E-Exercise is an effective 12-week blended intervention consisting of around five face-to-face physiotherapy sessions and a web-based application for patients with hip/knee osteoarthritis. In order to facilitate effective implementation of e-Exercise, this study aims to identify physiotherapists' experiences and determinants related to the usage of e-Exercise. Methods: An explanatory sequential mixed methods design embedded in a randomized controlled trial comparing e-Exercise with usual physiotherapy in patients with hip/knee osteoarthritis. Usage of e-Exercise was based on recruitment rates of 123 physiotherapists allocated to e-Exercise and objective web-based application usage data. Experiences and determinants related to e-Exercise usage were investigated with a questionnaire and clarified with semi-structured interviews. Results: Of the 123 physiotherapists allocated to e-Exercise, 54 recruited more than one eligible patient, of whom 10 physiotherapists continued using e-Exercise after the study period. Physiotherapists had mixed experiences with e-Exercise. Determinants related to intervention usage were appropriateness, added value, time, workload, professional autonomy, environmental factors, and financial consequences. Physiotherapists recommended to improve the ability to tailor e-Exercise to the individual needs of the patient patients' individual needs. Discussion: Determinants related to the usage of e-Exercise provided valuable information for the implementation of e-Exercise on broader scale. Most importantly, the flexibility of e-Exercise needs to be improved. Next, there is a need for education on how to integrate an online program within physiotherapy
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In this mixed methods study, a moderated mediation model predicting effects of leader-member exchange (LMX) and organizational citizenship behaviors (OCB) on innovative work behaviors, with employability as a mediator, has been tested. Multi-source data from 487 pairs of employees and supervisors working in 151 small and medium-sized enterprises (SMEs) supported our hypothesized model. The results of structural equation modelling provide support for our model. In particular, the benefits of close relationships and high-quality exchanges between employee and supervisor (LMX), and fostering individual development as a result of employees’ OCB have an indirect effect on innovative work behaviors through positive effects on workers’ employability. Innovative work behaviors depend on employees’ knowledge, skills, and expertise. In other words, enhancing workers’ employability nurtures innovative work behaviors. In addition, we found a moderation effect of organizational politics on the relationship between employability and innovative work behaviors. Secondly, qualitative methods focusing on experiences of the antecedents and outcomes of employability were used to complement our quantitative results. All in all, this study has important consequences for managerial strategies and practices in SMEs and call for an awareness of the dysfunctional effect of perceived organizational politics.
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Het versterken van de leesvaardigheid is een prioriteit voor de Nederlandse overheid, omdat goed tekstbegrip essentieel is voor het leren en voor het functioneren in de maatschappij. Onderzoek wijst uit dat Nederlandse jongeren minder vaardig en minder graag lezen, waardoor effectieve leeslessen nodig zijn. In lees- en literatuurlessen Nederlands (en lessen in moderne vreemde talen) ligt de nadruk vaak op het beantwoorden van vragen over teksten, met weinig aandacht voor het lezen en begrijpen van literaire teksten zoals poëzie. Dit is een gemiste kans, omdat het lezen van dergelijke teksten de leesvaardigheid en het begrip van taal en cultuur kan vergroten. In dit onderzoek is voor het eerst onderzocht hoe havo- en vwo-leerlingen poëzie lezen en begrijpen in vergelijking met proza (korte verhalen en beschrijvende teksten), met behulp van tekst-met-vragen en oogbewegingstechnologie. Een eerste bevinding is dat de leesprestaties voor poëzie consistent lager zijn dan voor proza in alle leerjaren. Daarnaast verbetert het begrip van poëzie niet in de loop van de leerjaren, terwijl het begrip van proza dat wel doet. De eyetracking gegevens laten met name zien dat leerlingen zowel poëzie als proza de eerste keer snel en lineair (oppervlakkig) lezen, maar poëzieteksten langer lezen na het lezen van een vraag. Vervolgens werd een leesprogramma voor poëzie en proza ontwikkeld en getest. Het programma is gebaseerd op observerend leren aan de hand van video's van de oogbewegingen van leerlingen. Leerlingen die deelnamen aan het programma lazen en begrepen poëzie, korte verhalen en informatieve teksten significant beter, ook in vergelijking met leerlingen die reguliere leeslessen volgden. Het is daarom aan te bevelen om in lessen Nederlands en in andere lessen aandacht te besteden aan het leesproces van leerlingen, met name poëzie.
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Aim. To report the expectations and experiences of general practitioners and practice nurses regarding the U-CARE programme, to gain a better understanding of the barriers and facilitators in providing proactive, structured care to frail older people and to determine whether implementation is feasible. Background. Care for older patients with complex care needs in primary care is fragmented, reactive and time consuming. A structured, proactive care programme was developed to improve physical functioning and quality of life in frail older patients. Design. An explanatory mixed-methods study nested in a cluster-randomized trial. Methods. The barriers to and needs for the provision of structured, proactive care, and expectations regarding the U-CARE programme were assessed with prequestionnaires sent to all participating general practitioners (n = 32) and practice nurses (n = 21) in October 2010. Postquestionnaires measured experiences with the programme after 5 months. Twelve months later, focus group meetings were conducted. Results. Practice nurses and general practitioners reported that it was difficult to provide proactive and structured care to older patients with multi-morbidity, different cultural backgrounds and low socioeconomic status. Barriers were a lack of time and financial compensation. Most general practitioners and practice nurses indicated that the programme added value for the coordination of care and allowed them to provide structured care. Conclusion. This explanatory mixed-methods study showed that general practitioners and practice nurses perceived the U-CARE programme as feasible in general practice. A transition was made from reactive, ad hoc care towards a proactive and preventive care approach
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Purpose: To deal with an increasingly competitive environment, organizations are combining continuous improvement (CI) practices with digitalization to accrue their benefits on operational performance and achieve operational excellence. The purpose of this study was to identify the enablers and inhibitors of digitalization as part of CI projects. Design/methodology/approach: A mixed-methods sequential explanatory research design consisting of an online survey and semi-structured interviews was used to examine how digitalization technologies have been incorporated by organizations in their CI projects. Findings: Key enablers of digitalization were found to be leadership capabilities, strategic direction, stakeholder involvement, system compatibility, data quality and giving employees room to experiment. Knowledge of digitalization was found to affect all these enablers. Research limitations/implications: The empirical findings are based on a nonprobability sample of Dutch CI practitioners, limiting their generalizability. Practical implications: The empirical findings highlight the need for organizations to adopt a structured approach to implementing digitalization as part of their CI projects, starting by ensuring that the necessary knowledge and skills are either present or accessible to the organization. Originality/value: The empirical findings show that enablers of digitalization in the context of CI are strongly interlinked, and thus require a holistic approach.
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Young adult caregivers experience reduced wellbeing when the combination of family care and an educational program becomes too demanding. We aim to clarify the role views, competences, and needs of lecturers regarding the identification and support of these students to prevent negative mental health consequences. A mixed-methods explanatory sequential design was used. We collected quantitative data using a survey of lecturers teaching in bachelor education programs in the Netherlands ( n = 208) and then conducted in-depth interviews ( n = 13). Descriptive statistics and deductive thematic analyses were performed. Most participants (70.2%) thought that supporting young adult caregivers was the responsibility of the educational institution, and 49% agreed that it was a responsibility of the lecturer, but only 66.8% indicated that they feel competent to do so. However, 45.2% indicated that they needed more training and expertise to identify and support these students. All interviewees felt responsible for their students' wellbeing but highlighted a lack of clarity regarding their role fulfillment. In practice, their ability to identify and support these students depended on their available time and level of expertise. The lecturers required agreements on responsibility and procedures for further referral, as well as information on support and referral opportunities, communication skills courses, and peer-to-peer coaching.
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This explanatory sequential mixed methods study explores the perceptions of academic and administrative managers responsible for teacher training at a public university in Colombia, as well as their views on improving such training after learning about the performance of teachers student teachers in the 2019 Saber Pro test, the differences in their test scores, and the relationships and statistical correlations between these outcomes and the students’ personal, family, socioeconomic and academic characteristics. Our findings show significant differences in the student teachers’ mean scores and performance when data are grouped according to personal, socioeconomic and academic conditions; a significant relationship between performance and student teacher characteristics; and correlations between critical reading scores and the other competencies assessed. Our data also highlight the lack of knowledge among academic and administrative managers about students’ life circumstances and the diversity of factors that may impact their performance; the importance of correlational data; the difference between expected and true outcomes; the inequity under which students seem to pursue their education; the limitations in access to resources; the training required for teachers to be able to analyze quantitative data and use specific software; the impact of teachers’ critical reading skills on student outcomes; the importance of data-driven decision-making; and the need for teachers to engage in quantitative research practices.
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PurposeTo identify healthcare professionals’ perspectives on key barriers to improving physical activity in hospitalized adult patients, and to identify solutions to overcome these barriers. Methods: We used an explanatory sequential mixed-methods study design in a Dutch university hospital. A survey exploring 39 potential barriers was completed by 15 physicians/physician assistants, 106 nurses, four nursing assistants, and four physical therapists working on surgery, internal medicine, and cardiology wards. Next, three in-depth semi-structured focus groups – comprising 30 healthcare professionals – discussed the survey findings to identify key barriers and solutions. Focus group discussions were analyzed using thematic analysis. Results: Five themes were identified that described both the key barriers and the solutions to overcome these barriers. Healthcare professionals proposed several solutions, including clarifying the definition of physical activity, empowering patients to take responsibility for physical activity, giving physical therapists or physicians a prominent role in encouraging physical activity, and changing the hospital ward to entice patients to become physically active. Conclusions: Healthcare professionals need clear guidelines, roles, and responsibilities when it comes to physical activity. They also need personalized interventions that empower patients in physical activity. Finally, hospital wards should be designed and furnished so that patients are encouraged to be active.
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This study explores waste management literacy among secondary school communities in Tangerang City, Indonesia, using the Knowledge, Attitude, Behavior (KAB) model within the 3R (Reduce, Reuse, Recycle) framework. Employing a mixed-methods sequential explanatory design, the research integrates quantitative data from 357 participants including principals, teachers, staff, and students from seven schools near the Rawa Kucing Landfill, with qualitative insights from follow up interviews. This study was applied to multiple regression and correlation analyses to evaluate relationships between knowledge, attitude, and behavior. Results show that while knowledge positively influences behavior, attitude unexpectedly correlates negatively, revealing an attitude-behaviorgap. Although respondents generally hold positive attitudes toward waste management, these attitudes do not consistently translate into active engagement. The study’s qualitative phase uses interviews to identify barriers contributing to this gap, uncovering individual, social, and structural obstacles such as inadequate facilities and established waste practices that hinder effective waste management. Advocating for a comprehensive approach, the study recommends providing schools with 3R bins and training, sustainable behavior modeling by teachers, alignment of municipal waste collection with school efforts, family reinforcement of waste practices, and curricular integration of waste management. This coordinated approach seeks to bridge the attitude-behavior gap and promote sustainable waste practices across school communities in Tangerang City.
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BACKGROUND: Healthcare professionals in the hospital setting frequently assume primary caregiving responsibilities, which often leads family members to perceive this as standard practice during hospitalization. This dynamic may create a gap between actual and desired levels of family involvement. The aim of this study is to explore the opinions of families about their involvement in care during the hospitalization of a relative.METHODS: A sequential explanatory mixed-method study design was used, where quantitative data collection is followed by qualitative data collection for a deeper understanding of the quantitative findings. Data were collected between November 2023 and April 2024 across 15 wards in a university hospital in the north of the Netherlands. 153 family members of hospitalized patients completed the adapted Families' Importance in Nursing Care-Families' Opinions questionnaire, providing valuable quantitative data. Twenty-three of these family members were subsequently interviewed to gather qualitative insights. Data were analyzed sequentially, with the quantitative results guiding qualitative data collection. The two types of data were integrated to draw comprehensive conclusions about the significance of family involvement during hospitalization. The study adhered to the guidelines of the Good Reporting of A Mixed Method Study (GRAMMS).RESULTS: The questionnaire scores indicate a high willingness for involvement in care during hospitalization. Subsequent in-depth interviews led to the development of a model demonstrating that this involvement is sequentially related to the themes of acknowledgement, alignment, and collaboration.CONCLUSIONS: Family members expressed a need to be acknowledged by healthcare professionals as partners in care. Role agreements and information sharing during hospital care should be aligned to achieve effective collaboration between family members and healthcare professionals.
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