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Respect for autonomy versus health promotion

Introduction: In 2011 5,3 million people had a chronic disease. Secondly patients want to have more influence in regulating their own disease. Self-management is increasingly being mentioned as a possible solution. However the practice learns that this involves ethical dilemmas, which nurses are often confronted with. Aim: ‘What factors are important for nurses who promote self-management in patient with a chronical disease to maintain a healthy lifestyle, while taking into account de patients’ autonomy?Method: a literature search was done in databases Pubmed and Cochrane. Inclusion criteria were: Qualitative research studies published after 2003 in English or Dutch language, concerning adult patients with a chronical disease and related to the nursing profession.Secondly a semi-structural interview was done with two dialysis care professionals and transcripted verbatim. Results: Six studies met the selection criteria and were used to answer the question. The literature data indicate five factors that influence self-management: (1) Professional attitude of nurses: nurses use their own values and convictions in ethical decisions which leads to moral conflicts (2) Shared-decision making: sharing knowledge as a professional with the patient is a significant component in giving the patient autonomy (3) Patient directed support contributes to the success of self-management (4) Change of the traditional relation as professional-patient into a professional cooperation (5) Reflection on ethical dilemmas.During the semi-structural interviews as most important aspects of self-management were mentioned that patients must be informed adequately and supported by making decisions. Patients autonomy must be central in the organization of care. Conclusion: Within self-management the patient should be in a central position. While performing self management care, nurses can be confronted with personal opinions that conflict with patients’ values. Shared decision making, patient directed support, professional attitude of the caregivers and reflection on ethical dilemmas, are key elements for effective self-management.

Promoting Healthy Work for Employees with Chronic Illness

The ENWHP project and campaign Promoting Healthy Work for Employees with Chronic Illness (PH Work) should contribute towards the implementation of effective workplace health practices within corporate policies of enterprises in Europe. More specific the project should stimulate activities and policies in companies for: -retaining and encouraging return to work (RTW) of chronically ill employees. -preventing employees of moving into disability or early retirement. To contribute to an improvement of social and economic outcomes, like better quality of life and functioning, reduced costs because of lower absence rate, etc. PH Work campaign will look into current good practices, as to motivate and stimulate employers and employees on the promotion of healthy work for all. Running time of ENWHP PH Work project is from April 2011 till February 2013

The development and implementation of a mobile application in human services

Information and communications technologies (ICTs) in human services are on the rise and raise concerns about their place and impact on the daily activities of professionals and clients. This article describes a study in which a social mobile application was developed for job coaches and employees and implemented in a pilot phase. The aim of the mobile application was to provide a better communication between employees and their job coaches and to provide more up-to-date information about the organization. The application consisted of a personal web environment and app with vacancies, personal news, events, tips, and promotions. A qualitative methodology was used in the form of focus groups and in-depth interviews. The results of this study show that the participants are partly positive about the social mobile application. It can be concluded that the use of mobile technologies can be beneficial in a range of human services practice settings for both professionals and clients and, therefore, requires more attention from the academic field to focus on this relatively new but promising theme.