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3Health and social well-being depend on many contextual facets which are interdependent in a complex way and are all but limited to the field of cure and care. Publications of the World Health Organization and the Dutch Ministry of Health show that good health also depends on socioeconomic aspects such as stable living conditions and (pre-emptive) debt counselling. Inspired by these findings, many programs have been launched that aim for an integrated approach of health and social issues.
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Wetenschappelijke publicatie - Health andamp; Social Care in the Community
MULTIFILE
Designers have grown increasingly interested in social consequences of new technologies. As social impacts become increasingly important it might be fruitful to understand how social impacts develop and how a designer can anticipate these consequences. In health care practices, for instance, it is important to control unintended social impacts at forehand. Social impact is an outcome of the mediating effect of a technology with its social environment. Human behaviour in a social environment can be analysed from the perspective of a social ecological system. To anticipate social impacts simulations of social practices are needed. To simulate practices the persona approach has been adapted to a screenplay approach in which the elements of a social ecology are used to gain a rich description of a social environment. This has been applied for a 'Heart Managers' case. It was concluded that the screenplay approach can be used for a systematic simulation of future social impacts.
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The main objective of this report is to analyse and inform about international labour mobility, particularly within Europe, from the perspective of the Dutch Health and Social Care Sector. The report starts by describing the introduction of a new care system in The Netherlands. The government does not participate directly in the actual provision of care. This is a task principally for private care suppliers. Furthermore, the legal position of the Health and Social Care professions, regulated through the Individual Health Care Professions Act, and questions like the international recognition of degrees and the evaluation of foreign diplomas are discussed. This is followed by a clarification of the Dutch education system, particularly, relating to the study of medicine, nursing education and social work education. Subsequently, some core data on the ageing Dutch population are presented. The grey pressure increases and this will have an impact on health spending, health support and the future labour market. Then what follows is a description of the development of employment in the Dutch Health and Social Care Sector, per branch as well as the professions that are engaged in it. The general picture, at this moment, is that the Health and Social Care labour market is reasonably in balance. This trend will continue in the near future; shortages are expected only in the long term. All research done on the subject indicates that international mobility of medical and social professionals is still low in the Netherlands. The question remains whether a more active recruitment policy would be a solution for the expected long term shortages. The report concludes with a look at recruitment policy and some of its developments at the global, national and local level.
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The realization of human rights standards depends in part on the commitment of local actors. It can be argued that local public service professionals such as social workers can also be regarded as key players. The possible role of social workers becomes imperative if these professionals are working in a policy context that is not congruent with human rights. If existing laws or policies cause or maintain disrespect for human rights, social workers are in a position to observe that this is having an adverse impact on clients. When social workers are regarded as human rights actors, the question arises how they can or should respond to law and policy that impedes them in carrying out their work with respect for human rights. This article adds to existing theories on social workers as human rights actors by examining the practices of social professionals working in such a challenging policy context. The research took place among professionals in social district teams in the city of Utrecht, the Netherlands. Following a series of decentralizations and austerity measures the social care landscape in the Netherlands has changed drastically over the last few years. As a result, social workers may find themselves on the one hand trying to realize the best possible care for their clients while on the other hand dealing with new laws and policy expectations focused on self-reliance and diminished access to specialist care. The article explores how social professionals’ responses to barriers in access to care affect human rights requirements. In doing so, this socio-legal study provides insight into the ways in which everyday social work relates to the realization of human rights at the local level.
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Wraparound care is een model voor het organiseren van integrale zorg aan gezinnen met een opeen-stapeling van problemen. Het benut hun oplossend vermogen, betrekt hun sociale netwerk en streeft hun empowerment na. Bovendien organiseert het samenwerking tussen verschillende sectoren. Ge-zinsbegeleiding en coördinatie van zorg liggen in één hand. In het kader van het programma Utrechtse Jeugd Centraal van de provincie Utrecht zijn in 2009 in de steden Utrecht en Amersfoort twee pilots wraparound care in het leven geroepen. Deze zijn vanaf de start door het Lectoraat Werken in Justitieel Kader van de HU met ontwikkelingsgericht handelingson-derzoek ondersteund. Daarnaast heeft zich in het najaar van 2010 een aantal initiatieven met elkaar verbonden die werken vanuit dezelfde ambities. Het gaat om de pilots wraparound care, de pilot ‘Eén kind, één plan’, ‘Talita’, een programma voor begeleid zelfstandig wonen voor tienermoeders en kwetsbare meisjes van stichting Timon, Hulp aan Huis, een samenwerkingsverband van instellingen die Intensieve Orthopedagogische Gezinsbehandeling (IOG) aanbieden, ‘Tien voor toekomst’ van het leger des Heils, Gezinscoaching’ van Vitras/CMD en Zuwe zorg, het project ‘Tussen-in’ van Al Amal, het project ‘Wisselgeld’ voor gezinnen met een Roma-achtergrond van de gemeente Nieuwegein. Sa-men met vertegenwoordigers van gemeentes en de provincie en onderzoekers en studenten van de HU vormden zij het ‘Kennisplatform Wraparound Care’ dat functioneerde als een ‘Community of Prac-tice’. Het is ondersteund met een door de provincie Utrecht gefinancierd onderzoeksprogramma
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Prostate cancer (PCA) has the highest prevalence for men in the western world. Besides general symptoms, these patients experience specific problems like erectyle dysfunction and urinary incontinence, which occur after treatment and may result in feelings of distress. PCA patients express a need for supportive care, although they are often not participating in the offered supportive care interventions. To study determinants of care seeking behavior, the influence of patient’s supportive care needs was assessed with the SCNS. With the ASE-model, we studied whether their attitude about supportive care, perceived social support and self-efficacy influence care seeking. Furthermore also the influence of external factors, e.g. distress, biographical and medical factors, previous experience with and evaluation of supportive care was studied. Methods A quantitative, cross-sectional study with a convenience sample of patients who completed a questionnaire was conducted. The SCNS measured care needs. Patient’s attitude towards care seeking, perceived social support and self-efficacy were assessed as well as several external factors. Results We included 87 patients, who returned a questionnaire by email or post. Pearson’s correlation coefficients showed significant associations between the future supportive care use and attitude, needs, and external factors depression, anxiety, previous experience with and evaluation of supportive care and age. Results of multiple regression analysis pointed out that psychological, physical needs and depression are the main determinants for future supportive care use. Conclusion The results show psychological, physical needs and depression are more important determinants of future supportive care use than ASE-factor attitude towards care seeking, anxiety, previous psychosocial care use, satisfaction with care and age. Results indicated that men look for expert information in more than one third of all cases. Urology/oncology nurses and health-care professionals could use this information for patient centered referrals and to further develop needs and preference based interventions.
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Due to the increase in the number of elderly and people seeking medical care, the hotel market with a blend of care and leisure experiences is expected to grow in the future (Han, 2013; Karuppan & Karuppan, 2010; Laesser, 2011). The role of care hotels as an intersection between the care and the tourism sectors makes a vacation in a care hotel an interesting social practice to study. In this contribution a social practices approach (Spaargaren, 1997) is applied to investigate how demand and supply interact during a care hotel vacation. Semi-structured interviews are used to identify successful and less successful interactions or practices between senior guests and personnel in five Dutch care hotels. These interactions are related to materials (care and leisure facilities), competences (skills and empathy of the personnel) and meanings (motivations and aspirations of guests) in the care hotel practice (see Shove et al., 2012). The results show that a social practice approach combined with a qualitative research method may be more suited to analysing the complex encounters between guests and personnel during care hotel vacations than more traditional theories from service or experience quality studies. Simultaneously, this study makes clear that we need to develop alternative qualitative (and/or quantitative) research methods to study more privacy-related or intimate practices or rituals as in the case of care hotels.
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Background: The substitution of healthcare is a way to control rising healthcare costs. The Primary Care Plus (PC+) intervention of the Dutch ‘Blue Care’ pioneer site aims to achieve this feat by facilitating consultations with medical specialists in the primary care setting. One of the specialties involved is dermatology. This study explores referral decisions following dermatology care in PC+ and the influence of predictive patient and consultation characteristics on this decision. Methods: This retrospective study used clinical data of patients who received dermatology care in PC+ between January 2015 and March 2017. The referral decision following PC+, (i.e., referral back to the general practitioner (GP) or referral to outpatient hospital care) was the primary outcome. Stepwise logistic regression modelling was used to describe variations in the referral decisions following PC+, with patient age and gender, number of PC+ consultations, patient diagnosis and treatment specialist as the predicting factors. Results: A total of 2952 patients visited PC+ for dermatology care. Of those patients with a registered referral, 80.2% (N = 2254) were referred back to the GP, and 19.8% (N = 558) were referred to outpatient hospital care. In the multivariable model, only the treating specialist and patient’s diagnosis independently influenced the referral decisions following PC+. Conclusion: The aim of PC+ is to reduce the number of referrals to outpatient hospital care. According to the results, the treating specialist and patient diagnosis influence referral decisions. Therefore, the results of this study can be used to discuss and improve specialist and patient profiles for PC+ to further optimise the effectiveness of the initiative.
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This contributed volume is based on the "European Core Competences Framework for health and social care professionals working with older people" (ECCF), developed and verified in a unique international cooperation between 26 universities and universities of applied sciences in 25 European countries, part of the European Later Life Active Network (ELLAN). In addition to the framework, the book outlines the necessary qualifications and describes the roles of professionals working with older people in health and social services. It explores healthy ageing for older people from different perspectives and describes the seven roles of health and social care professionals (Expert, Communicator, Collaborator, Organizer, Health and Welfare Advocate, Scholar, and Professional), before going on to define 18 related competences and elaborating them in performance indicators.
Beyond the ECCF, the book explains the widely used CanMED role model and puts forward theories to support a client centered and integrated approach on health and social care in order to change attitudes toward older clients and offer better care and support. It also provides health and social care professionals, for example nurses, allied health professionals and social workers with new contextual information and cultural awareness. It gives a voice to students by addressing selected perspectives for professional development. The book includes questions for reflective learning helping to make the book a vital practical instrument for use in the educational context throughout Europe.
Europe’s ageing populations represent a major challenge for both public health and social care systems. 18% of the population is 65 years old and over, and this proportion will increase in the coming years. As a result, more and more health and social care professionals will work with older people in different settings – at home, in the community, in hospitals or in long-term care settings.
Older people, and especially the frail, face a host of interrelated issues, e.g. cognitive restrictions, functional restrictions, psychosocial problems, multimorbidity, polypharmacy and social isolation. These problems call for an integrated approach to health and social care, which this book supplies. It is intended for health and social care professionals, students and educators, for a better understanding of Europe’s ageing society and of the impact on care and services. Furthermore, the ECCF offers educational institutes a unique resource for curriculum development, education, training and assessment.
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