Writing : A Versatile Resource in the Treatment of the Clients’ Proposals

This chapter investigates how writing serves as a resource in decision-making at the Clubhouse and how writing activities relate to professionals’ responses to clients. The ideology of the Clubhouse is one of interaction, and in accordance with this perspective, support workers and clients should be treated equally in decision-making processes related to the activity of the Clubhouse. However, as demonstrated in previous research, encouraging clients in mental health rehabilitation to participate actively in interaction and decision-making can be difficult. Therefore, support workers carry a substantial responsibility for promoting clients’ participation in interactions; this responsibility is supported by how they respond to clients. The focus in this chapter is on a certain type of participation-encouraging response—that is, a response that promotes the documentation of vaguely expressed ideas in written documents and encourages a dialogue between support workers and Clubhouse clients around the formulations in a text-in-production.This chapter investigates how writing serves as a resource in decision-making at the Clubhouse and how writing activities relate to professionals’ responses to clients. The ideology of the Clubhouse is one of interaction, and in accordance with this perspective, support workers and clients should be treated equally in decision-making processes related to the activity of the Clubhouse. However, as demonstrated in previous research, encouraging clients in mental health rehabilitation to participate actively in interaction and decision-making can be difficult. Therefore, support workers carry a substantial responsibility for promoting clients’ participation in interactions; this responsibility is supported by how they respond to clients. The focus in this chapter is on a certain type of participation-encouraging response—that is, a response that promotes the documentation of vaguely expressed ideas in written documents and encourages a dialogue between support workers and Clubhouse clients around the formulations in a text-in-production.Peer reviewe

Sparking conversations on Facebook brand pages: Investigating fans' reactions to rhetorical brand posts

On Facebook brands create pages to facilitate interaction with their (potential) customers, or fans. Brands publish content on these pages which often contain rhetorical figures. Facebook's technological affordances allow fans to respond to these posts leading to multiple participation framework levels that were initiated and can be seen by the brand, but may – at some point – no longer involve the brand. In this study, we uncovered how brands initiate interaction by posting content in an artfully divergent way by collecting 62 Dutch Facebook posts from 12 brands and fans' reactions they evoked. Using a mixed-methods approach, the posts' rhetorical figures and how fans responded to them were analyzed. The results showed that brands' posts often contain a deviation in meaning which enabled fans to respond in various ways: they responded to the actions posts generated, such as answering questions, but also responded by evaluating the brands. Despite the post's rhetorical type (trope or scheme), format (visual, verbal, or verbo-pictorial), or relevant next action projected, rhetorical posts on brand pages secure responses and thus participation from fans

A patient’s perspective on care decisions: a qualitative interview study

Abstract Background and Objectives Discussing treatment wishes and limitations during medical consultations aims to enable patients to define goals and preferences for future care. Patients and physicians, however, face multiple barriers, resulting in postponing or avoiding the conversation. The aim of this study was to explore an internal medicine outpatient clinic population’s perception on (discussing) treatment wishes and limitations. Methods Semi-structured interviews were conducted in two rounds with 44 internal medicine outpatient clinic patients at the University Medical Centre Utrecht, a tertiary care teaching medical centre in the Netherlands. Interviews were transcribed verbatim and thematically analysed with a phenomenological approach and inductive, data-driven coding. Results Four themes were identified, two (1–2) represent a deep conviction, two (3–4) are practically oriented: (1) patients associate treatment wishes and limitations with the end-of-life, making it sensitive and currently irrelevant, (2) patients assume this process leads to fixed choices, whilst their wishes might be situation dependent, (3) treatment wishes and limitations are about balancing whether a treatment ‘is worth it’, in which several subthemes carry weight, (4) the physician is assigned a key role. Conclusion and practice implications The themes provide starting points for future interventions. It should be emphasized that care decisions are a continuous, dynamic process, relevant at any time in any circumstance and the physician should be aware of his/her key role

Total Urgency and Frequency Score (TUFS) as a Measure of Urgency and Frequency in OAB and storage LUTS

The term lower urinary tract symptoms (LUTS) encompasses a range of urinary symptoms, including storage symptoms (e.g. overactive bladder [OAB]) as well as voiding and post-micturition symptoms. Although treatment of male LUTS tends to focus on voiding symptoms, patients typically find storage symptoms the most bothersome. The core storage symptom is urgency, which drives the other main storage symptoms of increased daytime frequency, nocturia and incontinence. Although several validated questionnaires have been widely used to study urgency, few measure the two important storage parameters, urgency and frequency, in a single assessment. The total urgency and frequency score (TUFS) is a new validated tool that captures both variables and is derived from the Patient Perception of Intensity of Urgency Scale, which has been validated in patients with OAB and LUTS. The TUFS was first validated in OAB in the phase IIa BLOSSOM study, which was designed to assess the efficacy and safety of mirabegron, a beta(3)-adrenoceptor agonist, in 260 patients. The responsiveness of the TUFS to treatment has been confirmed in a further three large-scale randomized controlled trials of solifenacin in patients with OAB or LUTS. Changes in TUFS from baseline to end of treatment were consistent with changes in micturition diary variables in all four studies. Furthermore, the TUFS was significantly correlated with several health-related quality-of-life variables in the phase III NEPTUNE study. Thus, the TUFS appears to be useful for assessing improvements in major storage symptoms (urgency and frequency) in clinical trials