Zoekresultaten

Quality of care in the intensive care unit from the perspective of patient's relatives

BACKGROUND: The quality standards of the Dutch Society of Intensive Care require monitoring of the satisfaction of patient's relatives with respect to care. Currently, no suitable instrument is available in the Netherlands to measure this. This study describes the development and psychometric evaluation of the questionnaire-based Consumer Quality Index 'Relatives in Intensive Care Unit' (CQI 'R-ICU'). The CQI 'R-ICU' measures the perceived quality of care from the perspective of patients' relatives, and identifies aspects of care that need improvement.METHODS: The CQI 'R-ICU' was developed using a mixed method design. Items were based on quality of care aspects from earlier studies and from focus group interviews with patients' relatives. The time period for the data collection of the psychometric evaluation was from October 2011 until July 2012. Relatives of adult intensive care patients in one university hospital and five general hospitals in the Netherlands were approached to participate. Psychometric evaluation included item analysis, inter-item analysis, and factor analysis.RESULTS: Twelve aspects were noted as being indicators of quality of care, and were subsequently selected for the questionnaire's vocabulary. The response rate of patients' relatives was 81% (n = 455). Quality of care was represented by two clusters, each showing a high reliability: 'Communication' (α = .80) and 'Participation' (α = .84). Relatives ranked the following aspects for quality of care as most important: no conflicting information, information from doctors and nurses is comprehensive, and health professionals take patients' relatives seriously. The least important care aspects were: need for contact with peers, nuisance, and contact with a spiritual counsellor. Aspects that needed the most urgent improvement (highest quality improvement scores) were: information about how relatives can contribute to the care of the patient, information about the use of meal-facilities in the hospital, and involvement in decision-making on the medical treatment of the patient.CONCLUSIONS: The CQI 'R-ICU' evaluates quality of care from the perspective of relatives of intensive care patients and provides practical information for quality assurance and improvement programs. The development and psychometric evaluation of the CQI 'R-ICU' led to a draft questionnaire, sufficient to justify further research into the reliability, validity, and the discriminative power of the questionnaire.

Corporate spirituality as organizational praxis

A methodology for doing research into corporate spirituality should enable us to deal with the religious component of spirituality instead of trying to separate spirituality from religious beliefs, as the positivist school proposes. Waaijman’s phenomenological-dialogical research cycle enables us to deal with religious diversity in a scientific way. Sölle’s concept of democratized spirituality allows for discovering everyday (corporate) life as a finding place and workplace for spirituality. Replacing theistic terms by the concept of ‘alterity’ in a definition of spirituality may stimulate corporate spirituality without excluding or disqualifying spiritual diversity. Arendt’s concept of ‘action’ is closely connected to democratised spirituality. From that we can deduce a number of characteristics of corporate spirituality that give flesh and bone to what corporate spirituality can be. This allows us to see that many elements of corporate spirituality are already present in our organizational praxis. It also tells us that we need to become more aware of them and practice them. In doing so we set out on a ‘via transformativa’ that eventually may transform our organizations.

Montessoris perspective on citizenship education

Revisiting the Lorax complex: Deep ecology and biophilia in cross-cultural perspective

By supporting creation of protected areas, conservation projects are known to bring economic prosperity to the local communities, but also incite criticism. A common theme in the critique of conservation organizations is the proximity to neoliberal agencies seeking to capitalize on environment, which disadvantage the local communities. Community participation has been proposed as a panacea for neoliberal conservation. However, conservation efficacy is not always contingent on the community involvement and reliance on ‘traditional’ practices in protected areas has not always benefitted biodiversity. Simultaneously, critique of conservation ignores evidence of indigenous activism as well as alternative forms of environmentalism which provide a broader ethical support base for conservation. This article highlights the challenges and contradictions, as well as offers hopeful directions in order to more effectively ground compassionate conservation. https://doi.org/10.1080/23251042.2015.1048765 https://www.linkedin.com/in/helenkopnina/

A neurological and philosophical perspective on the design of environments and technology for older people with dementia

Purpose – Older people with dementia (OPD) have specific housing and technology-related needs, for which various design principles exist. A model for designing environments and its constituting items for people with dementia that has a firm foundation in neurology may help guide designers in making design choices. The paper aims to discuss these issues. Design/methodology/approach – A general design model is presented consisting of three principles for OPD, namely designing for ageing people; designing for a favourable state and designing for beautiful moments. The neurosciences as a whole give shape to an eminent framework explaining the behaviour of OPD. One of the objectives of this paper is to translate the design principles into design specifications and to show that these specifications can be translated in a design. Findings – Philosophical concepts are introduced which are required to understand design for OPD. Four case studies from Dutch nursing homes are presented that show how the theory of modal aspects of the philosopher Dooyeweerd can be used to map design specifications in a systematic way. Research limitations/implications – These examples of design solutions illustrate the applicability of the model developed in this article. It emphasises the importance of the environment for supporting the daily life of OPD. Originality/value – There is a need for a design model for OPD. The environment and technology should initiate positive behaviours and meaningful experiences. In this paper, a general model for the designing of environments for OPD was developed that has a firm foundation in neurology and behavioural sciences. This model consists of six distinct steps and each step can be investigated empirically. In other words, this model may lay the foundation for an evidence-based design. Original article at Emerald: https://doi.org/10.1108/JET-11-2017-0043 For this paper Joost van Hoof received the Highly Recommended Award from Emerald Publishing Ltd. in October 2019: https://www.emeraldgrouppublishing.com/authors/literati/awards.htm?year=2019

Empowerment from a narrative perspective

The exploration of the narrative nature of local memory websites in relation to empowerment theory produces new insights in the nested levels of analysis of both. Empowerment’s value orientation calls for a focus on strengths instead of weaknesses and, as such, requires specific language that accommodates the conviction that resources are locally available, instead of scarce. Consequently, empowerment theory describes resources as being present in processes and outcomes on interdependent psychological, organizational and communal levels. The application of the empowerment framework’s components to the theoretical outcomes and processes of local memory websites illuminates the connecting roles local narratives play as resources in empowerment. First of all, personal stories, community narratives and dominant cultural narratives influence and support each other across levels. Secondly, narratives spread local knowledge which leads to shared values and common believes for collectives on various levels. And thirdly, the sharing of narratives happens through social networks that manifest themselves on different levels, which, as such, facilitate sharing other resources. Based on these perspectives, we offer a simplified model for empowerment with a focus on the interdependencies between levels of networks. Against this background, we discuss relevant analytical perspectives as a departure point for the empirical exploration of unstudied relations between empowerment and local memory websites.