Objectives To determine nurse-sensitive outcomes in district nursing care for community-living older people. Nurse-sensitive outcomes are defined as patient outcomes that are relevant based on nurses’ scope and domain of practice and that are influenced by nursing inputs and interventions. Design A Delphi study following the RAND/UCLA Appropriateness Method with two rounds of data collection. Setting District nursing care in the community care setting in the Netherlands. Participants Experts with current or recent clinical experience as district nurses as well as expertise in research, teaching, practice, or policy in the area of district nursing. Main outcome measures Experts assessed potential nurse-sensitive outcomes for their sensitivity to nursing care by scoring the relevance of each outcome and the ability of the outcome to be influenced by nursing care (influenceability). The relevance and influenceability of each outcome were scored on a nine-point Likert scale. A group median of 7 to 9 indicated that the outcome was assessed as relevant and/or influenceable. To measure agreement among experts, the disagreement index was used, with a score of <1 indicating agreement. Results In Delphi round two, 11 experts assessed 46 outcomes. In total, 26 outcomes (56.5%) were assessed as nurse-sensitive. The nurse-sensitive outcomes with the highest median scores for both relevance and influenceability were the patient’s autonomy, the patient’s ability to make decisions regarding the provision of care, the patient’s satisfaction with delivered district nursing care, the quality of dying and death, and the compliance of the patient with needed care. Conclusions This study determined 26 nurse-sensitive outcomes for district nursing care for community-living older people based on the collective opinion of experts in district nursing care. This insight could guide the development of quality indicators for district nursing care. Further research is needed to operationalise the outcomes and to determine which outcomes are relevant for specific subgroups.
After the arrival of refugees in the Netherlands, many citizens wanted to act and help the social inclusion of refugees. Community initiatives emerged where some of the initiatives even grew into potential Social Enterprises. In this research we investigated the main issues initiatives around refugees encounter when growing into a social enterprise (RQ1). Through the organization of learning networks we gathered data form initiatives who were currently in this process. The two main issues that arose were making a good business model and in what way impact can be measured when the impact area is the social inclusion of refugees. Our second research question (RQ2) investigated in what way the social initiatives help refugees in their social inclusion process. For this research question we interviewed refugees whom where involved with one of the initiatives participating in our research. Our main findings are that the participants in this research are all trying to take control over their lives, learning how to make a change and are trying to achieve a life that is good for them. They attributed various benefits to their active participation in the initiatives. They all mention that they met new people, that the people who started the initiative were very helpful and that they liked participating.
Citizen participation is booming, especially the number of urban bottom-up initiatives where information and communication technologies (ICT) are deployed is increasing rapidly. This growth is good news for society as recent historical research shows that the more citizens actively and persistently interfere with public issues, the more likely a society will be resilient. And yet, at the same time, a growing number of scholars argue that due to the unprecedented impact of ICT, the public sphere is at stake. How to understand both trends? How do the anti-‘public sphere’ developments relate to the growing number of citizens’ initiatives using ICT? And if these citizen initiatives can indeed be understood as manifestations of public spheres, how can ICT foster or hinder the development of these public spheres? These questions will be explored by analyzing a Dutch citizen initiative called ‘Buuv’ (an online ‘market’ place for and by local residents) from a ‘public sphere’ perspective. The author will turn to The human condition (1958) of Hannah Arendt in order to elaborate a ‘public sphere’ perspective. An Arendtian perspective (as any perspective) highlights, however, some aspects and underexposes other aspects. Furthermore, chances are that Arendt’s thoughts are somewhat outdated, in the sense that we now live in a world where the online and the offline life intertwine — an experience that is referred to with the term ‘onlife’. Bearing these remarks in mind, the author will elaborate on the value of Arendt’s ideas to 1) the endeavor of understanding current trends in society—more urban bottom-up initiatives and anti-‘public sphere’ developments due to the broad uptake of ICT—and 2) the endeavor of revitalizing the public sphere in an onlife world. IEEE copyright
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