The transition from institutional to community care for vulnerable people has been shaping the welfare system in Europe over the last decades. For the period of 2014-20 deinstitutionalization became one of the highlighted priorities of the European Commission in order to promote reforms in disability and mental health care in the convergence regions, too. Between 2007 and 2013, Estonia as many other Eastern European countries has implemented the first wave of deinstitutionalization and during the new EU budget period a second wave will be occurred in order to continue and hopefully complete the transition. In this study, we try to give an overview on the experiences of different European countries highlighting good practices and possible pitfalls. This study has been conducted at the request of the Estonian Ministry of Social Affairs.
Intention of healthcare providers to use video-communication in terminal care: a cross-sectional study. Richard M. H. Evering, Marloes G. Postel, Harmieke van Os-Medendorp, Marloes Bults and Marjolein E. M. den Ouden BMC Palliative Care volume 21, Article number: 213 (2022) Cite this articleAbstractBackgroundInterdisciplinary collaboration between healthcare providers with regard to consultation, transfer and advice in terminal care is both important and challenging. The use of video communication in terminal care is low while in first-line healthcare it has the potential to improve quality of care, as it allows healthcare providers to assess the clinical situation in real time and determine collectively what care is needed. The aim of the present study is to explore the intention to use video communication by healthcare providers in interprofessional terminal care and predictors herein.MethodsIn this cross-sectional study, an online survey was used to explore the intention to use video communication. The survey was sent to first-line healthcare providers involved in terminal care (at home, in hospices and/ or nursing homes) and consisted of 39 questions regarding demographics, experience with video communication and constructs of intention to use (i.e. Outcome expectancy, Effort expectancy, Attitude, Social influence, Facilitating conditions, Anxiety, Self-efficacy and Personal innovativeness) based on the Unified Theory of Acceptance and Use of Technology and Diffusion of Innovation Theory. Descriptive statistics were used to analyze demographics and experiences with video communication. A multiple linear regression analysis was performed to give insight in the intention to use video communication and predictors herein.Results90 respondents were included in the analysis.65 (72%) respondents had experience with video communication within their profession, although only 15 respondents (17%) used it in terminal care. In general, healthcare providers intended to use video communication in terminal care (Mean (M) = 3.6; Standard Deviation (SD) = .88). The regression model was significant and explained 44% of the variance in intention to use video communication, with ‘Outcome expectancy’ and ‘Social influence’ as significant predictors.ConclusionsHealthcare providers have in general the intention to use video communication in interprofessional terminal care. However, their actual use in terminal care is low. ‘Outcome expectancy’ and ‘Social influence’ seem to be important predictors for intention to use video communication. This implicates the importance of informing healthcare providers, and their colleagues and significant others, about the usefulness and efficiency of video communication.
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The goal of a local energy community (LEC) is to create a more sustainable, resilient, and efficient energy system by reducing dependence on centralized power sources and enabling greater participation and control by local communities and individuals. LEC requires transformations in local energy systems, and strongly depends on the preferences and actions of the local actors involved. The necessity for extensive stakeholder involvement adds complexity to the energy transition, posing a significant challenge for all involved parties. The municipality of Leidschendam-Voorburg has committed to the national decision for energy transition. It has taken a strategic approach by proceeding De Heuvel/Amstelwijk as the pioneer in this initiative, leading the way for other neighborhoods to follow. It is crucial to devise strategies that effectively facilitate stakeholder engagement. To this end, a thorough stakeholder analysis is needed. Such an analysis can focus on the identification of key stakeholders, their interests, their influence, and their behavioral characteristics in relation to the energy transition. Additionally, it's crucial to uncover the challenges encountered by these stakeholders and finally develop appropriate strategies to address them hence enhance their engagement. This thesis begins with an introduction to the research background, including a presentation of the case study and a statement of the problem identified in the field, followed by the research questions underpinning the study. A thorough literature review ensues, providing a robust synthesis of existing research relating to stakeholder engagement in LECs, with a view to expediting energy transitions. The literature review not only forms the foundation for the research methods adopted in this study but also promotes in the construction of the conceptual model. Subsequent to the literature review, the research method is detailed. The filed research is conducted in five steps: Step 1 - identification of stakeholders, Step 2 - prioritization of stakeholders, Step 3 - interviewing, Step 4 - data analysis, including stakeholder profiling with mapping and addressing challenges, and finally, Step 5 - proposal of strategies for stakeholder engagement enhancement based on the expected and current levels of stakeholders engagement. This research collects necessary information to understand the profiles of stakeholders in De Heuvel/Amstelwijk, tackle challenges faced by different stakeholders, propose strategies to increase stakeholders engagement. It not only aims to enrich the depth of theoretical knowledge on the subject matter but also strives to aid in the development of a localized energy strategy that is optimally suited for the De Heuvel/Amstelwijk neighborhood as good example for other neighborhoods.
