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A Locked Room:The Significance of Empathy and Being Seen, Particularly for Older Adults
No full textJoachim Duyndam aims to understand the situation of older adults by exploring the human condition of being fundamentally “isolated” in one’s self-experience and the supportive and liberating effect of empathy in breaking this self-isolation. Based on contemporary theories of emotions, he develops an understanding of empathy related to the inner experiential side of emotions. According to his reception of these theories, emotions have a “rational” publicly perceptible “outer side” and an intra-subjective “inner side”, whereby the latter makes people isolated in their self-experience. Using Michel Tournier’s philosophical recounting of the classical story of Robinson Crusoe, Duyndam argues that empathy directed at the inner side of someone’s experiences provides some form of recognition, that is, completion of one’s unique self, which is a prerequisite for experiencing meaning in life. Duyndam reveals an underlying structure of social isolation and loneliness and the vital role of empathy for all dimensions of meaning in life. This is particularly relevant since existential loneliness and social isolation are significant later-life risks
Factors associated with posttraumatic stress severity and treatment response in a retrospective, naturalistic sample of homicidally bereaved children and young people
No full textBackground: Research on the mental health of homicidally bereaved children and young people is scarce. Despite the importance of timely referral of those at risk of developing severe mental health problems, few convincing risk factors have been identified. The effectiveness of current treatment models is unclear.Objective: This study examined factors associated with posttraumatic stress (PTS)symptom severity and treatment response in a naturalistic sample of homicidally bereaved children and young people who received traumatic grief-focused cognitive behavioural therapy (TGF-CBT); and assessed whether PTS-symptoms decreased between the start and termination of treatment.Method: Data was used from 222 children and young people aged between 8 and 25, who had completed therapy by July 2017, and for whom either start – or end scores on PTS-symptoms, or both, were available. PTS-symptoms were measured with the Children's Revised Impact of Event Scale-8 (CRIES-8). We explored associations of personal and loss-related variables with baseline symptom levels and symptom reduction during treatment, using latent growth modelling.Results: PTS-symptoms decreased significantly from pre- to posttreatment and with a large effect size. Higher age was associated with early treatment discontinuation. Female sex was associated with higher baseline scores, and having lost a parent or sibling with lower baseline scores. Higher baseline scores were associated with larger symptom reduction during treatment.Conclusions: TGF-CBT shows promise in reducing PTS-symptoms following homicidal bereavement, regardless of the individual differences in personal or loss-related characteristics included in this study. However, it is important to recognize the uniqueness of children and young people confronted with homicidal loss, and to tailor treatment to their individual needs and developmental stage. More research on risk and protective factors for adverse mental health outcomes and response to treatment in children and young people bereaved by homicide is urgently needed
'Someone must do it':multiple views on family's role in end-of-life care - an international qualitative study
No full textBackground:Family is a crucial social institution in end-of-life care. Family caregivers are encouraged to take on more responsibility at different times during the illness, providing personal and medical care. Unpaid work can be overburdening, with women often spending more time in care work than men.Objectives:This study explored multiple views on the family’s role in end-of-life care from a critical perspective and a relational autonomy lens, considering gender in a socio-cultural context and applying a relational autonomy framework. It explored patients, relatives and healthcare providers’ points of view.Design:This qualitative study was part of the iLIVE project, involving patients with incurable diseases, their relatives and health carers from hospital and non-hospital sites.Methods:Individual interviews of at least five patients, five relatives and five healthcare providers in each of the 10 participating countries using a semi-structured interview guide based on Giger–Davidhizar–Haff’s model for cultural assessment in end-of-life care. Thematic analysis was performed initially within each country and across the complete dataset. Data sources, including researchers’ field notes, were translated into English for international collaborative analysis.Results:We conducted 158 interviews (57 patients, 48 relatives and 53 healthcare providers). After collaborative analysis, five themes were identified across the countries: family as a finite care resource, families’ active role in decision-making, open communication with the family, care burden and socio-cultural mandates. Families were crucial for providing informal care during severe illness, often acting as the only resource. Patients acknowledged the strain on carers, leading to a conceptual model highlighting socio-cultural influences, relational autonomy, care burden and feminisation of care.Conclusion:Society, health teams and family systems still need to better support the role of family caregivers described across countries. The model implies that family roles in end-of-life care balance relational autonomy with socio-cultural values. Real-world end-of-life scenarios do not occur in a wholly individualistic, closed-off atmosphere but in an interpersonal setting. Gender is often prominent, but normative ideas influence the decisions and actions of all involved
"Educating children to follow the voice of their conscience" - a comparative study of the Dutch educationalists Philipp Abraham Kohnstamm (1875-1951) and Martinus Jan Langeveld (1905-1989) within the context of early twentieth-century Europe
No full textTwo of the greatest Dutch educationalists of the twentieth century, Philipp Abraham Kohnstamm (1875–1951) and Martinus Jan Langeveld (1905–1989), believed that education meant, above all, the formation of a conscience. They developed their ideas in a time full of developments within Europe: the rise of fascism, two world wars, and pioneering theories on human development by Charles Darwin (1809–1882) and Sigmund Freud (1856–1939), among others. Kohnstamm’s and Langeveld’s educational theories were also influenced, to a greater or lesser extent, by optimistic ideas about the spontaneous development of the child and the unique personality of humankind, as expressed in movements such as New Education, New Psychology, and the philosophy of Henri Bergson (1859–1941). This article aims to compare these two Dutch educationalists on conscience formation to contextualise their differences and similarities and subsequently understand them within European developments, such as New Psychology, and specifically the Dutch context of the twentieth century
The Impact of Hospice Care Structures on Care Processes: A Retrospective Cohort Study
No full textBackground: Palliative care is subject to substantial variations in care, which may be shaped through adapting the organisational structures through which care is provided. Whilst the goal of these structures is to improve patient care, there is a lack of evidence regarding their effect on care processes and patient outcomes. Aims: This study aims to describe the relationship between care structures and the quantity and domains of care processes in hospice care. Design: Retrospective cohort study. Settings/Participants: Data were collected from Dutch hospice patient’s clinical records and hospice surveys, detailing hospice structures, patient clinical characteristics and care processes. Results: 662 patients were included from 42 hospices, mean age 76.1 years. Hospices were categorised according to their care structures - structured clinical documentation and multidisciplinary meetings. Patients receiving care in hospices with structured multidisciplinary meetings had an increased quantity of documented care processes per patient on admission through identification (median 4 vs 3, P < .001), medication (2 vs 1, P = .004) and non-medication (1 vs 0, P < .001) interventions, monitoring (2 vs 1, P < .001) and evaluation (0 vs 0, P = .014), and prior to death. Similar increases were identified for patients who received care in hospices with structured documentation upon admission, but these changes were not consistent prior to death. Conclusions: This study details that the care structures of documentation and multidisciplinary meetings are associated with increased quantity and breadth of documentation of care processes in hospice care. Employing these existing structures may result in improvements in the documentation of patient care processes, and thus better communication around patient care
Flourishing as an aim of higher education:exploring the aspirations and challenges of the educational philosophy of the University of Humanistic Studies (UvH)
No full textIn the University of Humanistic Studies (UvH) research and education are inspired by an inclusive humanistic worldview. As a worldview-based university, the UvH has both an entitlement to promote humanism as the prime source of inspiration and a responsibility to live up to its worldview-based mission. It strives not only for the academic formation of students, but also promotes humanistic moral and ethical values and assists students in developing skills and dispositions that enable them to live a good life, more specifically a good working, civic, and personal life. In my own words, it aims for students' flourishing. This aim leads to various challenges in a university, and I discuss two of them. First, the university has to combine the promotion of humanistic values and the cultivation of students' disposition to put these into practice with respect for the autonomy of students. Second, it has to combine aiming for students' flourishing with looking after the mental well-being of students while ensuring that caring for, and preventing, students' psychological problems does not overrule, or even jeopardize, education for flourishing
The Dignity Circle:Towards a non-ideal approach of social dignity in the context of marginalisation and care
Get PDFEenzaamheid als collectieve aangelegenheid:Versterk de sociale verbanden
Get PDFMensen met weinig zelfvertrouwen en zonder een ‘robuuste identiteit' voldoen moeilijker aan de verwachtingen van de maatschappij. Zij hebben daardoor meer kans op problematische eenzaamheid. Om eenzaamheid tegen te gaan, moeten we niet alleen aandacht schenken aan individuele kwetsbaarheden, maar ook aan de sociale omgeving, zegt Anja Machielse
