Zoekresultaten

That which goes unsaid: Experiences of everyday life in residential care for residents with limited communication ability. A collective case study.

Background The experiences of residents who have communication difficulties such as dysphasia are largely absent from the literature. Aim To illuminate the everyday experiences of four residents with severe communication difficulties living in a residential care setting in the Netherlands. Methodology & Methods A collective case study methodology was used. Seventy-five hours of observation, interview and documentary data was gathered over six weeks. Alternative strategies of communication were developed to enable the co-creation of dialogue between participants and researcher. For example, a participant who could not talk used intentionally created artwork to share her ideas with the researcher. Findings Participants' daily experiences were characterised by struggling against the constraints of the residential setting: having to wait, having unmet needs, experiencing vulnerability and uncertainty. Participants' communication difficulties exacerbated these constraints. Their experiences of struggling were sometimes ameliorated by significant social contact with family or particular staff members, and engaging in enjoyable activities. Occasionally the experiences of enjoying the here-and-now, and being 'seen' as a person by the other, would create beautiful moments in which truly person centred engagement would occur. These moments were neither articulated nor recorded, and were thus invisible after they had occurred. Similarly, the experiences of struggling against the constraints were neither acknowledged nor recorded. Significant experiences in the lives of these four residents were therefore invisible to others. The unifying theme representing the participants' daily experiences was: That which goes unsaid. Discussion It was necessary to develop communication strategies which would by-pass the researcher's assumptions and enable participants to introduce their own ideas and opinions. This ongoing process of co-creation of dialogue required work from, and trust between, participants and researcher. What is new? • Expressly seeking the views of residents with communication difficulties • Successfully using process consent with participants in this situation • Using intentionally created artwork during data gathering in this context What has regional, national or international relevance? The findings indicate that people with communication difficulties may not receive optimal care in residential settings in the Netherlands. Methods are described which could be used by practitioners in their everyday work, and which show facilitators or practice developers how they can help carers to engage in more effective communication with this kind of resident. Additionally, this research contributes to the international discussion about ethical participation of vulnerable people in research.

Designing the perfect new European Bauhaus neighbourhood

The concept of Smart Healthy Age-Friendly Environments (SHAFE) emphasises the comprehensive person-centred experience as essential to promoting living environments. SHAFE takes an interdisciplinary approach, conceptualising complete and multidisciplinary solutions for an inclusive society. From this approach, we promote participation, health, and well-being experiences by finding the best possible combinations of social, physical, and digital solutions in the community. This initiative emerged bottom-up in Europe from the dream and conviction that innovation can improve health equity, foster caring communities, and sustainable development. Smart, adaptable, and inclusive solutions can promote and support independence and autonomy throughout the lifespan, regardless of age, gender, disabilities, cultural differences, and personal choices, as well as promote happier and fairer living places.

Development and testing of an online community care platform for frail older adults in the Netherlands

Background: Recent transitions in long-term care in the Netherlands have major consequences for community- dwelling older adults. A new paradigm expects them to manage and arrange their own care and support as much as possible. Technology can support this shift. A study has been conducted to explore the needs of community- dwelling frail older adults with regard to an online platform. An existing platform was subsequently modified, based upon these needs, resulting in an online community care platform (OCC-platform) comprising of care, health, and communication functions. The purpose of this platform was to support frail older adults in their independence and functioning, by stimulating self-care and providing reliable information, products and services. Methods: The study used a User-Centred Design. The development processes involved the following steps: Step 1) Identification of the User Requirements. To assess the user requirements, direct observations (N = 3) and interviews (N = 14) were performed. Step 2) Modification of an Existing Online Platform. Based upon Step 1, available online platforms were explored to determine whether an existing useful product was available. Two companies collaborated in modifying such a platform; Step 3) Testing the Modified Platform. A total of 73 older adults were invited to test a prototype of the OCC-platform during 6 months, which comprised of two phases: (1) a training phase; and (2) a testing phase. Results: An iterative process of modifications resulted in an interactive software concept on a Standard PC, containing 11 Functions. The Functions of ‘contacts’, ‘services’ and ‘messaging’, were by far, the most frequently used. The use was at its highest during the first 2 weeks of the testing and then its use steadily declined. The vast majority of the subjects (94%) were positive about the usability of the platform. Only a minority of the subjects (27%) indicated that the platform had added value for them. Conclusion: The overall prospect was that an OCC-platform can contribute to the social participation and the self-management competencies of frail older adults, together with their social cohesion in the community. In order to validate these prospects, further research is needed on the characteristics and the impact of online platforms.

Moments to remember

The pervasive use of media at current-day festivals thoroughly impacts how these live events are experienced, anticipated, and remembered. This empirical study examined event-goers’ live media practices – taking photos, making videos, and in-the-moment sharing of content on social media platforms – at three large cultural events in the Netherlands. Taking a practice approach (Ahva 2017; Couldry 2004), the author studied online and offline event environments through extensive ethnographic fieldwork: online and offline observations, and interviews with 379 eventgoers. Analysis of this research material shows that through their live media practices eventgoers are continuously involved in mediated memory work (Lohmeier and Pentzold 2014; Van Dijck 2007), a form of live storytelling thatrevolves around how they want to remember the event. The article focuses on the impact of mediated memory work on the live experience in the present. It distinguishes two types of mediatised experience of live events: live as future memory and the experiential live. The author argues that memory is increasingly incorporated into the live experience in the present, so much so that, for many eventgoers, mediated memory-making is crucial to having a full live event experience. The article shows how empirical research in media studies can shed new light on key questions within memory studies.

Gaining insight into talent moments in Honours Education

Reinforcement Learning to send reminders at right moments in smartphone Exercise Application

Just-in-time adaptive intervention (JITAI) has gained attention recently and previous studies have indicated that it is an effective strategy in the field of mobile healthcare intervention. Identifying the right moment for the intervention is a crucial component. In this paper the reinforcement learning (RL) technique has been used in a smartphone exercise application to promote physical activity. This RL model determines the ‘right’ time to deliver a restricted number of notifications adaptively, with respect to users’ temporary context information (i.e., time and calendar). A four-week trial study was conducted to examine the feasibility of our model with real target users. JITAI reminders were sent by the RL model in the fourth week of the intervention, while the participants could only access the app’s other functionalities during the first 3 weeks. Eleven target users registered for this study, and the data from 7 participants using the application for 4 weeks and receiving the intervening reminders were analyzed. Not only were the reaction behaviors of users after receiving the reminders analyzed from the application data, but the user experience with the reminders was also explored in a questionnaire and exit interviews. The results show that 83.3% reminders sent at adaptive moments were able to elicit user reaction within 50 min, and 66.7% of physical activities in the intervention week were performed within 5 h of the delivery of a reminder. Our findings indicated the usability of the RL model, while the timing of the moments to deliver reminders can be further improved based on lessons learned.