De gemeente Utrecht is sinds de invoering van de Jeugdwet in 2015 verantwoordelijk voor alle hulp en ondersteuning aan de Utrechtse jeugd. Met de daarmee samenhangende transformatie is een inhoudelijke vernieuwing van de jeugdhulp beoogd. Eén van de leidende principes voor de gemeente Utrecht is daarbij ‘normaliseren en uitgaan van de mogelijkheden’. Bij de toepassing van deze leidende principes bleek het begrip normaliseren complex en niet iedereen had eenzelfde beeld. Daarnaast is het woord soms beladen, wanneer het wordt geassocieerd met problemen niet serieus nemen. Dit bemoeilijkte het gesprek over normaliseren en wat daarvoor nodig en gewenst is. In de Kenniswerkplaats Jeugd Utrecht Stad (KJUS) werken partners vanuit verschillende perspectieven, zoals jongeren, ouders, praktijk, beleid, onderwijs, onderzoek en opleidingen, samen om zorg en ondersteuning voor jongeren en gezinnen in de stad Utrecht te innoveren en te verbeteren. De kern hierbij is dat gebruik wordt gemaakt van verschillende kennisbronnen: kennis vanuit onderzoek, professionele kennis en ervaringskennis. De gemeente Utrecht heeft daarom de KJUS gevraagd de belangrijkste aspecten van normaliseren in kaart te brengen met input vanuit de verschillende perspectieven. Vanuit de KJUS voerden het Trimbos-instituut en het Lectoraat Jeugd van de Hogeschool Utrecht een group concept mapping procedure uit. Dit is een participatieve mixed-method procedure voor het in kaart brengen van een complex en diffuus onderwerp als basis voor planning en evaluatie. Een groep van 27 deelnemers nam deel aan de brainstormfase. De groep bestond uit jongeren, ouders, beleidsmedewerkers en professionals die met jongeren werken in de stad Utrecht, zoals jongerenwerkers, sociaal makelaars, en professionals uit onderwijs, jeugdgezondheidszorg en jeugdhulp. In totaal formuleerden zij in deze fase 205 opvattingen over wat normaliseren voor hen betekent: 173 opvattingen in een live sessie en 32 opvattingen per e-mail. Na het verwijderen van dubbele opvattingen en het splitsen van samengestelde opvattingen werden de opvattingen naar elke deelnemer gestuurd voor waardering en sortering. Dit gebeurde individueel en online. De resultaten zijn statistisch verwerkt en grafisch weergegeven. De output is besproken en geïnterpreteerd, wat leidde tot de uiteindelijke concept map. Deze concept map bestaat uit 99 opvattingen over de betekenis van normaliseren, gegroepeerd in 19 thema’s (clusters), en weergegeven in een assenstelsel van twee dimensies: een dimensie ‘denken en doen’, variërend van ‘collectief’ tot ‘individueel’, en een dimensie ‘waarde’, variërend van ‘persoonlijk’ tot ‘professioneel’. De drie thema’s met de hoogste gemiddelde waardering waren: 'Variatie accepteren', 'Zonder oordeel luisteren en kijken naar een (hulp)vraag', en 'Mogen zijn zoals je bent'. De waardering van de thema’s voor het concreet omschrijven van normaliseren verschilde tussen de vier groepen deelnemers (jongeren, ouders, beleid en praktijk). Aangezien relatief weinig jongeren deelnamen aan de group concept mapping procedure, is een extra bijeenkomst georganiseerd voor jongeren. Hierbij is de concept map aan hen voorgelegd, zijn aangepaste beschrijvingen van de thema’s (clusters) geformuleerd en is voor de thema’s die zij het belangrijkst vonden besproken wat er volgens hen nodig is. Dit onderzoek heeft een concept map opgeleverd waarin de gedachten en ideeën van deelnemers uit de verschillende perspectieven letterlijk en figuurlijk een plek hebben gekregen om te komen tot een gemeenschappelijke visie op normaliseren in de stad Utrecht. De verwachting is dat de concept map zal bijdragen aan betere gesprekken over normaliseren met alle relevante perspectieven (beleidsmedewerkers, praktijkprofessionals, ouders en jeugdigen) in de stad Utrecht en benut kan worden voor meer gerichte acties om normaliseren te bevorderen.
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Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Methods Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Results Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. Conclusion This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.
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For children with asthma, physical activity (PA) can decrease the impact of their asthma. Thus far, effective PA promoting interventions for this group are lacking. To develop an intervention, the current study aimed to identify perspectives on physical activity of children with asthma, their parents, and healthcare providers. Children with asthma between 8 and 12 years old (n = 25), their parents (n = 17), and healthcare providers (n = 21) participated in a concept mapping study. Participants generated ideas that would help children with asthma to become more physically active. They sorted all ideas and rated their importance on influencing PA. Clusters were created with multidimensional scaling and cluster analysis. The researchers labelled the clusters as either environmental or personal factors using the Physical Activity for people with a Disability model. In total, 26 unique clusters were generated, of which 17 were labelled as environmental factors and 9 as personal factors. Important factors that promote physical activity in children with asthma according to all participating groups are asthma control, stimulating environments and relatives, and adapted facilities suiting the child’s needs. These factors, supported by the future users, enable developing an intervention that helps healthcare providers to promote PA in children with asthma.
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De Peer Support Group Kwalitatief Onderzoek van de HU is een groeiende, zelfsturende, HU-brede groep die is ontstaan uit de behoefte van onderzoekers en docenten om als ‘peers’ onderling kennis en ervaring te delen met betrekking tot kwalitatief onderzoek. De logistiek en organisatie van deze groep heeft een zeer fluïde karakter. Zij vormt zich naar de inhoudelijke en organisatorische behoeften van de groep. Deze behoeften zijn continu in beweging door onder andere veranderingen binnen de organisatie van de HU en de verschillende werkvelden en onderzoeksdomeinen waaruit de deelnemers afkomstig zijn. Maar ook door de ontwikkelingen die plaatsvinden op het terrein van kwalitatief onderzoek, binnen de eigen Peer Support Group (PSG) zelf en van de individuen die deel uitmaken van de PSG. In deze bijdrage zal ik nader uiteenzetten hoe complexiteit een rol speelt in het ontstaan en functioneren van de PSG.
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Objective: Self-management is a core theme within chronic care and several evidence-based interventions (EBIs) exist to promote self-management ability. However, these interventions cannot be adapted in a mere copy-paste manner. The current study describes and demonstrates a planned approach in adapting EBI’s in order to promote self-management in community-dwelling people with chronic conditions. Methods: We used Intervention Mapping (IM) to increase the intervention’s fit with a new context. IM helps researchers to take decisions about whether and what to adapt, while maintaining the working ingredients of existing EBI’s. Results: We present a case study in which we used IM to adapt EBI’s to the Flemish primary care context to promote self-management in people with one or more chronic disease. We present the reader with a contextual analysis, intervention aims, and content, sequence and scope of the resulting intervention. Conclusion: IM provides an excellent framework in providing detailed guidance on intervention adaption to a new context, while preserving the essential working ingredients of EBI’s. Practice Implications: The case study is exemplary for public health researchers and practitioners as a planned approach to seek and find EBI’s, and to make adaptations.
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IntroductionOver the past years, health games have shown to be an effective method for providing patient-education. At the same time, physical activity as medicine is increasingly popular when stimulating health in patients. Especially for those who are inactive and have a chronic disease, these two methods can even be more effective when combined. This may also be true for children with asthma, for whom physical activity is important to decrease the impact of their asthma. To meet the needs and wishes of these children, their parents, and healthcare providers, this study aims to obtain insight in factors that stimulate physical activity in children with asthma through the concept mapping method. This to ultimately develop a tailored health-game for children with asthma.MethodQualitative data were collected during concept mapping sessions with four groups of 8-11-year old children with asthma (n=25; 40% boy, age mean: 9.6y), two groups of parents (n=17; 29% male; age-range 29-57y, mean: 43.3y) and one group of 20 healthcare providers who received three online meetings (15% male; age-range 25-63y, mean:40.8y). During these sessions, participants generated ideas or solutions to the seeding statement ‘What is needed to increase the physical activity level of inactive children with asthma?’ After checking the complete list of ideas per group on clarity, participants clustered (based on similarity) and rated (score from 1 to 5, based on importance) the ideas individually. Using multidimensional scaling and hierarchical cluster-analysis one concept map was generated for each group. For this study we received approval of the medical ethics committee of the AMC; all participants signed informed consent.ResultsChildren generated 160 ideas in total and respectively 4, 5, 7 and 10 clusters, parents generated 73 ideas and respectively 5 and 8 clusters, and healthcare providers generated 116 ideas and 13 clusters. The child clusters with the highest importance scores were: positive feelings (mean: 3.9; SD: 1.0), availability of suitable and joyful sports (mean: 3.8; standard deviation [SD]:0.5), and guidance by motivated others (mean: 3.7; SD: 0.6). For parents, the highest-scored clusters were: motivated others (mean: 3.9; SD: 0.3), knowledge about asthma consequences by the child and others (mean: 3.7; SD: 0.6), and child self-confidence (mean: 3.6; SD: 0.7), Health-care providers reported knowledge about asthma by child and others (mean: 4.2; SD: 0.1), the need for motivated parents (mean: 4.2; SD: 0.8), exercise-stimulating environment (mean: 4.1; SD: 0.1), and appropriate asthma-treatment (mean: 4.1; SD: 0.4) as important physical activity stimulating factors in this population. However, some factors cannot be influenced by one person or a health-game. Since knowledge about asthma, self-confidence and positive feelings can be, the focus is on these clusters in the next level process of the study: the designing phase of the health-game.ConclusionPhysical activity stimulation in children with asthma can be influenced by different factors in which knowledge, empowerment and joy seem important factors. To increase physical activity in children with asthma the new health-game will include these factors with high importance.
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To meet society’s changing demands, the responsive development of curricula is vital, and curriculum developers need to increasingly foresee and incorporate changes into their curricula in a timely manner. However, responsive curriculum development is a complex problem for curriculum developers in vocational and (higher) professional education, and comprehensive research on this theme is scarce. This study focused on responsive curriculum development processes in a Dutch higher professional education institution (N = 77 experts). A group concept mapping study into the supportive factors of this process revealed six factors: (1) a vision of education and learning, (2) a continuous and iterative development process, (3) teamwork, (4) involving stakeholders, (5) a conducive environment and conditions, and (6) agency. Participating experts highlighted the importance of ensuring that equal attention is devoted to each of these factors. However, the results also reveal the challenges that curriculum developers face. To deal with these, a framework of factors is suggested to facilitate curriculum conversations in which developers can negotiate – and give meaning to – the desired change in the curriculum context.
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The ageing of people with intellectual disabilities, with associated morbidity like dementia, calls for new types of care. Person-centered methods may support care staff in providing this, an example being Dementia Care Mapping (DCM). DCM has been shown to be feasible in ID-care. We examined the experiences of ID-professionals in using DCM. We performed a mixed-methods study, using quantitative data from care staff (N = 136) and qualitative data (focus-groups, individual interviews) from care staff, group home managers and DCM-in-intellectual disabilities mappers (N = 53). ageing, dementia, Dementia Care Mapping, intellectual disability, mixed-methods, personcentred care
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Depression is a highly prevalent and seriously impairing disorder. Evidence suggests that music therapy can decrease depression, though the music therapy that is offered is often not clearly described in studies. The purpose of this study was to develop an improvisational music therapy intervention based on insights from theory, evidence and clinical practice for young adults with depressive symptoms. The Intervention Mapping method was used and resulted in (1) a model to explain how emotion dysregulation may affect depressive symptoms using the Component Process Model (CPM) as a theoretical framework; (2) a model to clarify as to how improvisational music therapy may change depressive symptoms using synchronisation and emotional resonance; (3) a prototype Emotion-regulating Improvisational Music Therapy for Preventing Depressive symptoms (EIMT-PD); (4) a ten-session improvisational music therapy manual aimed at improving emotion regulation and reducing depressive symptoms; (5) a program implementation plan; and (6) a summary of a multiple baseline study protocol to evaluate the effectiveness and principles of EIMT-PD. EIMT-PD, using synchronisation and emotional resonance may be a promising music therapy to improve emotion regulation and, in line with our expectations, reduce depressive symptoms. More research is needed to assess its effectiveness and principles.
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In many learning spaces in higher professional education, students are required to do research. At the same time they, and many of their tutors, struggle with the doubt, the uncertainty and even the anxiety that often accompanies the research process. Research shows that uncertainty and safety (‘safe uncertainty’) play an important role in students’ experiences of the research process. In order to study this and to answer the question ‘how to cope with uncertainty during the research process?’, we have designed a tool called ‘research mapping’. In a workshop setting, research mapping visualizes first the research process and, secondly, the elements of safe uncertainty within. Subsequently, dialogue between the participants produces generalized insights in the research process and in the role of safe uncertainty in that process. Next to the benefits for students and tutors, also the learning space of doing research can be improved.
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