Zoekresultaten

Een kleine sociologie van sociale interventies: de bijziendheid van evidence based practice

Er wordt dezer dagen in de Nederlandse sociale sector veel geïnvesteerd in evidence based practice. Brede welzijnsorganisaties worden er in hun onderhandelingen met gemeenten op aangesproken, en wat niet 'evidence based' is vormt een makkelijke prooi voor bezuinigingen. Landelijke organisaties zoals NJi en MOVISIE werken hard aan het bouwen en vullen van vrij toegankelijke digitale databanken met daarin actuele informatie over welke effectonderzoeken beschikbaar zijn voor een hele reeks sociale interventies. Krachtig materiaal dat de modernisering van sociaal werk vooruit kan helpen, maar tegelijk leidend aan de eerder genoemde vorm van bijziendheid. Een volwaardig perspectief op beroepsinnovatie in de sociale sector kan zich niet beperken tot een normatief uitgangspunt, tot verkondigen wat zou moeten zijn. Dat volwaardig perspectief bereiken we pas als we kijken naar wat is, naar de diverse factoren die de dynamiek van beroepsinnovatie beïnvloeden, ook als ze minder verheffend zijn (bijvoorbeeld de invloed van platte commercie, of macht en populisme). We doen daarom een oproep om open biografieën van sociale interventies te ontwikkelen, om vanuit een sociologisch perspectief te beschrijven hoe allerlei sociale interventies een plek verwerven in het dagelijks leven van sociaal werk.

Social Innovation using the Best Practice Unit model

The model of the Best Practice Unit (BPU) is a specific form of practice based research. It is a variation of the Community of Practice (CoP) as developed by Wenger, McDermott and Snyder (2002) with the specific aim to innovate a professional practice by combining learning, development and research. We have applied the model over the past 10 years in the domain of care and social welfare in the Netherlands. Characteristics of the model are: the interaction between individual and collective learning processes, the development of (new or better) working methods, and the implementation of these methods in daily practice. Multiple knowledge sources are being used: experiential knowledge, professional knowledge and scientific knowledge. Research is serving diverse purposes: articulating tacit knowledge, documenting the learning and innovation process, systematically describing the revealed or developed ways of working, and evaluating the efficacy of new methods. An analysis of 10 different research projects shows that the BPU is an effective model.

Art in social work practice

Considering design practice

Academic design research often fails to contribute to design practice. This dissertation explores how design research collaborations can provide knowledge that design professionals will use in practice. The research shows that design professionals are not addressed as an important audience between the many audiences of collaborative research projects. The research provides insight in the learning process by design professionals in design research collaborations and it identifies opportunities for even more learning. It shows that design professionals can learn about more than designing, but also about application domains or project organization.

Learning communities of practice in care

Lifelong learning is necessary for nurses and caregivers to provide good, person-centred care. To facilitate such learning and embed it into regular working processes, learning communities of practice are considered promising. However, there is little insight into how learning networks contribute to learning exactly and what factors of success can be found. The study is part of a ZonMw-funded research project ‘LeerSaam Noord’ in the Netherlands, which aims to strengthen the professionalization of the nursing workforce and promote person-centred care. We describe what learning in learning communities looks like in four different healthcare contexts during the start-up phase of the research project. A thematic analysis of eleven patient case-discussions in these learning communities took place. In addition, quantitative measurements on learning climate, reciprocity behavior, and perceptions of professional attitude and autonomy, were used to underpin findings. Reflective questioning and discussing professional dilemma's i.e. patient cases in which conflicting interests between the patient and the professional emerge, are of importance for successful learning.

Effectiveness of transmural team-based palliative care in prevention of hospitalizations in patients at the end of life

Background: Team-based palliative care interventions have shown positive results for patients at the end of life in both hospital and community settings. However, evidence on the effectiveness of transmural, that is, spanning hospital and home, team-based palliative care collaborations is limited. Aim: To systematically review whether transmural team-based palliative care interventions can prevent hospital admissions and increase death at home. Design: Systematic review and meta-analysis. Data sources: MEDLINE (Ovid), Embase (Ovid), CINAHL (Ebsco), PsychINFO (Ovid), and Cochrane Library (Wiley) were systematically searched until January 2021. Studies incorporating teams in which hospital and community professionals co-managed patients, hospital-based teams with community follow-up, and case-management interventions led by palliative care teams were included. Data was extracted by two researchers independently. Results: About 19 studies were included involving 6614 patients, of whom 2202 received an intervention. The overall pooled odds ratio of at least one hospital (re)admissions was 0.46 (95% confidence interval (CI) 0.34–0.68) in favor of the intervention group. The highest reduction in admission was in the hospital-based teams with community follow-up: OR 0.21 (95% CI 0.07–0.66). The pooled effect on home deaths was 2.19 (95% CI 1.26–3.79), favoring the intervention, with also the highest in the hospital-based teams: OR 4.77 (95% CI 1.23–18.47). However, studies had high heterogeneity regarding intervention, study population, and follow-up time. Conclusion: Transmural team-based palliative care interventions, especially hospital-based teams that follow-up patients at home, show an overall effect on lowering hospital admissions and increasing the number of patients dying at home. However, broad clinical and statistical heterogeneity of included studies results in uncertainty about the effect size.