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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The proportion of elderly people in the society is constantly growing. The elderly who live alone form one of the most vulnerable groups in the society that is also at considerable risk for poverty and social isolation. According to the last population census in Estonia (2011), 39.3% of the elderly (65+) lived alone. The ageing of the population is accompanied by novel challenges, among them especially the coping of the elderly living alone. In 2015, the research team at the Tallinn University School of Governance, Law and Society conducted a study to map Estonian community-based practices that are available for the elderly (65+), especially for those who live alone at home, and the way these practices support interdependent coping and prevent the need for institutional care. This study, based on qualitative and quantitative data collected in Estonian communities, suggests that cooperation between Estonian local governments and communities should be more effective and involve regular interaction. Promising practices include developing network-based community support models and broadening communication possibilities.
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To investigate the digital aspect of travel among vulnerable-to-exclusion groups, Customer Journey Mapping [CJM] was used to gain qualitative and quantitative in-depth knowledge of the experiences of elderly people, low-income citizens, wheelchair users, blind people and women. Due to COVID-19 the developed CJM method questioned participants about past trips over the phone or MS teams. This generated 36 interviews. Main outcomes: the elderly do not struggle with operating ticket machines or transport cards but are insecure about operating apps, finding information and rely on social ties. Low-income participants have good digital capabilities but suffer financial stress and prefer to pay cash. People in wheelchairs plan extensively in advance but receive limited support. Screen readers are crucial for blind people, and 69% of the women felt limited by safety; none of the men did.
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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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The study aims to describe the implementation of Activity Scheduling (AS) as a nursing intervention in an inpatient population of older adults with a major depressive disorder. DESIGN AND METHODS: In a single case report, the implementation of the intervention was described. FINDINGS: This case report shows that AS, when adapted into a brief and prescriptive course, can be beneficial for depressed elderly in an inpatient care setting. PRACTICE IMPLICATIONS: Although previous research shows promising results, there is a need for additional research on the effectiveness of the intervention when AS is executed by nurses.
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The present study attempts to explore the field of creative music workshops with the elderly. A growing amount of research has been carried out into running (creative) workshops, and besides we know a lot about the elderly and ageing. The aim of this research is to gather knowledge on the merging of both subjects, creative music workshops with the elderly in the so-called ‘fourth age’. In particular, this research project has been carried out as a study of a potential professional field for musicians and music educators. For this reason the research objective is focused on the position of the workshop leader and what is needed to run creative music workshops with elderly in residential homes for the elderly successfully. We therefore aim to explore aspects connected to this practice such as entrepreneurship, musicianship and leadership.
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As the population ages, the risk of becoming malnourished increases. Research has shown that poor oral health can be a risk factor for malnutrition in institutionalized elderly. However, it remains unclear whether oral health problems, edentulousness and health-related quality of life also pose a risk for malnutrition in community-dwelling older adults. In this cross-sectional observational study, 1325 community-living elderly (≥75 years) were asked to complete questionnaires regarding nutritional status, oral status (edentulous, remaining teeth, or implant-supported overdentures), oral health problems, health-related quality of life (HRQoL), frailty, activities of daily living (ADL) and complexity of care needs. Univariate and multivariate logistic regression analyses were performed with nutritional status as dependent variable. Of the respondents, 51% (n = 521) were edentulous, 38.8% (n = 397) had remaining teeth and 10.2% (n = 104) had an implant-supported overdenture. Elderly with complex care needs were malnourished most frequently, followed by frail and robust elderly (10%, 4.5% and 2.9%, respectively). Malnourished elderly reported more frequent problems with chewing and speech when compared with well-nourished elderly (univariate analysis). However, multivariate analysis did not show an association between malnutrition and oral health problems and edentulousness, although HRQoL was associated with malnutrition (odds ratio (OR) 0.972, confidence interval (CI) 0.951–0.955). Based on the results of this cross-sectional study, it can be concluded that poor HRQoL is significantly associated with malnutrition; however, edentulousness and oral health problems are not.
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BACKGROUND: Depression in later life is a common mental disorder with a prevalence rate of between 3% and 35% for minor depression and approximately 2% for Major Depressive Disorder (MDD). The most common treatment modalities for MDD are antidepressant medication and psychological interventions. Recently, Behavioral Activation (BA) has gained renewed attention as an effective treatment modality in MDD. Although BA is considered an easy accessible intervention for both patients and health care workers (such as nurses), there is no research on the effectiveness of the intervention in inpatient depressed elderly.The aim of study, described in the present proposal, is to examine the effects of BA when executed by nurses in an inpatient population of elderly persons with MDD. METHODS/DESIGN: The study is designed as a multi-center cluster randomized controlled trial. BA, described as The Systematic Activation Method (SAM) will be compared with Treatment as Usual (TAU). We aim to include ten mental health care units in the Netherlands that will each participate as a control unit or an experimental unit. The patients will meet the following criteria: (1) a primary diagnosis of Major Depressive Disorder (MDD) according to the DSM-IV criteria; (2) 60 years or older; (3) able to read and write in Dutch; (4) have consented to participate via the informed consent procedure. Based on an effect size d = 0.7, we intend to include 51 participants per condition (n = 102). The SAM will be implemented within the experimental units as an adjunctive therapy to Treatment As Usual (TAU). All patients will be assessed at baseline, after eight weeks, and after six months. The primary outcome will be the level of depression measured by means of the Beck Depression Inventory (Dutch version). Other assessments will be activity level, mastery, costs, anxiety and quality of life. DISCUSSION: To our knowledge this is the first study to test the effect of Behavioral Activation as a nursing intervention in an inpatient elderly population. This research has been approved by the medical research ethics committee for health-care settings in the Netherlands (No. NL26878.029.09) and is listed in the Dutch Trial Register (NTR No.1809).
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‘Legacy: Participatory Music Practices with Elderly People as a Resource for the Well-being of Healthcare Professionals’ was a qualitative research project into the learning and well-being of hospital nurses and nursing home caregivers working with vulnerable elderly people and participating in live music practices Meaningful Music in Healthcare (MiMiC) and Music and Dementia in the Netherlands.The data collection (2016-2019) employed an ethnographic approach and data triangulation of participant observation, episodic interviews and group discussions. The constructivist grounded theory approach to data analysis proceeded from sensitising concepts to initial and focused coding, ultimately reconstructed into a thick description merging empirical data, theory and the researcher’s interpretations. The emerging core categories, Participation, Experience and Learning Benefits, were conceptualised within an epistemological framework of philosophical pragmatism.The findings suggest that, through an emerging community of practice, healthcare professionals could collaborate with musicians to connect with patients or residents. The collaboration enabled the use of shared musical experiences as a resource for compassionate care. Still, allowing oneself to participate musically and showing emotional vulnerability were challenging. The accumulation of ‘experiencing’ and collegial encouragement supported healthcare professionals’ participation beyond their professional performance.Person-centred music-making resonated with the values of person-centred care. It enabled healthcare professionals to take time and become engaged with patients or residents in musical situations. Healthcare professionals described gaining new understandings of the patients or residents and each other, which could be seen promoting a cultural shift from task-centredness towards relationship-focused person-centred care.Musicians’ communication provided new professional insights into teamwork. Also, observing patients and residents’ responses to the music evoked sympathetic joy in healthcare professionals. Looking through the eyes of ‘the other’ was central for nurses and caregivers’ meaning-making of the value of music-making and awareness of its impact on patients, residents and themselves. The perceived benefits of the music practices for healthcare professionals’ job resources and satisfaction seemed connected to changes in care relationships, work atmosphere, sense of mindfulness and recognition.The conclusions of the research suggest that participatory music practices might be considered as supportive of delivering person-centred care. The findings could be applied in training programmes and professional development of musicians, nurses and caregivers.
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