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Enhancing citizens’ participation in the community to promote health and wellbeing

BackgroundIn 2015, Amsterdam became part of the WHO Age Friendly City community, thereby accepting the responsibility to work towards a more age friendly Amsterdam. To study senior citizens’ needs and wishes concerning the age friendliness of their neighbourhood, the municipality asked the Amsterdam University of Applied Science to set up two pilot projects in two neighbourhoods. Aim was to 1) gain insight in seniors’ views and wishes regarding an age friendly city, and 2) reflect on the experiences with working with senior co-researchers. MethodologyThe study followed a Participatory Action Research approach with research teams consisting of seniors as co-researchers and professional researchers. We chose two neighbourhoods with distinct characteristics: the Indische Buurt which is centrally located, vibrant, multicultural, and strongly gentrifying, and Buitenveldert, a suburban and spacious neighbourhood, with less facilities and a dominance of well-to-do senior citizens. In both areas, we recruited senior co-researchers to form the research teams. They generally lived in, or close to, the pilot neighbourhood, and varied in age and ethnical background. The aim was to put the co-researchers in the lead during the entire research process. However, it differed between the neighbourhoods which type of researcher was in the lead. As a team, they formulated the main research question, constructed a topic list for interviews with older citizens, convened the interviews, analysed the data, wrote the report, and presented the results. During the entire process, they were supported by professional researchers.Both research teams interviewed 40 senior citizens, who were recruited through the co-researchers’ networks, professional care organisations, neighbourhood communities, and local media. We intended to gather a sample representative for the neighbourhood population. In the Indische Buurt, this proved to be difficult, since the relatively large Turkish and Moroccan communities were difficult to get into contact with, and it was hard to find co-researchers from those communities who could have provided a way in. Process and outcomesWe will share some of the results, but we will mainly reflect on the research process. ProcessRegarding the process, we found some differences between the two neighbourhoods. In the Indische Buurt, it took much effort to find co-researchers, since the seniors we encountered said to be too busy with other neighbourhood activities. We did recruit a small group of four co-researchers of different ethnical background, but sadly lacking Turkish and Moroccan seniors. They started with a very limited research experience and experienced ownership, which greatly increased during the process. At the finalisation of the project, the group ceased to be, but the outcomes were followed up by existing groups and organisations in the neighbourhood.In Buitenveldert, a large group of co-researchers was recruited in no-time, bearing more resemblance to an action group than a research group. They were generally highly educated and some already had research experience. The group proved to be pro-active, had a strong feeling of ownership, and worked in constant collaboration with the ‘professional’ researchers, respecting each other’s knowledge and skills. At the finalisation of the project, the group remained active as partner of the local government. OutcomesConcerning the content of the outcomes, we found some expected differences and unexpected similarities. For instance, we expected to find different outcomes concerning housing and facilities between the neighbourhoods. Indeed, in Buitenveldert, housing was already age friendly whereas facilities were scarce and geographically far apart. Yet, in the Indische Buurt, housing was poorly equipped for physically impaired seniors, but facilities were abundant and close by.We also found that, in both neighbourhoods, senior citizens were reluctant to share their limitations and ask for support, despite differences in neighbourhood, ethnicity, age etc. Of course, this can be expected of seniors from the ‘silent generation’. However, they seemingly shared these emotions more easily with their peers than with professional researchers. ConclusionThe social-cultural context of the neighbourhood impacts the research process. Overall, co-research appears to be a fruitful method to involve senior citizens in decisions concerning the improvement of their neighbourhood. Aims and content of the workshopWe aim to:• present our reflections on the participative process of working with senior co-researchers in Amsterdam• exchange and discuss with the participants of the workshop the lessons learned on how to facilitate citizens’ participation in the community• discuss similar and future projects and possibilities for collaboration among the participants of the workshopContent of the workshop• Presentation• Exchange and discussion in small groups • Plenary discussion on possible collaboration projects aiming to enhance citizens’ participation in the community

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Patients at risk of the progression of chronic venous disease

The objective of this thesis is to make a first step towards prevention of the progression of chronic venous disease and the development of a first venous leg ulcer in chronic venous disease patients. The aim is to identify chronic venous disease patients at risk of developing more severe clinical stages, provide insight in the lifestyle related risk factors, and provide an overview of current chronic venous disease care in the Netherlands.

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Patients at risk of the progression of chronic venous disease
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A cross-sectional study of lactation room quality and Dutch working mothers’ satisfaction, perceived ease of, and perceived support for breast milk expression at work

BackgroundThe challenge of combining professional work and breastfeeding is a key reason why women choose not to breastfeed or to stop breastfeeding early. We posited that having access to a high-quality lactation room at the workplace could influence working mothers’ satisfaction and perceptions related to expressing breast milk at work, which could have important longer term consequences for the duration of breastfeeding. Specifically, we aimed to (1) develop a checklist for assessing the quality of lactation rooms and (2) explore how lactation room quality affects lactating mothers’ satisfaction and perceptions. Drawing on social ecological insights, we hypothesized that the quality of lactation rooms (operationalized as any space used for expressing milk at work) would be positively related to mothers’ satisfaction with the room, perceived ease of, and perceived support for milk expression at work.MethodsWe conducted two studies. In Study 1 we developed a lactation room quality checklist (LRQC) and assessed its reliability twice, using samples of 33 lactation rooms (Study 1a) and 31 lactation rooms (Study 1b). Data were collected in the Northern part of the Netherlands (between December 2016 and April 2017). Study 2 comprised a cross-sectional survey of 511 lactating mothers, working in a variety of Dutch organizations. The mothers were recruited through the Facebook page of a popular Dutch breastfeeding website. They completed online questionnaires containing the LRQC and measures aimed at assessing their satisfaction and perceptions related to milk expression at work (in June and July 2017).ResultsThe LRQC was deemed reliable and easy to apply in practice. As predicted, we found that objectively assessed higher-quality lactation rooms were associated with increased levels of satisfaction with the lactation rooms, perceived ease of milk expression at work, and perceived support from supervisors and co-workers for expressing milk in the workplace.ConclusionsThe availability of a high-quality lactation room could influence mothers’ decisions regarding breast milk expression at work and the commencement and/or continuation of breastfeeding. Future studies should explore whether and how lactation room quality affects breastfeeding choices, and which aspects are most important to include in lactation rooms.

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A cross-sectional study of lactation room quality and Dutch working mothers’ satisfaction, perceived ease of, and perceived support for breast milk expression at work