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Facilitators and barriers of implementing end-of-life care volunteering in a hospital in five European countries:the iLIVE study
No full textBackgroundEnd-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
How end-of-life care was limited during the first 18 months of the COVID-19 pandemic:a longitudinal survey study among healthcare providers (the CO-LIVE study)
No full textBackgroundDuring the COVID-19 pandemic, the way in which end-of-life care was provided, underwent a lot of changes and therefor different domains of end-of-life care were impacted. The aim of this study is to describe whether health care providers considered end-of-life care (in medical, nursing, psychosocial and spiritual care) limited by the pandemic through the first 18 months of the COVID-19 pandemic, and examine associations with COVID-19 related circumstances of care (e.g. visit restrictions) and health care providers’ characteristics.MethodsA longitudinal survey study among healthcare providers from different healthcare settings who provided end-of-life care during the pandemic’s first 18 months. Data of four time periods were analyzed using descriptive statistics and Generalized Estimating Equation.ResultsOf the respondents (n = 302) the majority had a nursing background (71.8%) and most worked in a hospital (30.3%). Especially in the first wave end-of-life care in all aspects was limited according to a substantial part of health care providers (between 29.7 and 57.7%). Psychosocial and spiritual care were more limited than medical and nursing care during all time periods. Care being limited according to health care providers was associated with visit restrictions, shortness of personal protective equipment or restrictions in caring for the deceased and decreased over time.ConclusionThe COVID-19 pandemic impacted different aspects of end-of-life care throughout the pandemic’s first 18 months. Over the course of the pandemic health care providers seemed to have invented ways to adjust their work in order to minimize the effect of limiting measures. More involvement of health care providers in decision-making may improve the prioritization of measures to deal with crisis situations in care. These reflections highlight priorities during crises and the role healthcare providers could play in maintaining good end-of-life care. This remains relevant in new health crises, where care may differ from what is considered good quality of care
Mastering life chances and choices; a metasynthesis of how disadvantaged young people navigate between self-identity and stigma
No full textCare-dependent people are increasingly expected to actively participate in an accelerating society. This metasynthesis provides insight into how contemporary society complicates the pathways to self-actualization for disadvantaged young people. Giddens’ concept of self-identity was used to analyze the experiences of disadvantaged young people in three participatory projects. These initiatives enable network governance where young people and professionals work together, to better match their care needs and support. Participants often feel that they need to magnify their capabilities to get opportunities for self-actualization and to magnify their disadvantages so they can be acknowledged as “care dependent”, a prerequisite to receive professional support. They call upon professionals and policymakers to recognize their multilayered self-identities and to provide a supportive environment that is adjusted to their own pace, so that they can belong and genuinely participate as their true selves
Finding consensus on well-being in education
No full textResearch on well-being and concern over the well-being of students and teachers has grown dramatically in recent years. Researchers and reformers in positive psychology and education, self-determination theory, social and emotional learning, liberal-democratic political and educational philosophy, and neo-Aristotelian theories of flourishing and character education have played formative and intersecting roles in what is now an international movement to promote the lifelong flourishing of students as an alternative to a human capital and economic growth focus for education. This article defends this flourishing-focused reorientation of education policy and practice, using a value-led and evidence-informed methodology. It sorts through the conceptual disputes and clarifies the ethical considerations that should guide efforts to advance the well-being of students and teachers, assesses key claims and arguments, and brings together compatible aspects of the leading philosophical and psychological perspectives on flourishing as an aim of education. It identifies ethically and evidentially justifiable points of consensus on well-being and flourishing in education, presents a consensus model of relationships between educational environments, learning, and flourishing, and concludes with some recommendations for educational policy and practice
Opkomst radicaal-rechts vraagt om antwoord sociaal werk
No full textSociaal werkers konden wel eens in gewetensnood komen als een gure rechts-radicale wind door hun vakgebied waait. Wapen ze daartegen, schrijft Thomas Kampen
