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De percepties van zorgprofessionals aangaande ‘nudging’ in ziekenhuizen

Tijdschrift Bestuurskunde, Aflevering 4 2020
Trefwoorden nudging, ethics, autonomy, healthcare, professionals
Auteurs Nienke Maria Huis in ’t Veld MSc, Rosanna Nagtegaal MSc en Prof. dr. Mirko Noordegraaf
SamenvattingAuteursinformatie

    ‘Nudging’ has been introduced as a policy and management tool as a way to influence behaviour without limiting choice. Nudging is mainly used to influence citizens’ behaviour but can also be used to influence the behavior of healthcare professionals. Examples include posters used to improve hand-hygiene compliance, or ‘default’ options in systems to reduce excessive prescriptions of specific medication. However, using nudges raises major worries and ethical issues, also in relation to the independence of healthcare professionals. While the scientific discussion about the desirability of nudges is extensive, the voices of healthcare professionals, who are the subjects of nudges, remain unheard. In this qualitative research we explore the perceptions of nudging held by various healthcare professionals. The interviews reveal that healthcare professionals are generally unfamiliar with the concept of nudging, but they do recognize nudges in their own field of practice. Furthermore, while they are predominantly positive about nudging, they also express concerns about the pressure on their autonomy. These concerns are related to changing professionalism and regulatory pressures in healthcare.


Nienke Maria Huis in ’t Veld MSc
N.M. Huis in ’t Veld, MSc is alumna aan de Universiteit Utrecht, departement Bestuurs- en Organisatiewetenschap.

Rosanna Nagtegaal MSc
R. Nagtegaal, MSc is promovenda aan de Universiteit Utrecht, departement Bestuurs- en Organisatiewetenschap.

Prof. dr. Mirko Noordegraaf
Prof. dr. M. Noordegraaf is hoogleraar Publiek Management aan de Universiteit Utrecht, departement Bestuurs- en Organisatiewetenschap.
Artikel

Access_open Ethics work for good participatory action research

Engaging in a commitment to epistemic justice

Tijdschrift Beleidsonderzoek Online, september 2020
Auteurs Tineke Abma
SamenvattingAuteursinformatie

    Participatory and responsive approaches to research strive to be democratic, inclusive and impactful. Participatory researchers share a commitment to epistemic justice and actively engage citizens and users as well as other stakeholders in the co-creation of knowledge for social change. While more and more researchers and policymakers feel attracted to these approaches in practice, the normative ideals of social inclusion and justice are sometimes hard to realize, because of established interests, power relations and system requirements. In this article I argue that participatory researchers and evaluators have a moral responsibility to do ‘ethics work’. This is more than just following ethical principles and codes of conduct. ‘Ethics work’ entails the labour and effort one puts into recognizing ethically salient aspects of situations, developing oneself as a reflexive practitioner, paying attention to emotions and relationships, collaboratively working out the right course of action and reflecting in the company of critical friends. In this article I present the theory and ethics of participatory approaches, illustrate ethical issues and ethics work related to collaboration, politics and power, and share lessons based on ten years of practice in the field of health and social well-being.

    Vooraf

    Participatief actieonderzoek en responsieve evaluatie staan volop in de belangstelling bij beleidsmakers en onderzoekers. Dit type beleidsonderzoek en -evaluatie beoogt democratisch, inclusief én impactvol te zijn. Het gaat om onderzoek mét in plaats van óver mensen. En het is actiegericht: onderzoek wil bijdragen aan concrete oplossingen door met betrokkenen gezamenlijke (verbeter)acties te ontwikkelen in de praktijk, en daarop te reflecteren en van te leren. Dit alles met het oog op sociale inclusie. Het zijn mooie idealen, maar wat betekent dit in de alledaagse, vaak weerbarstige onderzoekspraktijk?

    Op 20 januari 2020 organiseerde prof. Abma daarover een symposium, getiteld ‘Responsive, Participatory Research: Past, Present and Future Perspectives’ (Vrije Universiteit, Amsterdam). De rode draad op het symposium was de vraag wat goed en ethisch verantwoord participatief onderzoek is, en wat dit vraagt van onderzoekers en beleidsmakers. Drie lezingen op deze conferentie zijn nadien omgewerkt tot essays om lezers van Beleidsonderzoek Online vanuit verschillende perspectieven beter kennis te laten maken met deze vorm van onderzoek:

    Prof. Weerman en haar team focussen in hun bijdrage op het zich in de praktijk ontwikkelende onderzoeksdesign en het inzetten van creatieve methoden om participatie te bevorderen. Ze gaan na welke kwaliteitscriteria aan participatief actieonderzoek worden gesteld en hechten daarbij met name aan eisen ten aanzien van participatie, samen leren en verschil maken (zie BoO juli 2021). Ze benadrukken het belang van creativiteit en flexibiliteit.

    Prof. Abma bespreekt in haar artikel de normatieve dimensies en de ethiek van participatief actieonderzoek (zie BoO september 2020). Ze illustreert met een voorbeeld uit de crisishulpverlening aan GGZ-cliënten dat participatief actieonderzoek niet slechts een methodisch-technische exercitie is, maar een sociaal-politiek proces waarbij bestaande machtsverhoudingen verschuiven om ruimte te geven aan nieuwe stemmen en kennis. Dit omvat het zien van en stilstaan bij ethisch saillante dilemma’s en morele reflectie.

    De bijdrage van prof. Cook (zie BoO februari 2021) gaat over de weerbarstige praktijk van participatief actieonderzoek. Het doel is samen leren en voorbij geijkte oplossingen komen. Zij laat zien dat dit uitdagend is voor professionals die geconfronteerd worden met burgers die feedback geven en vragen om het (deels) loslaten van vaststaande professionele kaders. Er ontstaat dan ongemak en onzekerheid, maar zo beoogt en laat Cook overtuigend zien, deze ‘mess’ (niet meer goed weten wat goed en nodig is) is productief om te komen tot hernieuwde inzichten en innovaties.

    (Introductietekst opgesteld door prof. T. Abma)


Tineke Abma
Tineke A. Abma is Professor Participation & Diversity Amsterdam University Medical Centres, Amsterdam, and Executive Director of Leyden Academy on Vitality and Ageing, Leiden.
Thema-artikel

Een kritisch-pragmatische bestuurskunde

Oxymoron of gelukkig huwelijk?

Tijdschrift Bestuurskunde, Aflevering 1 2020
Trefwoorden critical pragmatism, public administration, energy justice, governance arrangements, regional energy strategies
Auteurs Dr. Tamara Metze
SamenvattingAuteursinformatie

    A pragmatic criticaster or a critical pragmatist is considered a schizophrenic in daily life: it seems impossible to be solution oriented and critical at the same time. You are either an optimist or a pessimist. This schism also seems to run between public administration and political scientists. Public administration is focused on (positive) problem solving, whereas political scientists – especially in a tradition of critical theory – examine the exertion of power. This essay proposes a combination of the two extremes: a critical-pragmatist approach for public administration.
    In this approach, critical political theory goes hand in hand with pragmatist reconstruction and design. This design is impossible without normative and procedural principles, for example ideas about sustainability, justice and democracy. This is illustrated with an example for designing just governance arrangements in the Dutch regional energy strategies. The article shows that public administration that is relevant, reflective and democratic builds on a critical-pragmatist approach.


Dr. Tamara Metze
Dr. T. Metze is universitair hoofddocent Bestuur en beleid aan de universiteit van Wageningen.
Article

Populism as a Visual Communication Style

An Exploratory Study of Populist Image Usage of Flemish Block/Interest in Belgium (1991-2018)

Tijdschrift Politics of the Low Countries, Aflevering 1 2020
Trefwoorden Populism, image use, visual style, campaign, posters, visual, Flanders, populist right, Belgium
Auteurs Kevin Straetemans
SamenvattingAuteursinformatie

    This article analyses the visual communication of the Flemish populist right-wing party Vlaams Blok/Vlaams Belang, and investigates whether or not the party uses a specific populist communication style in its campaign posters, whether or not its visual style evolves over time and how the party distinguishes itself from other (right-wing) parties in its use of images. To do this, the image use will be compared with the CVP/CD&V and the Volksunie/N-VA. This use of images will be investigated by analysing election posters from 1991 to 2018. The analysis shows that there is indeed a ‘populist visual style’. These items consist mainly of (negative) metaphors, false dilemmas, caricatures and the use of so-called ‘agonic’ visual techniques.


Kevin Straetemans
Kevin Straetemans attained a Master’s degree in Political Sciences at the Vrije Universiteit Brussel in 2018. He is currently pursuing an Educational Master in Social Sciences at the same university. His research interests are political parties, elections, extremism, propaganda and political communication.
Research Notes

Sub-Constituency Campaigning in PR Systems

Evidence from the 2014 General Elections in Belgium

Tijdschrift Politics of the Low Countries, Aflevering 3 2019
Trefwoorden Sub-constituency campaigning, PR system, political advertisements, election campaign, content analysis
Auteurs Jonas Lefevere, Knut De Swert en Artemis Tsoulou-Malakoudi
SamenvattingAuteursinformatie

    Sub-constituency campaigning occurs when parties focus their campaign resources on specific geographical areas within an electoral district. This behaviour was traditionally thought to occur only in single-member plurality elections, but recent research demonstrates that proportional systems with multi-member districts can also elicit sub-constituency campaigning. However, most studies of sub-constituency campaigning rely on self-reported measures of campaigning, not direct measures of campaign intensity in different regions and communities. We present novel data on geographical variations in the intensity of Flemish parties’ campaign advertising during the 2014 general elections in Belgium, which provides a direct measure of sub-constituency campaigning. Our findings show clear evidence of sub-constituency campaigning: parties campaign more intensely in municipalities where they have stronger electoral support and in municipalities with greater population density.


Jonas Lefevere
Jonas Lefevere is assistant professor at Vesalius College and the Institute for European Studies (VUB). His research interests include the strategic communication of political elites, the effects of campaign communication on political attitudes and electoral choice and the role of issue perceptions in electoral behavior.

Knut De Swert
Knut De Swert is Assistant Professor, Political Communication and Journalism, at the Amsterdam School of Communication Research (University of Amsterdam, The Netherlands). His research is situated in the field of media and politics, and mainly focuses on the quality of (political) journalism and foreign news in a comparative perspective.

Artemis Tsoulou-Malakoudi
Artemis Tsoulou-Malakoudi is a student research assistant for the EOS research project RepResent which focuses on representation and democratic resentment. She is currently following a Research Master’s at the University of Amsterdam with an interest in political communication research.
Artikel

Big data kwaliteit voor beleid

Tijdschrift Bestuurskunde, Aflevering 1 2016
Trefwoorden big data, quality, data-chain
Auteurs Dr.ir. Jan Kwakkel en prof.dr.ir. Alexander Verbraeck
SamenvattingAuteursinformatie

    Many people see big data as the solution to large societal challenges. But is this really the case? To what extend is the current interest in big data merely an example of the hype cycle, which is common to many technologies? Based on experiences in several big data projects, we explore what is truly novel about big data, and where big data might be meaningfully employed. From this, we distil two main points. First, ensuring the quality throughout the chain from data gathering through analysis and up to decision support is critical in ensuring the successful use of big data. Second, there are unavoidable tensions between the usability, desirability, and technological possibility of big data. Careful reflection on each of these is needed in any big data project.


Dr.ir. Jan Kwakkel
Dr.ir. J.H. Kwakkel is universitair docent aan de Technische Universiteit Delft

prof.dr.ir. Alexander Verbraeck
prof.dr.ir. A. Verbraeck is hoogleraar aan de Technische Universiteit Delft
Artikel

Big Data: een revolutie in gemeentelijk beleid?

Tijdschrift Bestuurs­wetenschappen, Aflevering 3 2015
Auteurs Tom Daalhuijsen MSc, Sebastiaan Steenman MSc en Prof. dr. Albert Meijer
SamenvattingAuteursinformatie

    Big Data is the new hype in municipal policy and the promise of Big Data is rationalization: better policy that is based on better information. In this article the authors investigate the extent to which the use of Big Data in municipal organizations results in a more rational policy process. Their empirical research was held in two Dutch municipalities: Tilburg, in the south of the Netherlands, and Assen, in the north of the Netherlands. They investigated how Tilburg deploys Big Data for the fight against crime and Assen is trying to improve its traffic management with Big Data. Their analysis shows that policy, more so than in the past, is being steered by specific information because Big Data is being used. The rationalization of policy, however, is limited by the possibilities of Big Data and by political dynamics. Their final conclusion therefore is that the uncertainty, unfamiliarity, complexity and constant change are partly made manageable and controllable by the use of Big Data in municipal organizations. Politics is also partly ‘tamed’ because politicians have to relate to ‘objective data’ from information systems.


Tom Daalhuijsen MSc
T. Daalhuijsen MSc werkt sinds kort als business analist bij Capgemini Nederland. Hij is in 2014 afgestudeerd bij de masteropleiding Bestuur en Beleid van de Universiteit Utrecht.

Sebastiaan Steenman MSc
S.C. Steenman MSc is docent in de bacheloropleiding Bestuurs- en Organisatiewetenschap en de masteropleiding Bestuur en Beleid van de Universiteit Utrecht.

Prof. dr. Albert Meijer
Prof. dr. A.J. Meijer is hoogleraar Publieke Innovatie aan de Universiteit Utrecht en redacteur van Bestuurswetenschappen.
Article

Angels gedoopt in honing: politieke tekeningen en hun betekenis

Tijdschrift Res Publica, Aflevering 3 2015
Trefwoorden political cartoons, visual (mis)communication, psychological defense mechanism, Dutch politics
Auteurs Joop van Holsteyn
SamenvattingAuteursinformatie

    Over the years, political cartoons have triggered debate and fierce and violent reactions. Apparently, cartoonists are able to get their critical, ‘negative’ message across both to the political elite and the general public at large. This line of reasoning, however, assumes that the communication between cartoonists and their mass public is successful, i.e., that the message that the cartoonist intends to send is correctly interpreted and received as intended. This is not obvious, since the decoding of the encrypted message of a cartoon is a complicated process that can easily go wrong, as the scarce research on the topic suggests. This study explores the idea that cartoons are correctly understood on the basis of a unique large scale survey in which over 24,000 respondents were asked via multiple-choice questions to identify the original, intended message of 11 cartoons of two Dutch cartoonists. The results show that overall it is extremely hard to correctly understand the meaning of cartoons. Moreover, among the few factors that help explain the difference in the capability to correctly understand cartoons, political preference is prominent and intriguing. People tend to ascribe a meaning to cartoons/cartoonists that fits their own political stand, and this suggests that psychological mechanisms are at work that may explain that more often than not the communication between the cartoonist and his public should likely be labelled miscommunication.


Joop van Holsteyn
Joop van Holsteyn is neerlandicus en politicoloog en is verbonden aan het Instituut voor Politieke Wetenschap van de Universiteit Leiden. In zijn onderzoek houdt hij zich onder meer bezig met verkiezingen en kiesgedrag, publieke opinie en opiniepeilingen, politieke partijen en partijlidmaatschap, en politieke tekeningen en hun betekenis.
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