Aim: To develop an understanding of how nurses obtain and take account of patient preferences in shared decision-making processes in evidence-based practice to provide personalized nursing care. Design: Qualitative grounded theory. Methods: This research was part of a PhD study successfully completed in December 2015. Semi-structured interviews were conducted with 27 nurses in four medium-sized hospitals in the Netherlands. Additionally, seven nurses were observed during their shift on the ward. Constant comparative analysis underpinned by Strauss and Corbin’s framework was used. Results: Three communication tools of nurses were identified to discern and attend to patient preferences to provide individual tailored nursing care: 1) A click-making tool that enables to build rapport instantly; 2) The use of antennae to carefully monitor the individual patient’s needs; 3) Asking empathic questions so that the care is fine-tuned to the individual patient’s preferences. This way, the nurses attempt to provide optimal nursing care to enhance the patient's perceived quality of life. Conclusion: The excellent nurses have a set of three implicit and intuitive tools to continuously attune their professional care to individual patient preferences in the evidence-based practice to provide personalized care. The nurses consciously spend time to discover patient preferences. The use of the implicit communication tools appears to be part of the nurses’ professional knowledge, and deserves further research as a follow up to this study. Considering the importance of taking account of patient preferences in the evidence-based practice, these findings have international relevance to nursing professionals across the world. Dit artikel is later verschenen in de Journal of Advanced Nursing onder de titel 'The role of patient preferences in nursing decision‐making in evidence based practice: excellent nurses’ communication tools' (2019).
Higher Education Institutions (HEIs) are dedicated to the professionalization of human capital; to accomplish this, the link with the productive sector is an active component that must be strengthened through formal mechanisms. The purpose of this paper is to estimate the relationships and effects from the Institutional Framework (IF), as well as from the independent variables in the context of linking HEI with the industrial sector. Survey data were collected from 47 HEIs in the Northwest of Mexico; a mixed research approach was applied and analyzed through the partial least-squares structural equations modeling (PLS-SEM) technique. Although the IF is identified as a relevant aspect for the model, this is not a problem for Mexican HEIs, since the analysis reflects a solid legal framework regarding the common basic levels and research. The main impact for experts who carry out research activities is that the route to creating, maintaining, and promoting integrated academic, technical, and administrative personnel as a specialized work team is not achieved. The main factor that does not contribute for researchers who carry out research activities is that the route to integrating (creating-maintaining-promoting) academic, technical, and administrative personnel as a specialized work team is not achieved. One finding is that the informants agree with the existing stimuli that are not aimed at research linked to the industrial sector and problem-solving through applied research. There is a need for retaining the groups of researchers to help make the benefits for the industry clear by offering advanced linkage levels.
Aims and objectives To gain insight into the perceived added value of a decision support App for district nurses and case managers intended to support a problem assessment and the provision of advices on possible solutions to facilitate ageing in place of people with dementia, and to investigate how they would implement the App in daily practice. Background District nurses and case managers play an important role in facilitating ageing in place of people with dementia (PwD). Detecting practical problems preventing PwD from living at home and advising on possible solutions is complex and challenging tasks for nurses and case managers. To support them with these tasks, a decision support App was developed. Methods A qualitative study using semi‐structured interviews was conducted. A photo‐elicitation method and an interview guide were used to structure the interviews. The data were analysed according to the principles of content analysis. Results In five interviews with seven district nurses and case managers, the added value was described in terms of five themes: (a) providing a broader/better overview of possible solutions; (b) providing a guideline/checklist for problem assessment and advice on solutions; (c) supporting an in‐depth problem assessment; (d) being a support tool for unexperienced case managers/district nurses; and (e) providing up‐to‐date information. The participants regarded the App as complementary to their current work procedure, which they would use in a flexible manner at different stages in the care continuum. Conclusions The participants valued both parts, the problem assessment and the overview of possible solutions. An important requisite for the usage would be that the content is continuously updated. Before implementation of the App can be recommended, an evaluation of its effectiveness regarding decision‐making should be conducted. Relevance to clinical practice This study underpins the need of nurses and case managers for decision support with regard to problem assessment and providing advices on possible solutions to facilitate ageing in place of PwD. There results also show the importance of listening to users experience and their perceived added value of decision support tools as this helps to explain the lack of statistically significant effects on quantitative outcome measure in contrast to a high willingness to use the App in a previous study.
The focus of the research is 'Automated Analysis of Human Performance Data'. The three interconnected main components are (i)Human Performance (ii) Monitoring Human Performance and (iii) Automated Data Analysis . Human Performance is both the process and result of the person interacting with context to engage in tasks, whereas the performance range is determined by the interaction between the person and the context. Cheap and reliable wearable sensors allow for gathering large amounts of data, which is very useful for understanding, and possibly predicting, the performance of the user. Given the amount of data generated by such sensors, manual analysis becomes infeasible; tools should be devised for performing automated analysis looking for patterns, features, and anomalies. Such tools can help transform wearable sensors into reliable high resolution devices and help experts analyse wearable sensor data in the context of human performance, and use it for diagnosis and intervention purposes. Shyr and Spisic describe Automated Data Analysis as follows: Automated data analysis provides a systematic process of inspecting, cleaning, transforming, and modelling data with the goal of discovering useful information, suggesting conclusions and supporting decision making for further analysis. Their philosophy is to do the tedious part of the work automatically, and allow experts to focus on performing their research and applying their domain knowledge. However, automated data analysis means that the system has to teach itself to interpret interim results and do iterations. Knuth stated: Science is knowledge which we understand so well that we can teach it to a computer; and if we don't fully understand something, it is an art to deal with it.[Knuth, 1974]. The knowledge on Human Performance and its Monitoring is to be 'taught' to the system. To be able to construct automated analysis systems, an overview of the essential processes and components of these systems is needed.Knuth Since the notion of an algorithm or a computer program provides us with an extremely useful test for the depth of our knowledge about any given subject, the process of going from an art to a science means that we learn how to automate something.
The objective of the SIA KIEM proposal Capturing Value is to understand financial decision making and capturing value as a logical step in the conceptual and realization phase of creative products. We will explore the narrative of reasoning and making choices in the use of different financial instruments by creative professionals. These narratives are telling about the values creative professionals attach to financial decision making and how these influence the choice of financial instruments. Most research focusses either on the (non)availability of financial instruments or on the use of these instruments. This research proposal focusses on the missing link: how do creative professionals reason when confronted with making financial decisions? Which options do they consider and how are these influenced by their attitude towards and knowledge of various formal and informal financial instruments? The project is a first step to develop a bigger and international research proposal on the way artists and creatives capture the financial value of their creations.
The energy transition is a highly complex technical and societal challenge, coping with e.g. existing ownership situations, intrusive retrofit measures, slow decision-making processes and uneven value distribution. Large scale retrofitting activities insulating multiple buildings at once is urgently needed to reach the climate targets but the decision-making of retrofitting in buildings with shared ownership is challenging. Each owner is accountable for his own energy bill (and footprint), giving a limited action scope. This has led to a fragmented response to the energy retrofitting challenge with negligible levels of building energy efficiency improvements conducted by multiple actors. Aggregating the energy design process on a building level would allow more systemic decisions to happen and offer the access to alternative types of funding for owners. “Collect Your Retrofits” intends to design a generic and collective retrofit approach in the challenging context of monumental areas. As there are no standardised approaches to conduct historical building energy retrofits, solutions are tailor-made, making the process expensive and unattractive for owners. The project will develop this approach under real conditions of two communities: a self-organised “woongroep” and a “VvE” in the historic centre of Amsterdam. Retrofit designs will be identified based on energy performance, carbon emissions, comfort and costs so that a prioritisation strategy can be drawn. Instead of each owner investing into their own energy retrofitting, the neighbourhood will invest into the most impactful measures and ensure that the generated economic value is retained locally in order to make further sustainable investments and thus accelerating the transition of the area to a CO2-neutral environment.
