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Kolade OR, Porat-Dahlerbruch J, Makhmutov R, van Achterberg T, Ellen ME. Strategies for engaging older adults and informal caregivers in health policy development: A scoping review. Health Res Policy Syst 2024; 22:26. [PMID: 38374133 PMCID: PMC10875823 DOI: 10.1186/s12961-024-01107-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/12/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Care for older adults is high on the global policy agenda. Active involvement of older adults and their informal caregivers in policy-making can lead to cost-effective health and long-term care interventions. Yet, approaches for their involvement in health policy development have yet to be extensively explored. This review maps the literature on strategies for older adults (65+ years) and informal caregivers' involvement in health policy development. METHOD As part of the European Union TRANS-SENIOR program, a scoping review was conducted using the Joanna Briggs Institute's methodology. Published and grey literature was searched, and eligible studies were screened. Data were extracted from included studies and analysed using the Multidimensional Framework for Patient and Family Engagement in Health and Healthcare. RESULTS A total of 13 engagement strategies were identified from 11 publications meeting the inclusion criteria. They were categorized as "traditional", "deliberative" and "others", adopting the World Bank's categorization of engagement methods. Older adults and informal caregivers are often consulted to elicit opinions and identify priorities. However, their involvement in policy formulation, implementation and evaluation is unclear from the available literature. Findings indicate that older adults and their informal caregivers do not often have equal influence and shared leadership in policy-making. CONCLUSION Although approaches for involving older adults and their informal caregivers' involvement were synthesized from literature, we found next to no information about their involvement in policy formulation, implementation and evaluation. Findings will guide future research in addressing identified gaps and guide policy-makers in identifying and incorporating engagement strategies to support evidence-informed policy-making processes that can improve health outcomes for older adults/informal caregivers.
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Affiliation(s)
- Opeyemi Rashidat Kolade
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, University of Leuven, KU Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium
| | - Joshua Porat-Dahlerbruch
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA
| | - Rustem Makhmutov
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Institute for Health and Nursing Science, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Theo van Achterberg
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, University of Leuven, KU Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium
| | - Moriah Esther Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
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Groenvynck L, Khemai C, de Boer B, Beaulen A, Hamers JPH, van Achterberg T, van Rossum E, Meijers JMM, Verbeek H. The perspectives of older people living with dementia regarding a possible move to a nursing home. Aging Ment Health 2023; 27:2377-2385. [PMID: 37099667 DOI: 10.1080/13607863.2023.2203693] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/04/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND/OBJECTIVES Moving into a nursing home is often an unavoidable life event for older people living with dementia. It is associated with negative emotions and outcomes. Research capturing their perspectives is scarce. This study aims to identify how older people living with dementia perceive a potential life in a nursing home and to understand their (future) care wishes. MATERIALS AND METHODS This study is part of the European TRANS-SENIOR research network. The study followed a qualitative phenomenological methodology. Semi-structured interviews with 18 community-dwelling older people living with dementia were conducted between August 2018 and October 2019 (METCZ20180085). A stepwise interpretive phenomenological analysis was performed. RESULTS The majority of community-dwelling older people feared the idea of potentially moving to a nursing home. The participants associated a possible move with negative perceptions and emotions. Additionally, this study emphasized the importance of knowledge of current and past experiences with care when identifying the participant's wishes. They wanted to remain (a) individuals, who are (b) autonomous and have (c) social contacts if they would move to a nursing home. DISCUSSION/IMPLICATIONS This study showed how past and current care experiences can educate/inform healthcare professionals on the future care wishes of older people living with dementia. The results indicated that listening to the wishes, and life stories of people living with dementia could be a way of identifying 'a suitable time' to suggest a move to a nursing home. This could improve the transitional care process and adjustment to living in a nursing home.
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Affiliation(s)
- Lindsay Groenvynck
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Chandni Khemai
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Bram de Boer
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Audrey Beaulen
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Jan P H Hamers
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Erik van Rossum
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- Zuyd University of Applied Sciences, Academy of Nursing, Research centre on Community Care, Heerlen, The Netherlands
| | - Judith M M Meijers
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- Zuyderland Care, Zuyderland Medical Center, Sittard-Geleen, The Netherlands
| | - Hilde Verbeek
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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Keymeulen A, Staal IIE, de Kroon MLA, van Achterberg T. Known groups validity of the SPARK36: To guide nurse-led consultations for the early detection of child developmental and parenting problems. J Adv Nurs 2023; 79:3997-4007. [PMID: 37226560 DOI: 10.1111/jan.15711] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/18/2023] [Accepted: 05/05/2023] [Indexed: 05/26/2023]
Abstract
AIM Early detection of child developmental and parenting problems is important for timely prevention. The SPARK36 (Structured Problem Analysis of Raising Kids aged 36 months) is a novel broad-scope structured interview guide aimed at assessing parenting concerns and needs for support for child developmental and parenting problems, using the parental and professional's (Youth Health Care nurses) perspective. The applicability of the SPARK36 in practice was already demonstrated. Our aim was to evaluate its known groups validity. DESING/METHODS SPARK36 data were collected in a cross-sectional study in 2020-2021. The known groups validity was assessed by testing two hypotheses: the SPARK36 risk assessment shows a higher risk of parenting and child developmental problems in children (1) from parents with a lower socioeconomic status and (2) from families with ≥4 risk factors for child maltreatment. To test the hypotheses, Fisher's exact tests were applied. RESULTS In total, 29 Youth Health Care nurses from four School Health Services performed SPARK36-led consultations with 599 parent-child pairs to assess the risk for child developmental and parenting problems. Both hypotheses were accepted at a significant p level. CONCLUSION The results of the known groups validity support the hypothesis that the SPARK36 risk assessment for child developmental and parenting problems is carried out in a valid way. Future research is needed to assess other aspects of the validity and reliability of the SPARK36. IMPACT This is a first step in validating the instrument for use during a nurse-led consultation with parents of 3-year-olds in Flemish School Health Services. Thereby, SPARK36 supports the nurses in accomplishing their assignment, making a risk assessment, and contributes to quality of care. PATIENT OR PUBLIC CONTRIBUTION This study aimed to evaluate the known groups validity of the SPARK36. Therefore, it was not conducted using input from the public or the patient population.
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Affiliation(s)
- Ann Keymeulen
- Flemish Scientific Society for Youth Health Care, Leuven, Belgium
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, University of Leuven, KU Leuven, Leuven, Belgium
| | - Ingrid I E Staal
- Preventive Child Health Care, Municipal Health Service Zeeland, Goes, The Netherlands
- Dutch Knowledge Centre for Youth Health, NCJ, Utrecht, The Netherlands
| | - Marlou L A de Kroon
- Department of Public Health and Primary Care, Environment and Health, Youth Health Care, University of Leuven, KU Leuven, Leuven, Belgium
- Department of Health Sciences, Environment and Health, Youth Health Care, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, University of Leuven, KU Leuven, Leuven, Belgium
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Fakha A, de Boer B, Hamers JP, Verbeek H, van Achterberg T. Systematic development of a set of implementation strategies for transitional care innovations in long-term care. Implement Sci Commun 2023; 4:103. [PMID: 37641112 PMCID: PMC10463528 DOI: 10.1186/s43058-023-00487-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/09/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Numerous transitional care innovations (TCIs) are being developed and implemented to optimize care continuity for older persons when transferring between multiple care settings, help meet their care needs, and ultimately improve their quality of life. Although the implementation of TCIs is influenced by contextual factors, the use of effective implementation strategies is largely lacking. Thus, to improve the implementation of TCIs targeting older persons receiving long-term care services, we systematically developed a set of viable strategies selected to address the influencing factors. METHODS As part of the TRANS-SENIOR research network, a stepwise approach following Implementation Mapping (steps 1 to 3) was applied to select implementation strategies. Building on the findings of previous studies, existing TCIs and factors influencing their implementation were identified. A combination of four taxonomies and overviews of change methods as well as relevant evidence on their effectiveness were used to select the implementation strategies targeting each of the relevant factors. Subsequently, individual consultations with scientific experts were performed for further validation of the process of mapping strategies to implementation factors and for capturing alternative ideas on relevant implementation strategies. RESULTS Twenty TCIs were identified and 12 influencing factors (mapped to the Consolidated Framework for Implementation Research) were designated as priority factors to be addressed with implementation strategies. A total of 40 strategies were selected. The majority of these target factors at the organizational level, e.g., by using structural redesign, public commitment, changing staffing models, conducting local consensus discussions, and organizational diagnosis and feedback. Strategies at the level of individuals included active learning, belief selection, and guided practice. Each strategy was operationalized into practical applications. CONCLUSIONS This project developed a set of theory and evidence-based implementation strategies to address the influencing factors, along further tailoring for each context, and enhance the implementation of TCIs in daily practice settings. Such work is critical to advance the use of implementation science methods to implement innovations in long-term care successfully.
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Affiliation(s)
- Amal Fakha
- Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands.
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands.
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium.
| | - Bram de Boer
- Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Jan P Hamers
- Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
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Fakha A, Leithaus M, de Boer B, van Achterberg T, Hamers JP, Verbeek H. Implementing Four Transitional Care Interventions for Older Adults: A Retrospective Collective Case Study. Gerontologist 2023; 63:451-466. [PMID: 36001088 PMCID: PMC10028228 DOI: 10.1093/geront/gnac128] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Four interventions to improve care transitions between hospital and home or community settings for older adults were implemented in Leuven, Belgium over the past 4 years. These complex interventions consist of multiple components that challenge their implementation in practice. This study examines the influencing factors, strategies used to address challenges in implementing these interventions, and implementation outcomes from the perspectives of health care professionals involved. RESEARCH DESIGN AND METHODS This was a qualitative, collective case study that was part of the TRANS-SENIOR research network. Authors conducted semistructured interviews with health care professionals about their perceptions regarding the implementation. Thematic analysis was used, and the Consolidated Framework for Implementation Research guided the final data interpretation. RESULTS Thirteen participants were interviewed. Participants reported major implementation bottlenecks at the organizational level (resources, structure, and information continuity), while facilitators were at the individual level (personal attributes and champions). They identified engagement as the primary strategy used, and suggested other important strategies for the future sustainability of the interventions (building strategic partnerships and lobbying for policies to support transitional care). They perceived the overall implementation favorably, with high uptake as a key outcome. DISCUSSION AND IMPLICATIONS This study highlights the strong role of health care providers, being motivated and self-driven, to foster the implementation of interventions in transitional care in a bottom-up way. It is important to use implementation strategies targeting both the individual-level factors as well as the organizational barriers for transitional care interventions in the future.
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Affiliation(s)
- Amal Fakha
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Merel Leithaus
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Bram de Boer
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Jan P Hamers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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Bunn C, Palmer V, Chng NR, Andersen E, Gray CM, Hunt K, Jelsma JGM, Morgan H, der Sanden MNV, Pereira HV, Philpott M, Roberts GC, Rooksby J, Røynesdal ØB, Silva MN, Sørensen M, Teixeira PJ, van Achterberg T, van de Glind I, van Mechelen W, van Nassau F, van der Ploeg HP, Wyke S. How European Fans in Training (EuroFIT), a lifestyle change program for men delivered in football clubs, achieved its effect: a mixed methods process evaluation embedded in a randomised controlled trial. BMC Public Health 2023; 23:526. [PMID: 36941552 PMCID: PMC10026416 DOI: 10.1186/s12889-023-15419-y] [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: 11/21/2022] [Accepted: 03/10/2023] [Indexed: 03/22/2023] Open
Abstract
BACKGROUND A randomised trial of European Fans in Training (EuroFIT), a 12-week healthy lifestyle program delivered in 15 professional football clubs in the Netherlands, Norway, Portugal, and the United Kingdom, successfully increased physical activity and improved diet but did not reduce sedentary time. To guide future implementation, this paper investigates how those effects were achieved. We ask: 1) how was EuroFIT implemented? 2) what were the processes through which outcomes were achieved? METHODS We analysed qualitative data implementation notes, observations of 29 of 180 weekly EuroFIT deliveries, semi-structured interviews with 16 coaches and 15 club representatives, and 30 focus group discussions with participants (15 post-program and 15 after 12 months). We descriptively analysed quantitative data on recruitment, attendance at sessions and logs of use of the technologies and survey data on the views of participants at baseline, post program and after 12 months. We used a triangulation protocol to investigate agreement between data from difference sources, organised around meeting 15 objectives within the two research questions. RESULTS We successfully recruited clubs, coaches and men to EuroFIT though the draw of the football club seemed stronger in the UK and Portugal. Advertising that emphasized getting fitter, club-based deliveries, and not 'standing out' worked and attendance and fidelity were good, so that coaches in all countries were able to deliver EuroFIT flexibly as intended. Coaches in all 15 clubs facilitated the use of behaviour change techniques and interaction between men, which together enhanced motivation. Participants found it harder to change sedentary time than physical activity and diet. Fitting changes into daily routines, planning for setbacks and recognising the personal benefit of behaviour change were important to maintain changes. Bespoke technologies were valued, but technological hitches frustrated participants. CONCLUSION EuroFIT was delivered as planned by trained club coaches working flexibly in all countries. It worked as expected to attract men and support initiation and maintenance of changes in physical activity and diet but the use of bespoke, unstable, technologies was frustrating. Future deliveries should eliminate the focus on sedentary time and should use only proven technologies to support self-monitoring and social interaction. TRIAL REGISTRATION ISRCTN81935608, registered 16/06/2015.
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Affiliation(s)
- Christopher Bunn
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK.
| | - Victoria Palmer
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Nai Rui Chng
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Eivind Andersen
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
| | - Cindy M Gray
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
- Institute for Social Marketing and Health, Faculty of Health and Sports Sciences, University of Stirling, Scotland, UK
| | - Judith G M Jelsma
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Heather Morgan
- Institute of Applied Health Sciences, University of Aberdeen, Scotland, UK
| | - Maria Nijhuis-van der Sanden
- Radboud Institute for Health Sciences, Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
| | - Hugo V Pereira
- CIDEFES - Centro de Investigação em Desporto, Faculdade de Educação Física e Desporto da Universidade Lusófona, Educação Física, Exercício e Saúde, Lisbon, Portugal
| | | | - Glyn C Roberts
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
| | - John Rooksby
- Computer and Information Sciences, Northumbria University, Newcastle Upon Tyne, UK
| | - Øystein B Røynesdal
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
- Department of Teacher Education, NLA University College, Bergen, Norway
| | - Marlene N Silva
- CIDEFES - Centro de Investigação em Desporto, Faculdade de Educação Física e Desporto da Universidade Lusófona, Educação Física, Exercício e Saúde, Lisbon, Portugal
- Direcção-Geral da Saúde, Programa Nacional Para a Promoção da Atividade Física, Lisbon, Portugal
| | - Marit Sørensen
- Institute for Sport and Social Science, Norwegian School of Sport Science, Oslo, Norway
| | - Pedro J Teixeira
- CIDEFES - Centro de Investigação em Desporto, Faculdade de Educação Física e Desporto da Universidade Lusófona, Educação Física, Exercício e Saúde, Lisbon, Portugal
| | - Theo van Achterberg
- Department of Public Health and Primary Care, KU Louvain, Academic Centre for Nursing and Midwifery, Louvain, Belgium
| | - Irene van de Glind
- FWG, Department of Researchesearch and Development, Utrecht, The Netherlands
| | - Willem van Mechelen
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Femke van Nassau
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Hidde P van der Ploeg
- Amsterdam Public Health Research Institute, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Sally Wyke
- School of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, UK
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Kraun L, van Achterberg T, Vlaeyen E, Fret B, Briké SM, Ellen M, De Vliegher K. Transitional care decision-making through the eyes of older people and informal caregivers: An in-depth interview-based study. Health Expect 2023; 26:1266-1275. [PMID: 36919194 PMCID: PMC10154836 DOI: 10.1111/hex.13743] [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: 12/30/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Older people with multifaceted care needs often require treatment and complex care across different settings. However, transitional care is often inadequately managed, and older people and their informal caregivers are not always sufficiently heard and/or supported in transitional care decision-making. OBJECTIVE To explore older people's and informal caregivers' experiences with, views on, and needs concerning empowerment in transitional care decision-making. METHODS A qualitative descriptive study was conducted in the TRANS-SENIOR consortium's collaborative research using semistructured in-depth interviews between October 2020 and June 2021 in Flanders, Belgium. A total of 29 people were interviewed, including 14 older people and 15 informal caregivers who faced a transition from home to another care setting or vice versa. Data were analysed according to the Qualitative Analysis Guide of Leuven. FINDINGS Five themes were identified in relation to the participant's experiences, views and needs: involvement in the decision-making process; informal caregivers' burden of responsibility; the importance of information and support; reflections on the decision and influencing factors. CONCLUSIONS Overall, older people and informal caregivers wished to be more seen, recognised, informed and proactively supported in transitional care decision-making. However, their preferences for greater involvement in decision-making vary and are affected by several factors that are both intrinsic and extrinsic. Therefore, healthcare systems might seek out age-tuned and person-centred empowerment approaches focusing on older people's and informal caregivers' empowerment. For future studies, we recommend developing specific strategies for such empowerment. PATIENT OR PUBLIC CONTRIBUTION Older persons' representatives were involved in designing the TRANS-SENIOR programme of research, including the current study. Healthcare professionals and nursing care directors were involved in the study design and the selection and recruitment of participants.
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Affiliation(s)
- Lotan Kraun
- Nursing Department, Wit-Gele Kruis van Vlaanderen, Brussels, Belgium.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.,Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Ellen Vlaeyen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Bram Fret
- Nursing Department, Wit-Gele Kruis van Vlaanderen, Brussels, Belgium
| | - Sarah Marie Briké
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Moriah Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel.,Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kristel De Vliegher
- Nursing Department, Wit-Gele Kruis van Vlaanderen, Brussels, Belgium.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
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Lepore M, Zúñiga F, Schols JMGA, Wingenfeld K, van Achterberg T, Murray B. How Long-Term Care Quality Measures Address Alzheimer's Disease and Related Dementias in European Countries. J Am Med Dir Assoc 2023; 24:729-734. [PMID: 36977501 DOI: 10.1016/j.jamda.2023.02.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/28/2023]
Abstract
OBJECTIVES Alzheimer's disease and related dementias (ADRD) are prevalent conditions in long-term care homes (LTCHs) with most LTCH residents living with ADRD in many countries. Despite the prevalence of ADRD in LTCHs, a recent examination of LTCH quality measurement programs in 4 countries revealed few LTCH quality measures addressed ADRD, most commonly as a risk adjuster. We sought to better understand how quality measurement programs address ADRD internationally. DESIGN International comparative analysis. SETTING AND PARTICIPANTS We examined LTCH quality measures in 4 European countries-Germany, Switzerland, Belgium, and the Netherlands. METHODS The specifications to calculate each measure were assessed to determine whether the measure was calculated without assessing for ADRD, included only residents with ADRD, excluded residents with ADRD, or was risk adjusted for the presence of ADRD among the LTCH residents. RESULTS A total of 143 measures were examined across 4 quality measurement programs. Thirty-seven percent of the measures explicitly address ADRD. The programs addressed ADRD in starkly different ways. In Germany, most (13 of 15) measures addressed ADRD, and did so as an exclusion or inclusion criterion, and in Switzerland all the measures addressed ADRD through risk adjustment. In Flanders, Belgium, all measures were calculated without assessing for ADRD. In the Netherlands, one-third of the measures explicitly addressed ADRD by restricting the measure to psychogeriatric units. CONCLUSIONS AND IMPLICATIONS Although limited to examining measures from LTCH quality measurement programs in 4 European countries, this study adds evidence that ADRD tends not to be addressed by LTCH quality measures, but when ADRD is addressed, it tends to be through inclusion or exclusion criteria. LTCH regulators, policymakers, and providers can use this information to assess options for addressing ADRD in quality measurement programs. Future research is needed to assess how standard indicators of ADRD care quality differ across quality measurement programs.
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Affiliation(s)
- Michael Lepore
- University of Maryland School of Nursing, Baltimore, MD, USA.
| | | | - Jos M G A Schols
- Department of Health Services Research and Department of Family Medicine, CAPHRI-Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Klaus Wingenfeld
- Institute of Nursing Science at the University of Bielefeld, Bielefeld, Germany
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Briana Murray
- University of Maryland School of Nursing, Baltimore, MD, USA
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9
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Kraun L, De Vliegher K, Ellen M, van Achterberg T. Interventions for the empowerment of older people and informal caregivers in transitional care decision-making: short report of a systematic review. BMC Geriatr 2023; 23:113. [PMID: 36855081 PMCID: PMC9976408 DOI: 10.1186/s12877-023-03813-5] [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: 09/02/2022] [Accepted: 02/08/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Care transitions across different settings necessitate careful decision-making for all parties involved, yet research indicates that older people and informal caregivers do not have a strong voice in such decisions. OBJECTIVE To provide a systematic overview of the literature about interventions designed to empower older people and informal caregivers in transitional care decision-making. DESIGN A systematic review (Prospero Protocol CRD42020167961; funded by the EU's Horizon 2020 program). DATA SOURCES Five databases were searched: PubMed, EMBASE, Web of Science, PsycINFO, and CINAHL. REVIEW METHODS The review included evaluations of empowerment in decision-making interventions for older people and informal caregivers facing care transitions, that were published from the inception of the databases up until April 2022. Data extractions were performed by two independent researchers and the quality of studies was assessed with the relevant JBI-critical appraisal tools. A narrative descriptive analysis of the results was performed. FINDINGS Ten studies, reporting on nine interventions, and including a total of 4642 participants, were included. Interventions included transition preparation tools, support from transition coaches, shared decision-making interventions, and advance care planning. Designs and outcomes assessed were highly diverse and showed a mix of positive and lacking effects. CONCLUSIONS There is a lack of research on how to empower older people and their informal caregivers in transitional care decision-making. Empowerment in decision-making is usually not central in transitional care interventions, and effects on actual empowerment are mostly not assessed. Conclusions on how to empower older people and informal caregivers in transitional care decision-making cannot be drawn.
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Affiliation(s)
- Lotan Kraun
- Nursing Departement, Wit-Gele Kruis van Vlaanderen, Brussels, Belgium. .,KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, University of Leuven, Leuven, Belgium. .,Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
| | - Kristel De Vliegher
- Nursing Departement, Wit-Gele Kruis van Vlaanderen, Brussels, Belgium.,KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, University of Leuven, Leuven, Belgium
| | - Moriah Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.,Institute of Health Policy Management and Evaluation, Dalla Lana School Of Public Health, University of Toronto, Toronto, Canada
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, University of Leuven, Leuven, Belgium
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10
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van Nassau F, Huis A, van de Glind I, Andersen E, Bunn C, Gray CM, Hunt K, Jelsma JGM, van Mechelen W, Morgan H, Røynesdal Ø, Pereira HV, van der Ploeg HP, Roberts GC, Silva MN, Sørensen M, Wyke S, Nijhuis-van der Sanden MWG, van Achterberg T. Factors influencing the implementation of the EuroFIT lifestyle change program in professional football clubs in Europe: a qualitative study in four European countries. Transl Behav Med 2023; 13:212-225. [PMID: 36694360 PMCID: PMC10105865 DOI: 10.1093/tbm/ibac100] [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: 01/26/2023] Open
Abstract
This paper investigated facilitators and barriers to implementing the European Football Fans in Training program (EuroFIT) in professional sports clubs in England, the Netherlands, Norway, and Portugal. We analyzed qualitative data collected at clubs that delivered EuroFIT, based on semi-structured interviews with coordinating staff (n = 15), coaches (n = 16), and focus group interviews with participants (n = 108), as well as data from clubs that considered delivering EuroFIT in the future, based on interviews with staff (n = 7) and stakeholders (n = 8). Facilitators for implementation related to the content and structure of the program, its evidence-base, and the context for delivery in the football stadia. Financial and human resources were both facilitators and barriers. Further barriers were mostly practical, relating to human resources and infrastructure. Major differences between countries related to experience and commitment to running community projects, and differences in infrastructure, financing, and human resources. Professional football clubs' ability to support health promotion efforts depended on their ethos and the financial and human resources available to them. Overall, the EuroFIT program was well received by clubs, coaches, participants, and stakeholders, which was reflected by the many facilitators supporting sustained implementation. For sustainable implementation, it is crucial that clubs and their stakeholders engage fully with the EuroFIT program and understand that for an adequate program delivery their views (ethos) and ways of working influence the implementation and thereby the effectiveness of EuroFIT. An important prerequisite for future roll out of EuroFIT would be a strong EuroFIT delivery partner organization to ensure financial and human resources while overseeing and guiding the quality of delivery in clubs.
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Affiliation(s)
- Femke van Nassau
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anita Huis
- Radboud Institute for Health Sciences, Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
| | - Irene van de Glind
- Radboud Institute for Health Sciences, Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
| | - Eivind Andersen
- Department of Sport and Social Sciences, NSSS, Institute for Sport and Social Sciences, Oslo, Norway
| | - Christopher Bunn
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Kate Hunt
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.,Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Judith G M Jelsma
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Heather Morgan
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Øystein Røynesdal
- Department of Sport and Social Sciences, NSSS, Institute for Sport and Social Sciences, Oslo, Norway.,Department of Teacher Education, NLA University College, Bergen, Norway.,Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Hugo V Pereira
- CIDEFES Faculdade de Educação Física e Desporto, Universidade Lusófona, Lisbon, Portugal.,Faculdade de Motricidade Humana, Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Universidade de Lisboa, Lisbon, Portugal
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Glyn C Roberts
- Department of Sport and Social Sciences, NSSS, Institute for Sport and Social Sciences, Oslo, Norway
| | - Marlene N Silva
- CIDEFES Faculdade de Educação Física e Desporto, Universidade Lusófona, Lisbon, Portugal.,Faculdade de Motricidade Humana, Centro Interdisciplinar para o Estudo da Performance Humana (CIPER), Universidade de Lisboa, Lisbon, Portugal
| | - Marit Sørensen
- Department of Sport and Social Sciences, NSSS, Institute for Sport and Social Sciences, Oslo, Norway
| | - Sally Wyke
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Theo van Achterberg
- Department of Public Health and Primary Care, KU Leuven, Academic Centre for Nursing and Midwifery, Leuven, Belgium
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11
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De Cuyper K, Vanlinthout E, Vanhoof J, van Achterberg T, Opgenhaffen T, Nijs S, Peeters T, Put J, Maes B, Van Audenhove C. Best practice recommendations on the application of seclusion and restraint in mental health services: An evidence, human rights and consensus-based approach. J Psychiatr Ment Health Nurs 2022; 30:580-593. [PMID: 36565433 DOI: 10.1111/jpm.12890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 06/23/2022] [Revised: 10/27/2022] [Accepted: 12/13/2022] [Indexed: 12/25/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Seclusion and restraint still regularly occur within inpatient mental health services. The Council of Europe requires the development of a policy on for instance age limits, techniques and time limits. However, they only define the outer limits of such a policy by indicating when rights are violated. Within these limits, many choices remain open. Staff and service managers lack clarity on safe and humane procedures. Research literature provides limited and contradictory insights on these matters. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The study resulted in 77 best practice recommendations on the practical application of restraint and seclusion as last resort intervention in inpatient youth and adult mental health services, including forensic facilities. To our knowledge, this is the first study in which the development of recommendations on this topic is not only based on scientific evidence, but also on an analysis of European human rights standards and consensus within and between expert-professionals and experts-by-experience. This approach allowed to develop for the first time recommendations on time limits, asking for second opinion, and registration of seclusion and restraint. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The 77 recommendations encourage staff to focus on teamwork, safety measures, humane treatment, age and time limits, asking for second opinion, observation, evaluation and registration when applying seclusion and restraint as last resort intervention. The implementation of the best practice recommendations is feasible provided that they are combined with a broad preventive approach and with collaboration between service managers, staff (educators) and experts-by-experience. Under these conditions, the recommendations will improve safety and humane treatment, and reduce harm to both service users and staff. ABSTRACT INTRODUCTION: Seclusion and restraint still regularly occur within inpatient mental health services. Professionals lack clarity on safe and humane procedures. Nevertheless, a detailed policy on for instance age limits, techniques and time limits is required. AIM We developed recommendations on the humane and safe application of seclusion, physical intervention and mechanical restraint in inpatient youth and adult mental health services, including forensic facilities. METHOD After developing a questionnaire based on a rapid scientific literature review and an analysis of human rights sources stemming from the Council of Europe, 60 expert-professionals and 18 experts-by-experience were consulted in Flanders (Belgium) through a Delphi-study. RESULTS After two rounds, all but one statement reached the consensus-level of 65% in both panels. The study resulted in 77 recommendations on teamwork, communication, materials and techniques, maximum duration, observation, evaluation, registration, second opinion and age limits. DISCUSSION Combining an evidence, human rights and consensus-based approach allowed for the first time to develop recommendations on time limits, asking for second opinion and registration. IMPLICATIONS FOR PRACTICE When combined with a preventive approach and collaboration between service managers, staff (educators) and experts-by-experience, the recommendations will improve safety and humane treatment, and reduce harm to service users and staff.
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Affiliation(s)
- Kathleen De Cuyper
- LUCAS - Centre for Care Research & Consultancy, University of Leuven, Leuven, Belgium
| | - Els Vanlinthout
- LUCAS - Centre for Care Research & Consultancy, University of Leuven, Leuven, Belgium
| | - Jasper Vanhoof
- Academic Centre of Nursing and Midwifery, University of Leuven, Leuven, Belgium
| | - Theo van Achterberg
- Academic Centre of Nursing and Midwifery, University of Leuven, Leuven, Belgium
| | - Tim Opgenhaffen
- Institute for Social Law, University of Leuven, Leuven, Belgium
| | - Sara Nijs
- Parenting and Special Education, University of Leuven, Leuven, Belgium
| | - Tine Peeters
- LUCAS - Centre for Care Research & Consultancy, University of Leuven, Leuven, Belgium
| | - Johan Put
- Institute for Social Law, University of Leuven, Leuven, Belgium
| | - Bea Maes
- Parenting and Special Education, University of Leuven, Leuven, Belgium
| | - Chantal Van Audenhove
- LUCAS - Centre for Care Research & Consultancy, University of Leuven, Leuven, Belgium
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12
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Lepore M, Zúñiga F, Schols J, Wingenfeld K, van Achterberg T, Murray B. INTERNATIONAL LONG-TERM CARE HOME QUALITY ASSURANCE: HOW DO EUROPEAN MEASURES ADDRESS DEMENTIA? Innov Aging 2022. [PMCID: PMC9770274 DOI: 10.1093/geroni/igac059.2803] [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: 12/24/2022] Open
Abstract
Alzheimer’s Disease and related dementias (ADRD) are prevalent conditions in long-term care homes (LTCHs) with about 50% of LTCH residents living with ADRD in many countries. Despite the prevalence of ADRD in LTCHs, a recent examination of LTCH quality assurance programs in four countries revealed a small percentage of LTCH quality measures across those countries addressed ADRD, most commonly as a risk adjuster, and once each as an inclusion or exclusion criterion. To better understand how quality assurance programs address ADRD internationally, we examined LTCH quality measures in four European countries—The Netherlands, Switzerland, Germany, and Belgium—following procedures previously used to examine international LTCH quality assurance measures. 73 measures were examined across 4 quality assurance programs. 26% of the measures addressed ADRD. The programs addressed ADRD in starkly different ways: in The Netherlands and Belgium no measures addressed ADRD; in Germany the majority (13/15) of measures addressed ADRD as an exclusion or inclusion criterion; and in Switzerland all the measures addressed ADRD through risk adjustment. Although limited to examining measures from LTCH quality assurance programs in four European countries, this study adds evidence that ADRD tends not to be addressed by LTCH quality measures, but when ADRD is addressed, it tends to be through risk adjustment. LTCH regulators, policymakers, and providers can use this information to assess options for addressing ADRD in quality assurance programs. Future research is needed to assess how standard indicators of quality differ across quality assurance regimes and how to address dementia beyond risk adjustment.
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Affiliation(s)
- Michael Lepore
- University of Maryland School of Nursing, Baltimore, Maryland, United States
| | | | - Jos Schols
- Maastricht University, Maastricht, Limburg, Netherlands
| | - Klaus Wingenfeld
- University of Bielefeld, Bielefeld, Nordrhein-Westfalen, Germany
| | | | - Briana Murray
- University of Maryland School of Nursing, Baltimore, Maryland, United States
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13
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Fakha A, Leithaus M, de Boer B, van Achterberg T, Hamers J, Verbeek H. EXPLORING THE IMPLEMENTATION OF FOUR TRANSITIONAL CARE INTERVENTIONS FOR OLDER ADULTS: A COLLECTIVE CASE STUDY. Innov Aging 2022. [DOI: 10.1093/geroni/igac059.332] [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: 12/24/2022] Open
Abstract
Abstract
Four transitional care interventions, aiming to improve transitions between hospital and home settings for older adults, were implemented in Belgium. These interventions are complex in nature and their implementation in practice is often challenging. This study explores the implementation of these interventions from the perspectives of healthcare professionals involved in the process, and by investigating three implementation aspects: influencing factors, strategies used, and outcomes. A retrospective qualitative collective case study was conducted using semi-structured interviews with thirteen healthcare professionals. Thematic analysis was used, and the Consolidated Framework for Implementation Research guided the final data interpretation. Key findings indicated that implementation barriers were mostly at the organizational level (i.e., resources, structure, networks & communication), while facilitators were at the individual level (i.e., personal attributes, champions). The prominent strategy used to implement these interventions was engagement and additional strategies were suggested for the future sustainability of the interventions (i.e., building strategic partnerships, developing policies to support transitional care). The overall implementation was perceived as favorable with high adoption as a key outcome. This study highlights the crucial role of healthcare professionals, being motivated and committed to fostering the implementation of interventions in transitional care. It is important to use implementation strategies targeting factors at both the individual level as well as the organizational level for implementing transitional care interventions in the future.
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Affiliation(s)
- Amal Fakha
- Maastricht University , Maastricht, Limburg , Netherlands
| | - Merel Leithaus
- Maastricht University , Maastricht, Limburg , Netherlands
| | - Bram de Boer
- Maastricht University , Maastricht, Limburg , Netherlands
| | | | - Jan Hamers
- Maastricht University , Maastricht, Limburg , Netherlands
| | - Hilde Verbeek
- Maastricht University , Maastricht, Limburg , Netherlands
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14
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Groenvynck L, de Boer B, Beaulen A, De Vries E, Hamers J, van Achterberg T, Meijers J, Verbeek H. THE PARADOXICAL EXPERIENCES OF INFORMAL CAREGIVERS DURING THE TRANSITION FROM HOME TO A NURSING HOME. Innov Aging 2022. [PMCID: PMC9765056 DOI: 10.1093/geroni/igac059.085] [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: 12/24/2022] Open
Abstract
The transition from home to a nursing home is a complex and emotional process, especially for older persons with dementia. The informal caregiver usually plays a central role in this care process, which is often fragmented. Therefore, this study aims to analyze the experiences of informal caregivers of older persons with dementia during this transition.An interpretative phenomenological design was used to analyze secondary data. In-depth interviews were conducted with informal caregivers, in the Netherlands, between February 2018 and July 2018. The study identified three, interwoven paradoxes influenced by the healthcare system and the healthcare professionals providing care. The first paradox described the initial negative emotions related to a nursing home move. Those emotions are a paradox to the feelings of relief and acceptance later in the transition process. The second paradox was related to a prospective need to postpone the transition for as long as possible and a retrospective need for a timely transition plan. The third paradox defines an internal struggle for the informal caregivers of wanting to remain involved while simultaneously experiencing a need for distance from care responsibilities. This study identifies a fine line between optimal and fragmented transitional care. The results can motivate informal caregivers to start planning the move. Similarly, it allows healthcare professionals to provide tailored support. Future research should focus on defining these paradoxes and their link with the healthcare system to determine if the transition from home to a nursing home can be optimized.
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Affiliation(s)
| | - Bram de Boer
- Maastricht University, Maastricht, Limburg, Netherlands
| | | | | | - Jan Hamers
- Maastricht University, Maastricht, Limburg, Netherlands
| | | | | | - Hilde Verbeek
- Maastricht University, Maastricht, Limburg, Netherlands
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15
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Kolade O, Porat-Dahlerbruch J, van Achterberg T, Ellen M. Strategies for engaging senior citizens and their informal caregivers in health policy development: a scoping review protocol. BMJ Open 2022; 12:e064505. [PMID: 36198463 PMCID: PMC9535191 DOI: 10.1136/bmjopen-2022-064505] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Care for senior citizens is a global policy issue. There has been limited focus on senior citizen and informal caregiver engagement in policy development. Encouraging senior citizen participation through active engagement in the policymaking process enhances the provision of better services and the creation of responsive policies and is critical to better healthcare. Accordingly, this review aims to map the available evidence to provide an overview of strategies for engaging senior citizens and informal caregivers in health policy development. METHODS AND ANALYSIS A scoping review will be conducted. This study will use the updated methodological guidance for conducting a scoping review developed by the Joanna Briggs Institute. This review aims to answer the question: 'What is known in the literature about strategies for engaging senior citizens and informal caregivers in health policy development?' Titles and abstracts will be screened to determine eligibility for full-text review based on already established eligibility criteria. Data will be extracted from relevant articles. A summary of extracted data will be presented. The results will be interpreted within the Multidimensional Framework for Patient and Family Engagement in Health and Healthcare. ETHICS AND DISSEMINATION Ethical review is not required as scoping reviews are a form of secondary data analysis that synthesises data from publicly available sources. Findings from this proposed review will be disseminated in conferences and to the global scientific community through published academic papers in reputable health policy-related journals.
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Affiliation(s)
- Opeyemi Kolade
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Joshua Porat-Dahlerbruch
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Moriah Ellen
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Institute of Health Policy Management and Evaluation, University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
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16
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Van Grootven B, Irusta LA, Christiaens W, Mistiaen P, De Meester C, Cornelis J, Dierckx de Casterlé B, Van Durme T, van Achterberg T. Experiences with the implementation of remote monitoring in patients with COVID-19: A qualitative study with patients and healthcare professionals. J Nurs Scholarsh 2022; 55:67-78. [PMID: 36165577 PMCID: PMC9537958 DOI: 10.1111/jnu.12814] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/26/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION This study investigated how patients with COVID-19, telemonitoring (TM) teams, general practitioners (GPs) and primary care nurses in Belgium experienced remote patient monitoring (RPM) in 12 healthcare organizations, in relation to the patients' illness, health, and care needs, perceived quality of care, patient and health system outcomes, and implementation challenges. DESIGN A qualitative research approach was adopted, including focus group discussions and semi-structured interviews. METHODS Four different groups of participants were interviewed, that is, patients (n = 17), TM teams (n = 27), GPs (n = 16), and primary care nurses (n = 12). An interview guide was drafted based on a literature review. Interviews were transcribed verbatim, and NVivo was used for managing and analyzing the data. The QUAGOL method was used to guide the data analysis process and was adapted for the purpose of a thematic content analysis. RESULTS All participants agreed that RPM-reassured patients. The overall perceived value of RPM for individual patients depended on how well the intervention matched with their needs. Patients who did not have the necessary language (Dutch/French speaking) and digital skills, who did not have the right equipment (smartphone or tablet), or who missed the necessary infrastructure (no internet coverage in their region) were often excluded. Remote patient monitoring also reassured healthcare professionals as it gave them information on a disease they had little knowledge about. Professionals involved in RPM experienced a high workload. All TM teams agreed that quality of data was a key factor to ensure an adequate follow-up, but they differed in what they found important. The logistic management of RPM was a challenge because of the contagious character of COVID-19, and the need for an effective information flow between the hospital team and primary care providers. Participants missed clarification about who was accountable for the care for patients in the projects. Primary care nurses and GPs missed access to RPM data. All agreed that the funding they received was not sufficient to cover all the costs associated with RPM. CONCLUSION Healthcare professionals and patients perceive RPM as valuable and believe that the concept will have its place in the Belgium health system. However, current RPM practice is challenged by many barriers, and the sustainability of RPM implementation is low. CLINICAL RELEVANCE Remote patient monitoring (RPM) was perceived as a valuable intervention for patients with COVID-19, but there were important concerns about unequal access to care. While the technology for RPM is available, the sustainability of implementation is low because of concerns with data quality, challenging logistics within projects, lack of data integration and communication, and a lack of an overarching guiding framework.
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Affiliation(s)
| | - Lucia Alvarez Irusta
- Faculty of Public Health, Institute of Health and SocietyCatholic University of LouvainBrusselsBelgium
| | | | | | | | | | | | - Thérèse Van Durme
- Faculty of Public Health, Institute of Health and SocietyCatholic University of LouvainBrusselsBelgium
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17
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Van Grootven B, van Achterberg T. Prediction models for functional status in community dwelling older adults: a systematic review. BMC Geriatr 2022; 22:465. [PMID: 35637447 PMCID: PMC9150308 DOI: 10.1186/s12877-022-03156-7] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Disability poses a burden for older persons, and is associated with poor outcomes and high societal costs. Prediction models could potentially identify persons who are at risk for disability. An up to date review of such models is missing. Objective To identify models developed for the prediction of functional status in community dwelling older persons. Methods A systematic review was performed including studies of older persons that developed and/or validated prediction models for the outcome functional status. Medline and EMBASE were searched, and reference lists and prospective citations were screened for additional references. Risk of bias was assessed using the PROBAST-tool. The performance of models was described and summarized, and the use of predictors was collated using the bag-of-words text mining procedure. Results Forty-three studies were included and reported 167 evaluations of prediction models. The median c-statistic values for the multivariable development models ranged between 0.65 and 0.76 (minimum = 0.58, maximum = 0.90), and were consistently higher than the values of the validation models for which median c-statistic values ranged between 0.6 and 0.68 (minimum = 0.50, maximum = 0.81). A total of 559 predictors were used in the models. The five predictors most frequently used were gait speed (n = 47), age (n = 38), cognition (n = 27), frailty (n = 24), and gender (n = 22). Conclusions No model can be recommended for implementation in practice. However, frailty models appear to be the most promising, because frailty components (e.g. gait speed) and frailty indexes demonstrated good to excellent predictive performance. However, the risk of study bias was high. Substantial improvements can be made in the methodology. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03156-7.
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18
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Kraun L, De Vliegher K, Vandamme M, Holtzheimer E, Ellen M, van Achterberg T. Older peoples's and informal caregivers' experiences, views, and needs in transitional care decision-making: A systematic review. Int J Nurs Stud 2022; 134:104303. [DOI: 10.1016/j.ijnurstu.2022.104303] [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: 09/03/2021] [Revised: 04/05/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
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19
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Fakha A, de Boer B, van Achterberg T, Hamers J, Verbeek H. Fostering the implementation of transitional care innovations for older persons: prioritizing the influencing key factors using a modified Delphi technique. BMC Geriatr 2022; 22:131. [PMID: 35172760 PMCID: PMC8848680 DOI: 10.1186/s12877-021-02672-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/26/2021] [Indexed: 12/03/2022] Open
Abstract
Background Transitions in care for older persons requiring long-term care are common and often problematic. Therefore, the implementation of transitional care innovations (TCIs) aims to improve necessary or avert avoidable care transitions. Various factors were recognized as influencers to the implementation of TCIs. This study aims to gain consensus on the relative importance level and the feasibility of addressing these factors with implementation strategies from the perspectives of experts. This work is within TRANS-SENIOR, an innovative research network focusing on care transitions. Methods A modified Delphi study was conducted with international scientific and practice-based experts, recruited using purposive and snowballing methods, from multiple disciplinary backgrounds, including implementation science, transitional care, long-term care, and healthcare innovations. This study was built on the findings of a previously conducted scoping review, whereby 25 factors (barriers, facilitators) influencing the implementation of TCIs were selected for the first Delphi round. Two sequential rounds of anonymous online surveys using an a priori consensus level of > 70% and a final expert consultation session were performed to determine the implementation factors’: i) direction of influence, ii) importance, and iii) feasibility to address with implementation strategies. The survey design was guided by the Consolidated Framework for Implementation Research (CFIR). Data were collected using Qualtrics software and analyzed with descriptive statistics and thematic analysis. Results Twenty-nine experts from 10 countries participated in the study. Eleven factors were ranked as of the highest importance among those that reached consensus. Notably, organizational and process-related factors, including engagement of leadership and key stakeholders, availability of resources, sense of urgency, and relative priority, showed to be imperative for the implementation of TCIs. Nineteen factors reached consensus for feasibility of addressing them with implementation strategies; however, the majority were rated as difficult to address. Experts indicated that it was hard to rate the direction of influence for all factors. Conclusions Priority factors influencing the implementation of TCIs were mostly at the organizational and process levels. The feasibility to address these factors remains difficult. Alternative strategies considering the interaction between the organizational context and the outer setting holds a potential for enhancing the implementation of TCIs. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02672-2.
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Affiliation(s)
- Amal Fakha
- CAPHRI Care and Public Health Research Institute, Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. .,Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands. .,KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 35, 3000, Leuven, Belgium.
| | - Bram de Boer
- CAPHRI Care and Public Health Research Institute, Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 35, 3000, Leuven, Belgium
| | - Jan Hamers
- CAPHRI Care and Public Health Research Institute, Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
| | - Hilde Verbeek
- CAPHRI Care and Public Health Research Institute, Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, the Netherlands
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20
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Groenvynck L, de Boer B, Beaulen A, de Vries E, Hamers JPH, van Achterberg T, van Rossum E, Khemai C, Meijers JMM, Verbeek H. The paradoxes experienced by informal caregivers of people with dementia during the transition from home to a nursing home. Age Ageing 2022. [PMCID: PMC8824707 DOI: 10.1093/ageing/afab241] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The transition from home to a nursing home is a common care process experienced by older persons with dementia and their informal caregivers. This transition process is often experienced as fragmented and is paired with negative outcomes for both older persons (e.g. mortality) and informal caregivers (e.g. grief). Due to the central role that informal caregivers play, it is crucial to capture their experiences throughout all phases of the transition. Methods A secondary data analysis was conducted using an interpretative phenomenological design. A total of 24 informal caregivers of older persons with dementia, moving to a nursing home, participated in in-depth interviews. Data were collected between February 2018 and July 2018 in the Netherlands. Data were analysed using Interpretative Phenomenological Analysis. Results The transition experiences are characterised by three paradoxes: (i) contradicting emotions during the transition process; (ii) the need for a timely transition versus the need to postpone the transition process and (iii) the need for involvement versus the need for distance. All paradoxes are influenced by the healthcare system. Conclusions The identified paradoxes show the impact of the healthcare system and the importance of timely planning/preparing for this transition on the experiences of informal caregivers. In addition, it provides healthcare professionals insight into the thought processes of informal caregivers. Future research can use these paradoxes as a foundation to develop innovations aiming to improve the transition process from home to a nursing home for informal caregivers and, consequently, older persons.
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Affiliation(s)
- Lindsay Groenvynck
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- KU Leuven, Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, Leuven, Belgium
| | - Bram de Boer
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Audrey Beaulen
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Erica de Vries
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Jan P H Hamers
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, Leuven, Belgium
| | - Erik van Rossum
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- Zuyd University of Applied Sciences, Academy of Nursing, Research Center on Community Care, Heerlen, The Netherlands
| | - Chandni Khemai
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Judith M M Meijers
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- Zuyderland Care, Zuyderland Medical Center, 6162 BG Sittard-Geleen, The Netherlands
| | - Hilde Verbeek
- Maastricht University, Care and Public Health Research Institute, Department of Health Services Research, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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21
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Groenvynck L, Fakha A, de Boer B, Hamers JPH, van Achterberg T, van Rossum E, Verbeek H. Interventions to Improve the Transition from Home to a Nursing Home: A Scoping Review. Gerontologist 2021; 62:e369-e383. [PMID: 33704485 PMCID: PMC9372886 DOI: 10.1093/geront/gnab036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/18/2020] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives The transition from home to a nursing home is a stressful event for both older persons and informal caregivers. Currently, this transition process is often fragmented, which can create a vicious cycle of health care-related events. Knowledge of existing care interventions can prevent or break this cycle. This project aims to summarize existing interventions for improving transitional care, identifying their effectiveness and key components. Research Design and Methods A scoping review was performed within the European TRANS-SENIOR consortium. The databases PubMed, EMBASE (Excerpta Medica Database), PsycINFO, Medline, and CINAHL (Cumulated Index to Nursing and Allied Health Literature) were searched. Studies were included if they described interventions designed to improve the transition from home to a nursing home. Results 17 studies were identified, describing 13 interventions. The majority of these interventions focused on nursing home adjustment with 1 study including the entire transition pathway. The study identified 8 multicomponent and 5 single-component interventions. From the multicomponent interventions, 7 main components were identified: education, relationships/communication, improving emotional well-being, personalized care, continuity of care, support provision, and ad hoc counseling. The study outcomes were heterogeneous, making them difficult to compare. The study outcomes varied, with studies often reporting nonsignificant changes for the main outcome measures. Discussion and Implications There is a mismatch between the theory on optimal transitional care and current transitional care interventions, as they often lack a comprehensive approach. This research is the first step toward a uniform definition of optimal transitional care and a tool to improve/develop (future) transitional care initiatives on the pathway from home to a nursing home.
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Affiliation(s)
- Lindsay Groenvynck
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Amal Fakha
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Bram de Boer
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Jan P H Hamers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Erik van Rossum
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.,Academy of Nursing, Research Center on Community Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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22
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Fakha A, Groenvynck L, de Boer B, van Achterberg T, Hamers J, Verbeek H. A myriad of factors influencing the implementation of transitional care innovations: a scoping review. Implement Sci 2021; 16:21. [PMID: 33637097 PMCID: PMC7912549 DOI: 10.1186/s13012-021-01087-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 10/09/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022] Open
Abstract
Background Care transitions of older persons between multiple care settings are frequently hampered by various issues such as discontinuous care delivery or poor information transfer among healthcare providers. Therefore, several innovations have been developed to optimize transitional care (TC). This review aims to identify which factors influence the implementation of TC innovations. Methods As part of TRANS-SENIOR, an international innovative training and research network focusing on enhancing or avoiding care transitions, a scoping review was conducted. The five stages of the Arksey and O’Malley framework were followed. PubMed/MEDLINE, EMBASE, and CINAHL were searched, and eligible studies published between years 2000 and 2020 were retrieved. Data were extracted from the included studies and mapped to the domains and constructs of the Consolidated Framework for Implementation Research (CFIR) and Care Transitions Framework (CTF). Results Of 1537 studies identified, 21 were included. Twenty different TC innovations were covered and aimed at improving or preventing transitions between multiple care settings, the majority focused on transitions from hospital to home. Key components of the innovations encompassed transition nurses, teach-back methods, follow-up home visits, partnerships with community services, and transfer units. Twenty-five prominent implementation factors (seven barriers, seven facilitators, and eleven factors with equivalent hindering/facilitating influence) were shown to affect the implementation of TC innovations. Low organizational readiness for implementation and the overall implementation climate were topmost hindering factors. Similarly, failing to target the right population group was commonly reported as a major barrier. Moreover, the presence of skilled users but with restricted knowledge and mixed attitudes about the innovation impeded its implementation. Among the eminent enabling factors, a high-perceived advantage of the innovation by staff, along with encouraging transition roles, and a continuous monitoring process facilitated the implementation of several innovations. Other important factors were a high degree of organizational networks, engaging activities, and culture; these factors had an almost equivalent hindering/facilitating influence. Conclusions Addressing the right target population and instituting transition roles in care settings appear to be specific factors to consider during the implementation of TC innovations. Long-term care settings should simultaneously emphasize their organizational readiness for implementation and change, in order to improve transitional care through innovations. Supplementary Information The online version contains supplementary material available at 10.1186/s13012-021-01087-2.
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Affiliation(s)
- Amal Fakha
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands. .,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands. .,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35, 3000, Leuven, Belgium.
| | - Lindsay Groenvynck
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35, 3000, Leuven, Belgium
| | - Bram de Boer
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35, 3000, Leuven, Belgium
| | - Jan Hamers
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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23
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Suzanne Giesbers APM, Schouteten RLJ, Poutsma E, van der Heijden BIJM, van Achterberg T. Towards a better understanding of the relationship between feedback and nurses' work engagement and burnout: A convergent mixed-methods study on nurses' attributions about the 'why' of feedback. Int J Nurs Stud 2021; 117:103889. [PMID: 33631398 DOI: 10.1016/j.ijnurstu.2021.103889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous studies on the effects of providing feedback about quality improvement measures to nurses show mixed results and the factors explaining the variance in effects are not yet well-understood. One of the factors that could explain the variance in outcomes is how nurses perceive the feedback. It is not the feedback per se that influences nurses, and consequently their performance, but rather the way the feedback is perceived. OBJECTIVES This article aims to enhance our understanding of Human Resource attributions and employee engagement and burnout in a feedback environment. An in-depth study of nurses' attributions about the 'why' of feedback on quality measurements, and its relation to engagement and burnout, was performed. DESIGN AND METHODS A convergent mixed-methods, multiple case study design was used. Evidence was drawn from four comparable surgical wards within three teaching hospitals in the Netherlands that volunteered to participate in this study. Nurses on each ward were provided with oral and written feedback on quality measurements every two weeks, over a four month period. After this period, an online survey was distributed to all the nurses (n = 184) on the four participating wards. Data were collected from 91 nurses. Parallel to the survey, individual, semi-structured face-to-face interviews were conducted with eight nurses and their ward manager in each ward, resulting in interview data from 32 nurses and four ward managers. RESULTS Results show that nurses - both as a group and individually - make varying attributions about their managers' purpose in providing feedback on quality measurements. The feedback environment is associated to nurses' attributions and these attributions are related to nurses' burnout. CONCLUSIONS By showing that feedback on quality measurements can be attributed differently by nurses and that the feedback environment plays a role in this, the study provides an interesting mechanism for explaining how feedback is related to performance. Implications for theory, practice and future research are discussed.
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Affiliation(s)
- A P M Suzanne Giesbers
- Jeroen Bosch Hospital, PO Box 90153, NL-5200 ME 's Hertogenbosch, the Netherlands; Radboud University, Institute for Management Research, PO Box 9108, NL-6500 HK Nijmegen, the Netherlands
| | - Roel L J Schouteten
- Radboud University, Institute for Management Research, PO Box 9108, NL-6500 HK Nijmegen, the Netherlands.
| | - Erik Poutsma
- Radboud University, Institute for Management Research, PO Box 9108, NL-6500 HK Nijmegen, the Netherlands
| | - Beatrice I J M van der Heijden
- Radboud University, Institute for Management Research, PO Box 9108, NL-6500 HK Nijmegen, the Netherlands; Open University of the Netherlands, School of Management, PO Box 2960, NL-6401 DL Heerlen, the Netherlands; Ghent University, Faculty of Economics and Business Administration, 9000 Ghent, Belgium; Hubei University, Hubei Business School, Wuhan, 368 Youyi Ave., Wuchang District, Wuhan 430062, China; Kingston University, Kingston Business School, London KT11LQ, United Kingdom
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 35, 3000 Leuven, Belgium; Radboud University Medical Centre, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, PO Box 9101, NL-6500 HB Nijmegen, the Netherlands; Uppsala University, Department of Public Health and Caring Sciences, Box 256, 751 05 Uppsala, Sweden
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24
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Vandervelde S, Scheepmans K, Milisen K, van Achterberg T, Vlaeyen E, Flamaing J, Dierckx de Casterlé B. Reducing the use of physical restraints in home care: development and feasibility testing of a multicomponent program to support the implementation of a guideline. BMC Geriatr 2021; 21:77. [PMID: 33494710 PMCID: PMC7831193 DOI: 10.1186/s12877-020-01946-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 12/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A validated evidence-based guideline was developed to reduce physical restraint use in home care. However, the implementation of guidelines in home care is challenging. Therefore, this study aims to systematically develop and evaluate a multicomponent program for the implementation of the guideline for reducing the use of physical restraints in home care. METHODS Intervention Mapping was used to develop a multicomponent program. This method contains six steps. Each step comprises several tasks towards the design, implementation and evaluation of an intervention; which is theory and evidence informed, as well as practical. To ensure that the multicomponent program would support the implementation of the guideline in home care, a feasibility study of 8 months was organized in one primary care district in Flanders, Belgium. A concurrent triangulation mixed methods design was used to evaluate the multicomponent program consisting of a knowledge test, focus groups and an online survey. RESULTS The Social Cognitive Theory and the Theory of Planned Behavior are the foundations of the multicomponent program. Based on modeling, active learning, guided practice, belief selection and resistance to social pressure, eight practical applications were developed to operationalize these methods. The key components of the program are: the ambassadors for restraint-free home care (n = 15), the tutorials, the physical restraint checklist and the flyer. The results of the feasibility study show the necessity to select uniform terminology and definition for physical restraints, to involve all stakeholders from the beginning of the process, to take time for the implementation process, to select competent ambassadors and to collaborate with other home care providers. CONCLUSIONS The multicomponent program shows promising results. Prior to future use, further research needs to focus on the last two steps of Intervention Mapping (program implementation plan and developing an evaluation plan), to guide implementation on a larger scale and to formally evaluate the effectiveness of the multicomponent program.
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Affiliation(s)
- Sara Vandervelde
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 35 blok d bus 7001, 3000, Leuven, Belgium
| | - Kristien Scheepmans
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 35 blok d bus 7001, 3000, Leuven, Belgium.,Wit-Gele Kruis van Vlaanderen, Nursing Department, Frontispiesstraat 8, bus 1.2, 1000, Brussels, Belgium
| | - Koen Milisen
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 35 blok d bus 7001, 3000, Leuven, Belgium.,University Hospital Leuven, Department of Geriatric Medicine, Herestraat 49, 3000, Leuven, Belgium
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 35 blok d bus 7001, 3000, Leuven, Belgium
| | - Ellen Vlaeyen
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 35 blok d bus 7001, 3000, Leuven, Belgium
| | - Johan Flamaing
- University Hospital Leuven, Department of Geriatric Medicine, Herestraat 49, 3000, Leuven, Belgium.,KU Leuven, Department of Public Health and Primary Care, Division of Gerontology and Geriatrics, Kapucijnenvoer 35 blok d bus 7001, 3000, Leuven, Belgium
| | - Bernadette Dierckx de Casterlé
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Kapucijnenvoer 35 blok d bus 7001, 3000, Leuven, Belgium.
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25
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Trogrlic Z, van der Jagt M, van Achterberg T, Ponssen H, Schoonderbeek J, Schreiner F, Verbrugge S, Dijkstra A, Bakker J, Ista E. Prospective multicentre multifaceted before-after implementation study of ICU delirium guidelines: a process evaluation. BMJ Open Qual 2020; 9:bmjoq-2019-000871. [PMID: 32948600 PMCID: PMC7511605 DOI: 10.1136/bmjoq-2019-000871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/16/2020] [Accepted: 05/26/2020] [Indexed: 11/25/2022] Open
Abstract
Objective We aimed to explore: the exposure of healthcare workers to a delirium guidelines implementation programme; effects on guideline adherence at intensive care unit (ICU) level; impact on knowledge and barriers, and experiences with the implementation. Design A mixed-methods process evaluation of a prospective multicentre implementation study. Setting Six ICUs. Participants 4449 adult ICU patients and 500 ICU professionals approximately. Intervention A tailored implementation programme. Main outcome measure Adherence to delirium guidelines recommendations at ICU level before, during and after implementation; knowledge and perceived barriers; and experiences with the implementation. Results Five of six ICUs were exposed to all implementation strategies as planned. More than 85% followed the required e-learnings; 92% of the nurses attended the clinical classroom lessons; five ICUs used all available implementation strategies and perceived to have implemented all guideline recommendations (>90%). Adherence to predefined performance indicators (PIs) at ICU level was only above the preset target (>85%) for delirium screening. For all other PIs, the inter-ICU variability was between 34% and 72%. The implementation of delirium guidelines was feasible and successful in resolving the majority of barriers found before the implementation. The improvement was well sustained 6 months after full guideline implementation. Knowledge about delirium was improved (from 61% to 65%). The implementation programme was experienced as very successful. Conclusions Multifaceted implementation can improve and sustain adherence to delirium guidelines, is feasible and can largely be performed as planned. However, variability in delirium guideline adherence at individual ICUs remains a challenge, indicating the need for more tailoring at centre level.
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Affiliation(s)
- Zoran Trogrlic
- Department of Intensive Care, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Mathieu van der Jagt
- Department of Intensive Care, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Theo van Achterberg
- Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Huibert Ponssen
- Department of Intensive Care, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands
| | | | - Frodo Schreiner
- Department of Intensive Care, IJsselland Ziekenhuis, Capelle aan den IJssel, The Netherlands
| | - Serge Verbrugge
- Department of Intensive Care, Sint Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands
| | - Annemieke Dijkstra
- Department of Intensive Care, Maasstad Ziekenhuis, Rotterdam, The Netherlands
| | - Jan Bakker
- Department of Intensive Care, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Pulmonology and Critical Care, New York University - Langone, New York, New York, USA.,Department of Pulmonology and Critical Care, Columbia University Medical Center, New York Presbyterian, New York, New York, USA.,Department of Intensive Care, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Erwin Ista
- Department of Pediatric Surgery, Intensive Care Unit, Erasmus MC Sophia Kinderziekenhuis, Rotterdam, The Netherlands.,Department of Internal Medicine, Nursing Science, Erasmus MC, Rotterdam, The Netherlands
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26
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Ameel M, Achterberg TV, Kinnunen UM, Kontio R, Junttila K. The Core Nursing Interventions in Adult Psychiatric Outpatient Care Identified by Nurses, a Delphi Study. Int J Nurs Knowl 2020; 32:177-184. [PMID: 33615726 DOI: 10.1111/2047-3095.12309] [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: 10/11/2020] [Revised: 11/17/2020] [Accepted: 11/21/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To define the core nursing interventions identified by nurses in the adult psychiatric outpatient care setting. METHODS A two-round Delphi study. The panel consisted of nurses and nurse managers. FINDINGS Nurses identified 53 core interventions, 50 of which are described in the Nursing Interventions Classification (NIC). Altogether, two thirds of these interventions were in the NIC domain 'Behavioral' and the emphasis was on NIC classes 'Coping Assistance' and 'Behavior Therapy,' suggesting that nurses define providing psychosocial support as the core in their work. CONCLUSIONS The findings indicate that the main role of nurses in the psychiatric outpatient care is to deliver psychosocial care for their patients. The lack of family interventions among the core interventions and the need to add the missing three interventions into the classification need more research in the future. IMPLICATIONS FOR NURSING PRACTICE This study helps to define nurses' role in the psychiatric outpatient care. The findings can be used in developing nursing education programs.
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Affiliation(s)
- Maria Ameel
- Helsinki University Hospital, Helsinki University, Helsinki, Finland and University of Turku department of Nursing Science, Turku, Finland
| | - Theo van Achterberg
- Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Ulla-Mari Kinnunen
- University of Eastern-Finland, Faculty of Social Sciences and Business Studies, Department of Health and Social Management, Kuopio, Finland
| | - Raija Kontio
- Helsinki University Hospital, Helsinki University, Helsinki, Finland and University of Turku department of Nursing Science, Turku, Finland
| | - Kristiina Junttila
- Helsinki University Hospital, Helsinki University, Helsinki, Finland and University of Turku department of Nursing Science, Turku, Finland
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27
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Groenvynck L, de Boer B, Hamers JPH, van Achterberg T, van Rossum E, Verbeek H. Toward a Partnership in the Transition from Home to a Nursing Home: The TRANSCIT Model. J Am Med Dir Assoc 2020; 22:351-356. [PMID: 33223451 DOI: 10.1016/j.jamda.2020.09.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 11/15/2022]
Abstract
The transition from home to a nursing home can be stressful and traumatic for both older persons and informal caregivers and is often associated with negative outcomes. Additionally, transitional care interventions often lack a comprehensive approach, possibly leading to fragmented care. To avoid this fragmentation and to optimize transitional care, a comprehensive and theory-based model is fundamental. It should include the needs of both older persons and informal caregivers. Therefore, this study, conducted within the European TRANS-SENIOR research consortium, proposes a model to optimize the transition from home to a nursing home, based on the experiences of older persons and informal caregivers. These experiences were captured by conducting a literature review with relevant literature retrieved from the databases CINAHL and PubMed. Studies were included if older persons and/or informal caregivers identified the experiences, needs, barriers, or facilitators during the transition from home to a nursing home. Subsequently, the data extracted from the included studies were mapped to the different stages of transition (pre-transition, mid-transition, and post-transition), creating the TRANSCIT-model. Finally, results were discussed with an expert panel, leading to a final proposed TRANSCIT model. The TRANSCIT model identified that older people and informal caregivers expressed an overall need for partnership during the transition from home to a nursing home. Moreover, it identified 4 key components throughout the transition trajectory (ie, pre-, mid-, and post-transition): (1) support, (2) communication, (3) information, and (4) time. The TRANSCIT model could advise policy makers, practitioners, and researchers on the development and evaluation of (future) transitional care interventions. It can be a guideline reckoning the needs of older people and their informal caregivers, emphasizing the need for a partnership, consequently reducing fragmentation in transitional care and optimizing the transition from home to a nursing home.
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Affiliation(s)
- Lindsay Groenvynck
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands; KU Leuven Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium.
| | - Bram de Boer
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands
| | - Jan P H Hamers
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands
| | - Theo van Achterberg
- KU Leuven Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Erik van Rossum
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands; Academy of Nursing, Research Centre on Community Care, Zuyd University of Applied Sciences, Heerlen, the Netherlands
| | - Hilde Verbeek
- Faculty of Health Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Living Lab of Ageing and Long Term Care, Maastricht University, Maastricht, the Netherlands
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28
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Brantnell A, Woodford J, Baraldi E, van Achterberg T, von Essen L. Views of Implementers and Nonimplementers of Internet-Administered Cognitive Behavioral Therapy for Depression and Anxiety: Survey of Primary Care Decision Makers in Sweden. J Med Internet Res 2020; 22:e18033. [PMID: 32784186 PMCID: PMC7450364 DOI: 10.2196/18033] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 01/29/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Internet-administered cognitive behavioral therapy (ICBT) has been demonstrated to be an effective intervention for adults with depression and/or anxiety and is recommended in national guidelines for provision within Swedish primary care. However, the number and type of organizations that have implemented ICBT within primary care in Sweden is currently unclear. Further, there is a lack of knowledge concerning barriers and facilitators to ICBT implementation. OBJECTIVE The two primary objectives were to identify and describe primary care organizations providing ICBT in Sweden and compare decision makers' (ie, directors of primary care organizations) views on barriers and facilitators to implementation of ICBT among ICBT implementers (ie, organizations that offered ICBT) and nonimplementers (ie, organizations that did not offer ICBT). METHODS An online survey based on a checklist for identifying barriers and facilitators to implementation was developed and made accessible to decision makers from all primary care organizations in Sweden. The survey consisted of background questions (eg, provision of ICBT and number of persons working with ICBT) and barriers and facilitators relating to the following categories: users, therapists, ICBT programs, organizations, and wider society. RESULTS The participation rate was 35.75% (404/1130). The majority (250/404, 61.8%) of participants were health care center directors and had backgrounds in nursing. Altogether, 89.8% (363/404) of the participating organizations provided CBT. A minority (83/404, 20.5%) of organizations offered ICBT. Most professionals delivering ICBT were psychologists (67/83, 80%) and social workers (31/83, 37%). The majority (61/83, 73%) of organizations had 1 to 2 persons delivering ICBT interventions. The number of patients treated with ICBT during the last 12 months was 1 to 10 in 65% (54/83) of the organizations, ranging between 1 and 400 treated patients across the whole sample. There were 9 significant (P<.05) differences out of 37 possible between implementers and nonimplementers. For example, more implementers (48/51, 94%) than nonimplementers (107/139, 76.9%) perceived few technical problems (P<.001), and more implementers (53/77, 68%) than nonimplementers (103/215, 47.9%) considered that their organization has resources to offer ICBT programs (P<.001). CONCLUSIONS Despite research demonstrating the effectiveness of ICBT for depression and anxiety and national guidelines recommending its use, ICBT is implemented in few primary care organizations in Sweden. Several interesting differences between implementers and nonimplementers were identified, which may help inform interventions focusing on facilitating the implementation of ICBT.
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Affiliation(s)
- Anders Brantnell
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Division of Industrial Engineering and Management, Department of Civil and Industrial Engineering, Uppsala University, Uppsala, Sweden
| | - Joanne Woodford
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Enrico Baraldi
- Division of Industrial Engineering and Management, Department of Civil and Industrial Engineering, Uppsala University, Uppsala, Sweden
| | - Theo van Achterberg
- KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Louise von Essen
- Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Ameel M, Leino H, Kontio R, van Achterberg T, Junttila K. Using the Nursing Interventions Classification to identify nursing interventions in free‐text nursing documentation in adult psychiatric outpatient care setting. J Clin Nurs 2020; 29:3435-3444. [DOI: 10.1111/jocn.15382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 05/05/2020] [Accepted: 06/05/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Ameel
- Helsinki University Hospital Helsinki Finland
- Department of Nursing Science University of Turku Turku Finland
- University of Helsinki Helsinki Finland
| | - Hanna Leino
- Helsinki University Hospital Helsinki Finland
- University of Helsinki Helsinki Finland
| | - Raija Kontio
- Helsinki University Hospital Helsinki Finland
- Department of Nursing Science University of Turku Turku Finland
- University of Helsinki Helsinki Finland
| | - Theo van Achterberg
- Department of Public Health and Primary Care Academic Centre for Nursing and Midwifery KU Leuven Leuven Belgium
| | - Kristiina Junttila
- Helsinki University Hospital Helsinki Finland
- Department of Nursing Science University of Turku Turku Finland
- University of Helsinki Helsinki Finland
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30
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Beentjes TAA, van Gaal BGI, van Achterberg T, Goossens PJJ. Self-Management Support Needs From the Perspectives of Persons With Severe Mental Illness: A Systematic Review and Thematic Synthesis of Qualitative Research. J Am Psychiatr Nurses Assoc 2020; 26:464-482. [PMID: 31578904 DOI: 10.1177/1078390319877953] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND: The development of de-hospitalization policies in mental health has resulted in a growing emphasis on self-management. In the chronic care model, self-management support is an essential element. Because of the episodic nature of severe mental illness (SMI) and its high relapse rates, we assume that the extent of self-management support needs of individuals with an SMI is considerable. However, a clear overview of the nature of the self-management support needs of persons with SMI is missing. AIMS: This study aimed to identify self-management support needs from the perspective of individuals with SMI. METHOD: A systematic review was conducted using the method of thematic synthesis of qualitative studies. After searching the databases MEDLINE, PsycINFO, CINAHL, and EMBASE, we screened the papers for the eligibility criteria: individuals with an SMI, adequately representing the voice of persons with SMI and describing their self-management support needs. Thirty-one papers were included. RESULTS: The main findings showed that participants in the studies described the need for informational support, emotional support, acknowledgment, encouragement, and guidance to make sense of their illness experiences, ease suffering, obtain validation and recognition, execute self-management tasks, and be led through unfamiliar territory. CONCLUSION: The perspectives of persons with SMI can provide a road map for constructing a self-management support intervention for persons with SMI. Important others have an essential role in fulfilling support needs. Independently managing an SMI is difficult. Therefore, it is preferable to let important others participate in self-management interventions and to introduce peer support.
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Affiliation(s)
- Titus A A Beentjes
- Titus A. A. Beentjes, MScN, APRN, RN, Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, the Netherlands; Dimence Group Mental Health Care Centre, Deventer, the Netherlands; Centre for Nursing Research, Saxion University of Applied Science, Deventer, the Netherlands
| | - Betsie G I van Gaal
- Betsie G. I. van Gaal, PhD, FEANS, Radboud university medical center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, the Netherlands; HAN University of Applied Sciences, Faculty of Health and Social Studies, Nijmegen, the Netherlands
| | - Theo van Achterberg
- Theo van Achterberg, PhD, FEANS, KU Leuven, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Peter J J Goossens
- Peter J. J. Goossens, PhD, APRN, RN, FEANS, Dimence Group Mental Health Care Centre, Deventer, the Netherlands; University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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31
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Brantnell A, Baraldi E, van Achterberg T. An inductive exploration of the implementation knowledge of research funders. Health Res Policy Syst 2019; 17:67. [PMID: 31319867 PMCID: PMC6637601 DOI: 10.1186/s12961-019-0472-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 06/28/2019] [Indexed: 11/19/2022] Open
Abstract
Background Healthcare research funders may undertake various roles to facilitate implementation of research findings. Their ability to enact such roles depends on several factors, knowledge of implementation being one essential requirement. However, previous studies do not assess the type or level of knowledge about implementation that research funders possess. This paper therefore presents findings from a qualitative, inductive study of the implementation knowledge of research funders. Three aspects of this knowledge are explored, namely how research funders define implementation, their level of self-assessed implementation knowledge and the factors influencing their self-assessment of implementation knowledge. Methods Research funders (n = 18) were purposefully selected from a sample of research funding organisations in Sweden (n = 10). In-depth semi-structured interviews were conducted, recorded and transcribed verbatim. An inductive method using a systematic coding procedure was employed to derive the findings. Results The research funders defined implementation as either an outcome or a process, with the majority believing that implementation of healthcare research results demands a process, although its complexity varied in the research funders’ view. They perceived their own level of implementation knowledge as either limited or substantial, with a majority regarding it as limited. Clinical research experience, clinical experience and task relevance were singled out as the clearest factors affecting the self-assessment of their own implementation knowledge. Conclusions This study, the first to focus on implementation knowledge of research funders, demonstrates that they are a category of policy-makers who may possess knowledge, based on their previous professional experience, that is comparable to some important findings from implementation research. Consequently, the findings not only pinpoint the relevance of professional experience, but also reveal a lack of awareness and knowledge of the results of implementation research among research funders in charge of healthcare research. Electronic supplementary material The online version of this article (10.1186/s12961-019-0472-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anders Brantnell
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - Enrico Baraldi
- Department of Industrial Engineering and Management, Uppsala University, Uppsala, Sweden
| | - Theo van Achterberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,KU Leuven Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.,Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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32
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Wyke S, Bunn C, Andersen E, Silva MN, van Nassau F, McSkimming P, Kolovos S, Gill JMR, Gray CM, Hunt K, Anderson AS, Bosmans J, Jelsma JGM, Kean S, Lemyre N, Loudon DW, Macaulay L, Maxwell DJ, McConnachie A, Mutrie N, Nijhuis-van der Sanden M, Pereira HV, Philpott M, Roberts GC, Rooksby J, Røynesdal ØB, Sattar N, Sørensen M, Teixeira PJ, Treweek S, van Achterberg T, van de Glind I, van Mechelen W, van der Ploeg HP. The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial. PLoS Med 2019; 16:e1002736. [PMID: 30721231 PMCID: PMC6363143 DOI: 10.1371/journal.pmed.1002736] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/24/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting. METHODS AND FINDINGS A total of 1,113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Recruitment was between September 19, 2015, and February 2, 2016. Participants consented to study procedures and provided usable activity monitor baseline data. They were randomised, stratified by club, to either the EuroFIT intervention or a 12-month waiting list comparison group. Follow-up measurement was post-programme and 12 months after baseline. EuroFIT is a 12-week, group-based programme delivered by coaches in football club stadia in 12 weekly 90-minute sessions. Weekly sessions aimed to improve physical activity, sedentary time, and diet and maintain changes long term. A pocket-worn device (SitFIT) allowed self-monitoring of sedentary time and daily steps, and a game-based app (MatchFIT) encouraged between-session social support. Primary outcome (objectively measured sedentary time and physical activity) measurements were obtained for 83% and 85% of intervention and comparison participants. Intention-to-treat analyses showed a baseline-adjusted mean difference in sedentary time at 12 months of -1.6 minutes/day (97.5% confidence interval [CI], -14.3-11.0; p = 0.77) and in step counts of 678 steps/day (97.5% CI, 309-1.048; p < 0.001) in favor of the intervention. There were significant improvements in diet, weight, well-being, self-esteem, vitality, and biomarkers of cardiometabolic health in favor of the intervention group, but not in quality of life. There was a 0.95 probability of EuroFIT being cost-effective compared with the comparison group if society is willing to pay £1.50 per extra step/day, a maximum probability of 0.61 if society is willing to pay £1,800 per minute less sedentary time/day, and 0.13 probability if society is willing to pay £30,000 per quality-adjusted life-year (QALY). It was not possible to blind participants to group allocation. Men attracted to the programme already had quite high levels of physical activity at baseline (8,372 steps/day), which may have limited room for improvement. Although participants came from across the socioeconomic spectrum, a majority were well educated and in paid work. There was an increase in recent injuries and in upper and lower joint pain scores post-programme. In addition, although the five-level EuroQoL questionnaire (EQ-5D-5L) is now the preferred measure for cost-effectiveness analyses across Europe, baseline scores were high (0.93), suggesting a ceiling effect for QALYs. CONCLUSION Participation in EuroFIT led to improvements in physical activity, diet, body weight, and biomarkers of cardiometabolic health, but not in sedentary time at 12 months. Within-trial analysis suggests it is not cost-effective in the short term for QALYs due to a ceiling effect in quality of life. Nevertheless, decision-makers may consider the incremental cost for increase in steps worth the investment. TRIAL REGISTRATION International Standard Randomised Controlled Trials, ISRCTN-81935608.
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Affiliation(s)
- Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Christopher Bunn
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Eivind Andersen
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - Marlene N Silva
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Paula McSkimming
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Spyros Kolovos
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Kate Hunt
- Institute for Social Marketing, University of Stirling, Stirling, United Kingdom
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Dundee, United Kingdom
| | - Judith Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sharon Kean
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Nicolas Lemyre
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | | | - Lisa Macaulay
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, the University of Edinburgh, Edinburgh, United Kingdom
| | - Maria Nijhuis-van der Sanden
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, the Netherlands
| | - Hugo V Pereira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Matthew Philpott
- European Healthy Stadia Network CIC Ltd., Liverpool, United Kingdom
| | - Glyn C Roberts
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - John Rooksby
- Computer and Information Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Øystein B Røynesdal
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Marit Sørensen
- Department of Coaching and Psychology, Norwegian School of Sport Science, Oslo, Norway
| | - Pedro J Teixeira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | | | - Irene van de Glind
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, the Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Ebben RHA, Siqeca F, Madsen UR, Vloet LCM, van Achterberg T. Effectiveness of implementation strategies for the improvement of guideline and protocol adherence in emergency care: a systematic review. BMJ Open 2018; 8:e017572. [PMID: 30478101 PMCID: PMC6254419 DOI: 10.1136/bmjopen-2017-017572] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 09/21/2018] [Accepted: 10/05/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Guideline and protocol adherence in prehospital and in-hospital emergency departments (EDs) is suboptimal. Therefore, the objective of this systematic review was to identify effective strategies for improving guideline and protocol adherence in prehospital and ED settings. DESIGN Systematic review. DATA SOURCES PubMed (including MEDLINE), CINAHL, EMBASE and Cochrane. METHODS We selected (quasi) experimental studies published between 2004 and 2018 that used strategies to increase guideline and protocol adherence in prehospital and in-hospital emergency care. Pairs of two independent reviewers performed the selection process, quality assessment and data extraction. RESULTS Eleven studies were included, nine of which were performed in the ED setting and two studies were performed in a combined prehospital and ED setting. For the ED setting, the studies indicated that educational strategies as sole intervention, and educational strategies in combination with audit and feedback, are probably effective in improving guideline adherence. Sole use of reminders in the ED setting also showed positive effects. The two studies in the combined prehospital and ED setting showed similar results for the sole use of educational interventions. CONCLUSIONS Our review does not allow firm conclusion on how to promote guideline and protocol adherence in prehospital emergency care, or the combination of prehospital and ED care. For ED settings, the sole use of reminders or educational interventions and the use of multifaceted strategies of education combined with audit and feedback are all likely to be effective in improving guideline adherence.
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Affiliation(s)
- Remco H A Ebben
- Faculty of Health and Social Studies, Research Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Flaka Siqeca
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Erasmus Scholar from the University of Prishtina, Kosovo at the KU Leuven, Leuven, Belgium
| | | | - Lilian C M Vloet
- Faculty of Health and Social Studies, Research Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
- Department of Public Health and Primary Care, Uppsala University, Uppsala, Sweden
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Coolbrandt A, Wildiers H, Aertgeerts B, Dierckx de Casterlé B, van Achterberg T, Milisen K. Systematic development of CHEMO-SUPPORT, a nursing intervention to support adult patients with cancer in dealing with chemotherapy-related symptoms at home. BMC Nurs 2018; 17:28. [PMID: 29983638 PMCID: PMC6020323 DOI: 10.1186/s12912-018-0297-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 06/18/2018] [Indexed: 11/22/2022] Open
Abstract
Background Given the great symptom burden associated with chemotherapy on the one hand and generally poor self-management of symptoms by cancer patients on the other hand, our aim was to develop a nursing intervention to reduce symptom burden in adult cancer patients treated with chemotherapy and to support them in dealing with their various symptoms at home. Methods Development of the intervention was guided by the Intervention Mapping Approach and included following steps: needs assessment, formulation of proximal programme objectives, selection of methods and strategies, production of programme components, and planning for implementation and evaluation of the intervention. A panel of multidisciplinary healthcare professionals (n = 12) and a panel of patients and family caregivers (n = 7) were actively involved developing the intervention at each stage. Results For the intervention, four patient performance objectives relating to self-management were advanced. Self-efficacy and outcome expectations were selected as key determinants of dealing with chemotherapy-related symptoms. As methods for supporting patients, motivational interviewing and tailoring were found to fit best with the change objectives and determinants. Existing patient information materials were re-designed after panel input to reinforce the new intervention approach. Conclusion The intervention mapping approach, including active involvement of the intervention providers and receivers, informed the design of this nursing intervention with two or more contacts. Further evaluation is needed to gain insight into the potential effects, feasibility and mechanisms of this complex intervention. Electronic supplementary material The online version of this article (10.1186/s12912-018-0297-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Annemarie Coolbrandt
- 1Department of Oncology Nursing, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.,2Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Hans Wildiers
- 3Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Bert Aertgeerts
- 4Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | | | - Theo van Achterberg
- 2Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Koen Milisen
- 2Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
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Coolbrandt A, Milisen K, Wildiers H, Aertgeerts B, van Achterberg T, Van der Elst E, Dierckx de Casterlé B. A nursing intervention aimed at reducing symptom burden during chemotherapy (CHEMO-SUPPORT): A mixed-methods study of the patient experience. Eur J Oncol Nurs 2018; 34:35-41. [DOI: 10.1016/j.ejon.2018.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
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van den Heuvel S, Goossens P, Terlouw C, Schoonhoven L, van Achterberg T. Informal Caregivers' Learning Experiences With Self-Management Support of Individuals Living With Bipolar Disorder: A Phenomenological Study. J Am Psychiatr Nurses Assoc 2018; 24:531-541. [PMID: 29313419 DOI: 10.1177/1078390317752864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The degree of informal caregiver involvement influences the self-management of individuals living with bipolar disorder (BD). OBJECTIVE This article aims to provide a description of informal caregivers' learning experiences in self-management support of BD in order to guide professionals in tailoring future psychosocial and psychoeducational interventions. DESIGN In-depth open interviews with 10 informal caregivers of patients with BD who followed treatment in the context of specialized outpatient bipolar care were conducted. RESULTS Four learning phases emerged from the phenomenological analysis describing the informal caregivers learning process: (1) understanding BD, (2) overcoming the dilemmas in self-management support for individuals living with BD, (3) dividing tasks and responsibilities, and (4) acquiring a personal definition of self-management support for individuals living with BD. CONCLUSION By grasping the concept of BD, informal caregivers gradually learn how to overcome dilemmas resulting from living with someone with BD, and how to control the expression of emotions. They learn to reflect on the nature of conflicts and how to share the responsibilities of illness management with individuals living with BD and professionals. Mastering these skills eventually allows them to define and delimit their supporting informal caregiver role in the self-management of BD. PRACTICE IMPLICATIONS Our findings provide information regarding the educational needs of informal caregivers to tailor counseling, and psychosocial and psychoeducational interventions in specialized outpatient care for individuals living with BD.
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Affiliation(s)
- Silvio van den Heuvel
- 1 Silvio van den Heuvel, MA, RN, Saxion University of Applied Sciences, Deventer, Netherlands; Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands; Dimence Group, Deventer, Netherlands; KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Peter Goossens
- 2 Peter Goossens, PhD, MANP, RN, FEANS, Dimence, Institute for Mental Healthcare, Deventer, Netherlands; Radboud Institute for Health Sciences, Nijmegen, Netherlands; Institute for the Education of Clinical Nurse Specialists in Mental Health, Utrecht, Netherlands; Ghent University, University Centre of Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Services, Ghent, Belgium
| | - Cees Terlouw
- 3 Cees Terlouw, PhD, Saxion University of Applied Sciences, Deventer, Netherlands
| | - Lisette Schoonhoven
- 4 Lisette Schoonhoven, PhD, RN, FEANS, University of Southampton, Southampton, UK
| | - Theo van Achterberg
- 5 Theo van Achterberg, PhD, RN, FEANS, KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium; Radboud Institute for Health Sciences, Nijmegen, Netherlands; Uppsala University, Uppsala, Sweden
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Coolbrandt A, Wildiers H, Laenen A, Aertgeerts B, Dierckx de Casterlé B, van Achterberg T, Milisen K. A Nursing Intervention for Reducing Symptom Burden During Chemotherapy. Oncol Nurs Forum 2018; 45:115-128. [DOI: 10.1188/18.onf.115-128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Helleman M, Goossens PJJ, van Achterberg T, Kaasenbrood A. Components of Brief Admission as a Crisis Intervention for Patients With a Borderline Personality Disorder: Results of a Delphi Study. J Am Psychiatr Nurses Assoc 2018; 24:314-326. [PMID: 28850006 DOI: 10.1177/1078390317728330] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Brief admission (BA) is a widely used intervention for patients with a borderline personality disorder but it has not yet clearly defined and still lacks clear operational standards. To fully develop this intervention, the relevant components need to be identified and clearly documented. OBJECTIVE To obtain consensus on the components of BA as a crisis intervention for patients with a borderline personality disorder. DESIGN Modified Delphi study. RESULTS Consensus of 100% was reached for the components: "BA plan must be developed together with the patient"; "The BA intervention should be mentioned in the care plan for the patient"; "Not all behavior on the part of the patient has to be accepted during a BA"; and "The BA can only be offered together with treatment by a community care professional." CONCLUSION Consensus on the components of BA was reached for 82 of the 90 components. This indicates a substantial degree of agreement on what BA should entail.
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Affiliation(s)
- Marjolein Helleman
- 1 Marjolein Helleman, RN, MScN, Dimence Group, Zwolle, Netherlands; Radboud University Medical Centre, Nijmegen, Netherlands
| | - Peter J J Goossens
- 2 Peter J. J. Goossens, RN, APRN, PhD, FEANS, Radboud University Medical Centre, Nijmegen, Netherlands; Dimence Group, Deventer, Netherlands; Ghent University, Ghent, Belgium; GGZ-VS, Institute for Education of Clinical Nurse Specialist in Mental Health, Utrecht, Netherlands
| | - Theo van Achterberg
- 3 Theo van Achterberg, RN, PhD, Radboud University Medical Centre, Nijmegen, Netherlands; KU Leuven, Leuven, Belgium
| | - Ad Kaasenbrood
- 4 Ad Kaasenbrood, MD, PhD, Centre for Personality Disorders, Utrecht, Netherlands; Team for Assertive Outreach, Arnhem, Netherlands
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Grönqvist H, Olsson EMG, Johansson B, Held C, Sjöström J, Lindahl Norberg A, Hovén E, Sanderman R, van Achterberg T, von Essen L. Fifteen Challenges in Establishing a Multidisciplinary Research Program on eHealth Research in a University Setting: A Case Study. J Med Internet Res 2017; 19:e173. [PMID: 28536090 PMCID: PMC5461416 DOI: 10.2196/jmir.7310] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 01/19/2017] [Revised: 03/22/2017] [Accepted: 04/08/2017] [Indexed: 12/02/2022] Open
Abstract
Background U-CARE is a multidisciplinary eHealth research program that involves the disciplines of caring science, clinical psychology, health economics, information systems, and medical science. It was set up from scratch in a university setting in 2010, funded by a governmental initiative. While establishing the research program, many challenges were faced. Systematic documentation of experiences from establishing new research environments is scarce. Objective The aim of this paper was to describe the challenges of establishing a publicly funded multidisciplinary eHealth research environment. Methods Researchers involved in developing the research program U-CARE identified challenges in the formal documentation and by reflecting on their experience of developing the program. The authors discussed the content and organization of challenges into themes until consensus was reached. Results The authors identified 15 major challenges, some general to establishing a new research environment and some specific for multidisciplinary eHealth programs. The challenges were organized into 6 themes: Organization, Communication, Implementation, Legislation, Software development, and Multidisciplinarity. Conclusions Several challenges were faced during the development of the program and several accomplishments were made. By sharing our experience, we hope to help other research groups embarking on a similar journey to be prepared for some of the challenges they are likely to face on their way.
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Affiliation(s)
- Helena Grönqvist
- U-CARE, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Birgitta Johansson
- U-CARE, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, Uppsala, Sweden
| | - Claes Held
- U-CARE, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.,Uppsala Clinical Research Center, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Jonas Sjöström
- U-CARE, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Department of Informatics and Media, Campus Gotland, Uppsala University, Uppsala, Sweden
| | - Annika Lindahl Norberg
- U-CARE, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Emma Hovén
- U-CARE, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Theo van Achterberg
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Louise von Essen
- U-CARE, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Huisman-de Waal G, Naber T, Schoonhoven L, Persoon A, Sauerwein H, van Achterberg T. Problems Experienced by Patients Receiving Parenteral Nutrition at Home: Results of an Open Interview Study. JPEN J Parenter Enteral Nutr 2017; 30:215-21. [PMID: 16639068 DOI: 10.1177/0148607106030003215] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Home parenteral nutrition (HPN) is offered to patients who are unable to absorb sufficient nourishment from normal oral food intake or tube feeding. Major causes include severe motility disorders and limited resorption surface in the small intestine. HPN is a lifesaving therapy but has severe consequences on daily life. The aim of this study was to make an inventory of the problems experienced by patients receiving HPN. METHODS Open interviews were held with 48 patients from the 2 major centers for HPN in the Netherlands, centered around the question: Which 3 HPN problems have the most severe impact on your daily life? Data were analyzed using content analysis. RESULTS The respondents mentioned 7 central problems: negative emotions, physical problems, social limitations, dependence on others, incapability, complications, and patient-care provider problems. In addition, practical problems were mentioned: sleeping problems, financial problems, and the "hospital atmosphere" at home. The latter issues formed less of a problem for the patients. CONCLUSION The main underlying elements in the lives of many HPN patients appeared to be loss, longing, and grief. In contrast, a smaller proportion of the patients expressed that they had clearly adapted to life with HPN. By means of the HPN, they were still alive and enjoying all the things they could still do.
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Affiliation(s)
- Getty Huisman-de Waal
- Department of Nursing Science, Radboud University Nijmegen Medical Center, The Netherlands
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Van Grootven B, van Achterberg T. The European Union’s Ambient and Assisted Living Joint Programme: An evaluation of its impact on population health and well-being. Health Informatics J 2016; 25:27-40. [DOI: 10.1177/1460458216683535] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Ambient Assisted Living Joint Programme, instituted in 2008 by the European Union, aimed to create better living conditions for older adults through the funding of information and communications technology projects. This review aimed to uncover what can be learned from the Ambient Assisted Living Joint Programme by determining (1) the target populations served, (2) technology-based interventions used and (3) effects on health and well-being outcomes. Information from the Ambient Assisted Living catalogue, project websites and deliverables and from papers in PubMed and EMBASE was reviewed. Overall, 152 projects from the first six rounds of funding were identified. Sensors, computers, phones, tablets and televisions were used for various purposes, that is, monitoring, feedback, coaching, reminders and communication. In total, 12 projects reported evaluating health and well-being outcomes; however, these evaluations demonstrated poor methodological quality. Only three projects reported exact values. For all other projects, published evidence on the effect of these projects on health and well-being outcomes was not available.
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Affiliation(s)
| | - Theo van Achterberg
- KU Leuven, Belgium; Uppsala University, Sweden; Radboud university medical center, Netherlands
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Giesbers A(S, Schouteten RL, Poutsma E, van der Heijden BI, van Achterberg T. Nurses’ perceptions of feedback to nursing teams on quality measurements: An embedded case study design. Int J Nurs Stud 2016; 64:120-129. [DOI: 10.1016/j.ijnurstu.2016.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/29/2016] [Accepted: 10/09/2016] [Indexed: 10/20/2022]
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Schiks I, Schoonhoven L, Verheugt F, Aengevaeren W, van Achterberg T. Performance evaluation of arterial femoral sheath removal by registered nurses after PCI. Eur J Cardiovasc Nurs 2016; 6:172-7. [PMID: 16997633 DOI: 10.1016/j.ejcnurse.2006.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Revised: 07/31/2006] [Accepted: 08/14/2006] [Indexed: 10/24/2022]
Abstract
Background Sheath removal after PCI by registered nurses can improve patients’ comfort and shorten immobilisation time. As sheath removal is not without risk, it is important to assure the quality of performance. Aims The aim was (a) to check if nurses’ performance in 1999 and 2005 was in accordance with the protocol for arterial sheath removal and (b) to compare both measurements to explore differences in performance over time. Methods We trained registered nurses in sheath removal and observed them during sheath removal in elective uncomplicated PCI-patients. We developed and used a checklist, including 10 elements and 65 items. Results Both in 1999 ( n=43 observations with 13 nurses) and 2005 ( n=42 observations with 16 nurses) the norm of more than 90% for the total score was not achieved: we found 82% and 80%, respectively. Four elements scored more than 90%, and three elements scored less than 80% at both points in time. The results on the other three elements differed significantly over time. Conclusion Registered nurses achieved the norm for good performance (80–89%) of removing arterial sheaths according to protocol after a training programme and this is stable in time. Since the norm for excellent performance (≥90%) was not achieved, current performance could be improved, e.g. by yearly repetition of training and observation of skills. More research is needed, and could focus on the validation of the instrument. Also multi-centre studies with this checklist could test the association between the quality of arterial femoral sheath removal and the occurrence of vascular complications.
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MESH Headings
- Adult
- Angioplasty, Balloon, Coronary/adverse effects
- Angioplasty, Balloon, Coronary/instrumentation
- Angioplasty, Balloon, Coronary/nursing
- Arteries
- Benchmarking
- Catheters, Indwelling
- Clinical Competence/standards
- Clinical Protocols/standards
- Education, Nursing, Continuing/organization & administration
- Employee Performance Appraisal
- Female
- Hospitals, University
- Humans
- Longitudinal Studies
- Male
- Middle Aged
- Nurse's Role
- Nursing Education Research
- Nursing Evaluation Research
- Nursing Staff, Hospital/education
- Nursing Staff, Hospital/organization & administration
- Postoperative Care/nursing
- Professional Autonomy
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Affiliation(s)
- Ingrid Schiks
- Heart Lung Centre, Cardiology, Radboud University Nijmegen Medical Centre, 6500 HB, Nijmegen, The Netherlands.
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de Brouwer BJM, Kaljouw MJ, Schoonhoven L, van Achterberg T. Essential elements of the nursing practice environment in nursing homes: Psychometric evaluation. Int J Older People Nurs 2016; 12. [DOI: 10.1111/opn.12137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Lisette Schoonhoven
- Faculty of Health Sciences; University of Southampton; Southampton General Hospital; Southampton UK
| | - Theo van Achterberg
- Centre for Health Services and Nursing Research; KU Leuven; Leuven Belgium
- Scientific Institute for Quality of Healthcare; Radboud University Medical Centre; Nijmegen The Netherlands
- Department of Public Health; Uppsala University; Uppsala Sweden
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Affiliation(s)
- Fritz Frauenfelder
- Vice Director of the Directorate of Nursing, Therapies and Social Work Psychiatric; University Hospital Zürich; Zürich Switzerland
| | - Theo van Achterberg
- Professor of Quality of Care, Department of Public Health and Primary Care; Academic Centre for Nursing and Midwifery, KU Leuven; Leuven Belgium
- Scientific Institute for Quality of Health Care; Radboud University Medical Centre; Nijmegen The Netherlands
- Department of Public Health and Primary Care; Uppsala University; Uppsala Sweden
| | - Maria Müller-Staub
- Director of Pflege PBS (Projects, Consulting, Research); Wil Switzerland
- Professor in Nursing Diagnostics; Hanze University; Groningen The Netherlands
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Ausserhofer D, Deschodt M, De Geest S, van Achterberg T, Meyer G, Verbeek H, Sjetne IS, Malinowska-Lipień I, Griffiths P, Schlüter W, Ellen M, Engberg S. “There's No Place Like Home”: A Scoping Review on the Impact of Homelike Residential Care Models on Resident-, Family-, and Staff-Related Outcomes. J Am Med Dir Assoc 2016; 17:685-93. [DOI: 10.1016/j.jamda.2016.03.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 03/15/2016] [Indexed: 11/17/2022]
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van Nassau F, van der Ploeg HP, Abrahamsen F, Andersen E, Anderson AS, Bosmans JE, Bunn C, Chalmers M, Clissmann C, Gill JMR, Gray CM, Hunt K, Jelsma JGM, La Guardia JG, Lemyre PN, Loudon DW, Macaulay L, Maxwell DJ, McConnachie A, Martin A, Mourselas N, Mutrie N, Nijhuis-van der Sanden R, O'Brien K, Pereira HV, Philpott M, Roberts GC, Rooksby J, Rost M, Røynesdal Ø, Sattar N, Silva MN, Sorensen M, Teixeira PJ, Treweek S, van Achterberg T, van de Glind I, van Mechelen W, Wyke S. Study protocol of European Fans in Training (EuroFIT): a four-country randomised controlled trial of a lifestyle program for men delivered in elite football clubs. BMC Public Health 2016; 16:598. [PMID: 27430332 PMCID: PMC4950080 DOI: 10.1186/s12889-016-3255-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/01/2016] [Indexed: 12/24/2022] Open
Abstract
Background Lifestyle interventions targeting physical activity, sedentary time and dietary behaviours have the potential to initiate and support behavioural change and result in public health gain. Although men have often been reluctant to engage in such lifestyle programs, many are at high risk of several chronic conditions. We have developed an evidence and theory-based, gender sensitised, health and lifestyle program (European Fans in Training (EuroFIT)), which is designed to attract men through the loyalty they feel to the football club they support. This paper describes the study protocol to evaluate the effectiveness and cost-effectiveness of the EuroFIT program in supporting men to improve their level of physical activity and reduce sedentary behaviour over 12 months. Methods The EuroFIT study is a pragmatic, two-arm, randomised controlled trial conducted in 15 football clubs in the Netherlands, Norway, Portugal and the UK (England). One-thousand men, aged 30 to 65 years, with a self-reported Body Mass Index (BMI) ≥27 kg/m2 will be recruited and individually randomised. The primary outcomes are objectively-assessed changes in total physical activity (steps per day) and total sedentary time (minutes per day) at 12 months after baseline assessment. Secondary outcomes are weight, BMI, waist circumference, resting systolic and diastolic blood pressure, cardio-metabolic blood biomarkers, food intake, self-reported physical activity and sedentary time, wellbeing, self-esteem, vitality and quality of life. Cost-effectiveness will be assessed and a process evaluation conducted. The EuroFIT program will be delivered over 12 weekly, 90-minute sessions that combine classroom discussion with graded physical activity in the setting of the football club. Classroom sessions provide participants with a toolbox of behaviour change techniques to initiate and sustain long-term lifestyle changes. The coaches will receive two days of training to enable them to create a positive social environment that supports men in engaging in sustained behaviour change. Discussion The EuroFIT trial will provide evidence on the effectiveness and cost-effectiveness of the EuroFIT program delivered by football clubs to their male fans, and will offer insight into factors associated with success in making sustained changes to physical activity, sedentary behaviour, and secondary outcomes, such as diet. Trial registration ISRCTN: 81935608. Registered 16 June 2015.
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Affiliation(s)
- Femke van Nassau
- Department of Public and Occupational Health, and EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, and EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands.
| | - Frank Abrahamsen
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - Eivind Andersen
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, Level 7, Ninewells Medical School, University of Dundee, Dundee, UK
| | - Judith E Bosmans
- Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Christopher Bunn
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS, UK
| | - Matthew Chalmers
- School of Computing Science, University of Glasgow, Glasgow, G12 8RZ, UK
| | | | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Cindy M Gray
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS, UK
| | - Kate Hunt
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Judith G M Jelsma
- Department of Public and Occupational Health, and EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | | | - Pierre N Lemyre
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - David W Loudon
- PAL Technologies Ltd, PAL Technologies Ltd 50 Richmond Street, Glasgow, G1 1XP, Scotland, UK
| | - Lisa Macaulay
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS, UK
| | - Douglas J Maxwell
- PAL Technologies Ltd, PAL Technologies Ltd 50 Richmond Street, Glasgow, G1 1XP, Scotland, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Scotland, UK
| | - Anne Martin
- Physical Activity for Health Research Centre, University of Edinburgh, Institute for Sport, Physical Education and Health Sciences, Edinburgh, EH8 8AQ, UK
| | - Nikos Mourselas
- PAL Technologies Ltd, PAL Technologies Ltd 50 Richmond Street, Glasgow, G1 1XP, Scotland, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Institute for Sport, Physical Education and Health Sciences, Edinburgh, EH8 8AQ, UK
| | - Ria Nijhuis-van der Sanden
- Radboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Kylie O'Brien
- Pintail Ltd, 77 Springhill Ave, Blackrock, Co. Dublin, Ireland
| | - Hugo V Pereira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Matthew Philpott
- European Healthy Stadia Network, 151 Dale Street, Liverpool, L2 2JH, UK
| | - Glyn C Roberts
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - John Rooksby
- School of Computing Science, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Mattias Rost
- School of Computing Science, University of Glasgow, Glasgow, G12 8RZ, UK
| | - Øystein Røynesdal
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Marlene N Silva
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal
| | - Marit Sorensen
- Norwegian School of Sport Sciences, Department of Coaching and Psychology, Oslo, Norway
| | - Pedro J Teixeira
- European Healthy Stadia Network, 151 Dale Street, Liverpool, L2 2JH, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Theo van Achterberg
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - Irene van de Glind
- Radboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, and EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands
| | - Sally Wyke
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS, UK
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48
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Voogt LA, Nugter A, Goossens PJJ, van Achterberg T. An Interview Study on "Providing Structure" as an Intervention in Psychiatric Inpatient Care: The Nursing Perspective. Perspect Psychiatr Care 2016; 52:208-16. [PMID: 25944548 DOI: 10.1111/ppc.12119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/20/2015] [Accepted: 03/26/2015] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To gain insight into nurses' perceptions and use of providing structure (PS) as an intervention during psychiatric inpatient care. DESIGN AND METHODS Interviews were conducted with nurses (n = 18) from two inpatient wards in psychiatry immediately following the occurrence of a PS event. This was done immediately following the occurrence of a PS event. Transcripts were analyzed using a qualitative coding process. FINDINGS Four general and 14 specific PS activities were described associated with the nursing intervention PS. PRACTICE IMPLICATIONS Nurses can now refer to specific activities of PS. An elaborated definition of PS is provided to facilitate a better understanding and using of PS as a psychiatric nursing intervention.
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Affiliation(s)
- L Amar Voogt
- Philadelphia Zorg regio Noordwest, Organization for People with a Mental Disability, Mental Health Care Hospital GGZ Noord-Holland Noord, Heiloo, The Netherlands.,Department of Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Annet Nugter
- Mental Health Care Hospital GGZ Noord-Holland Noord, Heerhugowaard, The Netherlands
| | - Peter J J Goossens
- Department of Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Center for Bipolar Disorder, Dimence Mental Health Care, Deventer, The Netherlands.,GGZ-VS Institute for the Education of Clinical Nurse Specialist in Mental Health, Utrecht, The Netherlands.,Department of Nursing Sciences, Ghent University, Ghent, Belgium
| | - Theo van Achterberg
- Department of Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium
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49
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Helleman M, Goossens PJJ, Kaasenbrood A, van Achterberg T. Brief Admissions During Prolonged Treatment in a Case Involving Borderline Personality Disorder and Posttraumatic Stress Disorder: Use and Functions. J Am Psychiatr Nurses Assoc 2016; 22:215-24. [PMID: 26935701 DOI: 10.1177/1078390316636196] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study describes the use of brief admissions to a psychiatric ward by a single patient across a period of 7 years. The patient suffered from a borderline personality disorder and a complex posttraumatic stress disorder. OBJECTIVE The purpose of this study was to describe how brief admission may be used during a long-term treatment process. DESIGN A single-case descriptive study with triangulation of the data was undertaken. Semistructured interviews were conducted with the patient and the patient's spouse, psychiatrist, ward nurse, and community psychiatric nurse. Other data were retrieved from the medical records of the patient. RESULTS Four phases could be distinguished in the treatment of the patient: crisis, treatment of posttraumatic stress disorder, treatment of borderline personality disorder, and recovery. The use of brief admissions positively influenced the course of treatment. CONCLUSIONS Brief admissions were initially used to prevent self-harm and suicide. The goals and functions expanded to prevention of prolonged admission, prevention of dropout from evidence-based therapy, and practicing with newly acquired skills and promotion of autonomy.
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Affiliation(s)
- Marjolein Helleman
- Marjolein Helleman, RN, MScN, Dimence Group, Zwolle, Netherlands; Radboud University Medical Centre, Nijmegen, Netherlands
| | - Peter J J Goossens
- Peter J. J. Goossens, RN, APRN, PhD, FEANS, Radboud University Medical Centre, Nijmegen, Netherlands; Dimence Group, Deventer, Netherlands; Ghent University, Ghent, Belgium; GGZ-VS, Utrecht, Netherlands
| | - Ad Kaasenbrood
- Ad Kaasenbrood, MD, PhD, Centre for Personality Disorders, Utrecht, Netherlands; Pro Persona, Arnhem, Netherlands
| | - Theo van Achterberg
- Theo van Achterberg, RN, PhD, FEANS, Radboud University Medical Centre, Nijmegen, Netherlands; KU Leuven, Leuven, Belgium
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50
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Craig P, Rahm-Hallberg I, Britten N, Borglin G, Meyer G, Köpke S, Noyes J, Chandler J, Levati S, Sales A, Thabane L, Giangregorio L, Feeley N, Cossette S, Taylor R, Hill J, Richards DA, Kuyken W, von Essen L, Williams A, Hemming K, Lilford R, Girling A, Taljaard M, Dimairo M, Petticrew M, Baird J, Moore G, Odendaal W, Atkins S, Lutge E, Leon N, Lewin S, Payne K, van Achterberg T, Sermeus W, Pitt M, Monks T. Researching Complex Interventions in Health: The State of the Art : Exeter, UK. 14-15 October 2015. BMC Health Serv Res 2016; 16 Suppl 1:101. [PMID: 27050396 PMCID: PMC4894677 DOI: 10.1186/s12913-016-1274-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
KEYNOTE PRESENTATIONS K1 Researching complex interventions: the need for robust approaches Peter Craig K2 Complex intervention studies: an important step in developing knowledge for practice Ingalill Rahm-Hallberg K3 Public and patient involvement in research: what, why and how? Nicky Britten K4 Mixed methods in health service research – where do we go from here? Gunilla Borglin SPEAKER PRESENTATIONS S1 Exploring complexity in systematic reviews of complex interventions Gabriele Meyer, Sascha Köpke, Jane Noyes, Jackie Chandler S2 Can complex health interventions be optimised before moving to a definitive RCT? Strategies and methods currently in use Sara Levati S3 A systematic approach to develop theory based implementation interventions Anne Sales S4 Pilot studies and feasibility studies for complex interventions: an introduction Lehana Thabane, Lora Giangregorio S5 What can be done to pilot complex interventions? Nancy Feeley, Sylvie Cossette S6 Using feasibility and pilot trials to test alternative methodologies and methodological procedures prior to full scale trials Rod Taylor S7 A mixed methods feasibility study in practice Jacqueline Hill, David A Richards, Willem Kuyken S8 Non-standard experimental designs and preference designs Louise von Essen S9 Evaluation gone wild: using natural experimental approaches to evaluate complex interventions Andrew Williams S10 The stepped wedge cluster randomised trial: an opportunity to increase the quality of evaluations of service delivery and public policy interventions Karla Hemming, Richard Lilford, Alan Girling, Monica Taljaard S11 Adaptive designs in confirmatory clinical trials: opportunities in investigating complex interventions Munyaradzi Dimairo S12 Processes, contexts and outcomes in complex interventions, and the implications for evaluation Mark Petticrew S13 Processes, contexts and outcomes in complex interventions, and the implications for evaluation Janis Baird, Graham Moore S14 Qualitative evaluation alongside RCTs: what to consider to get relevant and valuable results Willem Odendaal, Salla Atkins, Elizabeth Lutge, Natalie Leon, Simon Lewin S15 Using economic evaluations to understand the value of complex interventions: when maximising health status is not sufficient Katherine Payne S16 How to arrive at an implementation plan Theo van Achterberg S17 Modelling process and outcomes in complex interventions Walter Sermeus S18 Systems modelling for improving health care Martin Pitt, Thomas Monks
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Affiliation(s)
- Peter Craig
- />MRC/CSO Social and Public Health Sciences Unit (SPHSU), University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB UK
| | | | - Nicky Britten
- />University of Exeter Medical School, South Cloisters, St Luke’s Campus, Exeter, EX1 2LU UK
| | - Gunilla Borglin
- />Department of Caring Science, Malmö University, SE-205 06 Malmö, Sweden
| | - Gabriele Meyer
- />Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, D-06112 Halle (Saale), Germany
| | | | | | | | - Sara Levati
- />NMAHP Research Unit, Glasgow Caledonian University, ᅟ, UK
| | - Anne Sales
- />School of Nursing, University of Michigan, USA and Center for Clinical Management Research, VA Ann Arbor Healthcare System, ᅟ, USA
| | | | | | - Nancy Feeley
- />Ingram School of Nursing, McGill University, and Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, Québec Canada
| | - Sylvie Cossette
- />Faculty of Nursing, University of Montreal, and Montreal Heart Institute Research Center, Montreal, Québec Canada
| | - Rod Taylor
- />University of Exeter Medical School, South Cloisters, St Luke’s Campus, ᅟ, UK
| | - Jacqueline Hill
- />Mood Disorders Centre, School of Psychology, University of Exeter, ᅟ, UK
| | | | - Willem Kuyken
- />Department of Psychiatry, University of Oxford, ᅟ, UK
| | - Louise von Essen
- />Department of Public Health and Caring Sciences, Uppsala University, ᅟ, Sweden
| | - Andrew Williams
- />Farr Institute, Scotland, and the Scottish Collaboration for Public Health Research and Policy, 20 West Richmond Street (East Wing), Edinburgh, EH8 9DX UK
| | | | - Richard Lilford
- />Warwick Medical School, University of Warwick, Coventry, UK
| | - Alan Girling
- />Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, ᅟ, UK
| | - Monica Taljaard
- />Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Mark Petticrew
- />Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, ᅟ, UK
| | - Janis Baird
- />MRC Lifecourse Epidemiology Unit, University of Southampton, ᅟ, UK
| | | | - Willem Odendaal
- />Health Systems Research Unit, South African Medical Research Council, South Africa, http://www.mrc.ac.za/healthsystems/healthsystems.htm
| | | | - Elizabeth Lutge
- />Epidemiology, Health Research and Knowledge Management, KwaZulu-Natal Department of Health, ᅟ, South Africa
| | - Natalie Leon
- />South African Medical Research Council, ᅟ, South Africa
| | - Simon Lewin
- />Global Health Unit, Norwegian Knowledge Centre for the Health Services, ᅟ, Norway
| | | | | | - Walter Sermeus
- />School of Public Health & Primary Care, Leuven University KU Leuven, ᅟ, Belgium
| | - Martin Pitt
- />University of Exeter Medical School, ᅟ, UK
| | - Thomas Monks
- />Faculty of Health Sciences, University of Southampton, ᅟ, UK
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