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van Lieshout C, Frederix GWJ, Schoonhoven L. Economic evaluations in medical technological innovations a mapping review of methodologies. Cost Eff Resour Alloc 2024; 22:23. [PMID: 38504303 PMCID: PMC10953233 DOI: 10.1186/s12962-024-00529-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/01/2024] [Indexed: 03/21/2024] Open
Abstract
RATIONALE Economic evaluations play an important role in the development and implementation of healthcare innovations. For pharmaceutical products, the methodologies used are laid down in guidelines, whereas for medical technologies the guidelines are not as strenuous. The aim of this review was therefore to analyze what types of methodologies are used in economic evaluations of medical technologies. METHODS We performed a mapping review to identify economic evaluations for medical technologies. We decided to limit our search to one year (2022) and included cost utility and cost effectiveness analyses in which health technologies were evaluated. For each included study we identified the main methodological characteristics. RESULTS A total of 364 papers were included in the analysis, 268 (74%) contained cost-utility analyses and 91 (25%) cost-effectiveness analyses. A model was used in 236 (64%) analyses, 117 analyses were trial based evaluations. Probabilistic sensitivity analyses and/or bootstrapping was performed in 266 (73%) analyses. Deterministic sensitivity analyses were used in 306 (84%). Time horizon and perspective were underreported in 15-25% of the included studies. CONCLUSIONS This review shows the wide range of methodologies used in economic evaluations as well as the extent and rigor in which these methodologies are used. Many of the included papers did no use or did not sufficiently report the use of appropriate standard methods. This may lead to research waste, a delay in successful implementation of valuable innovations and in the end may delay improvement patient outcomes.
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Affiliation(s)
- C van Lieshout
- Department of Epidemiology and Health Economics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
- The Healthcare Innovation Center (THINC), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - G W J Frederix
- Department of Epidemiology and Health Economics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- The Healthcare Innovation Center (THINC), Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - L Schoonhoven
- Department of General Practice and Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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van Dongen LJC, Leino-Kilpi H, Jónsdóttir H, Meyer G, Henriques MA, Schoonhoven L, Suhonen R, Hafsteinsdóttir TB. The experiences of doctorally prepared nurses and doctoral nursing students with being mentored in the Nurse-Lead programme: A focus group study. Nurse Educ Pract 2023; 71:103744. [PMID: 37591035 DOI: 10.1016/j.nepr.2023.103744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/19/2023] [Accepted: 08/09/2023] [Indexed: 08/19/2023]
Abstract
AIM to explore experiences of being mentored and the contribution of the mentoring to leadership and professional development of doctorally prepared nurses and doctoral nursing students participating in the Nurse-Lead programme. BACKGROUND Mentoring is considered important for career development of academic nurses. Doctorally prepared nurses need a wide range of professional competences to develop sustainable careers. Therefore, they may benefit from a larger network of mentors, outside their own organization, to support their professional development. Therefore, a web-based leadership and mentoring programme was developed - the Nurse Lead programme. DESIGN A descriptive study with semi-structured focus groups. METHOD Three focus groups were conducted during an on-site programme meeting in 2019 with twenty-one doctorally prepared nurses and doctoral nursing students. The interview guide included questions about mentoring relationships and meaning of mentoring for leadership and professional development. The interviews were thematically analysed. RESULTS Five themes were identified: "Preferred characteristics of mentors", "Developing trusting relationships", "Engagement of the mentors", "Becoming a proficient researcher and team leader" and "Becoming an empowered and confident professional". CONCLUSION Mentoring supported the leadership and professional development of doctorally prepared nurses and doctoral nursing students. Participants were engaged in rewarding mentoring trajectories. The results indicate that a similar approach could be followed when developing mentoring programmes in the future.
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Affiliation(s)
- L J C van Dongen
- Department of Nursing Science, University of Turku, Finland; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; CWZ Academe, Canisius Wilhelmina Ziekenhuis, the Netherlands.
| | - H Leino-Kilpi
- Department of Nursing Science, University of Turku, Finland; Turku University Hospital, Finland
| | - H Jónsdóttir
- Faculty of Nursing and Midwifery, University of Iceland, Reykjavík, Iceland; Landspítali University Hospital, Reykjavík, Iceland
| | - G Meyer
- Institute for Health and Nursing Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - M A Henriques
- Nursing Research, Innovation and Development Centre of Lisbon, Nursing School of Lisbon, Lisbon, Portugal; Instituto Saúde Ambiental da Faculdade de Medicina da Universidade de Lisboa, Portugal
| | - L Schoonhoven
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, UK
| | - R Suhonen
- Department of Nursing Science, University of Turku, Finland; Turku University Hospital, Finland; City of Turku Welfare Services Division, Turku, Finland
| | - T B Hafsteinsdóttir
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; University of Applied Sciences, Utrecht, the Netherlands
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Peerboom FBAL, Hafsteinsdóttir TB, Weldam SW, Schoonhoven L. Surgical nurses' responses to worry: A qualitative focus-group study in the Netherlands. Intensive Crit Care Nurs 2022; 71:103231. [PMID: 35396098 DOI: 10.1016/j.iccn.2022.103231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/27/2022] [Accepted: 02/28/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Hospital nurses observe and respond to deterioration using the 'National Early Warning Score 2'. Surgical nurses are highly engaged in the early recognition of and response to deterioration. Responses to deterioration are based on deviating vital signs, while nurses also act on subjective indicators like worry. Scientific literature and (inter)national guidelines do not mention any information about acting upon worry. OBJECTIVE To gain an in-depth understanding of the actions nurses on surgical wards undertake to generate an appropriate response to nurses' worry when the 'National Early Warning Score 2' does not indicate deterioration. METHOD A qualitative focus-group study with surgical nurses working at a hospital in the Netherlands. Data was collected by focus-group interviews supported by vignettes and analysed thematically. FINDINGS Four focus-group interviews with a total of 20 participants were conducted between February and April 2020. Two sequential themes emerged: 'Searching for explanation and confirmation' and 'Responding by actively applying nursing interventions'. Nurses gathered additional information about the patient and searched for a reference point to place this information in perspective. Nurses also approached others for co-assessment and verification. However, nurses faced barriers in calling for medical assistance. They felt physicians did not take them seriously. After gathering additional information, nurses responded by applying nursing interventions to comfort the patient. CONCLUSION Nurses mainly try to formalise an in-depth understanding of their feeling of worry to convince a physician to accurately treat the patient. Spending much time on a search to this understanding leads to delays in escalating care.
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Affiliation(s)
- F B A L Peerboom
- Nursing Sciences, Program in Clinical Health Sciences, University of Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508GA Utrecht, The Netherlands; Zuyderland Medical Center, Department of Surgery, 6419PC Heerlen, The Netherlands.
| | - T B Hafsteinsdóttir
- Nursing Sciences, Program in Clinical Health Sciences, University of Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508GA Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, STR 6.131, P.O. Box 85500, 3508GA Utrecht, The Netherlands.
| | - S W Weldam
- Nursing Sciences, Program in Clinical Health Sciences, University of Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508GA Utrecht, The Netherlands; University Medical Center Utrecht, Division Heart and Lungs. P.O. Box 85500, 3508GA Utrecht, The Netherlands.
| | - L Schoonhoven
- Nursing Sciences, Program in Clinical Health Sciences, University of Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508GA Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, STR 6.131, P.O. Box 85500, 3508GA Utrecht, The Netherlands; School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, UK.
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Leenen JPL, Dijkman EM, van Hout A, Kalkman CJ, Schoonhoven L, Patijn GA. Nurses' experiences with continuous vital sign monitoring on the general surgical ward: a qualitative study based on the Behaviour Change Wheel. BMC Nurs 2022; 21:60. [PMID: 35287678 PMCID: PMC8919550 DOI: 10.1186/s12912-022-00837-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 03/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background To support early recognition of clinical deterioration on a general ward continuous vital signs monitoring (CMVS) systems using wearable devices are increasingly being investigated. Although nurses play a crucial role in successful implementation, reported nurse adoption and acceptance scores vary significantly. In-depth insight into the perspectives of nurses regarding CMVS is lacking. To this end, we applied a theoretical approach for behaviour change derived from the Behaviour Change Wheel (BCW). Aim To provide insight in the capability, opportunity and motivation of nurses working with CMVS, in order to inform future implementation efforts. Methods A qualitative study was conducted, including twelve nurses of a surgical ward in a tertiary teaching hospital with previous experience of working with CMVS. Semi-structured interviews were audiotaped, transcribed verbatim, and analysed using thematic analysis. The results were mapped onto the Capability, Opportunity, Motivation – Behaviour (COM-B) model of the BCW. Results Five key themes emerged. The theme ‘Learning and coaching on the job’ linked to Capability. Nurses favoured learning about CVSM by dealing with it in daily practice. Receiving bedside guidance and coaching was perceived as important. The theme ‘interpretation of vital sign trends’ also linked to Capability. Nurses mentioned the novelty of monitoring vital sign trends of patients on wards. The theme ‘Management of alarms’ linked to Opportunity. Nurses perceived the (false) alarms generated by the system as excessive resulting in feelings of irritation and uncertainty. The theme ‘Integration and compatibility with clinical workflow’ linked to Opportunity. CVSM was experienced as helpful and easy to use, although integration in mobile devices and the EMR was highly favoured and the management of clinical workflows would need improvement. The theme ‘Added value for nursing care’ linked to Motivation. All nurses recognized the potential added value of CVSM for postoperative care. Conclusion Our findings suggest all parts of the COM-B model should be considered when implementing CVSM on general wards. When the themes in Capability and Opportunity are not properly addressed by selecting interventions and policy categories, this may negatively influence the Motivation and may compromise successful implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00837-x.
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Affiliation(s)
- J P L Leenen
- Department of Surgery, Isala, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands. .,Connected Care Centre, Isala, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands.
| | - E M Dijkman
- Department of Surgery, Isala, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands
| | - A van Hout
- Research Group IT Innovations in Health Care, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands
| | - C J Kalkman
- Department of Anaesthesiology, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - L Schoonhoven
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, University Rd, Southampton, SO17 1BJ, UK
| | - G A Patijn
- Department of Surgery, Isala, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands.,Connected Care Centre, Isala, Dr. van Heesweg 2, 8025 AB, Zwolle, The Netherlands
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Wolbers I, Lalleman PCB, Schoonhoven L, Bleijenberg N. The Ambassador Project: Evaluating a Five-Year Nationwide Leadership Program to Bridge the gap Between Policy and District Nursing Practice. Policy Polit Nurs Pract 2021; 22:259-270. [PMID: 34693816 DOI: 10.1177/15271544211050917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
District nurses have a crucial position in healthcare provision and are expected to use leadership practices to ensure optimal quality patient care. To better equip them, a leadership program named the ambassador project was developed to support the development of a liaison role between policy and district nursing practice. This research aims to evaluate from different perspectives the impact of this nationwide, five-year leadership program for district nurses at the organizational, regional, and societal levels. A mixed-methods study was conducted using two focus groups based on peer-to-peer shadowing (n = 14), semistructured interviews (n = 13), and an online questionnaire (n = 45). The analysis shows that the impact of a nationwide leadership program for district nurses was perceived as predominantly positive, and nurses experienced an increase in courage, assertiveness, professional pride, and leadership skills. They obtained confidence in representing the group of district nurses at the organizational, regional, and societal levels when speaking with various key stakeholders from the healthcare system. They were able to bridge the gaps among daily practice, policymaking, and politics by using translations and shaping actions and information into terms suiting the needs of those involved.
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Affiliation(s)
- I Wolbers
- 8119University of Applied Sciences Utrecht, Utrecht, The Netherlands. Heidelberglaan 7, 3584 CS Utrecht, The Netherlands. + 31 618648355.
| | - P C B Lalleman
- Professor, 3170Fontys University of Applied Sciences, Eindhoven, The Netherlands. Rachelsmolen 1, 5612 MA Eindhoven, The Netherlands. + 31 610512726.
| | - L Schoonhoven
- Professor of Nursing Science, 168086Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. Universiteitsweg 100, 3584 CG Utrecht, The Netherlands.
| | - N Bleijenberg
- Professor of Nursing Science, 168086Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. Universiteitsweg 100, 3584 CG Utrecht, The Netherlands.
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Meulendijks AM, Welbie M, Tjin EPM, Schoonhoven L, Neumann HAM. A qualitative study on the patient's narrative in the progression of chronic venous disease into a first venous leg ulcer: a series of events. Br J Dermatol 2019; 183:332-339. [PMID: 31677155 DOI: 10.1111/bjd.18640] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND A venous leg ulcer (VLU) has a significant negative impact on quality of life. Prevention of a VLU is not yet imbedded in clinical practice because risk factors for developing a first VLU are not well known. OBJECTIVES To explore further the progression of chronic venous disease (CVD) into a first VLU from the patient's perspective. METHODS A qualitative study using semistructured interviews was conducted among male and female patients with a VLU. Patients from primary and secondary care, under and over 50 years of age, and with first and recurrent VLUs were included. The interviews were transcribed and analysed using a narrative approach to a thematic analysis. Transcripts were organized in chronological order and an iterative process was used to code the transcripts. RESULTS Four key themes and the connections made between them emerged from the 11 narratives on the progression of CVD towards a first VLU: 'comorbidity', 'mobility', 'work and lifestyle' and 'acknowledgment of CVD'. Comorbidity was linked to reduced mobility and late acknowledgment of CVD. Comorbidity also affected work and lifestyle and vice versa. Work and lifestyle affected mobility and was linked to the acknowledgment of CVD. CONCLUSIONS A reduction in mobility as a result of comorbidity and work and lifestyle occurred before the VLU developed. Patients did not recognize symptoms of CVD and did not acknowledge the chronicity of CVD. Healthcare professionals should be aware of reductions in mobility and the knowledge deficit in patients with CVD. What's already known about this topic? Not all patients with chronic venous disease (CVD) develop a venous leg ulcer (VLU). A patient's quality of life decreases significantly when a VLU develops. Risk factors for the development of a first VLU in patients with CVD are not well known, unlike risk factors for other chronic wounds like diabetic foot ulcer and pressure ulcers. What does this study add? The patient's narrative towards the development of a first VLU, a series of events. Insight into the events (comorbidity, mobility, work and lifestyle) that patients themselves link to the development of a VLU. Insight into the patients' acknowledgment of CVD in the progression of CVD towards a first VLU. What are the clinical implications of this work? More awareness is needed of CVD symptoms among patients and healthcare providers, as well as more awareness for prevention of a VLU in clinical practice. New insights (for further studies) are needed into the concept of mobility and the development of a VLU. Improved patient education and follow-up are needed for patients with CVD.
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Affiliation(s)
- A M Meulendijks
- University of Applied Sciences Utrecht, Research Group Healthy and Sustainable Living, Utrecht, the Netherlands.,Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - M Welbie
- University of Applied Sciences Utrecht, Research Group Healthy and Sustainable Living, Utrecht, the Netherlands
| | - E P M Tjin
- University of Applied Sciences Utrecht, Research Group Healthy and Sustainable Living, Utrecht, the Netherlands
| | - L Schoonhoven
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - H A M Neumann
- Department of Dermatology, Erasmus University Medical Centre Rotterdam, Rotterdam, the Netherlands
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van den Heuvel SCGH, Goossens PJJ, Terlouw C, Schoonhoven L, van Achterberg T. Self-Management Education for Bipolar Disorders: A Hermeneutic-Phenomenological Study on the Tacit Knowledge of Mental Health Nurses. Issues Ment Health Nurs 2019; 40:942-950. [PMID: 31381457 DOI: 10.1080/01612840.2019.1636166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Self-management of bipolar disorder (BD) education is a complex nursing intervention in which patients and informal caregivers are taught to be actively involved in self-monitoring and self-regulating activities. Some studies question if nurses are sufficiently equipped to deliver these educational tasks. Other studies suggest that nurses have gathered their knowledge implicitly by experience, but to date, this tacit knowledge is not described from the experiences of mental health nurses (MHNs) in ambulant BD care. Objective: To detect the tacit knowledge used by MHNs by interpreting their experiences in delivering self-management education to people with BD and their informal caregivers. Methods: A phenomenological-hermeneutical study amongst MHNs (N = 9) from three ambulant BD care clinics in the Netherlands. Face-to-face, open, in-depth interviews guided by a topic list, were conducted and transcribed verbatim prior to the hermeneutical analysis. Findings: We found five categories resembling the complex character of self-management interventions provided by MHNs: Building a trustful collaboration, Starting a dialogue about needs and responsibilities, Explaining BD, Utilizing mood monitoring instruments, and Conceptualizing self-management of BD. Conclusion: Eventually MHNs use tacit knowledge to cope with situations that demand an outside-the-box approach. Self-management education is partially trained and partially mastered through experience. Practice implications: In order to facilitate long-term self-management of BD, the collaboration of a supporting network is essential.
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Affiliation(s)
- S C G H van den Heuvel
- Expertise Centre for Health, Social Care and Technology, Saxion University of Applied Sciences , Deventer , The Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare , Nijmegen , The Netherlands.,Dimence Group, Center for Mental Health Care, SCBS Bipolar Disorders , Deventer , The Netherlands.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven , Leuven , Belgium
| | - P J J Goossens
- Dimence Group, Center for Mental Health Care, SCBS Bipolar Disorders , Deventer , The Netherlands.,Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University Centre for Nursing and Midwifery, Ghent University , Ghent , Belgium
| | - C Terlouw
- Expertise Centre for Educational Innovations, Saxion University of Applied Sciences , Deventer , the Netherlands
| | - L Schoonhoven
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University , Utrecht , the Netherlands.,School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton , Southampton , UK
| | - T van Achterberg
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare , Nijmegen , The Netherlands.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven , Leuven , Belgium
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Meulendijks AM, Franssen WMA, Schoonhoven L, Neumann HAM. A scoping review on Chronic Venous Disease and the development of a Venous Leg Ulcer: The role of obesity and mobility. J Tissue Viability 2019; 29:190-196. [PMID: 31668667 DOI: 10.1016/j.jtv.2019.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/02/2019] [Accepted: 10/07/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The risk factors obesity and reduced mobility are not well known in the development of a Venous Leg Ulcer (VLU). The aim of this scoping review is to explore the mechanisms by which obesity and reduced mobility contribute the development of a VLU in patients with Chronic Venous Disease (CVD). METHODS For this scoping review a search was performed in May 2019 in the Cochrane Library and Pubmed to identify studies on the working mechanisms of obesity and mobility in developing a VLU. Hand searches were performed to find additional studies explaining the working mechanisms (indirectly related to the VLU). Two reviewers independently reviewed the abstracts and full-text articles. RESULTS Twenty-eight studies met our eligibility criteria. Disturbed range of ankle motion and gait can lead to a reduced Calf Muscle Pump (CMP) function which leading to a venous outflow disorder. Increased abdominal pressure due to obesity can lead to a venous outflow obstruction and increased adipose tissue mass results in an increase in adipokine secretion. The venous outflow disorder, outflow obstruction and increased adipokine secretion can all lead to chronic systemic inflammation, increased endothelial permeability and hence microcirculatory dysfunction. This alone can result in a VLU. CONCLUSION Obesity and reduced mobility can lead to a reduction of the CMP function, an increase in abdominal pressure and an increase in adipose tissue mass. This can simultaneously lead to haemodynamic changes in the macro- and microcirculation of the lower extremities and eventually in a VLU. In patients with obesity and reduced mobility the microcirculation alone can lead to skin changes and eventually a VLU. Therefore, early recognition of CVD symptoms in patients with obesity and reduced mobility is crucial to diagnose and treat CVD to prevent a VLU.
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Affiliation(s)
- A M Meulendijks
- University of Applied Sciences Utrecht, Research Group Healthy and Sustainable Living, Utrecht, the Netherlands; University Medical Centre Utrecht, Department Julius Centre for Health Sciences and Primary Care, Nursing Studies, Utrecht, the Netherlands.
| | - W M A Franssen
- University of Hasselt, REVAL, Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - L Schoonhoven
- University Medical Centre Utrecht, Department Julius Centre for Health Sciences and Primary Care, Nursing Studies, Utrecht, the Netherlands
| | - H A M Neumann
- Erasmus University Medical Centre Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
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Beeckman D, Van den Bussche K, Alves P, Arnold Long M, Beele H, Ciprandi G, Coyer F, de Groot T, De Meyer D, Deschepper E, Dunk A, Fourie A, García-Molina P, Gray M, Iblasi A, Jelnes R, Johansen E, Karadağ A, Leblanc K, Kis Dadara Z, Meaume S, Pokorna A, Romanelli M, Ruppert S, Schoonhoven L, Smet S, Smith C, Steininger A, Stockmayr M, Van Damme N, Voegeli D, Van Hecke A, Verhaeghe S, Woo K, Kottner J. Towards an international language for incontinence-associated dermatitis (IAD): design and evaluation of psychometric properties of the Ghent Global IAD Categorization Tool (GLOBIAD) in 30 countries. Br J Dermatol 2018. [DOI: 10.1111/bjd.16754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Beeckman D, Van den Bussche K, Alves P, Arnold Long M, Beelev H, Ciprandi G, Coyer F, de Groot T, De Meyer D, Deschepper E, Dunk A, Fourie A, García-Molina P, Gray M, Iblasi A, Jelnes R, Johansen E, Karadag A, Leblanc K, Kis Dadara Z, Meaume S, Pokorna A, Romanelli M, Ruppert S, Schoonhoven L, Smet S, Smith C, Steininger A, Stockmayr M, Van Damme N, Voegeli D, Van Hecke A, Verhaeghe S, Woo K, Kottner J. 建立失禁相关性皮炎(IAD)相关国际通用术语:在30个国家/地区进行根特全球(IAD)分类工具(GLOBIAD)心理测量特性的设计和评估. Br J Dermatol 2018. [DOI: 10.1111/bjd.16766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Beeckman D, Van den Bussche K, Alves P, Arnold Long MC, Beele H, Ciprandi G, Coyer F, de Groot T, De Meyer D, Deschepper E, Dunk AM, Fourie A, García-Molina P, Gray M, Iblasi A, Jelnes R, Johansen E, Karadağ A, Leblanc K, Kis Dadara Z, Meaume S, Pokorna A, Romanelli M, Ruppert S, Schoonhoven L, Smet S, Smith C, Steininger A, Stockmayr M, Van Damme N, Voegeli D, Van Hecke A, Verhaeghe S, Woo K, Kottner J. Towards an international language for incontinence-associated dermatitis (IAD): design and evaluation of psychometric properties of the Ghent Global IAD Categorization Tool (GLOBIAD) in 30 countries. Br J Dermatol 2018; 178:1331-1340. [PMID: 29315488 DOI: 10.1111/bjd.16327] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Incontinence-associated dermatitis (IAD) is a specific type of irritant contact dermatitis with different severity levels. An internationally accepted instrument to assess the severity of IAD in adults, with established diagnostic accuracy, agreement and reliability, is needed to support clinical practice and research. OBJECTIVES To design the Ghent Global IAD Categorization Tool (GLOBIAD) and evaluate its psychometric properties. METHODS The design was based on expert consultation using a three-round Delphi procedure with 34 experts from 13 countries. The instrument was tested using IAD photographs, which reflected different severity levels, in a sample of 823 healthcare professionals from 30 countries. Measures for diagnostic accuracy (sensitivity and specificity), agreement, interrater reliability (multirater Fleiss kappa) and intrarater reliability (Cohen's kappa) were assessed. RESULTS The GLOBIAD consists of two categories based on the presence of persistent redness (category 1) and skin loss (category 2), both of which are subdivided based on the presence of clinical signs of infection. The agreement for differentiating between category 1 and category 2 was 0·86 [95% confidence interval (CI) 0·86-0·87], with a sensitivity of 90% and a specificity of 84%. The overall agreement was 0·55 (95% CI 0·55-0·56). The Fleiss kappa for differentiating between category 1 and category 2 was 0·65 (95% CI 0·65-0·65). The overall Fleiss kappa was 0·41 (95% CI 0·41-0·41). The Cohen's kappa for differentiating between category 1 and category 2 was 0·76 (95% CI 0·75-0·77). The overall Cohen's kappa was 0·61 (95% CI 0·59-0·62). CONCLUSIONS The development of the GLOBIAD is a major step towards a better systematic assessment of IAD in clinical practice and research worldwide. However, further validation is needed.
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Affiliation(s)
- D Beeckman
- University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.,School of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K Van den Bussche
- University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium
| | - P Alves
- Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Catholic University of Portugal, Oporto, Portugal
| | - M C Arnold Long
- Department of Nursing, Roper Hospital, Charleston, SC, U.S.A
| | - H Beele
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - G Ciprandi
- Department of Pediatric Surgery, Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy
| | - F Coyer
- Intensive Care Services, Royal Brisbane and Women's Hospital and School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - T de Groot
- Wond Expertise Centrum, Lange Land Ziekenhuis, Zoetermeer, the Netherlands
| | - D De Meyer
- University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium
| | - E Deschepper
- University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium
| | - A M Dunk
- Tissue Viability Unit, Canberra Hospital, ACT Health, Canberra, Australia
| | - A Fourie
- Scientific Affairs & Education Manager, 3M (Critical and Chronic Care Solutions), Johannesburg, South Africa
| | - P García-Molina
- Department of Nursing, University of Valencia, Valencia, Spain
| | - M Gray
- Department of Urology, University of Virginia, Charlottesville, VA, U.S.A
| | - A Iblasi
- Wound Care, King Saud Medical City (KSMC), Riyadh, Saudi Arabia
| | - R Jelnes
- Wound Clinic, Sygehus Sonderjylland, Sonderborg, Denmark
| | - E Johansen
- University College of Southeast Norway, Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, Drammen, Norway
| | - A Karadağ
- School of Nursing, Koc University, Istanbul, Turkey
| | - K Leblanc
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Z Kis Dadara
- Development of Care, Barmherzige Brüder Austria, Vienna, Austria
| | - S Meaume
- Geriatric and Wound Healing Department, APHP, Hôpital Rothschild, Paris, France
| | - A Pokorna
- Department of Nursing, Masaryk University, Faculty of Medicine, Brno, Czech Republic
| | - M Romanelli
- Department of Dermatology, University of Pisa, Pisa, Italy
| | - S Ruppert
- Department of Medicine II, Vienna General Hospital, Vienna, Austria
| | - L Schoonhoven
- Faculty of Health Sciences, University of Southampton, Southampton, U.K.,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC Wessex), University of Southampton, Southampton, U.K.,Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands
| | - S Smet
- Wound Care Center, Ghent University Hospital, Ghent, Belgium
| | - C Smith
- Wound Ostomy Clinic, Marion General Hospital, Marion, IN, U.S.A
| | - A Steininger
- Private Universität für Medizinische Informatik und Technik (UMIT) und Pflegeakademie der Barmherzigen Brüder Wien Pflegewissenschaft und Gerontologie, Vienna, Austria
| | - M Stockmayr
- Department of Surgery, Vienna General Hospital, Vienna, Austria
| | - N Van Damme
- University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium
| | - D Voegeli
- Faculty of Health Sciences, University of Southampton, Southampton, U.K
| | - A Van Hecke
- University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium
| | - S Verhaeghe
- University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium
| | - K Woo
- Department of Nursing, Queen's University, Kingston, Canada
| | - J Kottner
- University Centre for Nursing and Midwifery, Department of Public Health, Ghent University, Ghent, Belgium.,Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universtitätsmedizin Berlin, Berlin, Germany
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Clarkson P, Bader D, Schoonhoven L, Worsley P. A multidisciplinary approach to pressure ulcer prevention: exploring healthcare professionals’ knowledge and attitudes to pressure ulcer prevention in the community. Physiotherapy 2016. [DOI: 10.1016/j.physio.2016.10.322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Hazelhof T, Schoonhoven L, van Gaal B, Koopmans R, Gerritsen D. Nursing staff stress from challenging behaviour of residents with dementia: a concept analysis. Int Nurs Rev 2016; 63:507-16. [DOI: 10.1111/inr.12293] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2016] [Indexed: 11/29/2022]
Affiliation(s)
- T.J.G.M. Hazelhof
- Vitalis WoonZorggroep Eindhoven; Eindhoven the Netherlands
- Department of Primary and Community Care; Radboud University Medical Center; Radboud Alzheimer Centre; Nijmegen the Netherlands
| | - L. Schoonhoven
- Radboud University Medical Center; Radboud Institute for Health Sciences; Scientific Institute for Quality of Healthcare (IQ Healthcare); Nijmegen the Netherlands
- Faculty of Health Sciences; University of Southampton; Southampton UK
| | - B.G.I. van Gaal
- Radboud University Medical Center; Radboud Institute for Health Sciences; Scientific Institute for Quality of Healthcare (IQ Healthcare); Nijmegen the Netherlands
| | - R.T.C.M. Koopmans
- Department of Primary and Community Care; Radboud University Medical Center; Radboud Alzheimer Centre; Nijmegen the Netherlands
- Joachim en Anna; Centre for Specialized Geriatric Care; Nijmegen the Netherlands
| | - D.L. Gerritsen
- Department of Primary and Community Care; Radboud University Medical Center; Radboud Alzheimer Centre; Nijmegen the Netherlands
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de Wert L, Schoonhoven L, Stegen J, Piatkowski A, Hulst RVD, Poeze M, Bouvy N. Improving the effect of shear on skin viability with wound dressings. J Mech Behav Biomed Mater 2016; 60:505-514. [DOI: 10.1016/j.jmbbm.2016.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 03/02/2016] [Accepted: 03/09/2016] [Indexed: 11/30/2022]
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Ham HW, Schoonhoven L, Schuurmans MJ, Leenen LPH. [Pressure ulcers in trauma patients with suspected spine injury: a prospective cohort study with emphasis on device-related pressure ulcers]. Ned Tijdschr Geneeskd 2016; 160:D371. [PMID: 27334090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Of all patients in a hospital environment, trauma patients may be particularly at risk for developing (device-related) pressure ulcers (PUs), because of their traumatic injuries, immobility, and exposure to immobilizing and medical devices. Studies on device-related PUs are scarce. With this study, the incidence and characteristics of PUs and the proportion of PUs that are related to devices in adult trauma patients with suspected spinal injury were described. From January-December 2013, 254 trauma patients were visited every 2 days for skin assessment. The overall incidence of PUs was 28·3% (n = 72/254 patients). The incidence of device-related PUs was 20.1% (n = 51), and 13% (n = 33) developed solely device-related PUs. We observed 145 PUs in total of which 60·7% were related to devices (88/145). Device-related PUs were detected 16 different locations on the front and back of the body. These results show that the incidence of PUs and the proportion of device-related PUs is very high in trauma patients.
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Affiliation(s)
- H W Ham
- *Dit onderzoek werd eerder gepubliceerd in International Wound Journal (2016; epub 14 januari) met als titel 'Pressure ulcers in trauma patients with suspected spine injury: a prospective cohort study with emphasis on device-related pressure ulcers'. Afgedrukt met toestemming
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Van den Heuvel SCGH, Goossens PJJ, Terlouw C, Van Achterberg T, Schoonhoven L. Identifying and describing patients' learning experiences towards self-management of bipolar disorders: a phenomenological study. J Psychiatr Ment Health Nurs 2015; 22:801-10. [PMID: 26172454 DOI: 10.1111/jpm.12243] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/26/2022]
Abstract
ACCESSIBLE SUMMARY Existing evidence suggest that patient education in promoting self-management strategies of bipolar disorder (BD) is effective. However, results across the full range of service users with BD vary. Learning experiences of service users look to be a crucial factor to take into account when designing, delivering, and evaluating effective interventions that promote self-management in chronic illness. What learning activities service users actually undertake themselves when self-managing BD that might explain varying success rates, and guide future self-management educational programmes has not been examined. Unlike previous studies that suggest that outcomes in self-management depend on individual learning activities, the current study found that learning to self-manage BD takes place in a social network that functions as a learning environment in which it is saved for service users to make mistakes and to learn from these mistakes. Especially, coping with the dormant fear of a recurrent episode and acknowledging the limitations of an individual approach are important factors that facilitate this learning process. Practitioners who provide patient education in order to promote self-management of BD should tailor future interventions that facilitate learning by reflecting on the own experiences of service users. Community psychiatric nurses should keep an open discussion with service users and caregivers, facilitate the use of a network, and re-label problems into learning situations where both play an active role in building mutual trust, thereby enhancing self-management of BD. ABSTRACT Existing evidence suggest that self-management education of bipolar disorder (BD) is effective. However, why outcomes differ across the full range of service users has not been examined. This study describes learning experiences of service users in self-managing BD that provide a possible explanation for this varying effectiveness. We have conducted a phenomenological study via face-to-face, in-depth interviews, guided by a topic list, along service users with BD I or II (n = 16) in three specialised community care clinics across the Netherlands. Interviews were digitally recorded and transcribed verbatim prior to analysis in Atlas.ti 7. Unlike existing studies, which suggest that individual abilities of service users determine outcomes in self-management of BD, the current study found that self-management of BD is a learning process that takes place in a collaborative network. We identified five categories: acknowledgment of having BD, processing the information load, illness management, reflecting on living with BD, and self-management of BD. The success of self-management depends on the acknowledgment of individual limitations in learning to cope with BD and willingness to use a social network as a back-up instead. Especially, the dormant fear of a recurrent episode is a hampering factor in this learning process.
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Affiliation(s)
- S C G H Van den Heuvel
- Saxion University of Applied Sciences, Expertise Centre for Health, Social Care and Technology, Deventer, The Netherlands.,Radboud university medical center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,Dimence Group, Center for Mental Health Care, SCBS Bipolar Disorders, Deventer, The Netherlands.,KU Leuven, Centre for Health Services and Nursing Research, Leuven, Belgium
| | - P J J Goossens
- Radboud university medical center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,Dimence, SCBS Bipolar Disorders, Institute for Mental Healthcare, Deventer, The Netherlands.,GGZ-VS, Institute for the Education of Clinical Nurse Specialists in Mental Health, Utrecht, The Netherlands.,University Centre of Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Services, Ghent University, Ghent, Belgium
| | - C Terlouw
- Saxion University of Applied Sciences, Expertise Centre for Educational Innovations, Enschede, The Netherlands
| | - T Van Achterberg
- Radboud university medical center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,KU Leuven, Centre for Health Services and Nursing Research, Leuven, Belgium
| | - L Schoonhoven
- Radboud university medical center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,Faculty of Health Sciences, University of Southampton, Southampton, UK
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Wassenaar A, van den Boogaard M, Rood P, Schoonhoven L, Pickkers P. Development of a multicomponent intervention program to prevent delirium in intensive care unit patients. Intensive Care Med Exp 2015. [PMCID: PMC4798381 DOI: 10.1186/2197-425x-3-s1-a714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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van den Boogaard M, Schoonhoven L, Maseda E, Plowright C, Jones C, Luetz A, Sackey PV, Jorens PG, Aitken LM, van Haren FMP, Donders R, van der Hoeven JG, Pickkers P. Recalibration of the delirium prediction model for ICU patients (PRE-DELIRIC): a multinational observational study. Intensive Care Med 2014; 40:361-9. [DOI: 10.1007/s00134-013-3202-7] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 12/18/2013] [Indexed: 01/11/2023]
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19
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Huis A, Hulscher M, Adang E, Grol R, van Achterberg T, Schoonhoven L. P131: Cost-effectiveness of a team and leaders-directed strategy to improve nurses’ adherence to hand hygiene. Antimicrob Resist Infect Control 2013. [PMCID: PMC3687948 DOI: 10.1186/2047-2994-2-s1-p131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Dijkstra BM, Berben SAA, van Dongen RTM, Schoonhoven L. Review on pharmacological pain management in trauma patients in (pre-hospital) emergency medicine in the Netherlands. Eur J Pain 2013; 18:3-19. [PMID: 23737462 DOI: 10.1002/j.1532-2149.2013.00337.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2013] [Indexed: 12/26/2022]
Abstract
Pain is one of the main complaints of trauma patients in (pre-hospital) emergency medicine. Significant deficiencies in pain management in emergency medicine have been identified. No evidence-based protocols or guidelines have been developed so far, addressing effectiveness and safety issues, taking the specific circumstances of pain management of trauma patients in the chain of emergency care into account. The aim of this systematic review was to identify effective and safe initial pharmacological pain interventions, available in the Netherlands, for trauma patients with acute pain in the chain of emergency care. Up to December 2011, a systematic search strategy was performed with MeSH terms and free text words, using the bibliographic databases CINAHL, PubMed and Embase. Methodological quality of the articles was assessed using standardized evaluation forms. Of a total of 2328 studies, 25 relevant studies were identified. Paracetamol (both orally and intravenously) and intravenous opioids (morphine and fentanyl) proved to be effective. Non-steroidal anti-inflammatory drugs (NSAIDs) showed mixed results and are not recommended for use in pre-hospital ambulance or (helicopter) emergency medical services [(H)EMS]. These results could be used for the development of recommendations on evidence-based pharmacological pain management and an algorithm to support the provision of adequate (pre-hospital) pain management. Future studies should address analgesic effectiveness and safety of various drugs in (pre-hospital) emergency care. Furthermore, potential innovative routes of administration (e.g., intranasal opioids in adults) need further exploration.
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Affiliation(s)
- B M Dijkstra
- Department of Critical Care, Radboud University Nijmegen Medical Centre, The Netherlands; HAN University of Applied Sciences, Nijmegen, The Netherlands
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Weening-Verbree L, Huisman-de Waal G, van Dusseldorp L, van Achterberg T, Schoonhoven L. Oral health care in older people in long term care facilities: a systematic review of implementation strategies. Int J Nurs Stud 2013; 50:569-82. [PMID: 23290098 DOI: 10.1016/j.ijnurstu.2012.12.004] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 12/04/2012] [Accepted: 12/06/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Oral hygiene is necessary to maintain oral health and quality of life. However, the oral hygiene and the oral health care of older people in long term care facilities are poor. This indicates that care is not in compliance with the available guidelines and protocols, and stresses the importance of a clear evidence-based implementation strategy to improve oral health care. The aim of this study is to review implementation strategies used to promote or improve oral health care for older people in long term care facilities from the perspective of behaviour change, to code strategy content at the level of determinants, and to explore their effectiveness. DESIGN Systematic review of literature. DATA SOURCES The digital databases of the Cochrane Library, PubMed and Cinahl have been searched up to September 2011 for relevant articles. REVIEW METHODS After a systematic selection process, included studies were quality assessed by three researchers. We extracted the study characteristics using the EPOC Data Collection Checklist and Data Abstraction Form. Strategy content was extracted and coded by using the Coding Manual for Behavioural Change Techniques. This manual groups the behaviour change techniques under relevant behavioural determinants. RESULTS Twenty studies were included in this review. Implementation strategies were delivered by dental hygienists or dentists. Oral health care was performed by nurses and nurse assistants in all studies. All studies addressed knowledge, mostly operationalized as one educational session. Knowledge was most often combined with interventions addressing self efficacy. Implementation strategies aimed at knowledge (providing general information), self-efficacy (modelling) or facilitation of behaviour (providing materials to facilitate behaviour) were most often identified as successful in improving oral health. CONCLUSIONS Knowledge, self-efficacy and facilitation of behaviour are determinants that are often addressed in implementation strategies for successful improvement of oral health care in older patients. Strategies addressing increasing memory, feedback of clinical outcomes, and mobilizing social norm are promising and should be studied in the future. However, as the quality and heterogeneity of studies is a reason for concern, it is not possible to unequivocally recommend strategies or combinations of strategies for improving oral health care in the older population. When choosing strategies to improve oral health care, care professionals should thoroughly examine the setting and target group, identify barriers to change and tailor their implementation strategies to these barriers for oral health care.
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Affiliation(s)
- L Weening-Verbree
- University Medical Center Groningen, Centre for Dentistry and Oral Hygiene Groningen (CTM), Groningen, The Netherlands
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van den Boogaard M, Pickkers P, Slooter AJC, Kuiper MA, Spronk PE, van der Voort PHJ, van der Hoeven JG, Donders R, van Achterberg T, Schoonhoven L. Development and validation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for intensive care patients: observational multicentre study. BMJ 2012; 344:e420. [PMID: 22323509 PMCID: PMC3276486 DOI: 10.1136/bmj.e420] [Citation(s) in RCA: 241] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To develop and validate a delirium prediction model for adult intensive care patients and determine its additional value compared with prediction by caregivers. DESIGN Observational multicentre study. SETTING Five intensive care units in the Netherlands (two university hospitals and three university affiliated teaching hospitals). PARTICIPANTS 3056 intensive care patients aged 18 years or over. MAIN OUTCOME MEASURE Development of delirium (defined as at least one positive delirium screening) during patients' stay in intensive care. RESULTS The model was developed using 1613 consecutive intensive care patients in one hospital and temporally validated using 549 patients from the same hospital. For external validation, data were collected from 894 patients in four other hospitals. The prediction (PRE-DELIRIC) model contains 10 risk factors-age, APACHE-II score, admission group, coma, infection, metabolic acidosis, use of sedatives and morphine, urea concentration, and urgent admission. The model had an area under the receiver operating characteristics curve of 0.87 (95% confidence interval 0.85 to 0.89) and 0.86 after bootstrapping. Temporal validation and external validation resulted in areas under the curve of 0.89 (0.86 to 0.92) and 0.84 (0.82 to 0.87). The pooled area under the receiver operating characteristics curve (n=3056) was 0.85 (0.84 to 0.87). The area under the curve for nurses' and physicians' predictions (n=124) was significantly lower at 0.59 (0.49 to 0.70) for both. CONCLUSION The PRE-DELIRIC model for intensive care patients consists of 10 risk factors that are readily available within 24 hours after intensive care admission and has a high predictive value. Clinical prediction by nurses and physicians performed significantly worse. The model allows for early prediction of delirium and initiation of preventive measures. Trial registration Clinical trials NCT00604773 (development study) and NCT00961389 (validation study).
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Affiliation(s)
- M van den Boogaard
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, 6500HB Nijmegen, Netherlands
| | - P Pickkers
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, 6500HB Nijmegen, Netherlands
| | - A J C Slooter
- Department of Intensive Care, University Medical Centre Utrecht, Utrecht, Netherlands
| | - M A Kuiper
- Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, Netherlands
| | - P E Spronk
- Department of Intensive Care Medicine, Gelre Hospitals, Location Lukas, Apeldoorn, Netherlands
| | - P H J van der Voort
- Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - J G van der Hoeven
- Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, 6500HB Nijmegen, Netherlands
| | - R Donders
- Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Centre
| | - T van Achterberg
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre
| | - L Schoonhoven
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre
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Huis A, Schoonhoven L, Grol R, Donders R, Hulscher M, van Achterberg T. Comparing short term and sustained effects of two strategies to improve nurses’ adherence with hand hygiene prescriptions: a cluster randomised trial. BMC Proc 2011. [PMCID: PMC3239532 DOI: 10.1186/1753-6561-5-s6-p119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Van den Boogaard M, Schoonhoven L, Evers A, Van der Hoeven J, Van Achterberg TH, Pickkers P. Impact of delirium in critically ill patients on long-term health-related quality of life and cognitive functioning. Crit Care 2011. [PMCID: PMC3067012 DOI: 10.1186/cc9758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Beeckman D, Schoonhoven L, Fletcher J, Furtado K, Heyman H, Paquay L, De Bacquer D, Defloor T. Pressure ulcers and incontinence-associated dermatitis: effectiveness of the Pressure Ulcer Classification education tool on classification by nurses. BMJ Qual Saf 2010; 19:e3. [DOI: 10.1136/qshc.2008.028415] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Boogaard M, Pickkers P, Hoeven H, Donders R, Van Achterberg T, Schoonhoven L. PREDICT, Prediction of Delirium in ICU Patients: development and validation of a prediction model. Crit Care 2010. [PMCID: PMC2933976 DOI: 10.1186/cc8730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Noorda G, Hermans-Peters M, Smeitink J, van Achterberg T, Kemps H, Goverde W, Schoonhoven L. Mitochondrial disease: needs and problems of children, their parents and family. A systematic review and pilot study into the need for information of parents during the diagnostic phase. J Inherit Metab Dis 2007; 30:333-40. [PMID: 17508266 PMCID: PMC2794030 DOI: 10.1007/s10545-007-0426-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2006] [Revised: 02/06/2007] [Accepted: 02/14/2007] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Firstly, this paper aims to systematically review the mitochondrial disease literature to identify studies assessing the needs and problems in the daily life of children with a mitochondrial disease and of their parents and family. The second aim is to provide more insight into the need for information by the parents of these children during the diagnostic process while in hospital. DESIGN A systematic review and a pilot study, using a qualitative (focus group interviews; n = 7) and a quantitative (questionnaire; n = 37) design. RESULTS Mothers reported great socioeconomic and psychoaffective strain and showed psychopathological symptoms in the two studies published with respect to this topic. The pilot study showed that parents considered an honest and interested attitude of the person who is giving the information as most important. Furthermore they wanted oral and written information and a central point where they could go with their questions at any time they felt the need. The need for information increased during the four phases of the diagnostic process and was highest in the fourth phase. CONCLUSIONS The few studies found in the review, combined with expectations that having a mitochondrial disease must have a great impact on these children and their parents and family, call for more research in their needs and problems. Furthermore, there are gaps in the current information provision to parents of these children. A better understanding of the needs and problems of these children and their family is essential for effective care planning and might result in an improved quality of life.
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Affiliation(s)
- G Noorda
- University Children's Hospital, Radboud University Nijmegen Medical Centre, 432 CUKZ, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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de Laat EHEW, Schoonhoven L, Pickkers P, Verbeek ALM, van Achterberg T. Epidemiology, risk and prevention of pressure ulcers in critically ill patients: a literature review. J Wound Care 2006; 15:269-75. [PMID: 16802563 DOI: 10.12968/jowc.2006.15.6.26920] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
New nursing interventions and pressure-redistributing devices in intensive care units, and specific risk factors affecting critically ill patients, mean that different factors must be taken into consideration in preventing pressure ulcers.
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Affiliation(s)
- E H E W de Laat
- Pressure Ulcer Care, Radboud University Nijmegen Medical Centre, The Netherlands.
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Schoonhoven L, Grobbee DE, Donders ART, Algra A, Grypdonck MH, Bousema MT, Schrijvers AJP, Buskens E. Prediction of pressure ulcer development in hospitalized patients: a tool for risk assessment. Qual Saf Health Care 2006; 15:65-70. [PMID: 16456213 PMCID: PMC2563999 DOI: 10.1136/qshc.2005.015362] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2005] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To identify independent predictors for development of pressure ulcers in hospitalized patients and to develop a simple prediction rule for pressure ulcer development. DESIGN The Prevention and Pressure Ulcer Risk Score Evaluation (prePURSE) study is a prospective cohort study in which patients are followed up once a week until pressure ulcer occurrence, discharge from hospital, or length of stay over 12 weeks. Data were collected between January 1999 and June 2000. SETTING Two large hospitals in the Netherlands. PARTICIPANTS Adult patients admitted to the surgical, internal, neurological and geriatric wards for more than 5 days were eligible. A consecutive sample of 1536 patients was visited, 1431 (93%) of whom agreed to participate. Complete follow up data were available for 1229 (80%) patients. MAIN OUTCOME MEASURES Occurrence of a pressure ulcer grade 2 or worse during admission to hospital. RESULTS Independent predictors of pressure ulcers were age, weight at admission, abnormal appearance of the skin, friction and shear, and planned surgery in coming week. The area under the curve of the final prediction rule was 0.70 after bootstrapping. At a cut off score of 20, 42% of the patient weeks were identified as at risk for pressure ulcer development, thus correctly identifying 70% of the patient weeks in which a pressure ulcer occurred. CONCLUSION A simple clinical prediction rule based on five patient characteristics may help to identify patients at increased risk for pressure ulcer development and in need of preventive measures.
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Affiliation(s)
- L Schoonhoven
- Radboud Univeristy Nijmegen Medical Centre, Centre for Quality of Care Reseach, Nijmegen, The Netherlands.
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Schoonhoven L, Defloor T, Bours G, Clark M. Measuring pressure ulcer occurrence. J Tissue Viability 2005. [DOI: 10.1016/s0965-206x(05)52012-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Schoonhoven L. Prediction of pressure ulcers: problems and prospects. J Tissue Viability 2004. [DOI: 10.1016/s0965-206x(04)43014-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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