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Mylius CF, Mooiweer Y, Krijnen WP, Takken T, van Munster BC, van der Schans CP, Klaase JM. Changes in Self-Reported and Device-Measured Physical Activity Before Abdominal Resection Surgery: A Meta-Analysis. Clin Rehabil 2024; 38:216-233. [PMID: 37731348 DOI: 10.1177/02692155231202215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVE To determine the effect of interventions on physical activity levels of patients awaiting abdominal resection surgery using self-reported as well as device-measured outcome measures. DATA SOURCE PubMed and EMBASE databases were searched on the 18th of April 2023 up to April 2023 for studies on interventions to promote physical activity during the preoperative phase. REVIEW METHODS Studies were included if pre- and post-intervention physical activity was measured between diagnosis and abdominal surgery. Risk of bias was assessed by the Physiotherapy Evidence Database (PEDro) assessment tool for trials. Meta-analyses were performed to assess the effect of the pre-surgery activity promoting interventions on self-reported and device-measured physical activity. RESULTS Seventeen studies were included in the analysis with 452 subjects in the intervention groups. The random-effect meta-analysis showed a moderate improvement in intervention groups measures in pre-surgery physical activity levels compared to the baseline (SMD = 0.67, [CI = 0.30;1.03], I2 = 79%). The self-reported subgroup meta-analysis showed the largest increase in performed physical activity, (SMD = 0.78, [CI = 0.4;1.15], I2 = 79%) whilst non-significant increase was shown in the device-measured subgroup (SMD = 0.16, [CI = -0.64;0.97], I2 = 58%). CONCLUSION Increasing physical activity in the preoperative phase is feasible. Self-reported physical activity outcome measures show larger effects compared to device-measured outcome measures. More high-quality research should be performed utilizing objective measures.
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Affiliation(s)
- Caspar F Mylius
- Healthy Aging, Allied Health Care and Nursing, Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands
- Physiotherapy, Centre of Expertise Primary Care Groningen, Groningen, The Netherlands
| | - Yvet Mooiweer
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wim P Krijnen
- Healthy Aging, Allied Health Care and Nursing, Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands
| | - Tim Takken
- Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Barbara C van Munster
- University Center for Geriatric Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Healthy Aging, Allied Health Care and Nursing, Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Health Psychology Research, University of Groningen, University Medical Center Groningen, Health Psychology Research, Groningen, The Netherlands
| | - Joost M Klaase
- Department of Hepatobiliary Surgery and Liver Transplantation, University Medical Centre Groningen, Groningen, The Netherlands
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2
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Hogenbirk RNM, Wijma AG, van der Plas WY, Hentzen JEKR, de Bock GH, van der Schans CP, Kruijff S, Klaase JM. Actual physical activity after major abdominal cancer surgery: Far from optimal. Eur J Surg Oncol 2024; 50:107949. [PMID: 38215551 DOI: 10.1016/j.ejso.2024.107949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/13/2023] [Accepted: 01/02/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Enhanced recovery after surgery protocols emphasize the importance of early postoperative mobilization. However, literature quantifying actual physical activity after major abdominal cancer surgery is scarce and inconclusive. MATERIAL AND METHODS A single-center prospective cohort study was conducted at the University Medical Center Groningen from 2019 to 2021. Patients' postoperative physical activity was measured using an accelerometer, with the primary aim of assessing daily physical activity. Secondary aims were identifying patient-related factors associated with low physical activity and studying the consequences of low physical activity in terms of complication rate and length of hospital stay. RESULTS 143 patients included (48 % male; mean age 65 years), 38.5 %, 24.5 %, 19.6 %, and 14 % underwent pancreatic, hepatic, colorectal, or cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, respectively. Median daily step count was low; from median 71 steps on the first to 918 steps on the seventh postoperative day. An association between physical activity and age (OR 3.597, p = 0.013), preoperative weight loss ≥10 % (OR 4.984, p = 0.004), Eastern Cooperative Oncology Group performance status ≥2 (OR 4.016, p = 0.001), midline laparotomy (OR 2.851, p = 0.025), and operation duration (OR 1.003, p = 0.044) was found. An association was observed between physical activity and the occurrence of complications (OR 3.197, p = 0.039) and prolonged hospital stay (β 4.068, p = 0.013). CONCLUSION Postoperative physical activity is low in patients undergoing major abdominal cancer surgery and is linked to postoperative outcomes. Although physical activity should be encouraged in all patients, patient-specific risk factors were identified that can aid early recognition of patients at risk of low physical activity.
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Affiliation(s)
- Rianne N M Hogenbirk
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Allard G Wijma
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Willemijn Y van der Plas
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Surgery, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Judith E K R Hentzen
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Cees P van der Schans
- Department of Health Psychology and Department of Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Research Group Healthy Ageing, Allied Health Care and Nursing, Center of Expertise Healthy Ageing, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Schelto Kruijff
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Joost M Klaase
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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3
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Luitwieler N, Luijkx J, van der Stege HA, Grootoonk A, van der Schans CP, van der Putten AAJ, Waninge A. Transition to adulthood of adolescents with profound intellectual and multiple disabilities: Content validation of the SGU-PIMD to support families. J Appl Res Intellect Disabil 2024; 37:e13161. [PMID: 37793995 DOI: 10.1111/jar.13161] [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: 12/14/2022] [Revised: 09/11/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND For families with adolescent children, the transition to adulthood is usually challenging. This period may be extra demanding for families with a child with profound intellectual and multiple disabilities due to the child's strong and persistent support needs. To support these families during this phase and to facilitate the transition process of these adolescents, we adapted the Canadian skills for growing up (SGU) into the skills for growing up-profound intellectual and multiple disabilities (SGU-PIMD). The aim of this study is to determine its content validity. METHOD A Delphi study with family members and healthcare professionals was conducted. RESULTS Results showed good content validity. However, the Delphi panel suggested minor adjustments to improve relevance, comprehensibility and comprehensiveness. CONCLUSIONS The current SGU-PIMD can be used in practice for supporting adolescents with profound intellectual and multiple disabilities. However, there are also recommendations for research into the feasibility and acceptability of the instrument.
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Affiliation(s)
- Nicole Luitwieler
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Jorien Luijkx
- Faculty of Behavioural and Social Sciences, Basic Unit Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Heleen A van der Stege
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Anneke Grootoonk
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Annette A J van der Putten
- Faculty of Behavioural and Social Sciences, Basic Unit Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
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4
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Dorsman NI, Waninge A, van der Schans CP, Luijkx J, Van der Putten AAJ. The roles of adult siblings of individuals with a profound intellectual disability. J Appl Res Intellect Disabil 2023; 36:1308-1318. [PMID: 37550062 DOI: 10.1111/jar.13149] [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: 12/09/2022] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Adult siblings are important in the lives of individuals with profound intellectual disabilities, especially as parents age. However, little is known about the roles they assume. METHOD We examined these roles among 58 participants from the Netherlands, who completed an online questionnaire. RESULTS Most participants (89.7%) assumed multiple roles, and the majority were content with their roles. Between 7% and 58% indicated that they were the only individuals providing a certain role. Shared roles primarily involved healthcare professionals, other siblings, and parents. Almost half the participants (48.2%) assigned higher scores for the amount of support provided than for the experienced burden. CONCLUSIONS Adult siblings often assume multiple roles. The shared roles emphasise the importance of collaboration.
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Affiliation(s)
- Naomi I Dorsman
- Research Group on Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Research Group on Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Research Group on Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Jorien Luijkx
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Annette A J Van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
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5
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Hogenbirk RNM, van der Plas WY, Hentzen JEKR, van Wijk L, Wijma AG, Buis CI, Viddeleer AR, de Bock GH, van der Schans CP, van Dam GM, Kruijff S, Klaase JM. Postoperative muscle loss, protein intake, physical activity and outcome associations. Br J Surg 2023; 110:183-192. [PMID: 36394896 PMCID: PMC10364506 DOI: 10.1093/bjs/znac384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Skeletal muscle loss is often observed in intensive care patients. However, little is known about postoperative muscle loss, its associated risk factors, and its long-term consequences. The aim of this prospective observational study is to identify the incidence of and risk factors for surgery-related muscle loss (SRML) after major abdominal surgery, and to study the impact of SRML on fatigue and survival. METHODS Patients undergoing major abdominal cancer surgery were included in the MUSCLE POWER STUDY. Muscle thickness was measured by ultrasound in three muscles bilaterally (biceps brachii, rectus femoris, and vastus intermedius). SRML was defined as a decline of 10 per cent or more in diameter in at least one arm and leg muscle within 1 week postoperatively. Postoperative physical activity and nutritional intake were assessed using motility devices and nutritional diaries. Fatigue was measured with questionnaires and 1-year survival was assessed with Cox regression analysis. RESULTS A total of 173 patients (55 per cent male; mean (s.d.) age 64.3 (11.9) years) were included, 68 of whom patients (39 per cent) showed SRML. Preoperative weight loss and postoperative nutritional intake were statistically significantly associated with SRML in multivariable logistic regression analysis (P < 0.050). The combination of insufficient postoperative physical activity and nutritional intake had an odds ratio of 4.00 (95 per cent c.i. 1.03 to 15.47) of developing SRML (P = 0.045). No association with fatigue was observed. SRML was associated with decreased 1-year survival (hazard ratio 4.54, 95 per cent c.i. 1.42 to 14.58; P = 0.011). CONCLUSION SRML occurred in 39 per cent of patients after major abdominal cancer surgery, and was associated with a decreased 1-year survival.
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Affiliation(s)
- Rianne N M Hogenbirk
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Willemijn Y van der Plas
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Judith E K R Hentzen
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Laura van Wijk
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Allard G Wijma
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Carlijn I Buis
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alain R Viddeleer
- Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Geertruida H de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Department of Rehabilitation and Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Research Group Healthy Ageing, Allied Health Care and Nursing, Center of Expertise Healthy Ageing, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Gooitzen M van Dam
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, Groningen, The Netherlands.,TRACER Europe BV, Groningen, The Netherlands
| | - Schelto Kruijff
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joost M Klaase
- Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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6
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van der Schans CP, van der Schans S, van der Schans J, Mylius C, Klaase J. Monitoring physical impact and recovery of pancreatic cancer treatment using consumer wearable health data: A case report. Digit Health 2023; 9:20552076231177127. [PMID: 37252255 PMCID: PMC10214075 DOI: 10.1177/20552076231177127] [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: 09/15/2022] [Accepted: 05/04/2023] [Indexed: 05/31/2023] Open
Abstract
Consumer wearables health data may reflect the impact of pancreatic cancer and its treatment on cardiorespiratory fitness and the subsequent recovery after treatment. The patient is a 65-year-old male treated for borderline resectable pancreatic cancer. Treatment consisted of four courses of FOLFIRINOX neoadjuvant chemotherapy, a Whipple procedure with a right hemicolectomy and venous segment resection, and eight courses of adjuvant FOLFIRINOX chemotherapy. Physical activity and moderate to vigorous physical activity declined after the onset of symptoms, increased in the weeks before surgery, declined after surgery and then gradually recovered during and after adjuvant chemotherapy. Estimated VO2max remained stable during neoadjuvant chemotherapy, sharply decreased after surgery and then gradually recovered. Heart rate at rest increased and heart rate variability decreased after the onset of symptoms reaching their highest and lowest values after surgery. Both gradually returned to baseline seven months after the last course of chemotherapy. The physical impact of pancreatic cancer and its treatment and recovery was in this case reflected on consumer wearable health data. Seven months after the last chemotherapy recovery was close to baseline values.
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Affiliation(s)
- Cees P van der Schans
- Research Group Healthy Ageing, Allied Health
Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The
Netherlands
- Department Health Psychology, University Medical Centre Groningen, Groningen, The Netherlands
- Department Rehabilitation Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Simon van der Schans
- Unit of Global Health, Department of Health
Science, University Medical Centre Groningen, Groningen, The Netherlands
- Health-Ecore, Zeist, The Netherlands
| | - Jurjen van der Schans
- Unit of Global Health, Department of Health
Science, University Medical Centre Groningen, Groningen, The Netherlands
- Health-Ecore, Zeist, The Netherlands
- Department of Economics, Econometrics and
Finance, Faculty of Economics and Business, University of Groningen, Groningen, The
Netherlands
| | - Caspar Mylius
- Research Group Healthy Ageing, Allied Health
Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The
Netherlands
| | - Joost Klaase
- Department of Hepato-Pancreato-Biliary
Surgery and Liver Transplantation, University Medical Centre Groningen, Groningen, The Netherlands
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7
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de Vries HJ, Pennings HJM, van der Schans CP, Sanderman R, Oldenhuis HKE, Kamphuis W. Wearable-Measured Sleep and Resting Heart Rate Variability as an Outcome of and Predictor for Subjective Stress Measures: A Multiple N-of-1 Observational Study. Sensors (Basel) 2022; 23:s23010332. [PMID: 36616929 PMCID: PMC9823534 DOI: 10.3390/s23010332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 05/27/2023]
Abstract
The effects of stress may be alleviated when its impact or a decreased stress-resilience are detected early. This study explores whether wearable-measured sleep and resting HRV in police officers can be predicted by stress-related Ecological Momentary Assessment (EMA) measures in preceding days and predict stress-related EMA outcomes in subsequent days. Eight police officers used an Oura ring to collect daily Total Sleep Time (TST) and resting Heart Rate Variability (HRV) and an EMA app for measuring demands, stress, mental exhaustion, and vigor during 15-55 weeks. Vector Autoregression (VAR) models were created and complemented by Granger causation tests and Impulse Response Function visualizations. Demands negatively predicted TST and HRV in one participant. TST negatively predicted demands, stress, and mental exhaustion in two, three, and five participants, respectively, and positively predicted vigor in five participants. HRV negatively predicted demands in two participants, and stress and mental exhaustion in one participant. Changes in HRV lasted longer than those in TST. Bidirectional associations of TST and resting HRV with stress-related outcomes were observed at a weak-to-moderate strength, but not consistently across participants. TST and resting HRV are more consistent predictors of stress-resilience in upcoming days than indicators of stress-related measures in prior days.
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Affiliation(s)
- Herman J. de Vries
- Research Group Digital Transformation, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
- Department of Human Behaviour & Training, Netherlands Organization for Applied Scientific Research (TNO), 3769 DE Soesterberg, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, 9700 AB Groningen, The Netherlands
| | - Helena J. M. Pennings
- Department of Human Behaviour & Training, Netherlands Organization for Applied Scientific Research (TNO), 3769 DE Soesterberg, The Netherlands
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Cees P. van der Schans
- Department of Rehabilitation Medicine, University Medical Center Groningen, 9700 AB Groningen, The Netherlands
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, 9700 AB Groningen, The Netherlands
- Department of Psychology, Health and Technology, University of Twente, 7522 NB Enschede, The Netherlands
| | - Hilbrand K. E. Oldenhuis
- Research Group Digital Transformation, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Wim Kamphuis
- Department of Human Behaviour & Training, Netherlands Organization for Applied Scientific Research (TNO), 3769 DE Soesterberg, The Netherlands
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8
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Hendrickx AA, Küthe SW, van der Schans CP, Krijnen WP, Mouës-Vink CM, Damstra RJ. Early Referral for Breast-Cancer-Related Lymphedema: Do We Follow the Evidence? A Two-Year Prospective Multicenter Cohort Study. Cancers (Basel) 2022; 14:cancers14236016. [PMID: 36497495 PMCID: PMC9738967 DOI: 10.3390/cancers14236016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
The early detection of breast-cancer-related lymphedema and referral for therapy has the potential to reduce lymphedema-related morbidity. Although research shows the benefits, a gap is observed between evidence and daily practice. We aimed to determine whether the early detection of lymphedema and referral for treatment is adequate following the current guidelines. Women with primary breast cancer treated with breast-conserving therapy or ablative treatment were included. Demographic-, general health-, tumor-, and treatment-related data were recorded. Bilateral arm volume measurements were performed preoperatively and 3, 6, 12, and 24 months post-surgery. A 5% or greater Relative Volume Change was considered the cutoff point for lymphedema and as an indication for therapy referral. After 24 months post-surgery, the main outcomes show that among the patients with early signs of lymphedema, based on a Relative Volume Change ≥5%, a nonreferral for therapy was noted in 83%. Additionally, we observed a significant improvement of the mean Relative Volume Change at 24 months within this group, which might implicate that nonreferral was an adequate choice and that watchful waiting is appropriate when lymphedema is detected within the first year post-surgery.
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Affiliation(s)
- Ad A. Hendrickx
- Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Compagnonsplein 1, 9202 NN Drachten, The Netherlands
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
- Correspondence:
| | - Saskia W. Küthe
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
- Department of Plastic, Reconstructive and Hand Surgery, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands
| | - Cees P. van der Schans
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Chantal M. Mouës-Vink
- Department of Plastic, Reconstructive and Hand Surgery, Medical Center Leeuwarden, 8934 AD Leeuwarden, The Netherlands
| | - Robert J. Damstra
- Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Compagnonsplein 1, 9202 NN Drachten, The Netherlands
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9
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Hogenbirk RNM, Viddeleer AR, Hentzen JEKR, van der Plas WY, van der Schans CP, de Bock GH, Kruijff S, Klaase JM. Thickness of Biceps and Quadriceps Femoris Muscle Measured Using Point-of-Care Ultrasound as a Representation of Total Skeletal Muscle Mass. J Clin Med 2022; 11:jcm11226606. [PMID: 36431082 PMCID: PMC9695176 DOI: 10.3390/jcm11226606] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
Generalized loss of muscle mass is associated with increased morbidity and mortality in patients with cancer. The gold standard to measure muscle mass is by using computed tomography (CT). However, the aim of this prospective observational cohort study was to determine whether point-of-care ultrasound (POCUS) could be an easy-to-use, bedside measurement alternative to evaluate muscle status. Patients scheduled for major abdominal cancer surgery with a recent preoperative CT scan available were included. POCUS was used to measure the muscle thickness of mm. biceps brachii, mm. recti femoris, and mm. vasti intermedius 1 day prior to surgery. The total skeletal muscle index (SMI) was derived from patients’ abdominal CT scan at the third lumbar level. Muscle force of the upper and lower extremities was measured using a handheld dynamometer. A total of 165 patients were included (55% male; 65 ± 12 years). All POCUS measurements of muscle thickness had a statistically significant correlation with CT-derived SMI (r ≥ 0.48; p < 0.001). The strongest correlation between POCUS muscle measurements and SMI was observed when all POCUS muscle groups were added together (r = 0.73; p < 0.001). Muscle strength had a stronger correlation with POCUS-measured muscle thickness than with CT-derived SMI. To conclude, this study indicated a strong correlation between combined muscle thickness measurements performed by POCUS- and CT-derived SMI and measurements of muscle strength. These results suggest that handheld ultrasound is a valid tool for the assessment of skeletal muscle status.
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Affiliation(s)
- Rianne N. M. Hogenbirk
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Correspondence:
| | - Alain R. Viddeleer
- Department of Radiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Judith E. K. R. Hentzen
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Willemijn Y. van der Plas
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Department of Surgery, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
| | - Cees P. van der Schans
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Center of Expertise Healthy Ageing, Hanze University of Applied Sciences, 9747 AS Groningen, The Netherlands
| | - Geertruida H. de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Schelto Kruijff
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Joost M. Klaase
- Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
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10
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Willems M, de Jong J, Overwijk A, Hilgenkamp TIM, van der Schans CP, Waninge A. Behaviour change techniques used in lifestyle support of adults with mild intellectual disabilities. J Appl Res Intellect Disabil 2022; 35:1327-1335. [PMID: 35734872 DOI: 10.1111/jar.13021] [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: 05/25/2021] [Revised: 03/27/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Professional caregivers are important in the daily support of lifestyle change for adults with mild intellectual disabilities; however, little is known about which behaviour change techniques (BCTs) are actually used. This study aims to gain insight in their use for lifestyle behaviour change using video observations. METHODS Professional caregivers (N = 14) were observed in daily work supporting adults with mild intellectual disabilities. Videos were analysed using the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy and BCTs utilised were coded. RESULTS Twenty one out of 40 BCTs were used by professional caregivers. The BCTs 'Information about others' approval', 'Identification as role model', 'Rewards on successful behaviour', 'Review behavioural goals' and 'Instructions on how to perform the behaviour' were most employed. CONCLUSION Professional caregivers used BCTs to support healthier lifestyle behaviour of adults with mild intellectual disabilities. However, most promising of them as defined previous by professionals were rarely used by professional caregivers.
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Affiliation(s)
- Mariël Willems
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Johan de Jong
- School of Sports Studies, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Annelies Overwijk
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Thessa I M Hilgenkamp
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands.,Physical Therapy Department, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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11
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Wagenaar MC, van der Putten AAJ, Douma JG, van der Schans CP, Waninge A. Definitions, signs, and symptoms of constipation in people with severe or profound intellectual disabilities: A systematic review. Heliyon 2022; 8:e09479. [PMID: 35663754 PMCID: PMC9156888 DOI: 10.1016/j.heliyon.2022.e09479] [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: 12/27/2021] [Revised: 04/06/2022] [Accepted: 05/13/2022] [Indexed: 10/25/2022] Open
Abstract
Background It is difficult to diagnose constipation for people with severe or profound intellectual disabilities. Definitions for this are ambiguous, and the symptoms and signs are often unnoticed. The aim of this study is to identify clear definitions of constipation for people with different levels of intellectual disabilities and to identify signs and symptoms. Method Guided by the PRISMA statement, a systematic review of the literature was conducted within electronic databases MEDLINE, Embase, CINAHL, Cochrane, and PsycINFO. Definitions, signs, and symptoms were extracted and the quality of definitions was assessed. Results In total, 24 studies were included. Quality of definitions ranged from poor to good quality. Standard and referenced definitions were used in ten studies, a self-composed definition was employed in eleven studies; and three studies did not refer to a source of the definition. The self-composed definitions had not been evaluated after being used for the target group, and no scientific substantiation was available. A broad range of signs and symptoms were described. Conclusions No substantiated definition has been ascertained for constipation for people with severe or profound intellectual disabilities. Further research will be necessary to identify which signs and symptoms are important for defining constipation in this target group.
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Affiliation(s)
- Marjolijn C Wagenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands
| | - Annette A J van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, the Netherlands
| | - Johanna G Douma
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, the Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands.,Department Health Psychology, University Medical Centre Groningen, Groningen, the Netherlands.,Department Rehabilitation Medicine, University Medical Centre Groningen, Groningen, the Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, the Netherlands.,Department Health Psychology, University Medical Centre Groningen, Groningen, the Netherlands
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12
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Overwijk A, Hilgenkamp TIM, van der Schans CP, van der Putten AAJ, Waninge A. Development of a Dutch Training/Education Program for a Healthy Lifestyle of People With Intellectual Disability. Intellect Dev Disabil 2022; 60:163-177. [PMID: 35297990 DOI: 10.1352/1934-9556-60.2.163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 08/18/2021] [Indexed: 06/14/2023]
Abstract
Individuals with intellectual disability (ID) need support from direct support professionals (DSPs) to engage in a healthy lifestyle. However, literature shows DSPs feel insufficiently equipped to support a healthy lifestyle. Therefore, the aim of this study is to develop a theory-based program for DSPs to support physical activity and healthy nutrition for people with moderate to profound levels of ID, and to design its evaluation. The Intervention Mapping Protocol (IM) was followed to develop a theory-based program for DSPs. The program evaluation consists of process and feasibility evaluations. This study provided a theory-based program consisting of a training and education section with online and face-to-face components to support DSPs in promoting health for people with ID.
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Affiliation(s)
- Annelies Overwijk
- Annelies Overwijk, Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences and University of Groningen, University Medical Center Groningen, Department of Health Psychology, Groningen, The Netherlands
| | - Thessa I M Hilgenkamp
- Thessa I.M. Hilgenkamp, Department of General Practice, Intellectual Disability Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands, and Department of Physical Therapy, University of Nevada
| | - Cees P van der Schans
- Cees P. van der Schans, Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine and Department of Health Psychology
| | - Annette A J van der Putten
- Annette A.J. van der Putten, Department of Inclusive and Special Needs Education, University of Groningen, The Netherlands
| | - Aly Waninge
- Aly Waninge, Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, and University of Groningen, University Medical Center Groningen, Department of Health Psychology, The Netherlands
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13
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Cheung SL, Krijnen WP, Fu Y, van der Schans CP, Hobbelen H. Filial Piety and Mental Health Among Older Chinese Immigrants in the Netherlands. Gerontol Geriatr Med 2022; 8:23337214221083470. [PMID: 35295286 PMCID: PMC8918955 DOI: 10.1177/23337214221083470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/10/2022] [Accepted: 02/09/2022] [Indexed: 12/05/2022] Open
Abstract
Filial piety is important to Chinese adults and is associated with mental health among older Chinese immigrants in the United States. However, it is unclear whether filial piety is linked to the mental health of Chinese immigrants in European countries. Therefore, this study aims to gain insights into the association between mental health and filial piety of first-generation Chinese immigrants in the Netherlands. A random sample of 143 participants took part in the study. A cross-sectional design was used. Data were collected through a postal survey conducted in the Chinese language between January 2021 and March 2021. The survey included a Mental Health Continuum-Short Form (MHC), and expected and perceived filial piety scale. The results indicated that in general, perceived filial piety exceeded expected filial piety (‘filial piety sufficient’). Regression analysis revealed that ‘filial piety sufficient’ is associated with a higher emotional MHC (B =.498, p =.035). This study provided new insights into the wellbeing of older Chinese immigrants in the Netherlands and showed accordance with the literature that filial piety remains an important factor for mental health.
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Affiliation(s)
- Sie-Long Cheung
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University Applied Sciences, Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University Applied Sciences, Groningen, The Netherlands
| | - Yuanyuan Fu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Cees P. van der Schans
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University Applied Sciences, Groningen, The Netherlands
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hans Hobbelen
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University Applied Sciences, Groningen, The Netherlands
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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14
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Sealy MJ, Stuiver MM, Midtgaard J, van der Schans CP, Roodenburg JLN, Jager-Wittenaar H. Perception and Performance of Physical Activity Behavior after Head and Neck Cancer Treatment: Exploration and Integration of Qualitative and Quantitative Findings. Int J Environ Res Public Health 2021; 19:287. [PMID: 35010547 PMCID: PMC8751059 DOI: 10.3390/ijerph19010287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Maintaining or increasing physical activity (PA) may prevent loss of muscle mass and strength after completion of head and neck cancer (HNC) treatment. However, the exercise level of HNC patients may not meet PA guidelines. We aimed to explore HNC survivors' views on PA, their report of PA, and to compare these with objectively measured PA. Combined qualitative and quantitative data of HNC survivors were explored post-treatment. Data from semi-structured interviews, questionnaires, and objective measurements of PA were collected, analyzed, and integrated. This resulted in the identification of five themes related to prioritizing, day-to-day life, intention, positive feelings, and social support, respectively, in nine HNC survivors (male: n = 5; age: 52-67 years). Objectively measured PA levels were sedentary to low. The lack of intention to increase PA may be related to HNC survivors' perception that their current activity level is sufficient, despite low levels of measured PA. While some participants feel they need no help with PA, others are insecure about possible harms. Healthcare professionals may be able to help improve PA in HNC survivors with a tailored approach that reduces fear of harm and helps to incorporate higher intensity PA in daily activities.
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Affiliation(s)
- Martine J. Sealy
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; (C.P.v.d.S.); (H.J.-W.)
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands;
| | - Martijn M. Stuiver
- Center for Quality of Life, Department of Head and Neck Surgery and Oncology, Division of Psychosocial Oncology and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands;
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Tafelbergweg 51, 1105 AZ Amsterdam, The Netherlands
| | - Julie Midtgaard
- Mental Health Services in the Capital Region of Denmark, Mental Health Centre Glostrup, University of Copenhagen, Nordstjernevej 41, DK-2600 Glostrup, Denmark;
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3, DK-2100 Copenhagen, Denmark
| | - Cees P. van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; (C.P.v.d.S.); (H.J.-W.)
- Department of Rehabilitation Medicine and Department of Health Psychology Research, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands
| | - Jan L. N. Roodenburg
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands;
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands; (C.P.v.d.S.); (H.J.-W.)
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands;
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15
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Mylius CF, Krijnen WP, Takken T, Lips DJ, Eker H, van der Schans CP, Klaase JM. Objectively measured preoperative physical activity is associated with time to functional recovery after hepato-pancreato-biliary cancer surgery: a pilot study. Perioper Med (Lond) 2021; 10:33. [PMID: 34602089 PMCID: PMC8489102 DOI: 10.1186/s13741-021-00202-7] [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: 10/20/2020] [Accepted: 06/16/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Surgical resection is currently the cornerstone of hepato-pancreato-biliary (HPB) cancer treatment. A low preoperative aerobic fitness level has been identified as a modifiable risk factor associated with complications after major abdominal surgery. A person's aerobic fitness is influenced by performing moderate to vigorous physical activity (MVPA). This study aims to determine the activity monitor measured levels of MVPA performed among patients on the waiting list for HPB cancer surgery and their association with postoperative outcomes. METHODS A prospective, observational multi-center cohort pilot study was conducted. Patients enlisted for resection surgery on suspicion of HPB (pre)malignancy were enrolled. Performed MVPA was measured by an Actigraph wGT3X-BT. Additionally, aerobic fitness was measured via the Incremental Shuttle Walk Test, and (post)operative variables were collected from the electronic patient files. The association between MVPA and the pre- and postoperative variables was determined by univariate and multivariable (logistic) robust regression. RESULTS A total of 38 participants, median age 66.0 (IQR 58.25-74.75) years, were enrolled. The median daily MVPA was 10.7 (IQR 6.9-18.0) min; only 8 participants met the Dutch MVPA guidelines. Participant's age and aerobic fitness were associated with MVPA by multivariable statistical analysis. Time to functional recovery was 8 (IQR 5-12) days and was associated with MVPA and type of surgery (major/minor) in multivariable analysis. CONCLUSION Seventy-six percent of patients enlisted for resection of HPB (pre)malignancy performed insufficient MVPA. A higher level of MVPA was associated with a shorter time to functional recovery.
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Affiliation(s)
- Caspar F Mylius
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA, Groningen, The Netherlands.
| | - Wim P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA, Groningen, The Netherlands
| | - Tim Takken
- Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Daan J Lips
- Department of Surgery, Medical Spectrum Twente, Enschede, The Netherlands
| | - Hasan Eker
- Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Health Psychology Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joost M Klaase
- Department of Hepatobiliary Surgery and Liver Transplantation, University Medical Centre Groningen, Groningen, The Netherlands
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16
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Dewansingh P, Reckman GAR, Mijlius CF, Krijnen WP, van der Schans CP, Jager-Wittenaar H, van den Heuvel EGHM. Protein, Calcium, Vitamin D Intake and 25(OH)D Status in Normal Weight, Overweight, and Obese Older Adults: A Systematic Review and Meta-Analysis. Front Nutr 2021; 8:718658. [PMID: 34568405 PMCID: PMC8461258 DOI: 10.3389/fnut.2021.718658] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/16/2021] [Indexed: 12/18/2022] Open
Abstract
The aging process is often accompanied by increase in body weight. Older adults with overweight or obesity might have an overconsumption in energy that is accompanied by inadequate intake of protein, vitamin D, and calcium. It is unclear if intake of protein and vitamin D and calcium is sufficient in older adults with overweight/obesity, and whether it differs from older adults with normal weight, since a recent overview of the literature review is lacking. Therefore, we systematically analyzed the current evidence on differences in nutrient intake/status of protein, vitamin D and calcium between older adults with different body mass index (BMI) categories. Randomized controlled trials and prospective cohort studies were identified from PubMed and EMBASE. Studies reporting nutrient intake/status in older adults aged ≥50 years with overweight/obesity and studies comparing between overweight/obesity and normal weight were included. Nutrient intake/status baseline values were reviewed and when possible calculated for one BMI category (single-group meta-analysis), or compared between BMI categories (meta-analysis). Nutrient intake/status was compared with international recommendations. Mean protein (N = 8) and calcium intake (N = 5) was 0.98 gram/kilogram body weight/day (g/kg/d) [95% Confidence Interval (CI) 0.89-1.08] and 965 mg [95% CI: 704-1225] in overweight/obese. Vitamin D intake was insufficient in all BMI categories (N = 5). The pooled mean for vitamin D intake was 6 ug [95% CI 4-9]. For 25(OH)D, the pooled mean was 54 nmol/L [95% CI 45-62], 52 nmol/L [95% CI 46-58], and 48 nmol/l [95% CI 33-62] in normal (N = 7), combined overweight and obese (N = 12), and obese older adults (N = 4), respectively. In conclusion, older adults with overweight and obesity have a borderline sufficient protein and sufficient calcium intake, but insufficient vitamin D intake. The 25(OH)D concentration is deficient for the obese older adults.
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Affiliation(s)
- Priya Dewansingh
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
| | - Gerlof A. R. Reckman
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Caspar F. Mijlius
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
- Faculty of Mathematics and Natural Sciences, University of Groningen, Groningen, Netherlands
| | - Cees P. van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
- Faculty of Medical Sciences, University Medical Center Groningen, Groningen, Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands
- Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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17
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Overwijk A, van der Putten AAJ, van der Schans CP, Willems M, Hilgenkamp TIM, Waninge A. Use of behaviour change techniques by direct support professionals to support healthy lifestyle behaviour for people with moderate to profound intellectual disabilities. J Appl Res Intellect Disabil 2021; 34:1048-1056. [PMID: 33295116 PMCID: PMC8359235 DOI: 10.1111/jar.12845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/22/2020] [Accepted: 11/12/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Behaviour change techniques (BCTs) can be employed to support a healthy lifestyle for people with intellectual disabilities. The aim of this study is to determine whether and which BCTs are used by direct support professionals (DSPs) for supporting healthy lifestyle behaviour of people with moderate to profound intellectual disabilities. METHOD Direct support professionals (n = 18) were observed in their daily work using audio-visual recordings. To code BCTs, the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy was employed. RESULTS Direct support professionals used 33 BCTs out of 42. The most used BCTs were as follows: 'feedback on performance', 'instructions on how to perform the behaviour', 'doing together', 'rewards on successful behaviour', 'reward effort towards behaviour', 'DSP changes environment', 'graded tasks', 'prompt practice' and 'model/demonstrate behaviour'. CONCLUSIONS Although a variety of BCTs is used by DSPs in their support of people with moderate to profound intellectual disabilities when facilitating healthy lifestyle behaviour, they rely on nine of them.
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Affiliation(s)
- Annelies Overwijk
- Research Group Healthy AgeingAllied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
- Department of Health PsychologyUniversity Medical Centre GroningenUniversity of GroningenGroningenThe Netherlands
| | | | - Cees P. van der Schans
- Research Group Healthy AgeingAllied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
- Department of Health PsychologyUniversity Medical Centre GroningenUniversity of GroningenGroningenThe Netherlands
- Department of Rehabilitation MedicineUniversity Medical Centre GroningenUniversity of GroningenGroningenThe Netherlands
| | - Mariël Willems
- Research Group Healthy AgeingAllied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
| | - Thessa I. M. Hilgenkamp
- Department of General PracticeIntellectual Disability MedicineErasmus MCUniversity Medical Centre RotterdamRotterdamThe Netherlands
- Department of Physical TherapyUniversity of NevadaLas VegasNVUSA
| | - Aly Waninge
- Research Group Healthy AgeingAllied Health Care and NursingHanze University of Applied SciencesGroningenThe Netherlands
- Department of Health PsychologyUniversity Medical Centre GroningenUniversity of GroningenGroningenThe Netherlands
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18
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Zijlstra E, Hagedoorn M, Lechner SC, van der Schans CP, Mobach MP. The experience of patients in an outpatient infusion facility: a qualitative study. F 2021. [DOI: 10.1108/f-03-2020-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
As hospitals are now being designed with an increasing number of single rooms or cubicles, the individual preference of patients with respect to social contact is of great interest. The purpose of this study is to gain a better understanding of the experience of patients in an outpatient infusion center.
Design/methodology/approach
A total of 29 semi-structured interviews were conducted, transcribed and analyzed by using direct content analysis.
Findings
Findings showed that patients perceived a lack of acoustic privacy and therefore tried to emotionally isolate themselves or withheld information from staff. In addition, patients complained about the sounds of infusion pumps, but they were neutral about the interior features. Patients who preferred non-talking desired enclosed private rooms and perceived negative distraction because of spatial crowding. In contrast, patients who preferred talking, or had no preference, desired shared rooms and perceived positive distraction because of spatial crowding.
Research limitations/implications
In conclusion, results showed a relation between physical aspects (i.e. physical enclosure) and the social environment.
Practical implications
The findings allow facility managers to better understand the patients’ experiences in an outpatient infusion facility and to make better-informed decisions. Patients with different preferences desired different physical aspects. Therefore, nursing staff of outpatient infusion centers should assess the preferences of patients. Moreover, architects should integrate different types of treatment places (i.e. enclosed private rooms and shared rooms) in new outpatient infusion centers to fulfill different preferences and patients should have the opportunity to discuss issues in private with nursing staff.
Originality/value
This study emphasizes the importance of a mix of treatment rooms, while new hospital designs mainly include single rooms or cubicles.
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19
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Hendrickx AA, Damstra RJ, Krijnen WP, van der Schans CP. Improvement of Limb Volumes after Bariatric Surgery in Nine End-Stage Primary, Secondary, and Obesity-Induced Lymphedema Patients: A Multiple Case Report. Lymphat Res Biol 2021; 20:64-70. [PMID: 33780644 DOI: 10.1089/lrb.2020.0055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Lymphedema (LE) is a chronic condition of swelling due to lymphatic impairment and is characterized by edema and fibro-adipose tissue deposition. LE may be caused by an anomalous development of the lymphatic system, known as primary LE, or may develop secondary to traumatic, infectious, or other external events. Knowledge is increasing about the plural and bidirectional relationship between LE and obesity. The rate of obesity is increasing worldwide, and bariatric surgery offers the most effective and durable treatment, as this surgery exhibits positive effects on many obesity-related diseases. We explored whether bariatric surgery could improve leg volumes in morbidly obese LE patients. Patients: Between 2013 and 2019, 829 patients were hospitalized in our Center of Expertise for Lymphovascular Medicine for intensive treatment of their LE. Nine patients with end-stage primary, secondary, or obesity-induced LE underwent a bariatric procedure related to their morbid obesity. Methods and Results: Data concerning age, gender, medical diagnosis, LE stage, type of bariatric treatment, body weight, body mass index (BMI), and limb volumes were retrospectively collected from the patient files. At the individual patient level, body weight, BMI, leg volumes, and their percent reduction between presurgery and postsurgery were calculated. At the group level, paired sample t-tests were conducted to compare the mean body weight, BMI, and volumes of both legs between postsurgery and presurgery. The data demonstrate a significant decrease in body weight, BMI, and leg volumes in morbidly obese end-stage primary, secondary, and obesity-induced LE patients following bariatric surgery. Conclusions: Our multiple case study indicates that bariatric surgery provides a good indication for concomitant treatment of morbid obesity and LE.
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Affiliation(s)
- Ad A Hendrickx
- Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Drachten, The Netherlands.,Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robert J Damstra
- Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Drachten, The Netherlands
| | - Wim P Krijnen
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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20
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Hagedoorn EI, Paans W, van der Schans CP, Jaarsma T, Luttik MLA, Keers JC. Family caregivers' perceived level of collaboration with hospital nurses: A cross-sectional study. J Nurs Manag 2021; 29:1064-1072. [PMID: 33404173 PMCID: PMC8359371 DOI: 10.1111/jonm.13244] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/13/2020] [Accepted: 12/30/2020] [Indexed: 01/23/2023]
Abstract
Aim To describe the extent of perceived collaboration between family caregivers of older persons and hospital nurses. Background Collaboration between hospital nurses and family caregivers is of increasing importance in older patient's care. Research lacks a specific focus on family caregiver's collaboration with nurses. Method Using a cross‐sectional design, 302 caregivers of older patients (≥70 years) completed the 20‐item Family Collaboration Scale with the subscales: trust in nursing care, accessible nurse and influence on decisions. Data were analysed with descriptive statistics and bivariate correlations. Results Family caregivers rated their level of trust in nurses and nurses' accessibility higher than the level of their influence on decisions. Family caregivers who had more contact with nurses perceived higher levels of influence on decisions (p ≤ .001) and overall collaboration (p ≤ .001). Conclusion Family caregivers' collaboration with nurses can be improved, especially in recognizing and exploiting family caregivers as partner in the care for older hospitalized persons and regarding their level of influence on decisions. Implications for Nursing Management Insight into family caregivers' collaboration with nurses will help nurse managers to jointly develop policy with nurses on how to organise more family caregivers' involvement in the standard care for older persons.
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Affiliation(s)
- Ellen I Hagedoorn
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Health Psychology, University Medical Center, University of Groningen, Groningen, The Netherlands.,Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Critical Care, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Wolter Paans
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Critical Care, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Health Psychology, University Medical Center, University of Groningen, Groningen, The Netherlands.,Department of Rehabilitation, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Tiny Jaarsma
- Department of Social and Welfare Studies (ISV), Linköping University, Linköping, Sweden
| | - Marie Louise A Luttik
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Joost C Keers
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Martini Hospital, Groningen, The Netherlands
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21
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Abstract
The aim of this study was to assess the criterion validity of a new screening instrument, the Early Language Scale (ELS), for the identification of young children at risk for developmental language disorder (DLD), and to determine optimal age-adjusted cut-off scores. We recruited a community-based sample of 265 children aged 1 to 6 years of age. Parents of these children responded on the ELS, a 26-item "yes-no" questionnaire. The children were assessed with extended language tests (language comprehension, word production, sentence production, communication). A composite score out of these tests (two tests below - 1 SD or one below - 1.5 SD) was used as reference standard. We assessed the validity of the ELS, measured by sensitivity, specificity, predictive values, and AUC. The optimal sensitivity/specificity age-dependent cut-off ELS score was at 15th percentile. Sensitivity and specificity were 0.62 and 0.93, respectively. Positive predictive value was moderate (0.53), negative predictive value was high (0.95), the positive likelihood ratio was 9.16, and negative likelihood ratio was 0.41. The area under the ROC curve was 0.88. The items covered the increasing language development for the ages from 1 to 6.Conclusion: The ELS is a valid instrument to identify children with DLD covering an age range of 1 to 6 years in community-based settings. What is Known: • Early identification and treatment of developmental language disorders can reduce negative effects on children's emotional functioning, academic success, and social relationships. • Short, validated language screening instruments that cover the full age range of early childhood language development lack. What is New: • The 26-item Early Language Scale (ELS) is a valid instrument to identify children at risk for developmental language disorder in well-child care and early educational settings among Dutch children aged 1-6 years.
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Affiliation(s)
- Margot I. Visser-Bochane
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
| | - Cees P. van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Health Psychology Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Margreet R. Luinge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA Groningen, The Netherlands
- Department of Otorhinolaryngology, Head & Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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22
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Kranenburg HA(R, Schmitt MA, Puentedura EJ, van der Schans CP, Heneghan NR, Hutting N. Manual therapists’ beliefs and use of spinal thrust joint manipulation. European Journal of Physiotherapy 2020. [DOI: 10.1080/21679169.2020.1857831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hendrikus Antonius (Rik) Kranenburg
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maarten A. Schmitt
- Research Center Innovations in Care, Rotterdam University of Applied Science, Rotterdam, The Netherlands
| | | | - Cees P. van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nicola R. Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Nathan Hutting
- Department of Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
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23
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Seves BL, Hoekstra F, Schoenmakers JW, Brandenbarg P, Hoekstra T, Hettinga FJ, Dekker R, van der Woude LH, van der Schans CP. Test-retest reliability and concurrent validity of the Adapted Short QUestionnaire to ASsess Health-enhancing physical activity (Adapted-SQUASH) in adults with disabilities. J Sports Sci 2020; 39:875-886. [DOI: 10.1080/02640414.2020.1850983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Bregje L. Seves
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | - Femke Hoekstra
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, Canada
| | - Jorrit W.A. Schoenmakers
- University of Groningen, University Medical Center Groningen, Department of Orthopedics, Groningen, The Netherlands
| | - Pim Brandenbarg
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Trynke Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
| | - Lucas H.V. van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise & Health Sciences, Loughborough University, UK
| | - Cees P. van der Schans
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
- Research and Innovation Group in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
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24
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Hagedoorn EI, Paans W, Jaarsma T, Keers JC, van der Schans CP, Luttik MLA. The importance of families in nursing care: attitudes of nurses in the Netherlands. Scand J Caring Sci 2020; 35:1207-1215. [PMID: 33270268 DOI: 10.1111/scs.12939] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 10/15/2019] [Accepted: 11/08/2020] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Positive attitudes towards family involvement in nursing care are essential for improving the involvement of and collaboration with patients' families. The aim of this study is to explore nurses' attitudes towards the importance of families in nursing care. METHOD Using a cross-sectional design, hospital and homecare nurses completed the Families Importance to Nursing Care (FINC-NA) scale, Dutch language version, consisting of four subscales. Data were analysed using descriptive statistics and regression analyses. RESULTS A total of 426 hospital and homecare nurses were eligible for analysis (mean (SD) age 42 years (13), 93% female). The mean (SD) attitude of nurses was 63.8 (12) (100-point scale) on the FINC-NA. Less than half of the nurses (44%) considered family as a collaboration partner, and 37% of nurses stated that families should be invited to actively participate in planning patient care. The nurses' attitudes were explained by years of work experience in nursing, work setting and existing policy regarding families in patient care. CONCLUSION This study identifies areas of improvement regarding to nurses' attitudes towards the importance of families in nursing care in order to establish a more family-focused approach in nursing care. Nursing policies should facilitate working with families as part of regular nursing processes. Furthermore, the importance of family involvement in care should be an explicit matter of concern for nursing educational institutions and for policy making within healthcare organisations.
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Affiliation(s)
- Ellen I Hagedoorn
- School of Nursing Groningen, Hanze University of Applied Sciences, Groningen, The Netherlands.,Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wolter Paans
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tiny Jaarsma
- Department of Social and Welfare studies (ISV), Linköping University, Linköping, Sweden
| | - Joost C Keers
- Martini Hospital Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University Medical Centre, University of Groningen, Groningen, The Netherlands
| | - Marie Louise A Luttik
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, The Netherlands
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25
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Cheung SL, Hobbelen HJSM, van der Schans CP, Krijnen WP. Cross-Cultural Equivalence of De Jong Gierveld Loneliness Scale Among Older Native and Diasporic Chinese Adults. Gerontologist 2020; 62:e62-e72. [PMID: 33045046 PMCID: PMC8827333 DOI: 10.1093/geront/gnaa151] [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: 05/22/2020] [Indexed: 11/26/2022] Open
Abstract
Background and Objectives Loneliness is prevalent among older adults and known to be detrimental to mental health. The objective of this study was to determine the psychometric properties of the Chinese 6-item De Jong Gierveld Loneliness Scale (DJGLS) in the older native and diasporic Chinese community. Research Design and Methods Participants were recruited from a local community in urban Tianjin, China and urban Chinese communities of older adults in the Netherlands. Scale properties, including reliability, were calculated with Cronbach’s alpha and multiple-group confirmatory factor analysis to examine the 2-dimensional structure of the scale and the cross-cultural equivalence between both countries. Item response analysis was employed to plot the relationships between the item response and expected total scale score. Results A total of 193 older adults from China and 135 older adults from the Netherlands were included. The Cronbach’s alphas were 0.68 (China) and 0.71 (the Netherlands). The DJGLS’s 2-dimensional structure was validated by the goodness of fit and the factor loadings. Cross-cultural equivalence was demonstrated with the multiple-group confirmatory analysis. In addition, sufficient discriminative power of the individual items was demonstrated by item response analysis in both countries. Discussion and Implications This study is the first to provide a detailed item behavior analysis with an item response analysis of the DJGLS. In conclusion, the findings of this study suggest that the DJGLS has an adequate and similar item and scalar equivalence for use in Chinese populations.
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Affiliation(s)
- Sie-Long Cheung
- Research group Healthy Ageing Allied Health Care and Nursing, Hanze University Applied Sciences Groningen, The Netherlands.,Department of Health Psychology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Hans J S M Hobbelen
- Research group Healthy Ageing Allied Health Care and Nursing, Hanze University Applied Sciences Groningen, The Netherlands.,Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Cees P van der Schans
- Research group Healthy Ageing Allied Health Care and Nursing, Hanze University Applied Sciences Groningen, The Netherlands.,Department of Health Psychology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Wim P Krijnen
- Research group Healthy Ageing Allied Health Care and Nursing, Hanze University Applied Sciences Groningen, The Netherlands
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26
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Dikkema Y, Nieuwenhuis MK, van der Schans CP, Mouton LJ. Questionnaires to Assess Facilitators and Barriers of Early Mobilization in Critically Ill Patients; Which One to Choose? A Systematic Review. Clin Nurs Res 2020; 30:442-454. [PMID: 32808531 DOI: 10.1177/1054773820948268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Implementing and performing early mobilization is a complex process requiring multidisciplinary input and cooperation. To gain insight in its facilitators and barriers, various surveys have been developed. A systematic review was conducted, to identify the psychometric properties, feasibility and suitability of questionnaires to assess facilitators and barriers of early mobilization in critically ill patients. Data were extracted regarding a.o. definition of early mobilization, development, psychometric properties, content and themes, question format. The search identified 537 publications of which 13 unique questionnaires were included. The questionnaires showed wide variation in extensiveness of development. Only six questionnaires actually assessed validity and reliability. Which questionnaire to choose depends on the aim of its use, required level of detail and specifics of the ICU, though three questionnaires were recommended as their definition of early mobilization covered a broad range of activities, including nursing related mobility activities. International consensus on what constitutes early mobilization is desirable.
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Affiliation(s)
- Yvonne Dikkema
- Association of Dutch Burn Centers, Burn Center Martini Hospital, Groningen, The Netherlands.,Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Department for Human Movement Sciences, Groningen, The Netherlands
| | - Marianne K Nieuwenhuis
- Association of Dutch Burn Centers, Burn Center Martini Hospital, Groningen, The Netherlands.,Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Department for Human Movement Sciences, Groningen, The Netherlands
| | - Cees P van der Schans
- Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Department of Health Psychology, Groningen, the Netherlands
| | - Leonora J Mouton
- University of Groningen, University Medical Center Groningen, Department for Human Movement Sciences, Groningen, The Netherlands
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27
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Visser-Bochane MI, Reijneveld SA, Krijnen WP, van der Schans CP, Luinge MR. Identifying Milestones in Language Development for Young Children Ages 1 to 6 Years. Acad Pediatr 2020; 20:421-429. [PMID: 31306799 DOI: 10.1016/j.acap.2019.07.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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] [Received: 03/21/2019] [Revised: 06/27/2019] [Accepted: 07/07/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Language development is important for children's success in life. Therefore, language is monitored by child health care professionals and parents, but a uniform set of milestones in language development is lacking. Our aim was to identify a set of clear and distinctive milestones that empirically reflect language development in children aged 1 to 6 years of age. METHODS We obtained a community-based sample of 1381 parents reporting on milestones derived from clinical signs and currently used language screening instruments. We used nonparametric Item Response Theory analysis to identify milestones belonging to one unidimensional scale. RESULTS Twenty-six milestones were excellently scalable (item H coefficients 0.62-0.90) and formed a strong scale (total H coefficient 0.83). The final set of identified milestones covered vocabulary, grammar, and communication, with an item ordering that holds for all children. CONCLUSIONS This unidimensional set of 26 clear and distinctive milestones reflects language development in young children and can be used as an instrument to monitor language development.
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Affiliation(s)
- Margot I Visser-Bochane
- Research Group Healthy Ageing, Allied Health Care and Nursing (MI Visser-Bochane, WP Krijnen, CP van der Schans, and MR Luinge), Hanze University Groningen, Applied Sciences, Groningen, the Netherlands.
| | - Sijmen A Reijneveld
- Department of Health Sciences (SA Reijneveld and CP van der Schans), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Wim P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing (MI Visser-Bochane, WP Krijnen, CP van der Schans, and MR Luinge), Hanze University Groningen, Applied Sciences, Groningen, the Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing (MI Visser-Bochane, WP Krijnen, CP van der Schans, and MR Luinge), Hanze University Groningen, Applied Sciences, Groningen, the Netherlands; Department of Health Sciences (SA Reijneveld and CP van der Schans), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Rehabilitation Medicine (CP van der Schans), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Margreet R Luinge
- Research Group Healthy Ageing, Allied Health Care and Nursing (MI Visser-Bochane, WP Krijnen, CP van der Schans, and MR Luinge), Hanze University Groningen, Applied Sciences, Groningen, the Netherlands; Department of Otorhinolaryngology, Head & Neck Surgery (MR Luinge), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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28
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Beek LT, Banning LB, Visser L, Roodenburg JL, van der Schans CP, Pol RA, Jager-Wittenaar H. Prevalence and Features of Risk for Malnutrition in Patients Prior to Vascular Surgery. Eur J Vasc Endovasc Surg 2019. [DOI: 10.1016/j.ejvs.2019.06.708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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29
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Nijholt W, Jager-Wittenaar H, Raj IS, van der Schans CP, Hobbelen H. Reliability and validity of ultrasound to estimate muscles: A comparison between different transducers and parameters. Clin Nutr ESPEN 2019; 35:146-152. [PMID: 31987109 DOI: 10.1016/j.clnesp.2019.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 10/14/2019] [Accepted: 10/24/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS We aimed to investigate the test-retest reliability and validity of ultrasound for two commonly used types of transducer, using different methods for the estimation of muscle size and echo intensity (EI). METHODS Fourteen healthy adults were included in this study. Ultrasound images of the rectus femoris size (thickness in cm and cross-sectional area [CSA] in cm2), obtained at the mid-thigh, were validated against MRI. Both a linear and a curved array transducer were used to assess rectus femoris size and EI (values 0-255, higher scores indicating increased intramuscular fat and interstitial fibrous tissue). To assess test-retest reliability of ultrasound, participants were tested twice, with a one-week interval. Validity and reliability were evaluated using paired sample t-tests, intraclass correlation coefficient (ICC), and Bland-Altman plots. RESULTS No significant differences between the repeated evaluations of rectus femoris thickness, CSA and EI were found. Reliability for thickness and CSA evaluations was excellent for both transducers (ICC = 0.87-0.97) and moderate for EI (ICC = 0.42-0.44). Mean difference between MRI and ultrasound for CSA (curved = 0.59 cm2, p = 0.086; linear = 2.1 cm2, p = 0.002) and thickness (curved = 0.31 cm, p = 0.01; linear = 0.21 cm, p = 0.043) were small but significant, except for CSA using a curved transducer. Agreement between ultrasound and MRI ranged from moderate for thickness (ICC = 0.45) to excellent for CSA (ICC = 0.92). CONCLUSIONS Our study demonstrates that the test-retest reliability and validity of muscle size estimation by ultrasound for both curved and linear array transducers seems to be adequate. Future studies should focus on the longitudinal evaluation of muscle size and EI by ultrasound.
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Affiliation(s)
- Willemke Nijholt
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.
| | - Harriët Jager-Wittenaar
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Maxillofacial Surgery, Groningen, the Netherlands.
| | - Isaac S Raj
- Royal Melbourne Institute of Technology University, Discipline of Exercise Sciences, School of Health and Biomedical Sciences, Bundoora, Victoria, Australia.
| | - Cees P van der Schans
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Health Psychology Research, Groningen, the Netherlands.
| | - Hans Hobbelen
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
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30
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Reckman GAR, Navis GJ, Krijnen WP, Vonk RJ, Jager-Wittenaar H, van der Schans CP. Aerobic exercise increases post-exercise exogenous protein oxidation in healthy young males. PLoS One 2019; 14:e0225803. [PMID: 31765432 PMCID: PMC6876877 DOI: 10.1371/journal.pone.0225803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/12/2019] [Indexed: 01/07/2023] Open
Abstract
The capacity to utilize ingested protein for optimal support of protein synthesis and lean body mass is described within the paradigm of anabolic competence. Protein synthesis can be stimulated by physical exercise, however, it is not known if physical exercise affects post-exercise protein oxidation. Characterization of the driving forces behind protein oxidation, such as exercise, can contribute to improved understanding of whole body protein metabolism. The purpose of this study is to determine the effect of two levels of aerobic exercise intensity on immediate post-exercise exogenous protein oxidation. Sixteen healthy males with a mean (SD) age of 24 (4) years participated. The subjects' VO2-max was estimated with the Åstrand cycling test. Habitual dietary intake was assessed with a three-day food diary. Exogenous protein oxidation was measured by isotope ratio mass spectrometry. These measurements were initiated after the ingestion of a 30 g 13C-milk protein test drink that was followed by 330 minutes breath sample collection. On three different days with at least one week in between, exogenous protein oxidation was measured: 1) during rest, 2) after 15 minutes of aerobic exercise at 30% of VO2-max (moderate intensity), and 3) after 15 minutes of aerobic exercise at 60% of VO2-max (vigorous intensity). After vigorous intensity aerobic exercise, 31.8%±8.0 of the 30 g 13C-milk protein was oxidized compared to 26.2%±7.1 during resting condition (p = 0.012), and 25.4%±7.6 after moderate intensity aerobic exercise compared to resting (p = 0.711). In conclusion, exogenous protein oxidation is increased after vigorous intensity aerobic exercise which could be the result of an increased protein turnover rate.
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Affiliation(s)
- Gerlof A. R. Reckman
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Centre of Expertise Healthy Ageing, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Gerjan J. Navis
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Centre of Expertise Healthy Ageing, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Roel J. Vonk
- Department of Cell Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Centre of Expertise Healthy Ageing, Hanze University of Applied Sciences, Groningen, the Netherlands
- Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Cees P. van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Centre of Expertise Healthy Ageing, Hanze University of Applied Sciences, Groningen, the Netherlands
- Department of Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Hoekstra F, Hoekstra T, van der Schans CP, Hettinga FJ, van der Woude LHV, Dekker R. The implementation of a physical activity counseling program in rehabilitation care: findings from the ReSpAct study. Disabil Rehabil 2019; 43:1710-1721. [PMID: 31622120 DOI: 10.1080/09638288.2019.1675188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE This study aimed to evaluate the implementation of a physical activity counseling program in rehabilitation and to study heterogeneity in received counseling and investigate its association with changes in patients' physical activity outcomes. METHODS This prospective cohort study was conducted in 18 rehabilitation institutions. Data were collected using surveys completed by professionals (n= ±70) and patients (n = 1719). Implementation was evaluated using different process outcomes: reach, dosage, satisfaction, maintenance. Patients' physical activity outcomes included changes in total minutes/week of physical activity. Latent class analyses were conducted to identify profiles of received counseling characteristics and multilevel models were used to investigate associations with physical activity outcomes. RESULTS 5873 Patients were provided with motivational interviewing-based counseling after rehabilitation. Professionals and patients were positive about the program. Sixteen institutions (89%) formally agreed to continue the program. The four identified profiles of counseling characteristics illustrate a large variation in received counseling among patients. No substantial differences in physical activity outcomes were found between profiles. CONCLUSION After a three-year program period, the physical activity counseling centers were sustainably implemented in Dutch rehabilitation care. This study illustrated an innovative approach to assess heterogeneity in implementation outcomes (e.g., counseling profiles) in relation to program outcomes (e.g., physical activity).Implications for rehabilitationPhysical activity counseling after rehabilitation is important to support people with disabilities in making the step from rehabilitation-based physical activities to community-based physical activities.Establishing "Physical Activity Counseling Centers" is a promising "disability-overarching" strategy to promote physical activity after rehabilitation.Although the actual received counseling (dosage) varied among patients, this did not coincide with large differences in physical activity outcomes.The training in Motivational Interviewing, the financial incentives, and the advisory support were considered as important or essential ingredients for a successful implementation of the counseling program in rehabilitation practice.
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Affiliation(s)
- Femke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Trynke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Dept Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Florentina J Hettinga
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, United Kingdom
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rienk Dekker
- Center for Rehabilitation, Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Sports Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Dijkhuizen A, Waninge A, Hermans S, van der Schans CP, Krijnen WP. Progressive resistance training for persons with intellectual disabilities and visual impairment. J Appl Res Intellect Disabil 2019; 32:1194-1202. [PMID: 31111635 DOI: 10.1111/jar.12610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 03/29/2019] [Accepted: 04/15/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Knowledge concerning the feasibility and effects of progressive resistance training (PRT) for persons with intellectual disabilities and visual impairment who are categorized in Gross Motor Function Classification System (GMFCS) Level 1 is limited. The aim of our study was to evaluate feasibility and effect of PRT on participants' Quadriceps strength and personal goals. METHODS Eight Participants followed a PRT program for 10 weeks. Feasibility was determined by percentage of attendance and compliance. The effect of PRT was analyzed with a linear mixed model (p < 0.05) and by normalized bootstrap (95% CI). RESULTS Participants attended 87.8% of the sessions and trained according to the PRT program, indicating sufficient compliance. Quadriceps strength increased significantly by 69%, and participants' personal goals were achieved. CONCLUSION PRT is a feasible and potentially effective method for increasing Quadriceps strength as well as achieving personal goals in persons with intellectual disabilities and visual impairment with GMFCS Level 1.
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Affiliation(s)
- Annemarie Dijkhuizen
- Research Group Healthy Aging, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Aging, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Groningen, The Netherlands.,Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
| | - Seph Hermans
- Revant Medical Specialist Rehabilitation, Rehabilitation Centre Breda, Breda, The Netherlands
| | - Cees P van der Schans
- Research Group Healthy Aging, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University Medical Centre Groningen, Groningen, The Netherlands
| | - Wim P Krijnen
- Research Group Healthy Aging, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, Groningen, The Netherlands
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van Timmeren DEA, Deddens A, van Schrojenstein Lantman-de Valk HMJ, van der Schans CP, Krijnen WP, Waninge A, van der Putten AAJ. The convergent validity of a Dutch Screening tool for Dysphagia (Signaleringslijst Verslikken) for people with severe or profound intellectual and multiple disabilities. J Appl Res Intellect Disabil 2019; 32:994-1001. [PMID: 30990246 DOI: 10.1111/jar.12592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 02/14/2019] [Accepted: 02/27/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Dysphagia is potentially life-threatening and highly prevalent in people with severe/profound intellectual and multiple disabilities (SPIMD). The "Signaleringslijst Verslikken" (SV) is a frequently used Dutch screening tool to detect dysphagia. The aim was to examine the convergent validity of the SV for people with SPIMD. METHOD Direct support staff completed the SV, with speech and language therapists scoring a validated tool, the Dysphagia Disorders Survey (DDS), for 41 persons with SPIMD, aged ≥50 years. The results were compared for agreement using the McNemar's Test. RESULTS The proportion of agreement was 0.59 (95% CI 0.43-0.72). The SV did not detect dysphagia in 17 participants (44%) who were assessed as having dysphagia according to the DDS. The difference in proportion of detection of dysphagia between the two methods was significant (p < 0.0001). CONCLUSIONS The results suggest that the convergent validity of the SV is insufficient: the SV is not sensitive for detecting dysphagia in people with SPIMD.
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Affiliation(s)
- Dinette E A van Timmeren
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
| | | | | | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wim P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Royal Dutch Visio-De Brink, Vries, The Netherlands
| | - Annette A J van der Putten
- Faculty of Behavioural and Social Sciences, Department of Special Needs Education and Youth Care, University of Groningen, Groningen, The Netherlands
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Steenbergen HA, de Jong BI, Fleuren MAH, van der Schans CP, Waninge A. Examining determinants of lifestyle interventions targeting persons with intellectual disabilities supported by healthcare organizations: Usability of the Measurement Instrument for Determinants of Innovations. J Appl Res Intellect Disabil 2019; 32:913-931. [PMID: 30950177 DOI: 10.1111/jar.12583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 01/17/2019] [Accepted: 02/05/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Due to complex processes of implementation of innovations aimed at persons with intellectual disabilities in healthcare organizations, lifestyle interventions are not used as intended or not used at all. In order to provide insight into determinants influencing this implementation, this study aims to ascertain if the Measurement Instrument for Determinants of Innovations (MIDI) is useful for objectively evaluating implementation. METHOD With semi-structured interviews, data concerning determinants of implementation of lifestyle interventions were aggregated. These data were compared to the determinants questioned in the MIDI. Adaptations to the MIDI were made in consultation with the author of the MIDI. RESULTS All determinants of the MIDI, except for that concerning legislation and regulations, were represented in the interview data. Determinants not represented in the MIDI were the level of intellectual disabilities, suitability of materials and physical environment, multi-levelness of interventions and several persons who could be involved in the intervention, such as direct support persons (DSPs), a therapist or family, and the communication between these involved persons. CONCLUSION The present authors suggested making adjustments to existing questions of the MIDI in order to improve usability for deployment in organizations that provide care to persons with intellectual disabilities. The adjustments need to be tested with other interventions.
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Affiliation(s)
- Henderika A Steenbergen
- Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brenda I de Jong
- Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Margot A H Fleuren
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Cees P van der Schans
- Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.,Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
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Hoekstra T, Alingh RA, de Vries HS, Bes R, Hoekstra F, van der Schans CP, Dekker R, Hettinga FJ, van der Woude LHV. A questionnaire to assess rehabilitation patients’ experiences with motivational interviewing consultation in the context of physical activity stimulation. Disabil Rehabil 2019; 42:2198-2203. [DOI: 10.1080/09638288.2018.1545055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Trynke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Rolinde A. Alingh
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Rik Bes
- Centre for Motivation and Change, Hilversum, The Netherlands
| | - Femke Hoekstra
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P. van der Schans
- Research and Innovation Group in Health Care and Nursing, Hanze University Groningen, Groningen, The Netherlands
| | - Rienk Dekker
- Center for Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands
- Center for Sports Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Florentina J. Hettinga
- School of Biological Sciences, Centre of Sport and Exercise Science, University of Essex, Colchester, UK
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36
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Hagedoorn EI, Keers JC, Jaarsma T, van der Schans CP, Luttik MLA, Paans W. The association of collaboration between family caregivers and nurses in the hospital and their preparedness for caregiving at home. Geriatr Nurs 2019; 41:373-380. [PMID: 30867090 DOI: 10.1016/j.gerinurse.2019.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/11/2019] [Accepted: 02/15/2019] [Indexed: 11/13/2022]
Abstract
Family caregivers of an older person who was recently hospitalized often feel unprepared for their new or expanded tasks. Quality and continuity of care for older people is expected to improve when nurses collaborate with family caregivers as partners in care. The aim of this study was to explore the unique contribution of collaboration between family caregivers of older patients and hospital nurses as a possible predictor for preparedness of caregiving after hospital discharge. With a cross sectional design, a postal survey was sent to 777 family caregivers of home-dwelling hospitalized patients (≥70 years). Regression analyses were used to test the association between collaboration and preparedness for caregiving. In total, 506 (68%) family caregivers responded of whom 281 (38%) were eligible. Their mean (SD) age was 65 (13) and 71% were female. Family caregivers' level of collaboration with nurses was significantly associated with their preparedness for caregiving.
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Affiliation(s)
- Ellen I Hagedoorn
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, P.O. Box 3109, 9701 DC, Groningen, the Netherlands; University of Groningen, University Medical Center, Department of Health Psychology, A. Deusinglaan 1, 9713 AV, Groningen, the Netherlands; Research Group Nursing Diagnostics, Hanze University of Applied Sciences, P.O. Box 3109, 9701 DC, Groningen, the Netherlands.
| | - Joost C Keers
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, P.O. Box 3109, 9701 DC, Groningen, the Netherlands; Martini Hospital, Groningen, the Netherlands.
| | - Tiny Jaarsma
- Department of Social and Welfare Studies (ISV), Linköping University, SE-581 83, Linköping, Sweden.
| | - Cees P van der Schans
- Research Group Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences, P.O. Box 3109, 9701 DC, Groningen, the Netherlands; University of Groningen, University Medical Center, Department of Health Psychology, A. Deusinglaan 1, 9713 AV, Groningen, the Netherlands; University of Groningen, University Medical Center, Department of Rehabilitation, A. Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - Marie Louise A Luttik
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, P.O. Box 3109, 9701 DC, Groningen, the Netherlands.
| | - Wolter Paans
- Research Group Nursing Diagnostics, Hanze University of Applied Sciences, P.O. Box 3109, 9701 DC, Groningen, the Netherlands.
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37
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Sealy MJ, Dechaphunkul T, van der Schans CP, Krijnen WP, Roodenburg JLN, Walker J, Jager-Wittenaar H, Baracos VE. Low muscle mass is associated with early termination of chemotherapy related to toxicity in patients with head and neck cancer. Clin Nutr 2019; 39:501-509. [PMID: 30846324 DOI: 10.1016/j.clnu.2019.02.029] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/11/2019] [Accepted: 02/16/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND & AIMS We studied whether low pre-treatment muscle mass, measured with CT at thoracic (T4) or lumbar level (L3) associates with early termination of chemotherapy related to toxicity in head and neck cancer (HNC) patients. METHODS This was a retrospective chart and image review. Adult HNC patients treated with (surgery and) platinum-based chemo-radiotherapy were included if a pre-treatment CT scan at T4 or L3 level was available. Muscle mass was evaluated by assessment of skeletal muscle index (SMI; cm2/m2). T4 and L3 SMI measurements were corrected for deviation from their respective means and were merged into one score for SMI difference (cm2/m2). All cases were assessed for presence of toxicity-related unplanned early termination of chemotherapy ('early termination'). Univariate and multivariate logistic regression models were used to investigate associations between pooled SMI and early termination. RESULTS 213 patients (age: 57.9 ± 10.3 y, male: 77%, T4 image: 45%) were included. A significant association between SMI as a continuous variable and early termination was found, both in the univariate analysis (p = 0.007, OR = 0.96 [0.94-0.99]) and the multivariate analysis (p = 0.021, OR 0.96 [0.92-0.99]). The multivariate models identified potential associations with type of chemotherapy, presence of co-morbidity, a combination of (former) smoking and alcohol consumption, and sex. CONCLUSION Lower muscle mass was robustly associated with higher odds of early termination of chemotherapy in HNC patients. Further prospective studies are required to tailor the care for patients with low muscle mass and to avoid early termination of chemotherapy.
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Affiliation(s)
- Martine J Sealy
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA, Groningen, the Netherlands; Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
| | - Tanadech Dechaphunkul
- Department of Oncology, University of Alberta, Edmonton, AB, Canada; Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand.
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA, Groningen, the Netherlands; Department of Rehabilitation Medicine, University of Groningen, University Medical Center, Groningen, the Netherlands; Department of Health Psychology Research, University of Groningen, University Medical Center, Groningen, the Netherlands.
| | - Wim P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA, Groningen, the Netherlands; Johan Bernoulli Institute for Mathematics and Computer Science, University of Groningen, Groningen, the Netherlands.
| | - Jan L N Roodenburg
- Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
| | - John Walker
- Department of Oncology, University of Alberta, Edmonton, AB, Canada.
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714 CA, Groningen, the Netherlands; Department of Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.
| | - Vickie E Baracos
- Department of Oncology, University of Alberta, Edmonton, AB, Canada.
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Nijholt W, Beek LT, Hobbelen JSM, van der Vaart H, Wempe JB, van der Schans CP, Jager-Wittenaar H. The added value of ultrasound muscle measurements in patients with COPD: An exploratory study. Clin Nutr ESPEN 2019; 30:152-158. [PMID: 30904216 DOI: 10.1016/j.clnesp.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 11/08/2018] [Accepted: 01/03/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Malnutrition and sarcopenia are common nutrition (-related) disorders in patients with COPD and are associated with negative health outcomes and mortality. This study aims to correlate ultrasound measured rectus femoris size with fat-free mass and muscle function in patients with COPD. METHODS Patients with COPD, at the start of a pulmonary rehabilitation program, were asked to participate in this study. Rectus femoris (RF) size (thickness in cm, cross-sectional area [CSA] in cm2) was determined by ultrasound. Fat-free mass index (FFMI in kg/m2) was estimated with bioelectrical impedance analyses, using a disease-specific equation. Handgrip strength (HGS) was measured in kilograms and the five times sit to stand test (in seconds, higher scores indicating decreased strength) was performed to assess leg muscle power. The Incremental Shuttle Walk Test (ISWT, in m) was used to assess maximal exercise capacity. RESULTS In total, 44 patients with COPD (mean age 59.8 ± 8.6 years, 43% male, median FEV1%pred 37 [IQR = 23-52]) were included. Greater RF-CSA and thickness were associated with higher FFMI (r = 0.57, p < 0.001; r = 0.53, p = 0.003, respectively) and HGS (CSA r = 0.58, p < 0.001, thickness r = 0.48, p = 0.009). No significant correlations between RF-thickness, CSA, and leg muscle power were found (r = -0.33, p = 0.091; r = -0.35, p = 0.073, respectively). Furthermore, no correlation between RF size and maximal exercise capacity was observed (thickness r = 0.21, p = 0.297, CSA r = 0.22, p = 0.274). CONCLUSIONS This exploratory study shows that in patients with COPD, rectus femoris size is moderately correlated with FFMI and HGS. Future studies should focus on the role of ultrasound in evaluating nutritional status.
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Affiliation(s)
- Willemke Nijholt
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.
| | - Lies Ter Beek
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Haren, Groningen, the Netherlands
| | - Johannes S M Hobbelen
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, the Netherlands
| | - Hester van der Vaart
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Haren, Groningen, the Netherlands
| | - Johan B Wempe
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Haren, Groningen, the Netherlands
| | - Cees P van der Schans
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Health Psychology Research, Groningen, the Netherlands
| | - Harriët Jager-Wittenaar
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Maxillofacial Surgery, Groningen, the Netherlands
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van Adrichem EJ, Dekker R, Krijnen WP, Verschuuren EAM, Dijkstra PU, van der Schans CP. Physical Activity, Sedentary Time, and Associated Factors in Recipients of Solid-Organ Transplantation. Phys Ther 2018; 98:646-657. [PMID: 29757444 DOI: 10.1093/ptj/pzy055] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/25/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Short-term survival after solid-organ transplantation has substantially improved, and the focus has shifted to long-term survival, including the role of physical activity (PA). Knowledge about PA and sedentary time in recipients of solid-organ transplantation is limited, and identification of the levels and associated factors is necessary for intervention development. OBJECTIVE The objectives of this study were to investigate the level of PA and sedentary time in recipients of solid-organ transplantation and to identify factors associated with these behaviors. DESIGN The design consisted of a cross-sectional survey. METHODS Questionnaires on PA level, sedentary time, and potential associated factors were used for recipients of solid-organ transplantation (kidney, liver, lung, and heart [N = 656]). Multiple regression analyses with a variable selection procedure were used. RESULTS Fewer than 60% of the recipients fulfilled the PA guideline. Factors significantly associated with a lower level of PA included being a woman, younger age (nonlinear), not actively working or being retired, physical limitations, and low expectations and self-confidence. Factors significantly associated with less sedentary time included exercise self-efficacy and not actively working or being retired. Significantly associated with more sedentary time were a high education level, fear of negative effects, physical limitations, and the motivator "health and physical outcomes." The type of transplantation did not significantly influence either of the outcome measures. LIMITATIONS The design did not allow for causal inferences to be made. The studied associated factors were limited to individual and interpersonal factors. Self-reported measures of PA and sedentary time were used. CONCLUSIONS In intervention development directed at increasing the level of PA and reducing sedentary time in recipients of solid-organ transplantation, attention should be paid to physical limitations, fear of negative effects, low expectations and self-confidence, health and physical outcomes, and exercise self-efficacy.
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Affiliation(s)
- Edwin J van Adrichem
- University Medical Center Groningen, Department of Rehabilitation Medicine, University of Groningen, Groningen, the Netherlands; Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands; and University Medical Center Groningen, Groningen Transplant Center, University of Groningen. Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - Rienk Dekker
- University Medical Center Groningen, Department of Rehabilitation Medicine, University of Groningen; and University Medical Center Groningen, Center of Sports Medicine, University of Groningen
| | - Wim P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences
| | - Erik A M Verschuuren
- University Medical Center Groningen, Groningen Transplant Center, University of Groningen; and University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, University of Groningen
| | - Pieter U Dijkstra
- University Medical Center Groningen, Department of Rehabilitation Medicine, University of Groningen; and University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, University of Groningen
| | - Cees P van der Schans
- University Medical Center Groningen, Department of Rehabilitation Medicine, University of Groningen; and Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences
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de Wit E, Steenbergen B, Visser-Bochane MI, van der Schans CP, van Dijk P, Luinge MR. Response to the Letter to the Editor From Moncrieff (2017) Regarding de Wit et al. (2016), "Characteristics of Auditory Processing Disorders: A Systematic Review". J Speech Lang Hear Res 2018; 61:1517-1519. [PMID: 29800061 DOI: 10.1044/2018_jslhr-h-17-0412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 12/18/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this letter is to respond to Moncrieff's (2017) letter to the editor, "Response to de Wit et al., 2016, 'Characteristics of Auditory Processing Disorders: A Systematic Review,'" published in May 2017 by the Journal of Speech, Language, and Hearing Research. CONCLUSION We believe that our original conclusions are valid given the limited evidence that is currently available about the etiology of auditory processing disorders (APD). The focus of our systematic review was to identify the characteristics of children with a diagnosis of APD or a suspicion of APD. The results of our study showed that the characteristics of these children are not specific or limited to the auditory modality but are multimodal instead. In our view, it is incorrect to use the diagnosis APD, because there is not necessarily a specific auditory deficit in a large group of children suffering from listening difficulties. Before we start using any new diagnoses, a better insight into how bottom-up and top-down processes are precisely involved in listening needs to be developed. In addition, more insight is needed with respect to the similarities and differences between the different developmental disorders of children.
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Affiliation(s)
- Ellen de Wit
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
- University of Groningen, Graduate School of Medical Sciences, Research School of Behavioral and Cognitive Neurosciences, the Netherlands
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University Nijmegen, the Netherlands
- Australian Catholic University, Melbourne, Australia
| | - Margot I Visser-Bochane
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
- University of Groningen, Graduate School of Medical Sciences, Research School of Behavioral and Cognitive Neurosciences, the Netherlands
| | - Margreet R Luinge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Groningen, University Medical Center Groningen, the Netherlands
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Dijkhuizen A, Douma RK, Krijnen WP, van der Schans CP, Waninge A. Measuring Quadriceps strength in adults with severe or moderate intellectual and visual disabilities: Feasibility and reliability. J Appl Res Intellect Disabil 2018; 31:1083-1090. [DOI: 10.1111/jar.12468] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Annemarie Dijkhuizen
- Research Group Healthy Aging; Allied Health Care and Nursing; Hanze University Groningen; University of Applied Sciences Groningen; The Netherlands
| | - Rob K. Douma
- Research Group Healthy Aging; Allied Health Care and Nursing; Hanze University Groningen; University of Applied Sciences Groningen; The Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Aging; Allied Health Care and Nursing; Hanze University Groningen; University of Applied Sciences Groningen; The Netherlands
| | - Cees P. van der Schans
- Research Group Healthy Aging; Allied Health Care and Nursing; Hanze University Groningen; University of Applied Sciences Groningen; The Netherlands
- Department of Rehabilitation Medicine; University Medical Center Groningen; The Netherlands
| | - Aly Waninge
- Research Group Healthy Aging; Allied Health Care and Nursing; Hanze University Groningen; University of Applied Sciences Groningen; The Netherlands
- Centre of Expertise for Blind and Partially Sighted People; Royal Dutch Visio; Haren The Netherlands
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42
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Willems M, Waninge A, Hilgenkamp TIM, van Empelen P, Krijnen WP, van der Schans CP, Melville CA. Effects of lifestyle change interventions for people with intellectual disabilities: Systematic review and meta-analysis of randomized controlled trials. J Appl Res Intellect Disabil 2018; 31:949-961. [DOI: 10.1111/jar.12463] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Mariël Willems
- Research Group Healthy Ageing; Allied Health Care and Nursing; Hanzehogeschool Groningen; Groningen The Netherlands
| | - Aly Waninge
- Research Group Healthy Ageing; Allied Health Care and Nursing; Hanzehogeschool Groningen; Groningen The Netherlands
| | - Thessa I. M. Hilgenkamp
- Department of General Practice; Intellectual Disability Medicine; Erasmus MC University Medical Center Rotterdam; Rotterdam The Netherlands
| | - Pepijn van Empelen
- Research Group Child Health; Netherlands Institute of Applied Scientific Research; Leiden The Netherlands
| | - Wim P. Krijnen
- Research Group Healthy Ageing; Allied Health Care and Nursing; Hanzehogeschool Groningen; Groningen The Netherlands
| | - Cees P. van der Schans
- Research Group Healthy Ageing; Allied Health Care and Nursing; Hanzehogeschool Groningen; Groningen The Netherlands
| | - Craig A. Melville
- Institute of Health and Wellbeing; College of Medical Veterinary and Life Sciences; Gartnavel Royal Hospital; University of Glasgow; Glasgow UK
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43
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Abonie US, Hoekstra F, Hoekstra T, van der Schans CP, Dekker R, van der Woude LHV, Hettinga FJ. Activity Pacing, Fatigue, Physical Activity And Quality Of Life In Adults With Multiple Sclerosis. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000535321.74341.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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44
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Ter Beek L, van der Vaart H, Wempe JB, Dzialendzik AO, Roodenburg JL, van der Schans CP, Keller HH, Jager-Wittenaar H. Dietary resilience in patients with severe COPD at the start of a pulmonary rehabilitation program. Int J Chron Obstruct Pulmon Dis 2018; 13:1317-1324. [PMID: 29719387 PMCID: PMC5922418 DOI: 10.2147/copd.s151720] [Citation(s) in RCA: 6] [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] [Indexed: 01/19/2023] Open
Abstract
Background COPD may impact food-related activities, such as grocery shopping, cooking, and eating. Decreased food intake may result in an unhealthy diet, and in malnutrition, which is highly prevalent in patients with COPD. Malnutrition is known to negatively impact clinical outcome and quality of life. Aims In this qualitative study, we aimed to explore strategies used to overcome food-related challenges, ie, dietary resilience, and whether these led to a healthy diet. Furthermore, we aimed to identify the key themes of motivation for dietary resilience in patients with severe COPD. Methods In October 2015 to April 2016, 12 patients with severe COPD starting a pulmonary rehabilitation program were interviewed. Qualitative description and thematic analysis were performed. Results All participants mentioned the use of strategies to overcome challenges. Key themes of motivation for dietary resilience were identified as “wanting to be as healthy as possible”, “staying independent”, and “promoting a sense of continuity and duty”. Two out of 12 participants met the criteria for a healthy diet. Conclusion Our study showed a variety of motivational factors and strategies reported by patients with severe COPD to overcome food-related challenges. However, the majority (n=10) of the participants did not meet the criteria for a healthy diet. The identified key themes can be used to develop education to support patients with severe COPD to improve their diet.
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Affiliation(s)
- Lies Ter Beek
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Department of Maxillofacial Surgery, Groningen, the Netherlands
| | - Hester van der Vaart
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Groningen, the Netherlands
| | - Johan B Wempe
- University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases and Tuberculosis, Center for Rehabilitation, Groningen, the Netherlands
| | | | - Jan Ln Roodenburg
- University of Groningen, University Medical Center Groningen, Department of Maxillofacial Surgery, Groningen, the Netherlands
| | - Cees P van der Schans
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Health Psychology Research, Groningen, the Netherlands
| | - Heather H Keller
- University of Waterloo, Schlegel Research Institute for Aging, Waterloo, ON, Canada.,University of Waterloo, Department of Kinesiology, Waterloo, ON, Canada
| | - Harriët Jager-Wittenaar
- Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Department of Maxillofacial Surgery, Groningen, the Netherlands
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45
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Reinders JJ, Krijnen WP, Goldschmidt AM, van Offenbeek MAG, Stegenga B, van der Schans CP. Changing dominance in mixed profession groups: putting theory into practice. European Journal of Work and Organizational Psychology 2018. [DOI: 10.1080/1359432x.2018.1458712] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jan J. Reinders
- Research Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
- Department of Community and Individual Oral Health Care, University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Wim P. Krijnen
- Research Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
| | - Aline M. Goldschmidt
- Department of Community and Individual Oral Health Care, University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Groningen, The Netherlands
| | - Marjolein A. G. van Offenbeek
- Department of Innovation Management & Strategy, Research on Healthcare Organization and innovation, University of Groningen, Groningen, The Netherlands
| | - Boudewijn Stegenga
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P. van der Schans
- Research Healthy Ageing Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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46
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Reinders JJ, Krijnen WP, Jerković-Ćosić K, Lycklama À Nijeholt M, van Offenbeek MA, Stegenga B, van der Schans CP. Reasons That Dutch Dentists and Dental Hygienists Oppose or Support an Extended Scope of Practice for Dental Hygienists. J Allied Health 2018; 47:255-264. [PMID: 30508836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/20/2017] [Indexed: 06/09/2023]
Abstract
BACKGROUND In the Netherlands, the scope of dental hygiene practice was expanded in 2006. The objective of this study was to explore reasons among dentists and dental hygienists for supporting or opposing an extended scope of practice and to find explanatory factors. METHODS A questionnaire containing pre-defined reasons and an open-ended question was distributed among 1,674 randomly selected members of two Dutch professional associations (874 dentists, 800 dental hygienists). Data were analyzed with binary logistic regression with Bayesian information criterion (BIC) model selection. RESULTS Response were obtained from 541 practitioners (32.3%): i.e., 233 dentists (43.1%) and 308 dental hygienists (56.9%). Non-response analysis revealed no differences, and representativeness analysis showed similarities between samples and target populations. Most often, dentists reported flexible collaboration (50.2%) and dental hygienists indicated task variation (71.1%) as supportive reasons. As opposing reasons, dentists generally reported quality of care (41.2%) and dental hygienists' self-competence (22.7%). Reasons were explained by profession, gender, and new-style practitioners. CONCLUSION Dentists and dental hygienists conveyed different reasons for supporting or opposing an extended scope of dental hygiene practice. Outcomes can be categorized as reasons related to economic, professional status, quality, job satisfaction, and flexible collaboration and are not only explained by profession.
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Affiliation(s)
- Jan J Reinders
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, PO Box 275, 9700 VB Groningen, the Netherlands. Tel +31 (0)50-363 3483, fax +31 (0)50-363 2696.
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47
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Dewansingh P, Melse-Boonstra A, Krijnen WP, van der Schans CP, Jager-Wittenaar H, van den Heuvel EG. Supplemental protein from dairy products increases body weight and vitamin D improves physical performance in older adults: a systematic review and meta-analysis. Nutr Res 2018; 49:1-22. [DOI: 10.1016/j.nutres.2017.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 08/17/2017] [Accepted: 08/22/2017] [Indexed: 12/24/2022]
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48
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Hoekstra F, van Offenbeek MAG, Dekker R, Hettinga FJ, Hoekstra T, van der Woude LHV, van der Schans CP. Implementation fidelity trajectories of a health promotion program in multidisciplinary settings: managing tensions in rehabilitation care. Implement Sci 2017; 12:143. [PMID: 29191230 PMCID: PMC5709964 DOI: 10.1186/s13012-017-0667-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/06/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Although the importance of evaluating implementation fidelity is acknowledged, little is known about heterogeneity in fidelity over time. This study aims to generate insight into the heterogeneity in implementation fidelity trajectories of a health promotion program in multidisciplinary settings and the relationship with changes in patients' health behavior. METHODS This study used longitudinal data from the nationwide implementation of an evidence-informed physical activity promotion program in Dutch rehabilitation care. Fidelity scores were calculated based on annual surveys filled in by involved professionals (n = ± 70). Higher fidelity scores indicate a more complete implementation of the program's core components. A hierarchical cluster analysis was conducted on the implementation fidelity scores of 17 organizations at three different time points. Quantitative and qualitative data were used to explore organizational and professional differences between identified trajectories. Regression analyses were conducted to determine differences in patient outcomes. RESULTS Three trajectories were identified as the following: 'stable high fidelity' (n = 9), 'moderate and improving fidelity' (n = 6), and 'unstable fidelity' (n = 2). The stable high fidelity organizations were generally smaller, started earlier, and implemented the program in a more structured way compared to moderate and improving fidelity organizations. At the implementation period's start and end, support from physicians and physiotherapists, professionals' appreciation, and program compatibility were rated more positively by professionals working in stable high fidelity organizations as compared to the moderate and improving fidelity organizations (p < .05). Qualitative data showed that the stable high fidelity organizations had often an explicit vision and strategy about the implementation of the program. Intriguingly, the trajectories were not associated with patients' self-reported physical activity outcomes (adjusted model β = - 651.6, t(613) = - 1032, p = .303). CONCLUSIONS Differences in organizational-level implementation fidelity trajectories did not result in outcome differences at patient-level. This suggests that an effective implementation fidelity trajectory is contingent on the local organization's conditions. More specifically, achieving stable high implementation fidelity required the management of tensions: realizing a localized change vision, while safeguarding the program's standardized core components and engaging the scarce physicians throughout the process. When scaling up evidence-informed health promotion programs, we propose to tailor the management of implementation tensions to local organizations' starting position, size, and circumstances. TRIAL REGISTRATION The Netherlands National Trial Register NTR3961 . Registered 18 April 2013.
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Affiliation(s)
- Femke Hoekstra
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, PO Box 196, 9700, AD, Groningen, The Netherlands.
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | | | - Rienk Dekker
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Center for Sports Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Florentina J Hettinga
- School of Biological Sciences, Center of Sport and Exercise Science, University of Essex, Colchester, UK
| | - Trynke Hoekstra
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, PO Box 196, 9700, AD, Groningen, The Netherlands
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, PO Box 196, 9700, AD, Groningen, The Netherlands
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Bunt S, Steverink N, Andrew MK, Schans CPVD, Hobbelen H. Cross-Cultural Adaptation of the Social Vulnerability Index for Use in the Dutch Context. Int J Environ Res Public Health 2017; 14:ijerph14111387. [PMID: 29135914 PMCID: PMC5708026 DOI: 10.3390/ijerph14111387] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/30/2017] [Accepted: 11/10/2017] [Indexed: 01/15/2023]
Abstract
Being able to identify socially frail older adults is essential for designing interventions and policy and for the prediction of health outcomes, both on the level of individual older adults and of the population. The aim of the present study was to adapt the Social Vulnerability Index (SVI) to the Dutch language and culture for those purposes. A systematic cross-cultural adaptation of the initial Social Vulnerability Index was performed following five steps: initial translation, synthesis of translations, back translation, a Delphi procedure, and a test for face validity and feasibility. The main result of this study is a face-valid 32 item Dutch version of the Social Vulnerability Index (SVI-D) that is feasible in health care and social care settings. The SVI-D is a useful index to measure social frailty in Dutch-language countries and offers a broad, holistic quantification of older people’s social circumstances related to the risk of adverse health outcomes.
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Affiliation(s)
- Steven Bunt
- Research Group in Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, 9714 CA Groningen, The Netherlands.
| | - Nardi Steverink
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, 9712 TG Groningen, The Netherlands.
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands.
| | - Melissa K Andrew
- Department of Medicine (Geriatrics), Dalhousie University, Halifax, NS B3H 2E1, Canada.
| | - Cees P van der Schans
- Research Group in Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, 9714 CA Groningen, The Netherlands.
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands.
- Department of Rehabilitation, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.
| | - Hans Hobbelen
- Research Group in Healthy Ageing, Allied Health Care and Nursing, Hanze University Groningen, University of Applied Sciences, 9714 CA Groningen, The Netherlands.
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, 9700 AD Groningen, The Netherlands.
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Nijholt W, Scafoglieri A, Jager-Wittenaar H, Hobbelen JSM, van der Schans CP. The reliability and validity of ultrasound to quantify muscles in older adults: a systematic review. J Cachexia Sarcopenia Muscle 2017; 8:702-712. [PMID: 28703496 PMCID: PMC5659048 DOI: 10.1002/jcsm.12210] [Citation(s) in RCA: 227] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/27/2017] [Accepted: 03/20/2017] [Indexed: 11/06/2022] Open
Abstract
This review evaluates the reliability and validity of ultrasound to quantify muscles in older adults. The databases PubMed, Cochrane, and Cumulative Index to Nursing and Allied Health Literature were systematically searched for studies. In 17 studies, the reliability (n = 13) and validity (n = 8) of ultrasound to quantify muscles in community-dwelling older adults (≥60 years) or a clinical population were evaluated. Four out of 13 reliability studies investigated both intra-rater and inter-rater reliability. Intraclass correlation coefficient (ICC) scores for reliability ranged from -0.26 to 1.00. The highest ICC scores were found for the vastus lateralis, rectus femoris, upper arm anterior, and the trunk (ICC = 0.72 to 1.000). All included validity studies found ICC scores ranging from 0.92 to 0.999. Two studies describing the validity of ultrasound to predict lean body mass showed good validity as compared with dual-energy X-ray absorptiometry (r2 = 0.92 to 0.96). This systematic review shows that ultrasound is a reliable and valid tool for the assessment of muscle size in older adults. More high-quality research is required to confirm these findings in both clinical and healthy populations. Furthermore, ultrasound assessment of small muscles needs further evaluation. Ultrasound to predict lean body mass is feasible; however, future research is required to validate prediction equations in older adults with varying function and health.
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Affiliation(s)
- Willemke Nijholt
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Aldo Scafoglieri
- Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johannes S M Hobbelen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Cees P van der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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