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What is a healthy social network?:Reflections on the social network advice
In late 2023, the Dutch Ministry of Health, Welfare, and Sport launched an advisory on the social network that people need to avoid feeling lonely and to stay healthy. The advisory emphasizes the importance of the social network for health and includes suggestions for strengthening it. The advisory is presented in this paper. A qualitative formulation was chosen because there was not an unequivocal threshold value for a healthy social network. The social network advice was formulated by the Scientific Advisory Committee (SAC) of the ‘Eén tegen Eenzaamheid’ (One against Loneliness) program. The authors of this article are members of the SAC
An Anatomy of Human Dignity:Dissecting the Heart of Humanistic Management
Human dignity is introduced in the humanistic management school to distinguish humanistic from economistic perspectives on organizational business practices. Placing human dignity at the core of management leads to a different outlook on doing business, organizing and leading. Within the humanistic management literature, there are several distinct paths to ground human dignity in humanistic management. One school views human dignity as a form of motivation, another focuses on its value-laden components, and still others view human dignity as a form of human development. We introduce relational anthropology as a fourth possibility, emphasizing relationality in the notion of human dignity, with love at its core as the essence of human experience. However, as the experience of human dignity is universally human, culturally specific and extremely personal, interpretations of experienced dignity could be very different for different people. We continue to discuss a cosmopolitan view on human dignity, in which we reject both naïve universalism and lazy relativism, pointing to the challenge of leading moral plurality. We close by summarizing the different approaches to human dignity in a conciliatory framework and outline why we believe an explicit emphasis on qualitative, phenomenological research is the best way forward, bringing love to the stage as the potentially unifying principle for humanistic management
Uncharted Territory:Delving into Unexplored Knowledge to Curb Ableism in Academia
IntroductionLanguage can reflect bias: an ‘intellectual’ disability means for many people that you cannot be an academic knowledge producer; a ‘learning’ disability means that your education will be hampered. Like language definitions, academic practices can reflect societal biases. The social (in)justice regarding knowledge and knowledge production is called epistemic injustice, and it has resulted in exclusion of nonconventional knowers, such as persons with intellectual or learning disabilities, from academia and higher education (other than as objects of research).MethodsThis paper will discuss academic practices through the lens of epistemic (in)justice and look at the potential of inclusive research and educational practices therein. We will briefly describe dominant ways of knowing (e.g., abstract, verbal), and counter these practices in exploring practical, tacit, embodied and affective ways of knowing.FindingsFor people with intellectual disabilities to be able to gain recognition as ‘real’ knowers within academia, we need to include diverse types of knowing and enable academic practices to be inclusive of people with intellectual disabilities. Inclusive practices can support a paradigm shift away from dominant ways of knowledge production in research and education, by centralising and correctly interpreting alternate knowledge. Experiences of scholars with intellectual disabilities appear to confirm the value of different ways of knowing.ConclusionsDrawing from these experiences, we will discuss the importance of relational autonomy, collectively owned and adaptive knowledge, and the learning context
Facilitators and barriers of implementing end-of-life care volunteering in a hospital in five European countries:the iLIVE study
BackgroundEnd-of-life (EoL) care volunteers in hospitals are a novel approach to support patients and their close ones. The iLIVE Volunteer Study supported hospital volunteer coordinators from five European countries to design and implement an EoL care volunteer service on general wards in their hospitals. This study aimed to identify and explore barriers and facilitators to the implementation of EoL care volunteer services in the five hospitals.MethodsVolunteer coordinators (VCs) from the Netherlands (NL), Norway (NO), Slovenia (SI), Spain (ES) and United Kingdom (UK) participated in a focus group interview and subsequent in-depth one-to-one interviews. A theory-inspired framework based on the five domains of the Consolidated Framework for Implementation Research (CFIR) was used for data collection and analysis. Results from the focus group were depicted in radar charts per hospital.ResultsBarriers across all hospitals were the COVID-19 pandemic delaying the implementation process, and the lack of recognition of the added value of EoL care volunteers by hospital staff. Site-specific barriers were struggles with promoting the service in a highly structured setting with many stakeholders (NL), negative views among nurses on hospital volunteering (NL, NO), a lack of support from healthcare professionals and the management (SI, ES), and uncertainty about their role in implementation among VCs (ES). Site-specific facilitators were training of volunteers (NO, SI, NL), involving volunteers in promoting the service (NO), and education and awareness for healthcare professionals about the role and boundaries of volunteers (UK).ConclusionEstablishing a comprehensive EoL care volunteer service for patients in non-specialist palliative care wards involves multiple considerations including training, creating awareness and ensuring management support. Implementation requires involvement of stakeholders in a way that enables medical EoL care and volunteering to co-exist. Further research is needed to explore how trust and equal partnerships between volunteers and professional staff can be built and sustained
Navigating Dilemmas on Advance Euthanasia Directives of Patients with Advanced Dementia.
ObjectivesThis study revisited the complexities faced by physicians in meeting due care criteria for euthanasia in patients with advanced dementia in The Netherlands. Despite increasing cases and legal provisions for advance euthanasia directives (AEDs), physicians encounter challenges with ethical issues, including patient communication and assessing unbearable suffering in patients who lack decisional capacity. This study examines the perspectives of elderly care physicians (ECPs), support and consultation on euthanasia in The Netherlands (SCEN) physicians, and euthanasia expertise center (EEC) physicians.DesignA multimethod descriptive study using a questionnaire with both closed and open-ended questions.Setting and ParticipantsThis study explores the complexities faced by physicians in handling AED-based euthanasia requests of patients with advanced dementia.MethodsBaseline characteristics of physician subgroups were analyzed descriptively, and subgroup variations were assessed using univariate regression. Qualitative data underwent thematic content analysis.ResultsWith a 13.8% response rate, the study included 290 participants: 108 ECPs, 188 SCEN physicians, and 53 EEC physicians. Some had combined roles: ECP and SCEN physicians (n = 29), ECP and EEC physician (n = 1), SCEN physicians and EEC physicians (n = 17), and ECP, SCEN physicians, and EEC physicians (n = 6). ECPs received most AED-based euthanasia requests but only 7 EEC physicians and 1 SCEN physician performed euthanasia. All subgroups stressed the importance of patient communication. ECPs found euthanasia ethically justifiable only when communication was possible, highlighting the need to understand current euthanasia wishes and verify unbearable suffering. Effective communication was deemed crucial for confirming request relevance, identifying obstacles, involving patients, fostering trust, and alleviating fears. Physicians generally agreed that unbearable suffering could be assessed through patient expressions, observations, and family input.Conclusions and ImplicationsDespite receiving AED-based euthanasia requests, few physicians proceeded. Subgroup analysis showed varying views, with ECPs emphasizing communication and EEC physicians focusing on determining unbearable suffering. All subgroups highlighted the importance of current patient expressions and involvement in the decision-making process
"You Needed to Accept the Situation":Resilience of Nursing Home Residents in Times of COVID-19
The restrictive measures taken by nursing homes during the COVID-19 outbreak in 2020 (e.g., quarantine) may have been important stressors for which residents needed resilience to safeguard their well-being. Based on 30 semi-structured interviews with nursing home residents and close relatives, this study explored the lived experiences with respect to the restrictive measures. The data were collected in psychogeriatric, somatic, and mixed wards in The Netherlands and Flanders, Belgium. The restrictive measures were important stressors for residents, indicated by feelings of loneliness, sadness, and powerlessness. To deal with these measures, residents used various resources, which were determined by factors in the individual (e.g., health), interactional (e.g., possibilities for social interactions) and contextual (e.g. nursing home policy) domains. Because the lived experiences with respect to the restrictive measures seemed to relate to the resilience of nursing home residents, it is crucial to reinforce resources in the individual, interactional, and contextual domains
Examining People's Experiences of Working in Collaborative Relationships While Conducting Inclusive Research Involving Persons with Intellectual Disabilities
This study examined the experiences of working in collaborative relationships while conducting inclusive research involving persons with intellectual disabilities. More specifically, the study explored work relationships, social relationships, and factors that influence collaboration within inclusive research teams. Interviews were conducted with nine researchers with intellectual disabilities, eight academic researchers, and nine principal investigators who were all involved in six inclusive research projects together. The analysis of the interviews produced four themes: (1) the diverse nature of the involvement of researchers with intellectual disabilities; (2) the significance of involving researchers with intellectual disabilities within academic research; (3) shaping equity in research projects; and (4) stereotyping hindering collaborations with researchers with intellectual disabilities. These findings have implications for research and practice, both in terms of promoting inclusive research and facilitating the meaningful participation of persons with intellectual disabilities within various aspects of society, including education, employment, healthcare, and social activities
Die Kunst der Frage und die eigentliche Rede:Von Heideggers existenzieller Analytik zu Mannheims dokumentarischer Methode
Losers of representation:Gains and losses of globalisation as seen by workers in internationalised companies in the Netherlands
Dichotomisation between winners and losers is a prominent element of the debate on globalisation, with ordinary workers often considered losers. However, little is known about what workers make of globalisation, how they experience the phenomenon, and how they talk about it. We use a set of focus groups to explore meaning-making on the globalisation of the economy among lower-educated employees of Dutch internationalised firms. We find that they weigh up the pros and cons and proudly struggle with the consequences of globalisation. To the degree that they feel left behind, it is by politics and government. This suggests that dislike of globalisation is the result of negative experiences with politics, rather than the other way around