This doctoral thesis describes three case studies of service engineers participating in organizational change, interacting with managers and consultants. The study investigates the role of differences in professional discourse and culture when these three professional groups interact in organizational change, and how this affects the change result. We bring together two scientific fields, first change management and second, linguistics. The intersection represents the overlapping field of professional discourse and culture. The research design was an explorative multiple case study using qualitative linguistic analyses. The study found that successful organizational change is the result of interaction between professional culture, the organizational culture and the organization/change context. The differences between the professional cultures and discourses can hamper the change process. The practical contribution of this study might be the increased awareness among professionals about their own professional, and often implicit, assumptions. Managers, consultants and service engineers have to be aware of the group dynamics and the specific role of their own typical professional discourse and culture in a change project setting.
Malnutrition is a serious and widespread health problem in community-dwelling older adults who receive care in hospital and at home. Hospital and home care nurses and nursing assistants have a key role in the delivery of high-quality multidisciplinary nutritional care. Nursing nutritional care in current practice, however, is still suboptimal, which impacts its quality and continuity. There appear to be at least two reasons for this. First, there is a lack of evidence for nutritional care interventions to be carried out by nurses. Second, there are several factors, that influence nurses’ and nursing assistants’ current behaviour, such as lack of knowledge, moderate awareness of the importance and neutral attitudes. This results in a lack of attention towards nutritional care. Therefore, there is a need to generate more evidence and to focus on targeting the factors that influence nurses’ and nursing assistants’ current behaviour to eventually promote behaviour change. To increase the likelihood of successfully changing their behaviour, an evidence-based educational intervention is appropriate. This might lead to enhancing nutritional care and positively impact nutritional status, health and well-being of community-dwelling older adults. The general objectives of this thesis are: 1) To understand the current state of evidence regarding nutrition-related interventions and factors that influence current behaviour in nutritional care for older adults provided by hospital and home care nurses and nursing assistants to prevent and treat malnutrition. 2) To develop an educational intervention for hospital and home care nurses and nursing assistants to promote behaviour change by affecting factors that influence current behaviour in nutritional care for older adults and to describe the intervention development and feasibility.
This book provides insight into an ambitious project to re-invent the educational method practiced at NHL Stenden. The predecessors used different approaches to the delivery of education. One of them used Competency-Based Education, whilst the other practiced Problem-Based Learning. The choice to combine the advantages of both methods, as well as to develop an entirely new concept that provided a better response to the fast and ever-increasing pace of changes in the workplace, was made by both institutions together. This approach was called Design-Based Education (DBE). Given the significant changes required of stakeholders to facilitate learning according to the new DBE approach, it is important to take stock of what these changes mean in terms of teaching and learning and to ascertain from early steps how everybody can stay, or step, on board.
