Decision-making in case of an unintended pregnancy: an overview of what is known about this complex process.

Unintended pregnancies are a worldwide health issue, faced each year by one in 16 people, and experienced in various ways. In this study we focus on unintended pregnancies that are, at some point, experienced as unwanted because they present the pregnant person with a decision to continue or terminate the pregnancy. The aim of this study is to learn more about the decision-making process, as there is a lack of insights into how people with an unintended pregnancy reach a decision.

Differentiating social environments of high-risk professionals and specialised nurses: a qualitative empirical study on social embeddedness.

High-risk professionals and specialised nurses in hospitals are frequently exposed to potentially traumatic events. Psychotrauma researchers have extensively studied personal risk factors of traumatisation among high-risk professionals, but it is hard to understand psychological functioning when professionals are decontextualised from their social environment. Generally, it has been well documented that to reduce the risk of posttraumatic stress disorder (PTSD) or other mental health problems related to traumatisation, it is essential to be embedded in a supportive social environment.

Social Embeddedness of Firefighters, Paramedics, Specialized Nurses, Police Officers, and Military Personnel: Systematic Review in Relation to the Risk of Traumatization.

Firefighters, paramedics, specialized nurses working in Intensive Care Units (ICUs), Operating Rooms (OR), and Emergency Rooms (ER), police officers and military personnel are more frequently exposed to potentially traumatic events than the general population; they are considered high-risk professionals. To reduce the risk of traumatization it is of great importance to be embedded in a social environment with supportive relationships. We performed a systematic review (based on the PRISMA-Guidelines) looking for social connections within the environment in which high-risk professionals are embedded (work, home, community), to obtain evidence on the impact of these connections on the risk of traumatization.

Fear, fight, familiarize: the experiences of people living with relapsing-remitting multiple sclerosis and taking oral medication.

: In addition to becoming familiar with the life changing event of having a chronic illness and exploring its meaning in daily life, people with relapsing-remitting Multiple Sclerosis (RRMS) are faced with important decisions about immunomodulating treatment. Biomedical research on the use of Disease Modifying Therapies (DMTs) mostly focuses on adherence, conceptualized and understood as a behavioral act leading to a desired outcome. Less attention has been paid to the meaning for a person with RRMS of starting and continuing the use of DMTs.

Trapped in my lungs and fighting a losing battle. A phenomenological study of patients living with chronic obstructive and pulmonary disease.

Chronic obstructive and pulmonary disease (COPD) has detrimental effects on individuals with the disease. COPD causes breathlessness, morbidity and associated psychosocial distress. This study was guided by the phenomenological question what is it like to have COPD and situated in Van Manen's phenomenology of practice.

Me? The invisible call of responsibility and its promise for care ethics: a phenomenological view.

Care ethics emphasizes responsibility as a key element for caring practices. Responsibilities to care are taken by certain groups of people, making caring practices into moral and political practices in which responsibilities are assigned, assumed, or implicitly expected, as well as deflected. Despite this attention for social practices of distribution and its unequal result, making certain groups of people the recipient of more caring responsibilities than others, the passive aspect of a caring responsibility has been underexposed by care ethics.

The Mindful Body: A Phenomenology of the Body With Multiple Sclerosis.

For people living with multiple sclerosis (MS), one's own body may no longer be taken for granted but may become instead an insistent presence. In this article, we describe how the body experience of people with MS can reflect an ongoing oscillation between four experiential dimensions: bodily uncertainty, having a precious body, being a different body, and the mindful body. People with MS can become engaged in a mode of permanent bodily alertness and may demonstrate adaptive responses to their ill body.

Beyond demarcation: Care ethics as an interdisciplinary field of inquiry.

Background:: For many years the body of literature known as 'care ethics' or 'ethics of care' has been discussed as regards its status and nature. There is much confusion and little structured discussion. The paper of Klaver et al.

Nested Tensions in Care.

This project presents research-based art works that inquire into the tensions in everyday life from an ethical viewpoint of care, which sees people as embedded, "nested" in care-based relationships. Trust is the glue that holds these "nests" together. Care is the air that lifts them up, but tensions exist as well-between dependency and autonomy, vulnerability and strength, for example.

How shared is shared decision-making? A care-ethical view on the role of partner and family.

The aim of shared decision-making (SDM) is to provide information to patients in order to enable them to decide autonomously and freely about treatment together with the doctor, without interference, force or coercion by others. Relatives may be considered as hindering or impeding a patient's own decision. Qualitative-empirical research into lived experience of SDM of patients with cancer, however, problematises the patient's autonomy when facing terminal illness and the need to make decisions regarding treatment.

Lean leadership: an ethnographic study.

Purpose: The purpose of this study is to provide a critical analysis of contemporary Lean leadership in the context of a healthcare practice. The Lean leadership model supports professionals with a leading role in implementing Lean. This article presents a case study focusing specifically on leadership behaviours and issues that were experienced, observed and reported in a Dutch university medical centre.

An interactive-technology health behavior promotion program for heart failure patients: a pilot study of experiences and needs of patients and nurses in the hospital setting.

Background: Heart failure (HF) is a chronic condition, prevalent especially among older people, characterized by acute episodes leading to hospitalization. To promote HF patients' engagement in physical activity (PA) and adherence to medication, we developed Motivate4Change: a new interactive, information and communication technology (ICT)-based health promotion program for delivery in the hospital. The development of this program was guided by the Intervention Mapping protocol for the planning of health promotion programs.

Patient involvement in research programming and implementation: A responsive evaluation of the Dialogue Model for research agenda setting.

Background: The Dialogue Model for research agenda-setting, involving multiple stakeholders including patients, was developed and validated in the Netherlands. However, there is little insight into whether and how patient involvement is sustained during the programming and implementation of research agendas.

Aim: To understand how the Dialogue Model can be optimised by focusing on programming and implementation, in order to stimulate the inclusion of (the perspectives of) patients in research.

Patient safety in the operating theatre: how A3 thinking can help reduce door movement.

Issue: Research has often stressed the significance of reducing door movement during surgery for preventing surgical site infections. This study investigated the possible effect of a lean A3 intervention on the reduction of door movement during surgery in a university medical center in the Netherlands.

Initial Assessment: A digital counter recorded door movement during 8009 surgical procedures during 8 months.

Experiences of leaders in the implementation of Lean in a teaching hospital--barriers and facilitators in clinical practices: a qualitative study.

Objectives: To date, experiences of leaders in the implementation of Lean after a Lean Training Programme have not been systematically investigated within teaching hospitals. Existing studies have identified barriers and facilitators only from an improvement programme perspective and have not considered the experiences of leaders themselves. This study aims to bridge this gap.

Relational responsibilities in responsive evaluation.

This article explores how we can enhance our understanding of the moral responsibilities in daily, plural practices of responsive evaluation. It introduces an interpretive framework for understanding the moral aspects of evaluation practice. The framework supports responsive evaluators to better understand and handle their moral responsibilities.

Moral learning in an integrated social and healthcare service network.

The traditional organizational boundaries between healthcare, social work, police and other non-profit organizations are fading and being replaced by new relational patterns among a variety of disciplines. Professionals work from their own history, role, values and relationships. It is often unclear who is responsible for what because this new network structure requires rules and procedures to be re-interpreted and re-negotiated.

Patient issues in health research and quality of care: an inventory and data synthesis.

Aim: The purpose of this review is to generate an inventory of issues that matter from a patient perspective in health research and quality of care. From these issues, criteria will be elicited to support patient(s) (groups) in their role as advisor or advocate when appraising health research, health policy and quality of health care.

Background: Literature shows that patients are beginning to develop their own voice and agenda's with issues in order to be prepared for the collaboration with professionals.

Dialogue for air, air for dialogue: towards shared responsibilities in COPD practice.

For the past several years patients have been expected to play a key role in their recovery. Self management and disease management have reached a hype status. Considering these recent trends what does this mean for the division of responsibilities between doctors and patients? What kind of role should healthcare providers play? With findings based on a qualitative research project of an innovative practice for people with Chronic Obstructive Pulmonary Disease (COPD) we reflect on these questions.