As a result of the COVID-19 measures, many people experienced social isolation and a lack of meaningful contact, especially vulnerable elderly people. For a specific group of musicians specialized in person-centred artistically-led participatory practices in healthcare settings, this sparked the exploration of migrating their live practice online, by making use of video-calling technology. From a ‘lifelong learning’ perspective—which considers musicians as being capable of responding to societal change by creating new, meaningful artistic practices—such a sudden migration from offline to online, under the exceptional circumstances at the beginning of the COVID-19 pandemic, created an instant challenge for the musicians to demonstrate their flexibility and adaptability. On the other hand, the limits caused by the conditions and immediacy of this response, combined with a feeling of diminished humanness in virtual interaction, seemed to jeopardize the person-centred values that the work of this group is built upon.This article explores this issue by expanding on the musicians’ flexibility towards personcentredness and their attempts to safeguard these values when they suddenly switch from a ‘physical’ to ‘virtual’ space.
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BackgroundPeople from lower and middle socioeconomic classes and vulnerable populations are among the worst affected by the COVID-19 pandemic, thus exacerbating disparities and the digital divide.ObjectiveTo draw a portrait of e-services as a digital approach to support digital health literacy in vulnerable populations amid the COVID-19 infodemic, and identify the barriers and facilitators for their implementation.MethodsA scoping review was performed to gather published literature with a broad range of study designs and grey literature without exclusions based on country of publication. A search was created in Medline (Ovid) in March 2021 and translated to Medline, PsycINFO, Scopus and CINAHL with Full Text (EBSCOhost). The combined literature search generated 819 manuscripts. To be included, manuscripts had to be written in English, and present information on digital intervention(s) (e.g. social media) used to enable or increase digital health literacy among vulnerable populations during the COVID-19 pandemic (e.g. older adults, Indigenous people living on reserve).ResultsFive articles were included in the study. Various digital health literacy-enabling e-services have been implemented in different vulnerable populations. Identified e-services aimed to increase disease knowledge, digital health literacy and social media usage, help in coping with changes in routines and practices, decrease fear and anxiety, increase digital knowledge and skills, decrease health literacy barriers and increase technology acceptance in specific groups. Many facilitators of digital health literacy-enabling e-services implementation were identified in expectant mothers and their families, older adults and people with low-income. Barriers such as low literacy limited to no knowledge about the viruses, medium of contamination, treatment options played an important role in distracting and believing in misinformation and disinformation. Poor health literacy was the only barrier found, which may hinder the understanding of individual health needs, illness processes and treatments for people with HIV/AIDS.ConclusionsThe literature on the topic is scarce, sparse and immature. We did not find any literature on digital health literacy in Indigenous people, though we targeted this vulnerable population. Although only a few papers were included, two types of health conditions were covered by the literature on digital health literacy-enabling e-services, namely chronic conditions and conditions that are new to the patients. Digital health literacy can help improve prevention and adherence to a healthy lifestyle, improve capacity building and enable users to take the best advantage of the options available, thus strengthening the patient’s involvement in health decisions and empowerment, and finally improving health outcomes. Therefore, there is an urgent need to pursue research on digital health literacy and develop digital platforms to help solve current and future COVID-19-related health needs.
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This applied research project aims to generate a better understanding of the effects of heatwaves on vulnerable population groups in the municipality of The Hague, and suggests ways in which the municipality can help such groups to cope with these heatwaves. The research was performed as a cooperation between The Hague University of Applied Sciences (THUAS), the International Institute of Social Studies (ISS, Erasmus University Rotterdam) and the International Centre for Frugal Innovation (ICFI, Leiden-Delft-Erasmus Universities). Heatwaves constitute an important yet often overlooked part of climate change and their impacts qualify as disasters. According to the World Disasters Report 2020, the three heatwaves affecting Belgium, France, Germany, Italy, the Netherlands, Spain, Switzerland and the UK in the summer of 2019 caused 3,453 deaths.1 2020 was a new record year for the Netherlands because it was the first time that a heatwave included five days in a row during which the temperature reached 35 degrees or more. In addition, 40 degrees was measured for the first time, and periods of tropical days and nights are generally getting longer. Most importantly, this trend is accelerating faster than the climate change models are predicting.2 In addition, the COVID-19 pandemic is compounding the effect of heatwaves, as vulnerable individuals may be reluctant to seek cool spaces out of fear of infection. Already in 2006, the Netherlands ranked near the top of the global disaster index due to the number of excess deaths that could be attributed to the heatwave. In the same year, the EU published the first climate strategy in which heat is recognised as a priority. In 2008, the Netherlands developed its first national heat plan.4 The municipality of The Hague has a municipal climate adaptation strategy and has developed a draft local heat plan in the summer of 2021, which was published in February 2022 . This research was not meant to be and was not set up as an evaluation of the current heat plan, which has not yet been activated. At the level of municipalities and cities, the concept of urban resilience is key. It refers to “the capacity of individuals, communities, institutions, businesses, and systems within a city to survive, adapt, and grow no matter what kinds of chronic stresses and acute shocks they experience”. Heatwaves clearly constitute acute shocks which are rapidly developing into chronic stresses. In turn, heatwaves also exacerbate the chronic stresses that are already there, i.e. existing chronic stresses also lead to greater impact of a heatwave. In other words, there are negative interaction effects. Addressing these effects requires overcoming the silo approach to urban governance, in which different municipal departments as well as other stakeholders (such as the Red Cross, housing corporations, tenants’ associations, care organisations, entrepreneurs etc.) each address different parts of the problem, rather than doing so in an integrated and inclusive manner. The dataset for this study is archived in DANS Easy: https://doi.org/10.17026/dans-xeb-h8uk
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As the Dutch population is aging, the field of music-in-healthcare keeps expanding. Healthcare, institutionally and at home, is multiprofessional and demands interprofessional collaboration. Musicians are sought-after collaborators in social and healthcare fields, yet lesser-known agents of this multiprofessional group. Although live music supports social-emotional wellbeing and vitality, and nurtures compassionate care delivery, interprofessional collaboration between musicians, social work, and healthcare professionals remains marginal. This limits optimising and integrating music-making in the care. A significant part of this problem is a lack of collaborative transdisciplinary education for music, social, and healthcare students that deep-dives into the development of interprofessional skills. To meet the growing demand for musical collaborations by particularly elderly care organisations, and to innovate musical contributions to the quality of social and healthcare in Northern Netherlands, a transdisciplinary education for music, physiotherapy, and social work studies is needed. This project aims to equip multiprofessional student groups of Hanze with interprofessional skills through co-creative transdisciplinary learning aimed at innovating and improving musical collaborative approaches for working with vulnerable, often older people. The education builds upon experiential learning in Learning LABs, and collaborative project work in real-life care settings, supported by transdisciplinary community forming.The expected outcomes include a new concept of a transdisciplinary education for HBO-curricula, concrete building blocks for a transdisciplinary arts-in-health minor study, innovative student-led approaches for supporting the care and wellbeing of (older) vulnerable people, enhanced integration of musicians in interprofessional care teams, and new interprofessional structures for educational collaboration between music, social work and healthcare faculties.
In leaving the more traditional territories of the concert performance for broader societal contexts, professional musicians increasingly devise music in closer collaboration with their audience rather than present it on a stage. Although the interest for such forms of devising co-creative musicking within the (elderly) health care sector is growing, the work can be considered relatively new. In terms of research, multiple studies have sought to understand the impact of such work on musicians and participants, however little is known about what underpins the musicians’ actions in these settings. With this study, I sought to address this gap by investigating professional musicians’ emerging practices when devising co-creative musicking with elderly people. Three broad concepts were used as a theoretical background to the study: Theory of Practice, co-creative musicking, and Praxialism. Firstly, I used Theory of Practice to help understand the nature of emerging practices in a wider context of change in the field of music and habitus of musicians and participants. Theory of Practice enabled me to consider a practice as “a routinized type of behaviour which consists of several elements, interconnected to one another: forms of bodily activities, forms of mental activities, ‘things’ and their use, a background knowledge in the form of understanding, know-how, states of emotion, and motivational knowledge” (Reckwitz, 2002, p. 249). Secondly, I drew the knowledge from co-creative musicking, which is a concept I gathered from two existing concepts: co-creation and musicking. Musicking (Small, 1998), which considers music as something we do (including any mode of engagement with music), provided a holistic and inclusive way of looking at participation in music-making. The co-creation paradigm encompasses a view on enterprise that consists of bringing together parties to jointly create an outcome that is meaningful to all (Prahalad & Ramaswamy, 2004; Ramaswamy & Ozcan, 2014). The concept served as a lens to specify the jointness of the musicking and challenge issues of power in the engagement of participants in the creative-productive process. Thirdly, Praxialism considers musicking as an activity that encompasses “musical doers, musical doing, something done and contexts in which the former take place” (Elliott, 1995). Praxialism sets out a vision on music that goes beyond the musical work and includes the meanings and values of those involved (Silverman, Davis & Elliott, 2014). The concept allowed me to examine the work and emerging relationships as a result of devising co-creative musicking from an ethical perspective. Given the subject’s relative newness and rather unexplored status, I examined existing work empirically through an ethnographic approach (Hammersley & Atkinson, 2007). Four cases were selected where data was gathered through episodic interviewing (Flick, 2009) and participant observation. Elements of a constructivist Grounded Theory (Charmaz, 2014) were used for performing an abductive analysis. The analysis included initial coding, focused coding, the use of sensitizing concepts (Blumer 1969 in Hammersley, 2013) and memoing. I wrote a thick description (Geertz, 1973) for each case portraying the work from my personal experience. The descriptions are included in the dissertation as one separate chapter and foreshadow the exposition of the analysis in a next chapter. In-depth study of the creative-productive processes of the cases showed the involvement of multiple co-creative elements, such as a dialogical interaction between musicians and audience. However, participants’ contributions were often adopted implicitly, through the musicians interpreting behaviour and situations. This created a particular power dynamic and challenges as to what extent the negotiation can be considered co-creative. The implicitness of ‘making use’ of another person’s behaviour with the other not (always) being aware of this also triggered an ethical perspective, especially because some of the cases involved participants that were vulnerable. The imbalance in power made me examine the relationship that emerges between musicians and participants. As a result of a closer contact in the co-creative negotiation, I witnessed a contact of a highly personal, sometimes intimate, nature. I recognized elements of two types of connections. One type could be called ‘humanistic’, as a friendship in which there is reciprocal care and interest for the other. The other could be seen as ‘functional’, which means that the relationship is used as a resource for providing input for the creative musicking process. From this angle, I have compared the relationship with that of a relationship of an artist with a muse. After having examined the co-creative and relational sides of the interaction in the four cases, I tuned in to the musicians’ contribution to these processes and relationships. I discovered that their devising in practice consisted of a continuous double balancing act on two axes: one axis considers the other and oneself as its two ends. Another axis concerns the preparedness and unpredictability at its ends. Situated at the intersection of the two axes are the musicians’ intentionality, which is fed by their intentions, values and ethics. The implicitness of the co-creation, the two-sided relationship, the potential vulnerability of participants, and the musicians’ freedom in navigating and negotiation, together, make the devising of co-creative musicking with elderly people an activity that involves ethical challenges that are centred around a tension between prioritizing doing good for the other, associated with a eudaimonic intention, and prioritizing values of the musical art form, resembling a musicianist intention. The results therefore call for a musicianship that involves acting reflectively from an ethical perspective. Doctoral study by Karolien Dons
