Teachable moments are periods of time that increases someone's openness to lifestyle change and lifestyle advice. As a result of this greater receptiveness, interventions centered around important... Show moreTeachable moments are periods of time that increases someone's openness to lifestyle change and lifestyle advice. As a result of this greater receptiveness, interventions centered around important life events demonstrate great potential. This thesis explores how life events, particularly those related to cardiovascular disease, serve as teachable moments, addressing three key questions: whether life events indeed have the potential to be teachable moments, the underlying mechanism that turn a life event into an increased motivation for behavior change, and how to best utilize teachable moments in healthcare. The findings reveal that both societal crises and personal health events can create a teachable window where individuals are more receptive to lifestyle advice. Several factors driving this motivation include changes in self-concept, heightened awareness of vulnerability, interpreting an event in terms of behavior causes and consequences, avoiding future regret over unhealthy choices, and wanting to regain control over one's life through positive lifestyle changes. Additionally, the findings underscores the critical role of timing and approach in delivering lifestyle advice, to fully optimize the potential that teachable windows have. Show less
Brust, M.; Gebhardt, W.A.; Bruggen, S. van; Janssen, V.; Numans, M.E.; Kiefte-de Jong, J.C. 2023
AbstractObjectivePrevious research has shown that experiencing an acute cardiac event, such as a myocardial infarction (MI), can lead to lifestyle changes. This study aimed to explore the potential... Show moreAbstractObjectivePrevious research has shown that experiencing an acute cardiac event, such as a myocardial infarction (MI), can lead to lifestyle changes. This study aimed to explore the potential of a MI as a ‘teachable moment’ (TM) for positive lifestyle changes and to identify psychosocial sensemaking processes that facilitate or hinder the presence of a TM.MethodWe conducted semi-structured interviews with 14 patients who suffered their first MI and were hospitalized in a larger Dutch city. Participants were interviewed twice, respectively one and five months after their hospitalization. They were encouraged to explain how they experienced their MI and how this had affected their lifestyle. We used an Interpretative Phenomenological Analysis approach to the data collection and analysis.FindingsThe participants varied in their willingness to adopt a healthy lifestyle due to their MI. Most participants experienced their event as a TM for changing specific health behaviors, for example facilitated by reflecting on self-concept or social roles and by constructing and comprehending a personal narrative of their MI. Some participants struggled to follow through on their intentions to change their behavior, for example because of a negative attitude towards a healthy behavior or because they perceived it as incongruent to their identity. Only three participants maintained most former health behaviors, for example because they failed to acknowledge their MI as severe or because of earlier life events that elicited more blunted cognitive responses.ConclusionCardiac patients may experience a TM, which is the consequence of interrelated processes of psychosocial sensemaking. As this does not occur at a singular time point, we suggest using the term ‘teachable window’ rather than ‘moment’. Given these findings, there is a window of opportunity to provide continuous psychosocial and lifestyle support during and after hospitalization for acute cardiac events. Show less
Dementia is a progressive, life-limiting disease. A palliative approach to care, that focuses on the quality of life of people with dementia and their relatives, is therefore indicated. Advance... Show moreDementia is a progressive, life-limiting disease. A palliative approach to care, that focuses on the quality of life of people with dementia and their relatives, is therefore indicated. Advance care planning is core to palliative care. Relatives play a major role in this, because people with dementia often become unable to indicate their preferences for future care. Palliative dementia care is still sub optimally implemented, however. Nursing home staff and relatives of people with dementia need information about dementia and palliative care to ensure it is optimally implemented. Also, ongoing communication between everyone involved in the care of a person with dementia is required, including discussions about future care needs. This facilitates a palliative care approach in dementia. These conclusions result from a survey among elderly care physicians, a systematic review, care plan data in nursing homes and an intervention study in two nursing homes: the mySupport study. It appears that relatives want timely information about the end of life with dementia. That way they can prepare. Although physicians are usually the ones who educate relatives, nursing staff often have a stronger relationship with relatives. After training, they can play an important role in providing information. Show less
Koppel, M. ten; Pasman, H.R.W.; Steen, J.T. van der; Hout, H.P.J. van; Kylanen, M.; Block, L. van den; ... ; Alzheimer Europe 2019
This study has been carried out in the community of Sukamiskin, a kelurahan (‘village’) in Bandung, the Capital of West Java Province, located in the Sunda Region of Indonesia. Parallel to the... Show moreThis study has been carried out in the community of Sukamiskin, a kelurahan (‘village’) in Bandung, the Capital of West Java Province, located in the Sunda Region of Indonesia. Parallel to the historical development of the different medical systems, also the related health and communication systems among the people have been extended with new information, knowledge, and experience, which have similarly led to the development of different Traditional and Modern Health Information & Communication Systems (T&MHICS). The proposed Model of an Integrated Health Information & Communication Systems (IHICS) against the background of the three domains of respectively the societal discourse, the lay discourse and the expert discourse, as a planning tool in order to provide a contribution to the improvement of the local people’s level of health literacy, and as such to the ‘Information Society Indonesia’ within the context of public health development in the near future hopes to attribute a new significant meaning to the concept of Iber Kasehatan as a construct of an Integrated Health Information & communication Model (IHICM) in order to provide a contribution to the health of the local population of Sukamiskin in Bandung, as well as in other regions in Indonesia and the rest of the world., knowledge, and experience, which have similarly led to the development of different Traditional and Modern Health Information & Communication Systems (T&MHICS). The proposed Model of an Integrated Health Information & Communication Systems (IHICS) against the background of the three domains of respectively the societal discourse, the lay discourse and the expert discourse, as a planning tool in order to provide a contribution to the improvement of the local people’s level of health literacy, and as such to the ‘Information Society Indonesia’ within the context of public health development in the near future hopes to attribute a new significant meaning to the concept of Iber Kasehatan as a construct of an Integrated Health Information & communication Model (IHICM) in order to provide a contribution to the health of the local population of Sukamiskin in Bandung, as well as in other regions in Indonesia and the rest of the world. Show less
Increasingly, pleas are made for extending the involvement of minors in decision-making about participation in pediatric research. However, a number of issues arise from this desired... Show more Increasingly, pleas are made for extending the involvement of minors in decision-making about participation in pediatric research. However, a number of issues arise from this desired participation of minors. First, involvement in decision-making requires children and adolescents to be adequately informed about what participation in research entails. Second, the plea for increased involvement in decision-making requires further investigation whether children indeed can, should and want to play a role in the decision about research participation. This thesis addresses these issues and thereby contributes to insights in how to empower minors in the context of informed consent for research participation. New informed consent material was developed in close cooperation with children and other end-users, the process of which is described and evaluated. Also, insights in the role that minors can, should and want to play in the informed consent procedure are described. These insights were obtained by reviewing multidisciplinary scientific evidence on the competence of minors, by an ethical reflection on the view on children that we should adopt, and by consulting minors themselves about the perspectives on their role in decision-making. Finally, based on this research, recommendations are provided on how to empower minors in decision-making about research participation. Show less
e livre est une étude pionnière portant sur l’analyse conceptuelle et la traductibilité des termes de maladie dioula jusqu’ici non abordées par les recherches antérieures. Le Dioula est une langue... Show moree livre est une étude pionnière portant sur l’analyse conceptuelle et la traductibilité des termes de maladie dioula jusqu’ici non abordées par les recherches antérieures. Le Dioula est une langue mandé parlée au Burkina Faso. L’étude présente les représentations de la santé, de la maladie et du corps dans la culture dioula, les entités nosologiques populaires et l’étude linguistique des noms de maladies dioula. Cette étude linguistique a pour but d’analyser les termes du corpus afin de souligner leurs particularités linguistiques. Cette analyse est d’autant plus utile qu’elle permet d’une part, de s’imprégner davantage des concepts et conceptions relatifs à la maladie et d’autre part, de mettre en évidence les difficultés que les traducteurs et interprètes sont susceptibles de rencontrer dans ce domaine et de proposer des solutions. Cette analyse vise à faciliter la tâche du traducteur ou de l’interprète qui pourra se référer rapidement aux suggestions proposées en cas de difficulté ou de doute. L’étude décrit la formation des termes de maladies puis les processus sémantiques ou les figures de style rentrant dans la construction de ces termes et enfin le discours de plainte du malade. En outre, cette étude examine dans quelle mesure le relativisme culturel et linguistique peut servir dans le processus de traduction au lieu d’impliquer son impossibilité. L'auteur décrit un certain nombre de phénomènes intéressants en ce qui concerne les entités nosologiques populaires dioula : Il se peut que le terme de maladie dioula exprime un concept qui est complètement inconnu dans la culture cible. Le concept en question peut être abstrait ou concret, il peut être relié aux croyances religieuses, à une coutume sociale. De tels concepts sont souvent qualifiés de concepts « spécifiquement culturels ». Un exemple d’un concept abstrait dioula qui est reconnu comme difficile à traduire en d’autres langues relevant d’autres cultures est celui exprimé par le mot kɔnɔ. Ce dernier revêt un concept typiquement « dioula » qui est rarement appréhendé par des gens provenant d’autres cultures. L'un des problèmes théoriques soulevés concerne la traductibilité des termes médicaux dioula, culturellement spécifiques. Il est ressorti de l’analyse que des expressions qui sont profondément enracinées dans la culture dioula présentent plus de difficultés de traduction car le concept qu’ils véhiculent est inconnu du français ou de la biomédecine. Des pistes de solutions sont fournies parmi lesquelles l’on peut noter la démarche suivante : Une traduction du terme de maladie dioula par un mot français accompagnée de commentaires sémantiques et/ou métalinguistiques.Les données ont été collectées sur quatorze mois en plusieurs étapes. Au regard des problèmes théoriques et analytiques abordés dans les différentes sections du livre, il est d’un grand intérêt pour les personnels de santé, pour les spécialistes de la communication interculturelle, pour les lexicographes et les terminologues, pour les anthropologues de la santé sans oublier les traducteurs. Show less