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Van Bogaert W, Huysmans E, Coppieters I, Nijs J, Putman K, Ickmans K, Moens M, Goudman L, Stas L, Buyl R. The Mediating Role of Pain Cognitions and Pain Sensitivity in the Treatment Effect of Perioperative Pain Neuroscience Education in People Undergoing Surgery for Lumbar Radiculopathy. J Pain 2024:104521. [PMID: 38575104 DOI: 10.1016/j.jpain.2024.03.017] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 03/25/2024] [Accepted: 03/31/2024] [Indexed: 04/06/2024]
Abstract
Though perioperative pain neuroscience education (PPNE) positively influences patients' surgical outcomes, little is known about the mechanisms behind this treatment's success. Therefore, this study aims to evaluate the potential mediating role of pain cognitions and pain sensitivity in the treatment effect of PPNE on postoperative quality of life in people undergoing surgery for lumbar radiculopathy. This secondary analysis uses data from 120 participants of a randomized controlled trial who were randomized to receive either PPNE or perioperative biomedical education before undergoing surgery for lumbar radiculopathy. Quality of life was assessed 1-year postsurgery using the short form 36-item health survey (SF36) physical and mental component scores. Potential mediators included pain cognitions (ie, kinesiophobia, pain catastrophizing, and hypervigilance) and pain sensitivity (ie, endogenous nociceptive modulation), assessed 6 weeks postsurgery. Mediation models were constructed using structural equation modeling, and 95% confidence intervals (CIs) were calculated using 10,000 bootstrap samples. Analyses show a significant total effect for PPNE (estimate = .464, 95% CI [.105, .825]) and a significant indirect effect via pain catastrophizing on the SF36 physical component (estimate = .124, 95% CI [.001, .293]). No mediating effect was found through the remaining pain cognitions or pain sensitivity measures. Also, no potential mediators were identified for the treatment effect of PPNE on the SF36 mental component. Our findings suggest that pain catastrophizing mediates the treatment effect of PPNE on physical health-related quality of life in people undergoing surgery for lumbar radiculopathy. PERSPECTIVE: This secondary analysis identified pain catastrophizing as a mediator for PPNE in people undergoing surgery for lumbar radiculopathy. More so, its findings indicate that this educational intervention can enhance the postoperative physical health-related quality of life of these patients by addressing their catastrophizing thoughts. TRIAL REGISTRATION: Clinicaltrials.gov (NCT02630732).
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Affiliation(s)
- Wouter Van Bogaert
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; The Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; Institute of Health and Care Sciences, University of Gothenburg Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Koen Putman
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kelly Ickmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; Movement & Nutrition for Health & Performance Research Group (MOVE), Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maarten Moens
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; STIMULUS Research Group (reSearch and TeachIng neuroModULation Uz bruSsel/VUB), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lisa Goudman
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; STIMULUS Research Group (reSearch and TeachIng neuroModULation Uz bruSsel/VUB), Vrije Universiteit Brussel, Brussels, Belgium; Center for Neurosciences, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lara Stas
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Core Facility - Support for Quantitative and Qualitative Research (SQUARE), Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
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Van Bogaert W, Coppieters I, Nijs J, Buyl R, Ickmans K, Moens M, Goudman L, Putman K, Huysmans E. Influence of Preoperative Pain, Cognitions, and Quantitative Sensory Testing Measures on the Effects of Perioperative Pain Neuroscience Education for People Receiving Surgery for Lumbar Radiculopathy: Secondary Analysis of a Randomized Controlled Trial. J Orthop Sports Phys Ther 2024; 54:1-10. [PMID: 38189683 DOI: 10.2519/jospt.2024.12051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
OBJECTIVE: To explore whether preoperative pain intensity, pain cognitions, and quantitative sensory measures influence the established effectiveness of perioperative pain neuroscience education (PPNE) on health-related quality of life at 1 year after surgery for lumbar radiculopathy. DESIGN: Secondary analysis of a triple-blinded randomized controlled trial. METHODS: Participants (n = 90) were Dutch-speaking adults (18-65 years) who were scheduled for surgery for lumbar radiculopathy in 3 Belgian hospitals. They were randomized (1:1) to receive PPNE (n = 41) or perioperative biomedical education (n = 49). Linear mixed models were built for health-related quality of life (ie, SF-6D utility values, Physical and Mental Component of the 36-item Short Form Health Survey) using the following independent variables: therapy, time, and preoperative scores for back and leg pain intensity, pain catastrophizing, kinesiophobia, hypervigilance, and quantitative sensory measures. RESULTS: The impact of PPNE on SF-6D utility values over time was influenced by kinesiophobia (F = 3.30, P = .02) and leg pain intensity (F = 3.48, P = .02). Regardless of the intervention, back pain intensity negatively influenced SF-6D values over time (F = 3.99, P = .009). The Physical Component scores were negatively impacted by back pain intensity (F = 9.08, P = .003) and were influenced over time by leg pain intensity (F = 2.87, P = .04). The Mental Component scores were negatively impacted by back pain intensity (F = 6.64, P = .01) and pain catastrophizing (F = 5.42, P = .02), as well as hypervigilance (F = 3.16, P = .03) and leg pain intensity (F = 3.12, P = .03) over time. CONCLUSION: PPNE may be more effective than perioperative biomedical education in improving postoperative health utility values in patients who reported higher kinesiophobia and leg pain intensity before surgery for lumbar radiculopathy. J Orthop Sports Phys Ther 2024;54(4):1-10. Epub 8 January 2024. doi:10.2519/jospt.2024.12051.
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Vermeulen J, Buyl R, Luyben A, Fleming V, Tency I, Fobelets M. The exploration of professional midwifery autonomy: Understanding and experiences of final-year midwifery students. Nurse Educ Today 2024; 134:106101. [PMID: 38266429 DOI: 10.1016/j.nedt.2024.106101] [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] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/01/2023] [Accepted: 01/16/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND The concept of professional midwifery autonomy holds great significance in midwifery education. Notably, clinical placements play a crucial role in introducing students to its concept. However, the understanding and experiences of students regarding midwifery autonomy are relatively unknown. OBJECTIVES This study aimed to examine the experiences and understanding of midwifery autonomy among final-year midwifery students. METHODS A qualitative exploratory study using three focus group interviews with final-year midwifery students from each of the three Belgian regions; Flanders, Walloon and the Brussels Capital Region. Focus groups were recorded, transcribed verbatim and analysed using a thematic analysis. RESULTS Upon data analysis, five key themes emerged; 1) working independently, 2) positive learning environment, 3) professional context, 4) actions and decisions of others and 5) beneficial for women. Students emphasized the importance of promoting professional midwifery autonomy through the ability to make their own professional decisions and take initiatives. They highlighted the need for a safe and supportive learning environment that encourages independent practice, nurtures self-governance and facilitates personal growth. Additionally, collaborative relationships with other maternity care professionals and increased awareness among women and the broader healthcare community were identified as essential factors in embracing and promoting professional midwifery autonomy. CONCLUSIONS Our study provides valuable insights into the significance of midwifery autonomy among final-year midwifery students. To empower midwifery students to truly understand and experience professional midwifery autonomy, educators and preceptors should adopt strategies that enhance comprehension, foster independent yet collaborative practice, establish supportive learning environments, and equip students to navigate challenges effectively, ultimately improving maternal and new-born health.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ans Luyben
- Centre for Midwifery, Maternal & Perinatal Health, Bournemouth University, Bournemouth, United Kingdom; Lindenhofgruppe, Bern, Switzerland
| | | | - Inge Tency
- Midwifery Department, Odisee University of Applied Sciences, Sint Niklaas, Belgium; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Maaike Fobelets
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium; Department of Teacher Education, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Vermeulen J, Buyl R, Fobelets M. Exploring and enhancing midwives' professional autonomy: Embarking on a journey of empowerment for midwives globally. Eur J Midwifery 2023; 7:28. [PMID: 37881404 PMCID: PMC10594748 DOI: 10.18332/ejm/172426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/14/2023] [Accepted: 09/16/2023] [Indexed: 10/27/2023] Open
Affiliation(s)
- Joeri Vermeulen
- Department of Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maaike Fobelets
- Department of Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Institute for Teacher Education, Vrije Universiteit Brussel, Brussels, Belgium
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Huysmans E, Goudman L, Coppieters I, Van Bogaert W, Moens M, Buyl R, Nijs J, Louw A, Logghe T, Putman K, Ickmans K. Effect of perioperative pain neuroscience education in people undergoing surgery for lumbar radiculopathy: a multicentre randomised controlled trial. Br J Anaesth 2023; 131:572-585. [PMID: 37344337 DOI: 10.1016/j.bja.2023.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/21/2022] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Perioperative education should be improved to decrease unfavourable outcomes after lumbar surgery. This trial aimed to compare effectiveness in terms of pain, quality of life, pain cognition, surgical experience, healthcare use, work resumption, and cost-effectiveness of perioperative pain neuroscience education (PPNE) vs traditional biomedical education (perioperative biomedical education [PBE]) in people undergoing surgery for lumbar radiculopathy. METHODS In this multicentre RCT (ClinicalTrials.gov: NCT02630732), patients undergoing surgery for lumbar radiculopathy in three Belgian hospitals were randomised to receive PPNE or PBE. Both groups received one preoperative and one postoperative one-to-one education session and a booklet (balanced interventions), with an essentially different content (PPNE: biopsychosocial; PBE: biomedical). Pain was the primary outcome (Visual Analogue Scales+quantitative sensory testing). Assessments were at 3 days, 6 weeks, and 6 and 12 months after surgery. RESULTS Between March 2016 and April 2020, participants were randomly assigned to PPNE (n=58) or PBE (n=62). At 12 months, PPNE did not lead to significantly better pain outcomes, but it did result in more favourable 36-item Short Form Health Survey physical component (additional increase: 46.94; 95% confidence interval [CI]: 14.16-79.73; medium effect), Tampa Scale of Kinesiophobia (additional decrease: 3.15; 95% CI: 0.25-6.04; small effect), and Pain Catastrophising Scale (additional decrease: 6.18; 95% CI: 1.97-10.39; medium effect) scores. Females of the PPNE group showed higher probability for work resumption (95% vs 60% in the PBE group). PPNE was cost-effective compared with PBE (incremental costs: €-2732; incremental quality-adjusted life years: 0.012). CONCLUSIONS Perioperative pain neuroscience education showed superior clinical and cost-effectiveness than perioperative biomedical education in people undergoing surgery for lumbar radiculopathy. CLINICAL TRIAL REGISTRATION NCT02630732.
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Affiliation(s)
- Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium.
| | - Lisa Goudman
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation Flanders (Fonds Wetenschappelijk Onderzoek), Brussels, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium; STIMULUS Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium; The Laboratory for Brain-Gut Studies, Translational Research Center for Gastrointestinal Disorders, Katholieke Universiteit Leuven, Heverlee, Belgium
| | - Wouter Van Bogaert
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium; Research Foundation Flanders (Fonds Wetenschappelijk Onderzoek), Brussels, Belgium; Interuniversity Centre for Health Economics Research, Department of Public Health (Gezondheidswetenschappen - GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maarten Moens
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium; STIMULUS Research Group, Vrije Universiteit Brussel, Brussels, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium; Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, University of Gothenburg Center for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Tine Logghe
- Department of Physical Medicine and Revalidation, Sint-Dimpna Ziekenhuis Geel, Geel, Belgium
| | - Koen Putman
- Interuniversity Centre for Health Economics Research, Department of Public Health (Gezondheidswetenschappen - GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kelly Ickmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Bosmans J, Buyl R. Did We Have Sex? Proposal for an eHealth Solution to Warning Sexual Contacts of an STI Risk. Stud Health Technol Inform 2023; 305:315-316. [PMID: 37387026 DOI: 10.3233/shti230492] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Partner notificationis an important part of reaching people at risk for aSTI and getting them screened. There are however several barriersreducing the effectiveness of traditional partner notification. To overcome these barriers an eHealth appis proposed which helps people trace their sexual contacts in an anonymous way and find reliable information about safety and testing. This should allow people to warn their at risk contacts more easily when they test. As this is a rather new way of tracing sexual contacts, a multi-disciplinary approach is needed to study the possibilities of this technique.
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Affiliation(s)
| | - Ronald Buyl
- BISI, Vrije Universiteit Brussel, Brussels, Belgium
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Vermeulen J, Fobelets M, Fleming V, Luyben A, Stas L, Buyl R. How Do Midwives View Their Professional Autonomy, Now and in Future? Healthcare (Basel) 2023; 11:1800. [PMID: 37372919 DOI: 10.3390/healthcare11121800] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/09/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Internationally, midwives' professional autonomy is being challenged, resulting in their inability to practice to their full scope of practice. This situation contrasts with the increasing international calls for strengthening the midwifery profession. The aim of this study therefore is to explore Belgian midwives' views on their current and future autonomy. METHODS An online survey among Belgian midwives was performed. Data were collected and analyzed using a quantitative approach, while quotes from respondents were used to contextualize the quantitative data. RESULTS Three hundred and twelve midwives from different regions and professional settings in Belgium completed the questionnaire. Eighty-five percentage of respondents believe that they are mostly or completely autonomous. Brussels' midwives feel the most autonomous, while those in Wallonia feel the least. Primary care midwives feel more autonomous than hospital-based midwives. Older midwives and primary care midwives feel less recognized and respected by other professionals in maternity care. The majority of our respondents believe that in future midwives should be able to work more autonomously in constructive collaboration with other professionals. CONCLUSION While Belgian midwives generally rated their own professional autonomy as high, a significant majority of respondents desire more autonomy in future. In addition, our respondents want to be recognized and respected by society and other health professionals in maternity care. It is recommended to prioritize efforts in enhancing midwives' autonomy, while also addressing the need for increased recognition and respect from society and other maternity care professionals.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, 1090 Brussels, Belgium
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, 1090 Brussels, Belgium
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
- Department of Teacher Education, Vrije Universiteit Brussel (VUB), 1040 Brussels, Belgium
| | - Valerie Fleming
- Faculty of Health, Liverpool John Moores University, Liverpool L3 5UX, UK
| | - Ans Luyben
- Centre for Midwifery, Maternal & Perinatal Health, Bournemouth University, Bournemouth BH1 3LH, UK
- Frauenzentrum (Centre for Women's Health), Lindenhofgruppe, 3012 Bern, Switzerland
| | - Lara Stas
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
- Support for Quantitative and Qualitative Research (SQUARE), Core Facility of the Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
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Vermeulen J, Buyl R, Luyben A, Fleming V, Fobelets M. Key Maternity Care Stakeholders' Views on Midwives' Professional Autonomy. Healthcare (Basel) 2023; 11:healthcare11091231. [PMID: 37174773 PMCID: PMC10177750 DOI: 10.3390/healthcare11091231] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Advancement towards the professionalism of midwifery is closely linked to midwives' professional autonomy. Although the perspectives of Belgian midwives on their professional autonomy have been studied, the views of other maternity care stakeholders are a blind spot. The aim of this study, therefore, was to explore maternity care stakeholders' views on Belgian midwives' professional autonomy. A qualitative exploratory study was performed using focus group interviews. A heterogenous group of 27 maternity care stakeholders participated. The variation between midwives, with different levels of autonomy, was reported. The analysis of the data resulted in five themes: (1) The autonomous midwife is adequately educated and committed to continuous professional further education, (2) The autonomous midwife is competent, (3) The autonomous midwife is experienced, (4) The autonomous midwife assures safe and qualitative care, and (5) The autonomous midwife collaborates with all stakeholders in maternity care. A maternity collaborative framework, where all maternity care professionals respect each other's competences and autonomy, is crucial for providing safe and quality care. To achieve this, it is recommended to implement interprofessional education to establish strong foundations for interprofessional collaboration. Additionally, a regulatory body with supervisory powers can help ensure safe and quality care, while also supporting midwives' professional autonomy and professionalisation.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, 1090 Brussels, Belgium
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
| | - Ans Luyben
- Centre for Midwifery, Maternal & Perinatal Health, Bournemouth University, Bournemouth BH1 3LH, UK
- Frauenzentrum (Centre for Women's Health), Lindenhofgruppe, 3012 Bern, Switzerland
| | - Valerie Fleming
- Faculty of Health, Liverpool John Moores University, Liverpool L3 5UX, UK
| | - Maaike Fobelets
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, 1090 Brussels, Belgium
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
- Department of Teacher Education, Vrije Universiteit Brussel (VUB), 1040 Brussels, Belgium
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Peters R, Schmitt M, Mutsaers B, Buyl R, Verhagen A, Pool-Goudzwaard A, Koes B. Identifying Patient Characteristics Associated With the Occurrence of Post Treatment Non-serious Adverse Events After Cervical Spine Manual Therapy Treatment in Patients With Neck Pain. Arch Phys Med Rehabil 2023; 104:277-286. [PMID: 36037878 DOI: 10.1016/j.apmr.2022.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To compare prevalence rates of serious and non-serious adverse events after manipulation and mobilization and to identify risk factors of serious and non-serious adverse events following 4 types of manual therapy treatment in patients with neck pain. DESIGN A prospective cohort study in primary care manual therapy practice. PARTICIPANTS Patients with neck pain (N=686) provided data on adverse events after 1014 manipulation treatments, 829 mobilization treatments, 437 combined manipulation and mobilization treatments, and 891 treatments consisting of "other treatment modality". INTERVENTIONS Usual care manual therapy. MAIN OUTCOME MEASURES A chi-square test was performed to explore differences in prevalence rates. Logistic regression analysis was performed within the 4 treatment groups. A priori we defined associations between patient-characteristics and adverse events of odds ratio (OR)>2 or OR<0.5 as clinically relevant. RESULTS No serious adverse events, such as cervical artery dissection or stroke, were reported. With regard to non-serious adverse events, we found that these are common after manual therapy treatment: prevalence rates are ranging from 0.3% to 64.7%. We found a statistically significant difference between the 4 types of treatments, detrimental to mobilization treatment. Logistic regression analysis resulted in 3 main predictors related to non-serious adverse events after manual therapy treatment: smoking (OR ranges from 2.10 [95% confidence interval [CI] 1.37-3.11] to 3.33 [95% CI 1.83-5.93]), the presence of comorbidity (OR ranges from 2.32 [95% CI 1.22-4.44] to 3.88 [95% CI 1.62-9.26]), and female sex (OR ranges from 0.22 [95% CI 0.11-0.46] to 0.49 [95% CI 0.28-0.86]). CONCLUSION There is a significant difference in the occurrence of non-serious adverse events after mobilization compared with manipulation or a combination of manipulation and mobilization. Non-serious adverse events in manual therapy practice are common and are associated with smoking and the presence of comorbidity. In addition, women are more likely to report non-serious adverse events.
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Affiliation(s)
- Renske Peters
- SOMT, University of Physiotherapy, Amersfoort, The Netherlands; Erasmus Medical Centre, Department of General Practice, Rotterdam, The Netherlands.
| | - Maarten Schmitt
- Rotterdam Hogeschool, University of Applied Science, Rotterdam, The Netherlands
| | - Bert Mutsaers
- SOMT, University of Physiotherapy, Amersfoort, The Netherlands; Erasmus Medical Centre, Department of General Practice, Rotterdam, The Netherlands; Avans Hogeschool, University of Applied Sciences, Breda, The Netherlands
| | - Ronald Buyl
- BISI, VUB, University of Brussels, Jette, Belgium
| | - Arianne Verhagen
- University of Technology Sydney, Discipline of Physiotherapy, Sydney, Australia
| | - Annelies Pool-Goudzwaard
- SOMT, University of Physiotherapy, Amersfoort, The Netherlands; Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands
| | - Bart Koes
- Erasmus Medical Centre, Department of General Practice, Rotterdam, The Netherlands; Center for Muscle and Joint Health, University of Southern Denmark Odense, Denmark
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Huysmans E, Goudman L, Van Bogaert W, Nijs J, Putman K, Moens M, Buyl R, Ickmans K, Garcia Barajas G, Fernández-Carnero J, Coppieters I. Experimental Pain Measurements Do Not Relate to Pain Intensity and Pain Cognitions in People Scheduled for Surgery for Lumbar Radiculopathy. Pain Med 2023; 24:139-149. [PMID: 36053220 DOI: 10.1093/pm/pnac133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/03/2022] [Accepted: 08/05/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The present cross-sectional study aims to unravel associations of pain intensity and cognitions with quantitative sensory testing in people scheduled for surgery for lumbar radiculopathy. Additionally, insight will be provided into the presence of dysfunctional nociceptive processing and maladaptive pain cognitions in this population. DESIGN Cross-sectional study. SETTING Data from three hospitals in Belgium. SUBJECTS The final sample comprised 120 participants with lumbar radiculopathy scheduled for surgery, included between March 2016 and April 2019. METHODS Self-reported pain intensity was assessed on a visual analog scale, and pain cognitions were assessed with self-reported questionnaires (Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Pain Vigilance and Awareness Questionnaire). Quantitative sensory testing (detection thresholds, pain thresholds, temporal summation, and conditioned pain modulation) was evaluated, as well. RESULTS Evidence was found for the presence of an impaired inhibitory response to nociceptive stimuli and maladaptive pain cognitions in this population. Kinesiophobia was found to be present to a maladaptive degree in the majority of the patients (n = 106 [88%]). Significant, but weak, associations between electrical pain thresholds at the sural nerves and leg pain intensity (sural nerve symptomatic side: r = -0.23; P = 0.01; non-symptomatic side: r = -0.22; P = 0.02) and kinesiophobia levels (sural nerve non-symptomatic side: r = -0.26; P = 0.006) were identified. CONCLUSIONS Electrical detection thresholds and correlates for endogenous nociceptive facilitation and inhibition were not found to be related to any of the pain cognitions or to pain intensity in people scheduled to undergo surgery for lumbar radiculopathy.
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Affiliation(s)
- Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lisa Goudman
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- STIMULUS research group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wouter Van Bogaert
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Koen Putman
- Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maarten Moens
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- STIMULUS research group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kelly Ickmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation Flanders (FWO), Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Guillermo Garcia Barajas
- Department of Physical and Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Josue Fernández-Carnero
- Department of Physical and Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Huysmans E, Goudman L, Coppieters I, Malfliet A, Van Bogaert W, Nijs J, Moens M, Buyl R, Ickmans K, Putman K. Exploring Associations between Healthcare Use and Demographics, Pain and Pain Cognitions in People Scheduled for Surgery for Lumbar Radiculopathy: A Cross-Sectional Study. J Clin Med 2023; 12:jcm12010388. [PMID: 36615190 PMCID: PMC9821086 DOI: 10.3390/jcm12010388] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/08/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
This cross-sectional study explored associations between demographics, pain intensity and cognitions on the one hand and healthcare use (HCU) on the other hand in people undergoing surgery for lumbar radiculopathy. HCU during the 2 months preceding surgery was evaluated using a retrospective questionnaire. Demographics included sex, age and level of education and equivalent income. Back and leg pain intensity were evaluated using a visual analogue scale. Pain cognitions were assessed with the Tampa scale of kinesiophobia, the pain catastrophizing scale and the pain vigilance and awareness questionnaire. The sample comprised 120 participants (52% males; 49 years (Quartile (Q)1-Q3: 37.3-57.43)). The number of visits to the general practitioner was associated with sex (incidence rate ratio (IRR) for males = 0.811; p = 0.050), pain catastrophizing (IRR = 1.010; p = 0.041), pain magnification (IRR = 1.058; p = 0.004) and leg pain intensity (IRR = 1.004; p = 0.038). The number of neurosurgeon visits was associated with level of education (IRR moderate education = 1.518; p = 0.016 (reference: low education)). Receiving zero physiotherapy visits was associated with higher back pain intensity (Beta = 0.018; p = 0.028). Highest level of analgesics used was associated with sex (IRR for males = 0.502; p = 0.047) and leg pain (IRR = 1.014; p = 0.034). Only the association between general practitioner visits and pain magnification remained significant in multivariable analyses (IRR = 1.061; p = 0.033). The results suggest a rather indirect relationship between HCU and demographics, pain intensity and cognitions, involving a potential interplay between several patient- and healthcare system-related factors.
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Affiliation(s)
- Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Correspondence: ; Tel.: +32-024774420
| | - Lisa Goudman
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Research Foundation Flanders (FWO), Egmontstraat 5, 1000 Brussel, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
- Stimulus Consortium (Research and Teaching Neuromodulation Uz Brussel), Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- The Laboratory for Brain-Gut Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Herestraat 49, 3001 Heverlee, Belgium
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Research Foundation Flanders (FWO), Egmontstraat 5, 1000 Brussel, Belgium
| | - Wouter Van Bogaert
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Research Foundation Flanders (FWO), Egmontstraat 5, 1000 Brussel, Belgium
- Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 41119 Gothenburg, Sweden
| | - Maarten Moens
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
- Stimulus Consortium (Research and Teaching Neuromodulation Uz Brussel), Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Kelly Ickmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
- Research Foundation Flanders (FWO), Egmontstraat 5, 1000 Brussel, Belgium
| | - Koen Putman
- Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
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12
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Van Eetvelde E, Violon S, Poortmans N, Stijns J, Duinslaeger M, Vanhoeij M, Buyl R, Jacobs-Tulleneers-Thevissen D. Safe implementation of robotic right colectomy with intracorporeal anastomosis. J Robot Surg 2022; 17:1071-1076. [PMID: 36566471 DOI: 10.1007/s11701-022-01514-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/18/2022] [Indexed: 12/26/2022]
Abstract
The robotic platform can overcome technical difficulties associated with laparoscopic colon surgery. Transitioning from laparoscopic right colectomy with extracorporeal anastomosis (ECA) to robotic right colectomy with intracorporeal anastomosis (ICA) is associated with a learning phase. This study aimed at determining the length of this learning phase and its associated morbidity. We retrospectively analyzed all laparoscopic right colectomies with ECA (n = 38) and robotic right colectomies with ICA (n = 67) for (pre)malignant lesions performed by a single surgeon between January 2014 and December 2020. CUSUM-plot analysis of total procedure time was used for learning curve determination of robotic colectomies. Non-parametric tests were used for statistical analysis. Compared to laparoscopy, the learning phase robotic right colectomies (n = 35) had longer procedure times (p < 0.001) but no differences in anastomotic leakage rate, length of stay or 30-day morbidity. Conversion rate was reduced from 16 to 3 percent in the robotic group. This study provides evidence that robotic right colectomy with ICA can be safely implemented without increasing morbidity.
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Affiliation(s)
- E Van Eetvelde
- Department of Surgery, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium.
| | - S Violon
- Department of Surgery, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - N Poortmans
- Department of Surgery, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - J Stijns
- Department of Surgery, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - M Duinslaeger
- Department of Surgery, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - M Vanhoeij
- Department of Surgery, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
| | - R Buyl
- Biostatistics and Medical Informatics, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090, Brussels, Belgium
| | - D Jacobs-Tulleneers-Thevissen
- Department of Surgery, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium
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Vermeulen J, Bilsen J, Buyl R, De Smedt D, Gucciardo L, Faron G, Fobelets M. Response to the letter to the editor in response to “Women’s experiences with being pregnant and becoming a new mother during the COVID-19 pandemic”. Sexual & Reproductive Healthcare 2022; 33:100753. [PMID: 35803181 PMCID: PMC9250236 DOI: 10.1016/j.srhc.2022.100753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Johan Bilsen
- Faculty of Medicine and Pharmacy, Department of Public Health, Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Léonardo Gucciardo
- Department of Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Gilles Faron
- Department of Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Van Bogaert W, Tegner H, Coppieters I, Huysmans E, Nijs J, Moens M, Goudman L, Buyl R, Lundberg M. The Predictive Value of Fear Avoidance Beliefs for Outcomes Following Surgery for Lumbar Degenerative Disease: A Systematic Review and Best Evidence Synthesis. Pain Physician 2022; 25:441-457. [PMID: 36122254] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Currently, evidence regarding fear avoidance beliefs as potential predictors for lumbar surgery outcomes seems insufficient and strong conclusions are not yet available. OBJECTIVE This systematic review aimed to evaluate the predictive value of preoperative fear avoidance beliefs for postoperative pain intensity, functional status, and health-related quality of life following surgery for lumbar degenerative disease. STUDY DESIGN Systematic review and best evidence synthesis. METHODS An extensive search was performed in PubMed/Medline, EMBASE, PsycINFO, CINAHL and the Cochrane library for articles published up until October 2021. Two independent reviewers performed the screening, data extraction, and quality assessment, with a third independent reviewer consulting to resolve any disagreement. Observational studies that included patients undergoing surgery for lumbar degenerative disease, as well as evaluated fear avoidance beliefs (i.e., pain-related fear, pain catastrophizing, pain anxiety) in relation to a surgical outcome measure (i.e., pain intensity, functional status and health-related quality of life) were included in the review. The CHARMS- and QUIPS-tools were used for data extraction and quality assessment, respectively. A best evidence synthesis was performed resulting in conclusions regarding strong, moderate, conflicting, and limited levels of evidence. RESULTS A total of 24 studies (n = 17,881) were included in this review. Following best evidence synthesis, 3 included studies reported no significant predictive value of preoperative pain-related fear for postoperative pain intensity resulting in moderate evidence for this relationship. Moderate evidence was also found indicating no significant predictive value of preoperative pain-related fear for postoperative functional status, as 6 out of 8 relevant studies reported this result. Only one study reported on the predictive value of preoperative pain catastrophizing for postoperative health-related quality of life, resulting in limited evidence for the absence of this predictive relationship. All other relationships were found to have conflicting evidence. LIMITATIONS To evaluate surgical outcome, only patient-reported outcome measures as used by spine registries were included. Thus, our findings cannot be extrapolated to all surgery outcomes following lumbar degenerative disease and should only be interpreted in relation to postoperative pain intensity, functional status, or health-related quality of life. CONCLUSION Best evidence synthesis showed moderate evidence indicating that preoperative pain-related fear is not a significant predictor for postoperative pain and function following surgery for lumbar degenerative disease. Additionally, limited evidence was found for a lack of predictive value of preoperative pain catastrophizing for postoperative health-related quality of life. As current evidence regarding the predictive value of preoperative fear avoidance beliefs following such a surgery is mixed, further research is required before more definitive conclusions can be made.
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Affiliation(s)
- Wouter Van Bogaert
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium; Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium
| | - Heidi Tegner
- Department of Occupational Therapy and Physiotherapy, Rigshospitalet, Glostrup, Denmark
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; The Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium; Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Maarten Moens
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium; STIMULUS research group (reSearch and TeachIng neuroModULation Uz bruSsel/VUB), Vrije Universiteit Brussel, Brussels, Belgium; Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Lisa Goudman
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium; Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium; Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium; STIMULUS research group (reSearch and TeachIng neuroModULation Uz bruSsel/VUB), Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Mari Lundberg
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden; Institute of Health and Care Sciences, and the University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Jose A, Sasseville M, Dequanter S, Gorus E, Giguère A, Bourbonnais A, Abbasgholizadeh Rahimi S, Buyl R, Gagnon MP. Existing eHealth Solutions for Older Adults living with Neurocognitive Disorders (Mild and Major) or Dementia and their Informal Caregivers: Protocol for an Environmental Scan (Preprint). JMIR Res Protoc 2022; 11:e41015. [DOI: 10.2196/41015] [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] [Received: 08/01/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
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16
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De Raedemaeker K, Foulon I, Vella Azzopardi R, Lichtert E, Buyl R, Topsakal V, Beyer I, Bautmans I, Michel O, Gordts F. Audiometric Findings in Senior Adults of 80 Years and Older. Front Psychol 2022; 13:861555. [PMID: 35936317 PMCID: PMC9347294 DOI: 10.3389/fpsyg.2022.861555] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To examine hearing thresholds in senior adults of 80 years and older and compare this data to the current ISO 7029 reference values. Design A descriptive, prospective study testing pure-tone and speech audiometry in senior adults participating in the BUTTERFLY study or the BrUssels sTudy on The Early pRedictors of FraiLtY. A Gerontological study to identify determinants for active aging and for early stages of frailty in the oldest population. Using the formula given by ISO 7028:2017 the median value of hearing was calculated based on the sex and age of the participant and compared to the measured hearing thresholds. Results 151 senior adults were included. The prevalence of hearing loss was 90.7% (PTA > 20 dB HL). The results were compared to the mean ISO values, calculated for every participant. Both males and females in our study population had worse hearing thresholds than could be expected based on the ISO reference values. In our study population with moderate hearing loss (PTA > 40 dB HL), 38% is underserved in term of hearing restoration healthcare and yet another 38% is unsatisfied with the result of the hearing aids. Given the vast impact on the individual and society, this is a problem in need of our attention. Conclusion The ISO 7029 reference values may be an underestimation of hearing loss in senior adults of 80 years and older. Therefore we present a statistical distribution of hearing thresholds on different frequencies related to age and sex that can be used as a baseline for further development of the reference values.
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Affiliation(s)
- Kaat De Raedemaeker
- Department of Otorhinolaryngology Head and Neck Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
- *Correspondence: Kaat De Raedemaeker,
| | - Ina Foulon
- Department of Otorhinolaryngology Head and Neck Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roberta Vella Azzopardi
- Gerontology Department and Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Elke Lichtert
- Department of Otorhinolaryngology Head and Neck Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Vedat Topsakal
- Department of Otorhinolaryngology Head and Neck Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ingo Beyer
- Gerontology Department and Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Ivan Bautmans
- Gerontology Department and Frailty in Aging Research (FRIA) Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Olaf Michel
- Department of Otorhinolaryngology Head and Neck Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Frans Gordts
- Department of Otorhinolaryngology Head and Neck Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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17
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Vermeulen J, Bilsen J, Buyl R, De Smedt D, Gucciardo L, Faron G, Fobelets M. Women's experiences with being pregnant and becoming a new mother during the COVID-19 pandemic. Sex Reprod Healthc 2022; 32:100728. [PMID: 35490479 PMCID: PMC9040428 DOI: 10.1016/j.srhc.2022.100728] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/08/2022] [Accepted: 04/20/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE During the COVID-19 pandemic a national quarantine was imposed in Belgium, which led to changes in the maternity care provision. Despite emerging literature, it remains unclear how pregnant women and women who have recently given birth experienced this period. With this study we aim to explore these women's experiences during the COVID-19 pandemic. METHODS This qualitative study is a part of a large longitudinal study on women's health-related quality of life (HRQoL), during the COVID-19 pandemic. An open-ended question, in an online survey, asking women about their experiences during the perinatal period was analysed using a thematic analysis. RESULTS Of the 1007 women who participated in the HRQoL-study in June 2020, 556 (55%) women answered the open question. In general, we identified a multiplicity of mixed and interconnected feelings. Many women reported negative feelings; nevertheless, the pandemic also had some positive aspects for respondents. Six overreaching themes were identified: fear of contamination, feeling isolated and unsupported, not able to share experiences, disrupted care, feeling unprepared and experience a peaceful period. CONCLUSION Although perinatal healthcare professionals did their utmost to provide the necessary care, being pregnant or being a new mother during this pandemic was challenging at times. However, this period was also experienced as a peaceful period with lot of opportunities to rest. Some of the changes such as telework and restricted visiting policies were experienced positively by many. Lessons learned can support perinatal healthcare professionals and policy makers in the organisation of maternity care in the post-pandemic era.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Johan Bilsen
- Faculty of Medicine and Pharmacy, Department of Public Health, Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Léonardo Gucciardo
- Department of Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Gilles Faron
- Department of Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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18
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Muylle KM, Cornu P, Cools W, Barbé K, Buyl R, Van Laere S. Optimization of Performance by Combining Most Sensitive and Specific Models in Data Science Results in Majority Voting Ensemble. Stud Health Technol Inform 2022; 294:435-439. [PMID: 35612117 DOI: 10.3233/shti220496] [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] [Indexed: 06/15/2023]
Abstract
Ensemble modeling is an increasingly popular data science technique that combines the knowledge of multiple base learners to enhance predictive performance. In this paper, the idea was to increase predictive performance by holding out three algorithms when testing multiple classifiers: (a) the best overall performing algorithm (based on the harmonic mean of sensitivity and specificity (HMSS) of that algorithm); (b) the most sensitive model; and (c) the most specific model. This approach boils down to majority voting between the predictions of these three base learners. In this exemplary study, a case of identifying a prolonged QT interval after administering a drug-drug interaction with increased risk of QT prolongation (QT-DDI) is presented. Performance measures included accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Overall performance was measured by calculating the HMSS. Results show an increase in all performance measure characteristics compared to the original best performing algorithm, except for specificity where performance remained stable. The presented approach is fairly simple and shows potential to increase predictive performance, even without adjusting the default cut-offs to differentiate between high and low risk cases. Future research should look at a way of combining all tested algorithms, instead of using only three. Similarly, this approach should be tested on a multiclass prediction problem.
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Affiliation(s)
- Katoo M Muylle
- Centre for Pharmaceutical Research (CePhar), Vrije Universiteit Brussel, Belgium
| | - Pieter Cornu
- Centre for Pharmaceutical Research (CePhar), Vrije Universiteit Brussel, Belgium
| | - Wilfried Cools
- Department of Public Health, Vrije Universiteit Brussel, Belgium
| | - Kurt Barbé
- Department of Public Health, Vrije Universiteit Brussel, Belgium
| | - Ronald Buyl
- Department of Public Health, Vrije Universiteit Brussel, Belgium
| | - Sven Van Laere
- Department of Public Health, Vrije Universiteit Brussel, Belgium
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19
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Duerinck J, Van Der Veken J, Schuind S, Van Calenbergh F, van Loon J, Du Four S, Debacker S, Costa E, Raftopoulos C, De Witte O, Cools W, Buyl R, Van Velthoven V, D'Haens J, Bruneau M. Randomized Trial Comparing Burr Hole Craniostomy, Minicraniotomy, and Twist Drill Craniostomy for Treatment of Chronic Subdural Hematoma. Neurosurgery 2022; 91:304-311. [PMID: 35593710 DOI: 10.1227/neu.0000000000001997] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 02/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The mainstay of treatment for symptomatic or large chronic subdural hematoma (CSDH) is surgery, but controversy still exists regarding the best surgical technique. Three different techniques are commonly used: burr hole craniostomy (BHC), minicraniotomy (MC), and twist drill craniostomy (TDC). OBJECTIVE To determine which surgical technique for drainage of CSDH offers best results. METHODS We set up a multicenter prospective randomized trial (Comparison of Chronic Subdural Hematoma Treatment [COMPACT] trial) comparing BHC, MC, and TDC for the surgical treatment of CSDH. The primary end point was reoperation rate, and secondary end points included complication rates and clinical outcome. Patients were considered to have good outcome when they did not undergo reoperation, suffered no surgical or medical complication, and had no related mortality. Clinical outcome was also evaluated by evolution of the Markwalder score and the modified Rankin score. RESULTS Two-hundred forty-five patients were included in the final analysis: 79 BHC, 84 MC, and 82 TDC. Mean duration of surgery was shorter for TDC than for BHC and MC (P < .001). Reoperation rate was 7.6% for BHC, 13.1% for MC, and 19.5% for TDC (P = .07). This trend toward better results for BHC was not statistically significant in logistic regression analysis. The proportion of patients with good outcome was 78.5% for BHC group, 76.2% for MC, and 69.5% for TDC (P = .4). Evolution of the Markwalder score and modified Rankin score were not significantly different between treatment groups. CONCLUSION All 3 techniques are effective at treating patients with CSDH with eventual 6-month outcome being similar. Although not reaching statistical significance in our study, BHC offers the lowest recurrence rate combined with manageable complication rate.
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Affiliation(s)
| | - Jorn Van Der Veken
- Department of Neurosurgery, UZ Brussel, Brussels, Belgium.,Current affiliation: Department of Neurosurgery, Flinders Medical Centre, Adelaide, Australia
| | - Sophie Schuind
- Department of Neurosurgery, ULB Erasme, Brussels, Belgium
| | | | | | | | - Servaes Debacker
- Faculty of Medicine, Vrije Universiteit Brussel, Brussels, Belgium
| | - Emmanuel Costa
- Department of Neurosurgery, UCL Saint-Luc, Brussels, Belgium
| | | | | | - Wilfried Cools
- Interfaculty Center Data Processing and Statistics, UZ Brussel/Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Jean D'Haens
- Department of Neurosurgery, UZ Brussel, Brussels, Belgium
| | - Michaël Bruneau
- Department of Neurosurgery, ULB Erasme, Brussels, Belgium.,Current affiliation: Department of Neurosurgery, UZ Brussel, Brussels, Belgium
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20
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Dequanter S, Fobelets M, Steenhout I, Gagnon MP, Bourbonnais A, Rahimi S, Buyl R, Gorus E. Determinants of technology adoption and continued use among cognitively impaired older adults: a qualitative study. BMC Geriatr 2022; 22:376. [PMID: 35484488 PMCID: PMC9047390 DOI: 10.1186/s12877-022-03048-w] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Technology offers opportunities to support older adults with mild cognitive impairments to remain independent and socially connected, but is often not used. Although determinants of technology use among older adults in general are well studied, much less is known about how these factors impact technology use behaviour in cognitively impaired older adults. This study aimed to bridge this gap in research by examining the factors underlying technology use in community-dwelling older adults with mild cognitive impairments. Methods We applied a generic qualitative design and used 16 semi-structured interviews to collect data from Belgian (Flemish) community-dwelling older adults diagnosed with Mild Cognitive Impairment or dementia and informal caregivers. To get data from different perspectives, a focus group with professional caregivers was added. We used thematic analysis with an inductive approach to identify and select themes from the data. Results We identified two themes: introduction of technology and determinants of technology adoption and continued use. Successful technology adoption in cognitively impaired older adults is need-driven and subject to individual, technological and contextual characteristics. Specific for older adults with cognitive impairments are the importance of disease awareness and cognitive ability for adoption and continued use, respectively. Although social support can be a valuable alternative to technology, it is an important facilitator of continued technology use in these older adults. Similarly, integration of technologies in daily routines can buffer discontinuation of technologies. Conclusions Future research is encouraged to validate our findings in a postpandemic era and to further develop a novel theoretical framework for technology acceptance among older adults with cognitive impairments. Moreover, identification of crucial determinants as well as strategies to remove use barriers are also important future research tasks. Clinical practice should focus on improving disease awareness to facilitate technology adoption and policies should invest in training and support of professional caregivers and in reimbursement strategies to facilitate implementation of technology in practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03048-w.
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Affiliation(s)
- Samantha Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maaike Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iris Steenhout
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | | | | | - Samira Rahimi
- Department of Family Medicine, McGill University, Montreal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,MILA - Quebec Artificial Intelligence Institute, Montreal, Quebec, Canada
| | - Ronald Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Gorus
- Department of Gerontology, Faculty of Medicine and Pharmacy, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium. .,Department of Geriatrics, UZ Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium.
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21
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Van Laere S, Tommelein E, Dreesen E, Buyl R, Cornu P. Discrepancies between ePrescriptions and dispensing in Belgium, 6 years after the launch of the electronic prescribing - a mixed-method study. Acta Clin Belg 2022; 77:377-386. [PMID: 33586629 DOI: 10.1080/17843286.2021.1885884] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The number of electronic prescriptions (ePrescriptions) grows steadily in Belgium as in other European countries. In the future, Belgium wants to dematerialize the ePrescription flow, removing all paper trails. A quality check of the digital content and implementation of national ePrescription guidelines in the field was conducted, comparing the content at both prescription and pharmacy side. METHODS An explanatory mixed-methods design was applied. In a first phase, potential problems (warning flags) were identified by consulting stakeholders. Secondly, the warning flags were validated to problems (errors) in a random set of ePrescriptions collected in April 2019. In a third phase, explanatory interviews were held with various stakeholders in order to find explanations and to identify the initiators of these errors. RESULTS In the first phase, 15 warning flags were identified to evaluate the quality of an ePrescription. In the second phase, a random selection of 11,798 ePrescriptions was validated. The most prevalent errors found, were the digital construction of the messages (18.88%), combined with lots of necessarily deemed substitutions by the pharmacist (3.39%) not following what was prescribed originally. In the third phase, stakeholders indicated that software of the prescriber and the use of inconsistent databases between prescriber and pharmacy can often be seen as the cause and initiator of these problems. CONCLUSIONS Use of authentic medication databases and well-designed software systems have the potential to solve ePrescription problems. Focus should go to prevention instead of detection.
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Affiliation(s)
- S. Van Laere
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium
| | - E. Tommelein
- Department of Pharmaceutical Sciences (FARM), Drug Analysis and Drug Information (FASC), Vrije Universiteit Brussel, Brussels, Belgium
| | - E. Dreesen
- Tarification Service Koninklijk Limburgs Apothekers Verbond (KLAV), Hasselt, Belgium
| | - R. Buyl
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium
| | - P. Cornu
- Centre for Pharmaceutical Research (Cephar), Vrije Universiteit Brussel, Brussels, Belgium
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22
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Vermeulen J, Buyl R, Luyben A, Fleming V, Fobelets M. Defining midwifery autonomy in Belgium: Consensus of a modified Delphi study. J Adv Nurs 2022; 78:2849-2860. [PMID: 35266191 DOI: 10.1111/jan.15209] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/10/2022] [Accepted: 01/31/2022] [Indexed: 11/26/2022]
Abstract
AIMS Although there is substantial literature on autonomy of midwifery, the concept remains vague, and what it exactly constitutes is little clear. Attempts to define this have been carried out, but did not result in a communal understanding. The aim of this study therefore was to define a consistent definition of midwifery autonomy in Belgium. DESIGN A modified Delphi survey with content experts. METHODS Critical components of the available definitions on midwifery autonomy were retrieved from the literature, and translated into Dutch and French. An online Delphi panel of content expert assessed components of autonomy in midwifery on clarity and relevance between June and October 2021. From the validated components, a preliminary consolidated definition was generated, which was validated in a final Delphi round. RESULTS After round one, content experts (n = 27) evaluated 10 out of 17 components to be clear and relevant. Two components were judged inappropriate and therefore removed. After further adaptation four additional components were identified appropriate after the second round, and one component after a third Delphi round. Experts' suggestions for improving the clarity and relevance were taken into account. Finally, experts assessed the preliminary definition. After minor modifications the definition of midwifery autonomy in Belgium was confirmed valid. CONCLUSION We established a communal definition of midwifery autonomy in Belgium, the creation of such a definition results in a joint understanding of the concept of midwifery autonomy. IMPACT If midwives internationally want to successfully achieve autonomy, a clear understanding of the concept of midwifery autonomy is needed. The consensus definition of midwifery autonomy in Belgium comprises 15 components related to midwives' work content, professionalism and relationship with others. Our definition of midwifery autonomy has the potential to encourage an international dialogue, grounded in a common understanding of autonomy, enabling stakeholders in maternity care to strengthen professional midwifery autonomy.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ans Luyben
- Bournemouth University, Bournemouth, UK.,Lindenhofgruppe, Bern, Switzerland
| | | | - Maaike Fobelets
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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23
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Dequanter S, Gorus E, Van Laere S, De Witte N, Verté D, Steenhout I, Fobelets M, Buyl R. Internet use and cognitive frailty in older adults: a large-scale multidimensional approach. Eur J Ageing 2022; 19:1135-1144. [PMID: 36692741 PMCID: PMC9729622 DOI: 10.1007/s10433-022-00686-2] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 01/26/2023] Open
Abstract
Although research on sociodemographic correlates of internet use in older adults without and with pronounced cognitive impairment is already quite extensive, much less is known about the relationship between cognitive frailty (CF) and this behaviour. As CF is associated to multidimensional frailty aspects, this study explored the relationship between internet use and CF, operationalised as Subjective Cognitive Impairment, in older adults by means of a comprehensive explanatory model including sociodemographic factors and multiple frailty measures. The dataset included a sample of community-dwelling 60 + older adults that were included in the Belgian Ageing Studies (BAS) and that completed survey questions on (i) internet use frequency and (ii) internet activities. Multidimensional frailty was measured with the CFAI-Plus. The analysis comprised a structural equation modelling (SEM) procedure. Internet use was frequent; however, it became less frequent with higher CF. Moreover, the latter used less tablets as compared to the no-low CF group. Navigating the web, sharing email and online banking were the most frequently reported activities. Tele-communicating with Skype, online shopping and using e-government services were the least frequent. Age, female gender, lower income and living with a partner were also negatively associated with internet use. To conclude, CF, along with other frailty and sociodemographic factors, was negatively related to internet use in older adults. Future research should focus, amongst others, on the dynamic processes underlying internet use in the population of older adults affected by CF.
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Affiliation(s)
- Samantha Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ellen Gorus
- Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium ,Department of Geriatrics, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Sven Van Laere
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nico De Witte
- Department of Educational Sciences, Belgian Ageing Studies (BAS) Research Group, Vrije Universiteit Brussel, Brussels, Belgium ,Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
| | - Dominique Verté
- Department of Educational Sciences, Belgian Ageing Studies (BAS) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iris Steenhout
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maaike Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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24
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Foulon I, Philips D, Lichtert E, Buyl R, Topsakal V, Gordts F. Pediatric myringoplasty: A study of effectiveness and influencing factors. Int J Pediatr Otorhinolaryngol 2022; 153:110990. [PMID: 34973522 DOI: 10.1016/j.ijporl.2021.110990] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/02/2021] [Accepted: 11/22/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Until today, there is no consensus about the ideal age for a myringoplasty in children. In this retrospective study, we study our own series to characterize different prognostic factors to answer questions/dilemmas such as when to carry out surgery in a child with an ear drum perforation, when to postpone surgery or when to use a different technique to improve the outcome after tympanoplasty. METHODS We performed a retrospective study on charts of 97 children who underwent a myringoplasty. The same surgeon (IF) treated all included children and with the same classical surgical technique: retro-auricular approach and microscopic underlay placement of fascia of the musculus temporalis. Children with associated disease (cholesteatoma, revision surgery and ossicular chain defects) were excluded. All children had a minimum follow up of 12 months. A successful procedure was defined as a closed eardrum after 12 months and an air bone gap <20 dB. Prognostic factors were inventoried and studied. RESULTS Success rate after myringoplasty is 80.2% in this pediatric case series. Age was not a statistical significant prognostic factor. Only the history of an adenoidectomy had a positive effect on tympanic closure (p = 0.047). A negative prognostic factor was the size of the perforation: large perforations showed only 42.9% eardrum closure (p = 0.040). There was a complication rate of 28.9%, in which formation of granulation tissue and ear discharge were most common but easily treated. CONCLUSION Tympanoplasty type 1 with musculus temporalis fascia in underlay is a safe and successful technique in children of all ages with eardrum perforations. Our data suggests using a different technique (cartilage tympanoplasty) in cases with large perforation. Postponing surgery is not advocated, unless perhaps in children with poor Eustachian function or adenoidhyperplasia.
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Affiliation(s)
- Ina Foulon
- Department of Otolaryngology- Head and Neck Surgery, Belgium.
| | - Dylen Philips
- Department of Otolaryngology- Head and Neck Surgery, Belgium.
| | - Elke Lichtert
- Department of Otolaryngology- Head and Neck Surgery, Belgium.
| | - Ronald Buyl
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Vedat Topsakal
- Department of Otolaryngology- Head and Neck Surgery, Belgium.
| | - Frans Gordts
- Department of Otolaryngology- Head and Neck Surgery, Belgium.
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Gagnon MP, Boucher M, Ndiaye MA, Dequanter S, Buyl R, Gorus E, Fobelets M, Sasseville M, Barony R. Perceptions of and needs for e-Health solutions for elderly people with cognitive impairment, their caregivers and health care providers: A qualitative exploration. Alzheimers Dement 2022. [PMID: 34971238 DOI: 10.1002/alz.057475] [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] [Indexed: 11/11/2022]
Abstract
BACKGROUND The prevalence of mild cognitive impairment (MCI) and mild neurocognitive disorder (mNCD) are steadily increasing in Canada. Information and communication technologies (ICTs) in health represent an innovation to promote home care and autonomy for people with various degrees of cognitive impairment. The objective of this study is to develop a web-based multicriteria decision support tool adapted to older adults with MCI or mNCD, their informal caregivers, and health care providers (HCPs) to support the development and implementation of ICTs adapted to the needs and preferences of people with cognitive impairments and their caregivers. METHODS We used a participatory research strategy to develop of a decision support tool for the use of ICTs focused on the needs of patients, their caregivers, and HCPs. Data collection consisted of semi-structured interviews with elderly people with MCI (N = 10) and caregivers of people with mNCD (N= 7) to explore their current knowledge and perceptions of various ICTs as well as their needs and preferences for such interventions and a focus group with HCPs to understand their perceptions of the needs of seniors with MCI and caregivers of people with mNCD. RESULTS ICTs are seen as a beneficial solution to promote home care and autonomy for people with cognitive disorders. ICTs provide a sense of security and peace of mind, especially for caregivers of people with mNCD. However, the complexity and high cost of ICTs as well as the lack of support appear to be major limits to their use. HCP recognize the value of e-Health but claim to lack reliable information and were therefore highly unsure to recommend its use. CONCLUSIONS People suffering from cognitive disorders and their caregivers are generally open to technological developments and favour the use of ICTs. For health professionals, continuous training on ICTs would make them more comfortable to recommend them to patients and their families. Although the use of ICTs is promising for maintaining elderly people with cognitive disorders at home, our study shows that it will be necessary to find ways to make them accessible to promote their use.
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Affiliation(s)
- Marie-Pierre Gagnon
- Université Laval, Québec, QC, Canada.,VITAM - Centre de Recherche en Santé Durable, Québec, QC, Canada
| | | | - Mame-Awa Ndiaye
- VITAM - Centre de Recherche en Santé Durable, Québec, QC, Canada
| | | | - Ronald Buyl
- Vrije Universiteit Brussel, Brussel, Belgium
| | - Ellen Gorus
- Vrije Universiteit Brussel, Brussel, Belgium
| | | | - Maxime Sasseville
- VITAM - Centre de Recherche en Santé Durable, Québec, QC, Canada.,Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
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26
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Dequanter S, Steenhout I, Fobelets M, Gagnon MP, Sasseville M, Bourbonnais A, Giguère A, Ndiaye MA, Lambert A, Gorus E, Buyl R. Technology implementation in care practices for community-dwelling older adults with mild cognitive decline: Perspectives of professional caregivers in Quebec and Brussels. Digit Health 2022; 8:20552076221139693. [PMID: 36420317 PMCID: PMC9677160 DOI: 10.1177/20552076221139693] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/01/2022] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVE As worldwide population aging is accelerating, innovative technologies are being developed to support independent living among community-dwelling older adults with mild cognitive decline. However, the successful implementation of these interventions is often challenging. Until now, literature on implementation issues related to the specific context of older adults with mild cognitive decline is lacking and the few studies available do not focus specifically on the perspective of professional caregivers. Yet the perspective of these caregivers is important as they can be considered a key facilitator for technology implementation among this population. Therefore, this study was the first to examine technology implementation among community-dwelling older adults with mild cognitive decline from the broader perspective of professional caregivers. METHODS In this qualitative study, two focus groups consisting of a heterogeneous pool of professional caregivers were conducted: one in Quebec (Canada, n = 6) and one in Brussels (Belgium, n = 8). Braun and Clarke' method for thematic analysis, guided by a qualitative descriptive approach was applied to inductively identify themes from the data. RESULTS We identified factors influencing technology implementation in older adults with mild cognitive decline on three levels: an individual level (e.g., characteristics of older adults with mild cognitive decline and professional caregivers' attitude), an organizational level (e.g., lack of training among professional caregivers) and a level referring to the broader context (e.g., ethical considerations). CONCLUSIONS This study contributes to the research gap in knowledge on the needs of professional caregivers to facilitate technology implementation among the population of older adults with cognitive decline. Future directions for research, practice, and policy are given, more specifically to improve knowledge among caregivers and on the development of decision support to retrieve safe and effective technologies that suit patient-centered care.
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Affiliation(s)
- S Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - I Steenhout
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Square, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Teacher Education, Vrije Universiteit Brussel, Brussels, Belgium
| | - MP Gagnon
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Quebec, Canada
| | - M Sasseville
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- VITAM Centre de recherche en santé durable, Centre Intégré de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec, Canada
| | - A Bourbonnais
- Faculty of Nursing, Université de Montreal, Montreal, Canada
- Research Centre of the Institut Universitaire de gériatrie de Montréal, Canada
| | - A Giguère
- Department of Nursing Sciences, Université Laval, Quebec, Canada
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Quebec, Canada
| | - MA Ndiaye
- Arthritis Research Canada, Richmond, Canada
| | - A Lambert
- Department of Nursing Sciences, Université Laval, Quebec, Canada
| | - E Gorus
- Department of Gerontology, Faculty of Medicine and Pharmacy, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, UZ Brussel, Brussels, Belgium
| | - R Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
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27
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Dequanter S, Gagnon MP, Ndiaye MA, Gorus E, Fobelets M, Giguère A, Bourbonnais A, Buyl R. The Effectiveness of e-Health Solutions for Aging With Cognitive Impairment: A Systematic Review. Gerontologist 2021; 61:e373-e394. [PMID: 32525977 PMCID: PMC8437510 DOI: 10.1093/geront/gnaa065] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 09/24/2018] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives e-Health solutions are an innovative approach to support aging with cognitive impairment. Because technology is developing at a fast pace, the aim of this review was to present an overview of the research regarding the effectiveness of these solutions. Moreover, the availability of these solutions was examined. Research Design and Methods Systematic searches were conducted in 7 databases. Full texts of potentially relevant references were assessed by 2 reviewers, and discrepancies were solved through discussion. Data on study characteristics, technology type, application domain, availability, outcomes, and effects were extracted. A categorization exercise and narrative synthesis were conducted. Results In total, 72 studies describing 70 e-Health solutions were identified. The majority of solutions comprised cognitive training for older adults, followed by educational and supportive web platforms for caregivers. Outcomes included mainly measures of cognition, psychosocial functioning, caregiving processes, caregiver–care receiver relationship, and activities of daily living. Positive effects of cognitive training technologies were observed on cognitive functioning of older adults, as well as those of supportive web platforms on behavioral and psychological symptoms of dementia and caregiver self-efficacy. The effects of these solutions on depression in both target groups were inconclusive. The methodological quality of the studies was moderate to good. However, some important limitations were observed. Discussion and Implications The review identified cognitive training solutions and supportive web platforms as the most effective on a limited number of outcomes. Although other solutions seem promising, further research has to overcome methodological issues. Furthermore, solutions for leisure and reminiscence and outcomes specifically related to independent living deserve more attention.
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Affiliation(s)
- Samantha Dequanter
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
| | - Marie-Pierre Gagnon
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada.,Faculty of Nursing Sciences, Université Laval, Québec, Canada
| | - Mame-Awa Ndiaye
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada
| | - Ellen Gorus
- Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Belgium
| | - Maaike Fobelets
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
| | - Anik Giguère
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), Québec, Canada.,Faculty of Nursing Sciences, Université Laval, Québec, Canada
| | | | - Ronald Buyl
- Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Belgium
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Schutyser V, Buyl R, De Vos M, Tournaye H, Blockeel C. P-750 Clinical efficacy of virtual reality for acute pain and anxiety management during outpatient hysteroscopy and endometrial biopsy in subfertile patients. Hum Reprod 2021. [DOI: 10.1093/humrep/deab128.036] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Does the use of virtual reality (VR) headsets in diagnostic office hysteroscopy (HSC) with endometrial biopsy (EB) reduce anxiety and pain scores in the patient?
Summary answer
Virtual reality during office HSC do not seem to improve relaxation, anxiety, or pain scores. Physicians have a good perception of patients’ pain.
What is known already
Women undergoing outpatient HSC experience high levels of preoperative anxiety, which increase pain and discomfort during the procedure. The experience of pain is a complex phenomenon, which simultaneously occurs on cognitive, emotional, and behavioural levels, and is influenced by many factors. A Cochrane review failed to show a significant difference between different types of pain relief (analgesics, local anaesthetic and verbal support techniques …). VR is a multisensory immersion providing an interactive high level distraction, occupying a large portion of humans’ finite attentional resources (vision and audio), and leaving less cognitive capacity available to process pain.
Study design, size, duration
The sample size for this prospective randomized controlled trial was calculated at 196 patients (98 per group), considering a power of at least 80% to detect superiority of adding a VR headset versus standard care, standard deviation (SD = 2.0), using a two-sided, t-test, at significance level alpha of 0.05.
The preliminary results after 1 month include a sample of 48 patients
25 in the VR group and 23 controls.
Participants/materials, setting, methods
All 48 patients suffer subfertility and underwent HSC with EB at our tertiary-care fertility center. We used Oncomfort®, a commercially available VR autohypnosis relaxation program designed for perioperative settings. The headmounted smartphone display with headphones provides image sound distraction with suggestive hypnosis techniques incorporated. Before and immediately after the exam, both patients and surgeons fill out a questionnaire using the 10.0cm visual analog scale (VAS).
Main results and the role of chance
The mean duration of HSC was 3min43sec in the VR group, (range 2-6min), compared to 4min50 in the control group (range 1-12minutes), which was not significantly different (p = 0.09). Subjective variables of stress, anxiety and pain were evaluated at four different time points, i.e. before, during, immediately after HSC and one week later.
According to VAS, stress levels did not differ significantly (p > 0.05) between the VR group and the control group, or within
time
5.08 to 5.36 to 3.08 vs 4.48 to 4.83 to 2.48 before, during and after HSC respectively. Fear levels prior to HSC at 4.28 for VR patients and 3.52 for controls did not increase significantly during HSC in both groups: 4.44 vs 4.17. During HSC, pain levels increased from 1.40 to 4.720 in the VR group vs 0.65 to 4.109 (NS) in the controls, to decrease again afterwards to 2.60 vs 2.17 (NS) respectively.
Physicians rated the average pain levels of VR patients as 3.32 compared to 3.0 for controls, which was significantly correlated to patients’ perception (p < 0,005). Patients gave a positive rating to the VR experience (satisfaction score 7.17).
Limitations, reasons for caution
These are preliminary results, evaluating only a fourth of the required sample. A population selection bias could exist, as recruited patients were willing to accept VR. The very short induction period of 2 minutes could influence the effect of (immersiveness into) VR.
Wider implications of the findings
Pain management in ambulatory procedures should be multimodal and should include both pharmacological and non-pharmacological interventions. Introducing VR might increase patient tolerance for longer or more painful procedures. Offering a range of options will increase the spectrum of successful procedures in the outpatient setting and improve patient experience.
Trial registration number
B.U.N. 1432020000050
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Affiliation(s)
- V Schutyser
- Universitair Ziekenhuis, Centre for Reproductive Medicine- CRG, Brussels, Belgium
| | - R Buyl
- Vrije Universiteit Brussel, Biomedical Statistics And Informatics, Brussels, Belgium
| | - M De Vos
- Universitair Ziekenhuis, Centre for Reproductive Medicine- CRG, Brussels, Belgium
| | - H Tournaye
- Universitair Ziekenhuis, Centre for Reproductive Medicine- CRG, Brussels, Belgium
| | - C Blockeel
- Universitair Ziekenhuis, Centre for Reproductive Medicine- CRG, Brussels, Belgium
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29
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Schutyser V, Buyl R, Vos MD, Tournaye H, Blockeel C. P–750 Clinical efficacy of virtual reality for acute pain and anxiety management during outpatient hysteroscopy and endometrial biopsy in subfertile patients. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.749] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Does the use of virtual reality (VR) headsets in diagnostic office hysteroscopy (HSC) with endometrial biopsy (EB) reduce anxiety and pain scores in the patient?
Summary answer
Virtual reality during office HSC do not seem to improve relaxation, anxiety, or pain scores. Physicians have a good perception of patients’ pain.
What is known already
Women undergoing outpatient HSC experience high levels of preoperative anxiety, which increase pain and discomfort during the procedure. The experience of pain is a complex phenomenon, which simultaneously occurs on cognitive, emotional, and behavioural levels, and is influenced by many factors. A Cochrane review failed to show a significant difference between different types of pain relief (analgesics, local anaesthetic and verbal support techniques …). VR is a multisensory immersion providing an interactive high level distraction, occupying a large portion of humans’ finite attentional resources (vision and audio), and leaving less cognitive capacity available to process pain.
Study design, size, duration
The sample size for this prospective randomized controlled trial was calculated at 196 patients (98 per group), considering a power of at least 80% to detect superiority of adding a VR headset versus standard care, standard deviation (SD = 2.0), using a two-sided, t-test, at significance level alpha of 0.05.
The preliminary results after 1 month include a sample of 48 patients: 25 in the VR group and 23 controls.
Participants/materials, setting, methods
All 48 patients suffer subfertility and underwent HSC with EB at our tertiary-care fertility center. We used Oncomfort®, a commercially available VR autohypnosis relaxation program designed for perioperative settings. The headmounted smartphone display with headphones provides image sound distraction with suggestive hypnosis techniques incorporated. Before and immediately after the exam, both patients and surgeons fill out a questionnaire using the 10.0cm visual analog scale (VAS).
Main results and the role of chance
The mean duration of HSC was 3min43sec in the VR group, (range 2–6min), compared to 4min50 in the control group (range 1–12minutes), which was not significantly different (p = 0.09). Subjective variables of stress, anxiety and pain were evaluated at four different time points, i.e. before, during, immediately after HSC and one week later.
According to VAS, stress levels did not differ significantly (p > 0.05) between the VR group and the control group, or within time: 5.08 to 5.36 to 3.08 vs 4.48 to 4.83 to 2.48 before, during and after HSC respectively. Fear levels prior to HSC at 4.28 for VR patients and 3.52 for controls did not increase significantly during HSC in both groups: 4.44 vs 4.17. During HSC, pain levels increased from 1.40 to 4.720 in the VR group vs 0.65 to 4.109 (NS) in the controls, to decrease again afterwards to 2.60 vs 2.17 (NS) respectively.
Physicians rated the average pain levels of VR patients as 3.32 compared to 3.0 for controls, which was significantly correlated to patients’ perception (p < 0,005). Patients gave a positive rating to the VR experience (satisfaction score 7.17).
Limitations, reasons for caution
These are preliminary results, evaluating only a fourth of the required sample. A population selection bias could exist, as recruited patients were willing to accept VR. The very short induction period of 2 minutes could influence the effect of (immersiveness into) VR.
Wider implications of the findings: Pain management in ambulatory procedures should be multimodal and should include both pharmacological and non-pharmacological interventions. Introducing VR might increase patient tolerance for longer or more painful procedures. Offering a range of options will increase the spectrum of successful procedures in the outpatient setting and improve patient experience.
Trial registration number
B.U.N. 1432020000050
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Affiliation(s)
- V Schutyser
- Universitair Ziekenhuis, Centre for Reproductive Medicine- CRG, Brussels, Belgium
| | - R Buyl
- Vrije Universiteit Brussel, Biomedical Statistics And Informatics, Brussels, Belgium
| | - M. D Vos
- Universitair Ziekenhuis, Centre for Reproductive Medicine- CRG, Brussels, Belgium
| | - H Tournaye
- Universitair Ziekenhuis, Centre for Reproductive Medicine- CRG, Brussels, Belgium
| | - C Blockeel
- Universitair Ziekenhuis, Centre for Reproductive Medicine- CRG, Brussels, Belgium
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30
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Van Bogaert W, Putman K, Coppieters I, Goudman L, Nijs J, Moens M, Buyl R, Ickmans K, Huysmans E. Health-related quality of life deviations from population norms in patients with lumbar radiculopathy: associations with pain, pain cognitions, and endogenous nociceptive modulation. Qual Life Res 2021; 31:745-757. [PMID: 34342846 DOI: 10.1007/s11136-021-02964-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE The primary goal of this study was to compare the health-related quality of life (HRQoL) of people with lumbar radiculopathy to age- and sex-adjusted population norms. Additionally, it aimed to explore the associations between the HRQoL difference scores and measures related to pain cognitions, pain intensity, and endogenous nociceptive modulation. METHODS Using answers from the Short Form 36-item Health Survey and UK population norms, SF-6D difference scores were calculated. A one-sample t test was used to assess the SF-6D difference scores. Univariate and multivariate regression analyses were used to assess the associations between SF-6D difference scores and pain intensity [Visual Analogue Scale (VAS) for back and leg pain], pain cognitions [Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK), Pain Vigilance and Awareness Questionnaire (PVAQ)], and correlates for endogenous nociceptive modulation using quantitative sensory testing. RESULTS One hundred and twenty people with lumbar radiculopathy scheduled for surgery were included in this study. The mean SF-6D difference score of - 0.26 [SD = 0.09] was found to be significantly less than 0 [95%CI: - 0.27 to - 0.24]. Univariate analyses showed a significant influence from PCS, TSK, and PVAQ on the SF-6D difference scores. The final multivariate regression model included PCS and PVAQ, with only PCS maintaining a statistically significant regression coefficient [b = - 0.002; 95% CI: - 0.004 to - 0.001]. CONCLUSION People diagnosed with lumbar radiculopathy report significantly lower HRQoL scores when compared with age- and sex-adjusted UK norm values. Even though all examined pain cognitions were found to have a significant association, pain catastrophizing showed the most significant relation to the SF-6D difference scores. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov Identifier No. NCT02630732. Date of registration: November 25, 2015.
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Affiliation(s)
- Wouter Van Bogaert
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
- Interuniversity Center for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
- Research Foundation-Flanders (FWO), Brussels, Belgium.
| | - Koen Putman
- Interuniversity Center for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Iris Coppieters
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine & Health Sciences, Ghent University, Ghent, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Lisa Goudman
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Center for Neurosciences, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kelly Ickmans
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Eva Huysmans
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Interuniversity Center for Health Economics Research (I-CHER), Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
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31
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Van Gestel F, Frantz T, Vannerom C, Verhellen A, Gallagher AG, Elprama SA, Jacobs A, Buyl R, Bruneau M, Jansen B, Vandemeulebroucke J, Scheerlinck T, Duerinck J. The effect of augmented reality on the accuracy and learning curve of external ventricular drain placement. Neurosurg Focus 2021; 51:E8. [PMID: 34333479 DOI: 10.3171/2021.5.focus21215] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/13/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The traditional freehand technique for external ventricular drain (EVD) placement is most frequently used, but remains the primary risk factor for inaccurate drain placement. As this procedure could benefit from image guidance, the authors set forth to demonstrate the impact of augmented-reality (AR) assistance on the accuracy and learning curve of EVD placement compared with the freehand technique. METHODS Sixteen medical students performed a total of 128 EVD placements on a custom-made phantom head, both before and after receiving a standardized training session. They were guided by either the freehand technique or by AR, which provided an anatomical overlay and tailored guidance for EVD placement through inside-out infrared tracking. The outcome was quantified by the metric accuracy of EVD placement as well as by its clinical quality. RESULTS The mean target error was significantly impacted by either AR (p = 0.003) or training (p = 0.02) in a direct comparison with the untrained freehand performance. Both untrained (11.9 ± 4.5 mm) and trained (12.2 ± 4.7 mm) AR performances were significantly better than the untrained freehand performance (19.9 ± 4.2 mm), which improved after training (13.5 ± 4.7 mm). The quality of EVD placement as assessed by the modified Kakarla scale (mKS) was significantly impacted by AR guidance (p = 0.005) but not by training (p = 0.07). Both untrained and trained AR performances (59.4% mKS grade 1 for both) were significantly better than the untrained freehand performance (25.0% mKS grade 1). Spatial aptitude testing revealed a correlation between perceptual ability and untrained AR-guided performance (r = 0.63). CONCLUSIONS Compared with the freehand technique, AR guidance for EVD placement yielded a higher outcome accuracy and quality for procedure novices. With AR, untrained individuals performed as well as trained individuals, which indicates that AR guidance not only improved performance but also positively impacted the learning curve. Future efforts will focus on the translation and evaluation of AR for EVD placement in the clinical setting.
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Affiliation(s)
- Frederick Van Gestel
- 1Department of Neurosurgery, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels.,2Research Group Center For Neurosciences (C4N-NEUR), Vrije Universiteit Brussel, Brussels
| | - Taylor Frantz
- 3Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussels.,4imec, Leuven
| | - Cédric Vannerom
- 1Department of Neurosurgery, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels.,2Research Group Center For Neurosciences (C4N-NEUR), Vrije Universiteit Brussel, Brussels
| | - Anouk Verhellen
- 5Department of Studies on Media, Innovation & Technology (SMIT), Vrije Universiteit Brussel, Brussels
| | | | - Shirley A Elprama
- 5Department of Studies on Media, Innovation & Technology (SMIT), Vrije Universiteit Brussel, Brussels
| | - An Jacobs
- 5Department of Studies on Media, Innovation & Technology (SMIT), Vrije Universiteit Brussel, Brussels
| | - Ronald Buyl
- 7Department of Public Health, Research Group Biostatistics and Medical Informatics (BISI), Vrije Universiteit Brussel, Brussels
| | - Michaël Bruneau
- 1Department of Neurosurgery, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels
| | - Bart Jansen
- 3Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussels.,4imec, Leuven
| | - Jef Vandemeulebroucke
- 3Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussels.,4imec, Leuven
| | - Thierry Scheerlinck
- 8Department of Orthopedic Surgery and Traumatology, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels; and.,9Research Group Beeldvorming en Fysische wetenschappen (BEFY-ORTHO), Vrije Universiteit Brussel, Brussels, Belgium
| | - Johnny Duerinck
- 1Department of Neurosurgery, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels.,2Research Group Center For Neurosciences (C4N-NEUR), Vrije Universiteit Brussel, Brussels
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Goudman L, Huysmans E, Coppieters I, Ickmans K, Nijs J, Buyl R, Putman K, Moens M. Electrical (Pain) Thresholds and Conditioned Pain Modulation in Patients with Low Back-Related Leg Pain and Patients with Failed Back Surgery Syndrome: A Cross-Sectional Pilot Study. Pain Med 2021; 21:538-547. [PMID: 31165894 DOI: 10.1093/pm/pnz118] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE When evaluating sensory dysfunctions and pain mechanisms in patients with low back pain (LBP), a specific subgroup of patients with radicular symptoms is often excluded. Comparative studies that evaluate sensory sensitivity in patients with a dominant nociceptive and neuropathic pain component are rarely performed. Therefore, the goal of this study was to examine differences in electrical thresholds and conditioned pain modulation (CPM) between patients with low back-related leg pain (LBRLP) and patients with failed back surgery syndrome (FBSS). DESIGN Cross-sectional study. SETTING University Hospital Brussels. SUBJECTS Twenty-one patients with LBRLP and 21 patients with FBSS were included. METHODS Electrical detection thresholds (EDTs), electrical pain thresholds (EPTs), and CPM were evaluated on the symptomatic and nonsymptomatic sides. Within- and between-group differences were evaluated for all parameters. RESULTS No between-group differences were found for EDT and EPT at both sides. On the nonsymptomatic side, a significantly lower CPM effect was found in the FBSS group (P = 0.04). The only significant within-group difference was an increased EDT at the symptomatic side in patients with FBSS (P = 0.01). CONCLUSIONS LBP patients with a primary neuropathic pain component revealed altered detection sensitivity at the symptomatic side, without severe indications for altered nociceptive processing, compared with LBP patients without a dominant neuropathic pain component. Endogenous modulation is functioning in LBP patients, although it is possible that it might only be functioning partially in patients with a dominant neuropathic pain component.
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Affiliation(s)
- Lisa Goudman
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.,Pain in Motion International Research Group, www.paininmotion.be.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Huysmans
- Pain in Motion International Research Group, www.paininmotion.be.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.,Interuniversity Centre for Health Economics Research (I-CHER).,Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Iris Coppieters
- Pain in Motion International Research Group, www.paininmotion.be.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Kelly Ickmans
- Pain in Motion International Research Group, www.paininmotion.be.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion International Research Group, www.paininmotion.be.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Koen Putman
- Department of Public Health (GEWE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.,Interuniversity Centre for Health Economics Research (I-CHER)
| | - Maarten Moens
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.,Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Department of Radiology, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Vermeulen J, Buyl R, D'haenens F, Swinnen E, Stas L, Gucciardo L, Fobelets M. Midwifery students' satisfaction with perinatal simulation-based training. Women Birth 2020; 34:554-562. [PMID: 33384256 DOI: 10.1016/j.wombi.2020.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Simulation-based training has proved to be an effective teaching and learning approach in healthcare. Nevertheless, any assessment of its effectiveness should also take the students' perspective into account. AIM To validate the Satisfaction with Simulation Experience Scale (SSES) for use with midwifery students and evaluate midwifery students' satisfaction with perinatal simulation-based training. METHODS Satisfaction with simulation was assessed using the SSES, a measurement tool translated from English to Dutch. Data was collected in four consecutive years (2016-19). A mixed methods design was used to capture both qualitative and quantitative data. Using the quantitative data, factor analysis was performed to assess the construct validity, while Cronbach's alpha was used to assess internal consistency. Qualitative data was assessed using thematic content analysis. FINDINGS 367 SSES questionnaires were completed by 251 students. The exploratory factor analysis resulted in a three-factor model covering debriefing and reflection, clinical reasoning and clinical learning. Cronbach's alpha showed good internal consistency. Students were very satisfied with perinatal simulation-based training for all three factors: 4.30 (SD=0.47) for debriefing and reflection, 3.97 (SD=0.55) for clinical reasoning and 4.10 (SD=0.46) for clinical learning. Satisfaction scores remained high and stable over the years investigated. Thematic content analysis identified 6 categories: simulation-based training is valuable, the need for more simulation-based training, fidelity, students, negative feelings, and preparation is vital. CONCLUSION Students were satisfied with the simulation-based training, experiencing it as providing added value to their education. Simulations gave them the opportunity to make and learn from mistakes in a safe learning environment.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Laarbeeklaan 121, 1090 Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium.
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Florence D'haenens
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Laarbeeklaan 121, 1090 Brussels, Belgium
| | - Eva Swinnen
- Faculty of Physical Education and Physiotherapy, Rehabilitation Research, Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Lara Stas
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Leonardo Gucciardo
- Faculty of Medicine and Pharmacy, Department of Obstetrics and Prenatal Medicine, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium; Department of Obstetrics and Prenatal Medicine, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Laarbeeklaan 121, 1090 Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
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Abstract
BACKGROUND There is a lack of an up-to-date body of evidence and a comprehensive overview concerning literature on quality indicator (QI) development for dementia care. Therefore, we systematically reviewed recent literature and formulated recommendations for future research. METHODS PubMed, CINAHL and The Cochrane Library were searched for studies describing QI development or redefinition for dementia care (from first symptoms until admission to long-term care), published from 2008 to May 2019. RESULTS We included a total of 7 articles, comprising of 107 QIs. The majority of publications originated from Europe. These applied to outpatient care, primary care and end-of-life care. Most QIs referred to care processes. Several care domains were determined by the authors, ranging from screening and assessment to end-of-life care. The methodological quality of the QI sets differed considerably. The QI sets with the best methodological quality were developed using expert evaluation or a Delphi technique. CONCLUSIONS It can be concluded that a reasonable amount of QIs for assessing and optimizing community dementia care exists, however, further development and methodological improvements of these QIs are necessary. Involvement of people with dementia and caregivers in the development process and a broader focus including community oriented next to medically oriented QIs are examples of potential improvement measures.
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Affiliation(s)
- Samantha Dequanter
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics (BISI) Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maaike Fobelets
- Department of Health Care, Midwifery Department, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
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Vermeulen J, Luyben A, Buyl R, Debonnet S, Castiaux G, Niset A, Muyldermans J, Fleming V, Fobelets M. The state of professionalisation of midwifery in Belgium: A discussion paper. Women Birth 2020; 34:7-13. [PMID: 32988768 DOI: 10.1016/j.wombi.2020.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/31/2022]
Abstract
AIM To describe the state of the professionalisation of midwifery in Belgium, and to formulate recommendations for advancing the midwifery profession. METHODS A descriptive overview of maternity care in Belgium and the professionalisation of midwifery through an analysis of relevant policy and academic texts, underpinned by Greenwood's sociological criteria for a profession: (1) own body of knowledge, (2) recognised authority, (3) broader community sanctions, (4) own code of ethics and (5) professional culture sustained by formal professional associations. From these insights, recommendations for advancing the midwifery profession in Belgium are formulated. FINDINGS Current strengths of the professionalisation of midwifery in Belgium included unified midwifery education programmes, progress in midwifery research and overarching national documents for guiding midwifery education, practice and regulation. In contrast however challenges, such as the limited recognition of midwives' roles by its clientele, limitations of midwives' competencies and autonomy, lacking development of advanced roles in maternity care practice and a lack of unity of the organisation and its members, were also identified. Based on these, recommendations are made to strengthen Belgian midwifery. CONCLUSIONS Recommendations for advancing the midwifery profession in Belgium includes in particular increasing public awareness of midwives' roles and competencies, implementing the full scope of midwifery practice and monitoring and advancing this practice. Thus, professional autonomy over both midwifery practice and working conditions should be enhanced. United midwifery organisations, together with women's groups, other maternity care professionals and policy-makers as equal partners are key to bring about changes in the Belgian maternity care landscape.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Ans Luyben
- Centre for Midwifery, Maternal and Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK; Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Serena Debonnet
- Federal Public Service, Health, Food Chain Safety and Environment, Brussels, Belgium; Clinique Saint-Jean, Brussels, Belgium
| | - Geneviève Castiaux
- Paramedical Department Sainte-Elisabeth, University College of Namur-Liège-Luxembourg, Namur, Belgium
| | - Anne Niset
- Federal Public Service, Health, Food Chain Safety and Environment, Brussels, Belgium; Centre Hospitalier du Bois de l'Abbaye, Seraing, Belgium; Belgian Midwives Association, Antwerp, Belgium
| | - Joke Muyldermans
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Midwifery Practice InTeam, Hoeilaart, Belgium; Flemish Professional Association of Midwives, Antwerp, Belgium; Care4Education, Boortmeerbeek, Belgium
| | - Valerie Fleming
- School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, UK
| | - Maaike Fobelets
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Gagnon MP, Ndiaye MA, Larouche A, Chabot G, Chabot C, Buyl R, Fortin JP, Giguère A, Leblanc A, Légaré F, Motulsky A, Sicotte C, Witteman HO, Kavanagh É, Lépinay F, Roberge J, Hakim H, Brunet-Gauthier M, Délétroz C, Rahimi SA, Tchuente J, Sasseville M. User-Centered Design for Promoting Patient Engagement in Chronic Diseases Management: The Development of CONCERTO. Stud Health Technol Inform 2020; 270:1423-1424. [PMID: 32570690 DOI: 10.3233/shti200473] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Multimorbidity increases care needs among people with chronic diseases. In order to support communication between patients, their informal caregivers and their healthcare teams, we developed CONCERTO+, a patient portal for chronic disease management in primary care. A user-centered design comprising 3 iterations with patients and informal caregivers was performed. Clinicians were also invited to provide feedback on the feasibility of the solution. Several improvements were brought to CONCERTO+, and it is now ready to be implemented in real-life setting.
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Affiliation(s)
- Marie-Pierre Gagnon
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
- Faculty of Nursing, Université Laval, Québec, Canada
| | - Mame-Awa Ndiaye
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
| | | | | | | | - Ronald Buyl
- Department of Public Health, Vrije Universiteit Brussel, Jette, Belgium
| | - Jean-Paul Fortin
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
| | - Anik Giguère
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | - Annie Leblanc
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | - France Légaré
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | - Aude Motulsky
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Claude Sicotte
- School of Public Health, Université de Montréal, Montréal, Canada
| | - Holly O Witteman
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | | | | | | | - Hina Hakim
- Department of Family and Emergency Medicine, Université Laval, Québec, Canada
| | | | - Carole Délétroz
- School of Health Sciences (HESAV), HES-SO, Lausanne, Switzerland
| | - Samira A Rahimi
- Department of Health Sciences, Université du Québec à Chicoutimi, Canada
| | - Jack Tchuente
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
| | - Maxime Sasseville
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada
- Department of Health Sciences, Université du Québec à Chicoutimi, Canada
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Van Laere S, Buyl R, Nyssen M. A Stroll Along the Erroneous ePrescription Interactions Within the Belgian Pharmacy. Stud Health Technol Inform 2020; 270:803-807. [PMID: 32570493 DOI: 10.3233/shti200272] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
After the national introduction of the ePrescription in Belgium to the broader public in 2014, community pharmacists are still not satisfied completely. Reasons are (1) low acceptance of the implementation due to slow systems, (2) high reported downtimes, and (3) alert fatigue due to technical and incomprehensible error messages. Therefore, we investigated which technical errors occur in the flow of handling an ePrescription and how these errors can be avoided. A cross-sectional design was used to capture interactions of all national community pharmacists connected to the national eHealth platform on a randomly chosen working day. Per interaction, the number of errors made was observed. In total, 567,883 interactions were registered and analyzed, of which the getPrescription interaction, to download the ePrescription from the national server, was most prevalent (n = 196,433; 37.21%). A difference of 14,961 interaction calls was observed without reaching a final state (delivered or undelivered). Reasons for these differences are repetitive calls for obtaining the ePrescription or by trying to obtain the prescription again when this should no longer be possible (e.g., when an ePrescription is already delivered or archived). When looking at the markAsDelivered, markAsUndelivered or markAsArchived interactions, most of the technical handling errors are due to attempts that generate not allowed state transitions. Most of these incorrect state transitions could have been avoided by maintaining the state diagram in the pharmacist's system to enforce legal transitions and by training the community pharmacists to handle ePrescriptions appropriately.
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Affiliation(s)
- Sven Van Laere
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Belgium
| | - Ronald Buyl
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Belgium
| | - Marc Nyssen
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Belgium
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Buyl R, Beogo I, Fobelets M, Deletroz C, Van Landuyt P, Dequanter S, Gorus E, Bourbonnais A, Giguère A, Lechasseur K, Gagnon MP. e-Health interventions for healthy aging: a systematic review. Syst Rev 2020; 9:128. [PMID: 32493515 PMCID: PMC7271471 DOI: 10.1186/s13643-020-01385-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Healthy aging (HA) is a contemporary challenge for population health worldwide. Electronic health (e-Health) interventions have the potential to support empowerment and education of adults aged 50 and over. OBJECTIVES To summarize evidence on the effectiveness of e-Health interventions on HA and explore how specific e-Health interventions and their characteristics effectively impact HA. METHODS A systematic review was conducted based on the Cochrane Collaboration methods including any experimental study design published in French, Dutch, Spanish, and English from 2000 to 2018. RESULTS Fourteen studies comparing various e-Health interventions to multiple components controls were included. The target population, type of interventions, and outcomes measured were very heterogeneous across studies; thus, a meta-analysis was not possible. However, effect estimates indicate that e-Health interventions could improve physical activity. Positive effects were also found for other healthy behaviors (e.g., healthy eating), psychological outcomes (e.g., memory), and clinical parameters (e.g., blood pressure). Given the low certainty of the evidence related to most outcomes, these results should be interpreted cautiously. CONCLUSIONS This systematic review found limited evidence supporting the effectiveness of e-Health interventions, although the majority of studies show positive effects of these interventions for improving physical activity in older adults. Thus, better quality evidence is needed regarding the effects of e-Health on the physiological, psychological, and social dimensions of HA. SYSTEMATIC REVIEW REGISTRATION The review protocol was registered in PROSPERO (registration number: CRD42016033163).
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Affiliation(s)
- Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Idrissa Beogo
- École des sciences infirmières et des études de la santé/School of Nursing and Health Studies, Université de Saint-Boniface, Winnipeg, Manitoba Canada
| | - Maaike Fobelets
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Carole Deletroz
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, CH-1011 Lausanne, Switzerland
| | - Philip Van Landuyt
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Samantha Dequanter
- Faculty of Medicine and Pharmacy, Department of Public Health Sciences, Biostatistics and Medical Informatics(BISI) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Ellen Gorus
- Faculty of Medicine and Pharmacy, Department of Gerontology, Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Anne Bourbonnais
- Faculty of Nursing, Université de Montréal, Montreal, Quebec Canada
- Research Center of the Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, Quebec Canada
| | - Anik Giguère
- Faculty of Medicine, Université Laval, Quebec, Canada
- Centre de recherche sur les soins et services de première ligne de l’Université Laval (CERSSPL-UL), Quebec, Canada
- Research Center of the Centre Hospitalier de Québec-Université Laval (CRCHUQ-UL), Quebec, Canada
| | - Kathleen Lechasseur
- Faculty of Nursing Sciences, Université Laval, Québec, 1050 avenue de la Médecine, Quebec, Canada
| | - Marie-Pierre Gagnon
- Centre de recherche sur les soins et services de première ligne de l’Université Laval (CERSSPL-UL), Quebec, Canada
- Research Center of the Centre Hospitalier de Québec-Université Laval (CRCHUQ-UL), Quebec, Canada
- Faculty of Nursing Sciences, Université Laval, Québec, 1050 avenue de la Médecine, Quebec, Canada
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Van Laere S, Cornu P, Buyl R. A cross-sectional study of the Belgian community pharmacist’s satisfaction with the implementation of the electronic prescription. Int J Med Inform 2020; 135:104069. [DOI: 10.1016/j.ijmedinf.2019.104069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/20/2019] [Accepted: 12/26/2019] [Indexed: 11/26/2022]
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Vermeulen J, Buyl R, D'haenens F, Demedts D, Tricas-Sauras S, Haddani I, Fobelets M. The Development of the DDads Questionnaire: Awareness, Knowledge and Attitudes of the General Population Towards Paternal Depression. Front Psychiatry 2020; 11:561954. [PMID: 33551859 PMCID: PMC7859093 DOI: 10.3389/fpsyt.2020.561954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/21/2020] [Indexed: 11/14/2022] Open
Abstract
Objectives: Paternal perinatal depression affects ~10% of new fathers and is known to have a negative impact on men's relationship with their partner as well as with their baby. The attitudes of the general population toward paternal depression have received scant attention in the scientific literature. A better understanding of paternal depression might improve the health literacy of the population and also assist professionals and policy makers to adequately address this issue, to ultimately refine the existing health care alternatives for them. This paper describes the Belgian development, face and content validation of the DDads (Depression in Dads) questionnaire. Its focus is to identify the awareness, knowledge and attitudes of the general population toward paternal perinatal depression. Study Design: The DDads was developed using a three-step model with the following phases: (1) identification of the content domain, (2) item generation and (3) construction of the questionnaire. For the DDads validation a (a) Delphi method with content experts (n = 17) and (b) a cognitive debriefing method with lay experts (n = 20) were used to assess the clarity, relevance, wording and layout. Results: The questionnaire consists of three main components comprising: (1) three questions on awareness, (2) three questions on knowledge and (3) one question on attitudes and beliefs. After round one validation, all questions were considered content valid for relevance (I-CVI 0.94-1.00), and six questions for clarity (I-CVI 0.65-1.00). Scale content (S-CVI/Ave 0.93) and face validity (Face Validity Index 1.00) was obtained. One question was revised and split into two questions in a second round. For one of these questions, item content (0.80-0.93), scale content (0.92) and face validity (1.00) was reached. The one question, exploring the causes of paternal perinatal depression, remained inappropriate and was removed from the DDads. One last question was removed after interviews with lay experts. Conclusions: We developed an instrument to establish awareness, knowledge and attitudes of the general population toward paternal perinatal depression in Belgium. The DDads can be valuable in identifying knowledge gaps. It can help to inform policy makers and health professionals to identify gaps and predisposed attitudes in society toward paternal depression which may hinder appropriate management.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Department of Public Health, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Florence D'haenens
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
| | - Dennis Demedts
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Department of Public Health, Mental Health and Wellbeing Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sandra Tricas-Sauras
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Public Health School, CR5 - Department of Social Approaches to Health (CRISS), Université Libre de Bruxelles, Brussels, Belgium
| | - Ihsane Haddani
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium.,Department of Public Health, Biostatistics and Medical Informatics Research Group, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
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Abstract
OBJECTIVES The aim of this Belgian research study was to describe the characteristics of physicians who are at increased risk for patient-physician aggression. Second, aggression subtypes were described and data were provided on the prevalence of patient-physician aggression in Belgium. DESIGN Cross-sectional survey. SETTING Primary and secondary care inside and outside hospitals. PARTICIPANTS Any physician who had worked in Belgium for the preceding 12 months was eligible to participate (n=34 648). MAIN OUTCOME MEASURES An online, original questionnaire was used to obtain physician characteristics (eg, age, sex, native language), department, working conditions and contact with aggressive patients during their career and during the preceding 12 months. RESULTS The questionnaire was completed by 4930 participants and 3726 (76%) were valid to take into account for statistics. During the preceding 12 months, 37% had been victims of aggression: 33% experienced verbal aggression, 30% psychological, 14% physical and 10% sexual. Multiple answers were allowed. Women and younger physicians were more likely to experience aggression. Psychiatric departments and emergency departments were the settings most commonly associated with aggression. Physicians who provided primarily outpatient care were more subject to aggression. CONCLUSION Belgian physicians experience several forms of aggression. Those most at-risk of aggression are young and female physicians who work in outpatient, emergency or psychiatric settings.
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Affiliation(s)
- Lennart De Jager
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
| | - Michel Deneyer
- National Medical Council, Brussels, Belgium
- Department of Paediatrics, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health, Biostatistics and Medical Informatics, Information Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sophie Roelandt
- PRaag: Patrik Roelandt anti-aggression group, Roeselare, Belgium
| | - Ralph Pacqueu
- PRaag: Patrik Roelandt anti-aggression group, Roeselare, Belgium
| | - Dirk Devroey
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussels, Belgium
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Eechaute C, Leemans L, De Mesmaeker M, De Ridder R, Beckwée D, Struyf F, Roosen F, Buyl R, Putman K, Vaes P. The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains. J Sports Sci 2019; 38:86-93. [PMID: 31707915 DOI: 10.1080/02640414.2019.1682891] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The predictive value of the multiple hop test for first-time noncontact lateral ankle sprains. BACKGROUND Lateral ankle sprains (LAS) are very common sports injuries, cause high health care costs and are associated with postural control deficits. From a preventive point of view, clinicians should dispose valid field tests to identify athletes at risk for a LAS. The aim of this study is to evaluate the predictive value of the multiple hop test (MHT) for first-time noncontact LAS. METHODS Non-elite athletes (n = 232) performed the MHT at baseline. During a 12-month follow-up period, all noncontact LAS related to health care costs were recorded. Outcomes of the MHT (completion time, balance errors and perceived difficulty) between the injured and uninjured group were compared and odds ratios (OR) and relative risks (RR) were calculated using a logistic regression analysis. RESULTS Ten first-time noncontact LAS were recorded (4.3%). Injured athletes made significantly more change-in-support strategy (CSS) errors when compared to uninjured athletes (p = .04). The OR of the number of CSS errors was 1.14 (p = .03), the RR 4.1 (p = .04). CONCLUSIONS Athletes scoring > 12 CSS errors, have a four times increased risk for a first-time noncontact LAS. The MHT is a valid field test to identify athletes at risk for a first-time noncontact LAS.
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Affiliation(s)
- Christophe Eechaute
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lynn Leemans
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Margo De Mesmaeker
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roel De Ridder
- Department of Physical Therapy and Rehabilitation, Universiteit Gent, Gent, Belgium
| | - David Beckwée
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Filip Struyf
- Department of Rehabilitation Sciences and Physical Therapy, Universiteit Antwerpen, Wilrijk, Belgium
| | - Filip Roosen
- Department of Physical Therapy and Rehabilitation, Universiteit Gent, Gent, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Informatics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Koen Putman
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Vaes
- Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium
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Van Laere S, Cornu P, Dreesen E, Lenie J, Buyl R. Why do Belgian Community Pharmacists Still Treat Electronic Prescriptions as Paper-Based? J Med Syst 2019; 43:327. [PMID: 31646400 DOI: 10.1007/s10916-019-1456-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 09/10/2019] [Indexed: 10/25/2022]
Abstract
Belgium is in a transition phase from paper-based prescriptions to electronic prescriptions (ePrescriptions) during which both the paper and electronic format are valid. Since patients still get a paper proof of the ePrescription, sometimes pharmacists use the ePrescription as paper-based prescription. When the government demands a complete dematerialization, i.e. no more paper-based prescriptions, this will no longer be possible. Therefore, we questioned the frequency and reasons for treating an ePrescription as paper-based. The logged interactions in the national database were used to identify possible reasons. The tarification service Koninklijk Limburgs Apothekers Verbond (KLAV) provided prescriptions of June 2018. KLAV supports tarification for community pharmacies all over Belgium, thereby providing a representative sample for the Belgian community pharmacies. A two-stage cluster random sampling technique was applied to retrieve a subset of 10,000 prescriptions. In this subset we identified 4961 ePrescriptions (49.61%) of which 226 (4.56%, in total 2.26%) were treated as paper-based. Reasons observed for this incorrect handling are (1) non-compliance of the community pharmacist; (2) errors in software or handling of the community pharmacist; (3) errors at the prescriber side or patient tries to fraud; (4) incorrectly revoking the ePrescription; and (5) errors in software of prescriber. The main reasons for treating ePrescriptions as paper-based are non-compliance of the community pharmacist (n = 124, 54.87%) by ignoring its digital nature, and errors in software or handling of the community pharmacist (n = 85, 37.61%). Future research is necessary to investigate user opinions and to measure the impact of introducing ePrescribing in the daily routine.
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Affiliation(s)
- Sven Van Laere
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Pieter Cornu
- Centre for Pharmaceutical Research (CePhar), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
| | - Evy Dreesen
- Tarification Service Koninklijk Limburgs Apothekers Verbond (KLAV), Ilgatlaan 3, 3500, Hasselt, Belgium
| | - Jan Lenie
- Tarification Service Koninklijk Limburgs Apothekers Verbond (KLAV), Ilgatlaan 3, 3500, Hasselt, Belgium
| | - Ronald Buyl
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
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Fobelets M, Beeckman K, Buyl R, Healy P, Grylka-Baeschlin S, Nicoletti J, Canepa M, Devane D, Gross MM, Morano S, Daly D, Begley C, Putman K. Preference of birth mode and postnatal health related quality of life after one previous caesarean section in three European countries. Midwifery 2019; 79:102536. [PMID: 31561129 DOI: 10.1016/j.midw.2019.102536] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 09/13/2019] [Accepted: 09/18/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Women who have had a caesarean section may have a preference for birth mode during their subsequent pregnancy, either 'vaginal birth after caesarean' (VBAC) or 'elective repeat caesarean section' (ERCS). A mismatch between the preferred and actual birth mode may result in an impaired postnatal Health Related Quality of Life (HRQoL). This study examined the associations between antenatal birth mode preferences, the actual birth mode and postnatal HRQoL in women with one previous caesarean section in three European countries. DESIGN Prospective longitudinal survey, as a part of a cluster randomised trial (OptiBIRTH) SETTING: Fifteen maternity units in three European countries: Germany (5), Ireland (5) and Italy (5). PARTICIPANTS Women (≥ aged 18 years) living in Germany, Ireland and Italy with one previous caesarean section. The sample consisted of 862 women with complete antenatal and postpartum data. MEASUREMENTS Women's preference for birth mode after one previous caesarean section was assessed at inclusion to the trial, and HRQoL was assessed antenatally and at three months postpartum using the Short-Form Six-Dimension health survey. Based on women's preferences and actual birth mode six groups were determined: "match VBAC-VBAC" (preference for vaginal birth, actual mode of birth vaginal birth), "match ERCS-ERCS" (preference for caesarean section, actual mode of birth elective repeat caesarean section), "match ERCS-EMCS" (preference for caesarean section, actual mode of birth emergency repeat caesarean section), "mismatch VBAC-ERCS" (preference for vaginal birth, actual mode of birth elective repeat caesarean section), "mismatch VBAC-EMCS" (preference for vaginal birth, actual mode of birth emergency repeat caesarean section) and "no preference". Associations between the preferred and actual birth mode were examined using univariate and multivariate analyses. FINDINGS Women with preference for vaginal birth but who gave birth by elective repeat caesarean section (mismatch VBAC-ERCS) had a lower postnatal HRQoL compared to women with a preference for vaginal birth who actually had a birth vaginally (match VBAC-VBAC, p = 0.02). Poor antenatal HRQoL scores (p < 0.01) and maternal readmission postpartum (p = 0.03) are cofounding factors for poorer postnatal HRQoL scores. KEY CONCLUSIONS The results show that women with a preference for a vaginal birth who gave birth by an elective repeat caesarean section had a significantly lower HRQoL at three months postnatal. The long-term consequences and psychological health of women who do not achieve a vaginal birth after caesarean require further consideration and research. IMPLICATIONS FOR PRACTICE Attention should be given to the long-term impact of a mismatch in preferred and actual mode on the psychological health of women.
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Affiliation(s)
- Maaike Fobelets
- Department of Public Health, I-CHER (Interuniversity Centre for Health Economics Research), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium; Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Laarbeeklaan 121, 1090 Brussels, Belgium.
| | - Katrien Beeckman
- Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; Department of Nursing and Midwifery, Nursing and Midwifery research group, Universitair Ziekenhuis Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Belgium
| | - Patricia Healy
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Susanne Grylka-Baeschlin
- Midwifery Research and Education Unit, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Jane Nicoletti
- School of Medicine and Midwifery, Department of Neurology, Ophthalmology, Maternal and Childhood Sciences, Genoa University, Largo R. Benzi, 10-16132 Genova, Italy
| | - Matilde Canepa
- School of Medicine and Midwifery, Department of Neurology, Ophthalmology, Maternal and Childhood Sciences, Genoa University, Largo R. Benzi, 10-16132 Genova, Italy
| | - Declan Devane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Mechthild M Gross
- Midwifery Research and Education Unit, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Sandra Morano
- School of Medicine and Midwifery, Department of Neurology, Ophthalmology, Maternal and Childhood Sciences, Genoa University, Largo R. Benzi, 10-16132 Genova, Italy
| | - Deirdre Daly
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin D02 T283, Ireland
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin D02 T283, Ireland; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Koen Putman
- Department of Public Health, I-CHER (Interuniversity Centre for Health Economics Research), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussels, Laarbeeklaan 103, 1090 Brussels, Belgium
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Vermeulen J, Peersman W, Waegemans M, De Clercq G, Gucciardo L, Laubach M, Swinnen E, Beeckman K, Buyl R, Fobelets M. Learning experiences of final-year student midwives in labor wards: A qualitative exploratory study. Eur J Midwifery 2019; 3:15. [PMID: 33537594 PMCID: PMC7839143 DOI: 10.18332/ejm/111802] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/17/2019] [Accepted: 08/17/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Clinical placements are an integral part of midwifery education and are crucial for achieving professional competencies. Although students' experiences on placements have been shown to play a meaningful role in their learning, they have received scant attention in the literature. The aim of this paper is to describe the learning experiences of final-year student midwives in labor wards within the Brussels metropolitan region, Belgium. METHODS A qualitative exploratory study was conducted using two focus groups (N=20). Data analysis included: transcription of audio recordings, thematic content analysis with coding into recurrent and common themes, and broader categories. Discussions among researchers were incorporated in all phases of the analysis for integrity and data fit. RESULTS Data analysis identified the following categories as determining student learning experiences in labor wards: 1) managing opportunities, 2) being supported, and 3) dealing with the environment. Overall, respondents were positive and enthusiastic about their learning experiences, although some felt tense and unprepared. Students expressed concerns about differences in learning opportunities between placements and found it challenging to achieve all competencies. Student learning experiences were enhanced when they had placements for longer periods with the same supportive mentors. CONCLUSIONS Factors related to students' functioning, the healthcare professional, midwifery education and hospital environment affected their learning in labor wards. The combination of a more persevered preparation of students and mentors, together with a student-centered organization of placements, is crucial to create a positive learning experience for midwifery students in labor wards.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - Wim Peersman
- Social and Community Work, Odisee University College, Brussels, Belgium
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Matthias Waegemans
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - Gerlinde De Clercq
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
| | - Leonardo Gucciardo
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Obstetrics and Prenatal Medicine, University Hospital Brussels, Brussels, Belgium
| | - Monika Laubach
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Obstetrics and Prenatal Medicine, University Hospital Brussels, Brussels, Belgium
| | - Eva Swinnen
- Faculty of Physical Education and Physiotherapy, Rehabilitation Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Katrien Beeckman
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
- Faculty of Medicine and Pharmacy, Department Medical Sociology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Nursing and Midwifery Research Unit, University Hospital Brussels, Brussels, Belgium
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), Midwifery Research Education and Policymaking (MIDREP), University of Antwerp, Antwerp, Belgium
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Van Laere S, Cornu P, Buyl R. An Evaluation of the Belgian Community Pharmacist's Satisfaction with the Implementation of the Electronic Prescription Within a Pharmacist's Software. Stud Health Technol Inform 2019; 264:1884-1885. [PMID: 31438391 DOI: 10.3233/shti190696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In a cross-sectional study, we evaluated the perception of the community pharmacist in Belgium about his satisfaction with the implementation of the electronic prescription in his software. 246 community pharmacists scored the implementation in their software with an average of 6.46±2.16(SD) on a score of 10. This satisfaction is associated with the software used (p<0.001), the frequency of slow responses (p<0.001), the perception of unavailability of systems (p=0.003) and the knowledge of the pharmacist (p=0.036).
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Affiliation(s)
- Sven Van Laere
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium
| | - Pieter Cornu
- Centre for Pharmaceutical Research (CePhar),Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium
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Van Laere S, Buyl R. An Evaluation of the Technical Quality Within the Belgian Electronic Prescription: A Cross-Sectional Study. Stud Health Technol Inform 2019; 264:1070-1074. [PMID: 31438089 DOI: 10.3233/shti190389] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The increased use of eHealth services has shifted focus towards quality and interoperability. This study quantifies the technical quality of the ePrescription in Belgium by validating the construction of the Kind Messages for Electronic Health Records (KMEHR) used for communicating between prescriber and pharmacist, and by validating the digital signature within the ePrescription. A two-way cluster randomized subset of prescriptions of the tarification service Koninklijk Limburgs Apothekers Verbond (KLAV) is used (n = 82,952). Here, 38,032 prescriptions (45.85%) were handled electronically, but 180 prescriptions (0.22%) contained an empty KMEHR message at tarification. All 37,852 ePrescriptions (100%) passed the XSD Schema validation, but only 29,428 ePrescriptions (77.74%) passed the Software Development Kit (SDK) XPath validation rule set of the national Recip-e project. 37,622 ePrescriptions (99.39%) passed the validity test for having a correct digital signature. Improvement towards the construction and the digital signature is required in order to fully dematerialize the ePrescription workflow.
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Affiliation(s)
- Sven Van Laere
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussels, Belgium
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48
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Karara G, Verbeke F, Byiringiro JC, Nziza F, Buyl R, Nyssen M. Open Source HMIS Enabled Evaluation of Financial Burden of Disease and Patient Coverage in Three University Hospitals in Great Lakes Africa. Stud Health Technol Inform 2019; 264:969-973. [PMID: 31438068 DOI: 10.3233/shti190368] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since the eighties, case mix evaluation methods based on diagnosis-related groups (DRG) were gradually introduced in developed countries. These methods of assessing the costs of diseases to measure the productivity of the hospital have been introduced in management softwares that are not accessible to low-income countries. In this study, the authors applied these methods to an open source hospital management information system (HMIS) implemented in three university hospitals in Great Lakes Africa. A comparative study of the financial burden of five major diseases, monitored as part of a universal health coverage (UHC) analysis, was carried out. The level of coverage of patients in the hospitals was evaluated and the impact of UHC policies demonstrated. Although the financial protection of patients treated in the three hospitals had improved, HIV and tuberculosis treatments that ought to be free, remained a considerable financial burden for the patient.
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Affiliation(s)
- Gustave Karara
- Department of Public Health, Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium.,Burundi Health Informatics Association, Bujumbura, Burundi
| | - Frank Verbeke
- Burundi Health Informatics Association, Bujumbura, Burundi
| | - Jean-Claude Byiringiro
- Division of Clinical, Education and Research, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Franck Nziza
- Burundi Health Informatics Association, Bujumbura, Burundi
| | - Ronald Buyl
- Department of Public Health, Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Marc Nyssen
- Department of Public Health, Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium
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Foulon I, De Brucker Y, Buyl R, Lichtert E, Verbruggen K, Piérard D, Camfferman FA, Gucciardo L, Gordts F. Hearing Loss With Congenital Cytomegalovirus Infection. Pediatrics 2019; 144:peds.2018-3095. [PMID: 31266824 DOI: 10.1542/peds.2018-3095] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [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] [Accepted: 05/07/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In this study, we determined the prevalence of hearing loss in 157 children with proven congenital cytomegalovirus (cCMV) infection. We looked at possible risk determinants for developing hearing loss and proposed recommendations for screening and follow-up in the newborn. METHODS In a prospective 22-year study, 157 children with proven cCMV infection were evaluated for sensorineural hearing loss (SNHL). The development of SNHL was correlated with the type of maternal infection (primary versus nonprimary), the gestational age of maternal primary infection, imaging findings at birth, and the presence of symptomatic or asymptomatic infection in the newborn. RESULTS Of all children, 12.7% had SNHL, and 5.7% needed hearing amplification because of SNHL. Improvement, progression, and fluctuations of hearing thresholds were seen in 45%, 53.8%, and 5.7% of the children, respectively. Hearing loss was more common in the case of a symptomatic infection at birth (P = .017), after a maternal primary infection in the first trimester of pregnancy (P = .029), and in the presence of abnormalities on a neonatal brain ultrasound and/or MRI (P < .001). CONCLUSION SNHL is a common sequela in children with cCMV infection. Risk factors for SNHL were primary maternal infections before the 14th week of pregnancy, the presence of a disseminated infection at birth, and imaging abnormalities in the newborn. These children may benefit from a more thorough investigation for SNHL than children who do not present with those risk factors.
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Affiliation(s)
- Ina Foulon
- Departments of Otolaryngology, Head and Neck Surgery,
| | | | - Ronald Buyl
- Department of Public Health and Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel, Brussels, Belgium; and
| | - Elke Lichtert
- Departments of Otolaryngology, Head and Neck Surgery
| | | | - Denis Piérard
- Department of Microbiology and Infection Control, Belgian National Reference Centre for Congenital Infections, Universitair Ziekenhuis Brussel and Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Léonardo Gucciardo
- Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel and Vrije Universiteit Brussel, Brussels, Belgium
| | - Frans Gordts
- Departments of Otolaryngology, Head and Neck Surgery
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Mostinckx L, Segers I, Belva F, Buyl R, Santos-Ribeiro S, Blockeel C, Smitz J, Anckaert E, Tournaye H, De Vos M. Obstetric and neonatal outcome of ART in patients with polycystic ovary syndrome: IVM of oocytes versus controlled ovarian stimulation. Hum Reprod 2019; 34:1595-1607. [DOI: 10.1093/humrep/dez086] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/19/2019] [Accepted: 05/07/2019] [Indexed: 12/26/2022] Open
Abstract
ABSTRACT
STUDY QUESTION
Does IVM of immature oocytes retrieved from small antral follicles in women with polycystic ovary syndrome (PCOS) have an impact on obstetric and neonatal outcomes compared to controlled ovarian stimulation (COS)?
SUMMARY ANSWER
Obstetric and neonatal outcomes after IVM appear to be similar to those after COS.
WHAT IS KNOW ALREADY
Women with PCOS have an increased risk of adverse pregnancy outcomes and congenital malformations in their offspring. For patients with PCOS who require IVF, IVM of germinal vesicle (GV)-stage oocytes retrieved from antral follicles has been adopted as a mild approach ART, with improved pregnancy rates over the last two decades. Although reports of obstetrical and neonatal outcomes after IVM have been reassuring, the limited sample sizes in previous studies preclude firm conclusions, and further study is warranted.
STUDY DESIGN, SIZE, DURATION
This is a retrospective observational study analysing obstetric and neonatal data from 1036 clinical pregnancies in unique patients with PCOS who conceived following a cycle of IVM or COS between January 2010 and December 2016 in a tertiary reproductive centre. In total, 393 singleton pregnancies with a gestational age beyond 20 weeks were included. A phenotypic approach was used for the diagnosis of PCOS. Pregnancies following oocyte donation, standard IVF (as opposed to ICSI) or preimplantation genetic testing and pregnancies requiring testicular biopsy in the male partners were excluded.
PARTICIPANTS/MATERIALS,SETTING, METHODS
Pregnancy outcomes were analysed in women with PCOS phenotype A, C or D, as defined by different combinations of the Rotterdam criteria. Data from 164 pregnancies beyond 20 weeks after IVM were compared with those from 229 pregnancies after COS. Pregnancies in the IVM group were obtained after minimal ovarian stimulation and IVF with ICSI of transvaginally collected GV oocytes that had reached the metaphase II stage in vitro after 28 to 40 h of culture. No hCG trigger was administered before oocyte retrieval. Outcome measures were analysed or reported in singleton pregnancies only and included adverse obstetric events and neonatal health parameters, in particular birthweight, prematurity, small-for-gestational age, large-for-gestational age, perinatal death and major/minor malformation rates. The incidence of hypertensive disorders of pregnancy (HDP) and birthweight was analysed by multiple linear and logistic regression, adjusted for relevant treatment variables and maternal characteristics.
MAIN RESULTS AND THE ROLE OF CHANCE
The IVM and the COS groups differed significantly (P < 0.001) for maternal circulating AMH levels and PCOS phenotype distribution, with more of the PCOS phenotype A in the IVM group. Pregnant women in the IVM group were younger than pregnant women in the COS group (P = 0.05). With regard to obstetric complications in singleton pregnancies, in the unadjusted analysis, mothers of infants in the IVM group more often had HDP (29/164 (17.9%) vs 22/229 (9.6%), P = 0.02) compared with mothers in the COS group. Singletons born after IVM and COS had a similar birthweight standard deviation score (SDS) (0.51 ± 0.94 after IVM vs 0.33 ± 1.05 after COS, P = 0.19). Preterm birth rate (32–36.9 weeks) and early preterm birth rate (<32 weeks) were also similar in both groups. The total malformation rate was 4.1% in singletons after IVM and 2.4% in singletons after COS. Multivariate linear regression analysis accounting for relevant confounders demonstrated that parity was the only independent predictive factor (P = 0.04) for birthweight SDS. Multivariate logistic regression analysis showed that BMI, parity and type of ART (IVM as opposed to COS) were significantly correlated with the incidence of HDP. Only patients with the PCOS phenotype A showed a tendency towards a higher risk of HDP in those who underwent IVM compared to those who had COS.
LIMITATIONS, REASONS FOR CAUTION
The study is limited by its retrospective nature and loss to follow-up of a subset of children with no information regarding congenital malformations. Furthermore, the paediatricians who assessed the children after birth were not blinded for the type of ART procedure.
WIDER IMPLICATIONS OF THE FINDINGS
This study provides further evidence that, compared to COS, IVM of oocytes derived from small antral follicles does not adversely affect the neonatal health of the offspring of patients with PCOS. The observed increased risk of HDP in patients with PCOS phenotype A following IVM treatment warrants further scrutiny.
STUDY FUNDING/COMPETING INTEREST(S)
Translational IVM research at Universitair Ziekenhuis Brussel (UZ Brussel) and Vrije Universiteit Brussel (VUB) has been supported by grants from the Institute for the Promotion of Innovation by Science and Technology in Flanders (Agentschap voor Innovatie door Wetenschap en Technologie—IWT, project 110680), the Fund for Research Flanders (Fonds Wetenschappelijk Onderzoek–Vlaanderen—FWO, project G.0343.13) and the Belgian Foundation Against Cancer (HOPE project, Dossier C69). Clinical IVM research was supported by research grants from Cook Medical and Besins Healthcare. M.D.V. reports honoraria for lectures from Cook Medical and Besins Healthcare outside the submitted work. S.S.R. reports honoraria for lectures by MSD and Besins and research grants by MSD, Ferring and Merck Serono outside of the submitted work. C.B. reports personal fees from Merck-Serono, Ferring, IBSA, Finox, MSD and Abbott outside the submitted work. H.T. reports grants from Merck, MSD, Goodlife, Cook, Roche, Besins, Ferring, Mithra (now Allergan) and the Research Fund of Flanders (FWO) and consultancy fees from Finox, Abbott, Obseva and Ovascience outside the submitted work. The other authors have nothing to disclose.
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Affiliation(s)
- L Mostinckx
- Centre for Reproductive MedicineUZ Brussel, Brussels, Belgium
| | - I Segers
- Centre for Medical Genetics, UZ Brussel, Brussels, Belgium
| | - F Belva
- Centre for Medical Genetics, UZ Brussel, Brussels, Belgium
| | - R Buyl
- Department of Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels, Belgium
| | - S Santos-Ribeiro
- Gynecology/Reproductive Medicine, IVI-RMA Lisboa, Lisbon, Portugal
| | - C Blockeel
- Centre for Reproductive MedicineUZ Brussel, Brussels, Belgium
| | - J Smitz
- Laboratory of Clinical Chemistry and Radioimmunology, UZ Brussel, Brussels, Belgium
| | - E Anckaert
- Laboratory of Clinical Chemistry and Radioimmunology, UZ Brussel, Brussels, Belgium
| | - H Tournaye
- Centre for Reproductive MedicineUZ Brussel, Brussels, Belgium
| | - M De Vos
- Centre for Reproductive MedicineUZ Brussel, Brussels, Belgium
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