core interest in this paper in developing such a dynamic interpretation within the European context is the role of different generations (Silent Generation, Babyboomers, Generation X, Millennials). Younger cohorts of females are hypothesized to be more pro entrepreneurship and pro self-employment both in terms of attitudes, intentions, and behaviors, compared to older cohorts. They are furthermore assumed to converge with their male generation members in this regard. This paper empirically tests these two hypotheses by analyzing multi cross-sectional European data from the Eurobarometer over a span of thirty-five years (1980-2015). Results show that this generational approach sheds new light on explaining trends in female entrepreneurship. We find evidence of an increased growth in female entrepreneurship that can be attributed to generation replacement. This rise in total female entrepreneurship is characterized by diversity among European countries in the study. Positive attitudes toward entrepreneurship are essential to considering future self-employment. Education is a key factor. Female entrepreneurship, it is predicted, will become more prominent in Europe.

The value of a family-centered approach in preventive child healthcare

This thesis focuses on the effectiveness of a family-centered approach (in Dutch “DMOprotocol”, further referred to as the family-centered approach), designed for monitoring and enhancing children’s social-emotional development in Preventive Child Healthcare (PCH). The effectiveness study took place at a Dutch PCH organization (Icare JGZ). In a quasi-experimental design, regions in which the family-centered approach had already been implemented (northern and southeastern part of Drenthe) were compared to regions in which care-as-usual had been maintained (northern part of Overijssel). The aim was to assess the added value of the family-centered approach from different perspectives. Therefore several research questions were answered in analyses that arereported in different chapters of this thesis.

Ervaringen uit de gezinsbenadering

A consumer behavioural approach to food waste.

Purpose: Food waste occurs in every stage of the supply chain, but the value-added lost to waste is the highest when consumers waste food. The purpose of this paper is to understand the food waste behaviour of consumers to support policies for minimising food waste. Design/methodology/approach: Using the theory of planned behaviour (TPB) as a theoretical lens, the authors design a questionnaire that incorporates contextual factors to explain food waste behaviour. The authors test two models: base (four constructs of TPB) and extended (four constructs of TPB plus six contextual factors). The authors build partial least squares structural equation models to test the hypotheses. Findings: The data confirm significant relationships between food waste and contextual factors such as motives, financial attitudes, planning routines, food surplus, social relationships and Ramadan. Research limitations/implications: The data comes from an agriculturally resource-constrained country: Qatar. Practical implications: Food waste originating from various causes means more food should flow through the supply chains to reach consumers’ homes. Contextual factors identified in this work increase the explanatory power of the base model by 75 per cent. Social implications: Changing eating habits during certain periods of the year and food surplus have a strong impact on food waste behaviour. Originality/value: A country is considered to be food secure if it can provide its citizens with stable access to sufficient, safe and nutritious food. The findings and conclusions inform and impact upon the development of food waste and food security policies.

Towards a more family oriented and interdisciplinary language screening

Only a small number of children with atypical language development who can benefit from early intervention are actually identified before reaching school age. Our aim was to explore perceptions of caregivers of monolingual and multilingual children with and without atypical language development in order to provide relevant themes for improving language screening and referral in Well Child Care (WCC). We interviewed 38 Dutch caregivers of monolingual and multilingual children with and without atypical language development. They were recruited via kindergarten, nurseries, and speech and language pathologists. First, we analyzed the interviews of caregivers of monolingual children with atypical language development and caregivers of multilingual children. Second, we adopted data source triangulation with the interviews of caregivers of monolingual children without atypical language development for further exploration of the results of the first round. Third, we categorized emerging codes across identified subthemes and themes. We identified six subthemes: (1) Perception WCC; (2) Perception consult at the WCC; (3) Opinion of the consult at the WCC; (4) Desires regarding WCC; (5) Parent factors, and (6) Child factors (first and second round). Target themes, relating to the themes and subthemes, that can be used to enhance structural language screening in WCC are: a more family oriented consult, better interprofessional collaboration, and more specific knowledge about language development and different referral routes for children with atypical language development.