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Vullings N, Maas M, Adriaansen M, Vermeulen H, van der Wees P, Heinen M. Developing and testing a reflection method for implementation of the informal care guideline in community nursing: Design-based research. J Adv Nurs 2024. [PMID: 38515159 DOI: 10.1111/jan.16156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/20/2024] [Accepted: 03/02/2024] [Indexed: 03/23/2024]
Abstract
AIM To develop a reflection method for community nurses and certified nursing assistants to support the implementation of the Dutch Informal Care guideline in daily care. DESIGN Design-based research. METHODS A design group and four test groups of community nurses and nursing assistants were formed to develop a reflection method that aligns with the needs and preferences of its end-users. The design and test group meetings were video recorded. The video data were iteratively discussed and analysed thematically to adapt and refine the method and to identify its key features. RESULTS A final reflection method was developed. Five main themes were identified from the analysis: the group, reflective triggers, knowledge about the guidelines, the coach and preconditions. The themes are linked to nine key features representing the building blocks of the reflection method. The key features are group size, participants with different (educational) backgrounds, pairs of participants, expressing thoughts, video feedback, reflection game, making the connection with the guideline, coaching as a process facilitator and meeting organizational and contextual conditions for implementation. CONCLUSION An evidence- and practice-based reflection method for community nurses and certified nursing assistants is developed to support the implementation. By involving community nurses and certified nursing assistants, the method closely matches their needs and preferences. Critical elements of the reflection method are a game element, video feedback and working in pairs in a group of participants from different (educational) backgrounds. Guidance is needed to make the transfer from theory to practice. IMPACT A reflection method for community nurses and certified nursing assistants was developed to enhance care work according to guideline recommendations, aiming to improve the care provided by informal caregivers. REPORT METHOD The COREQ guideline was used. PATIENT OR PUBLIC CONTRIBUTION This reflection method was developed in close collaboration with all stakeholders during the entire study.
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Affiliation(s)
- Nicole Vullings
- Institute of Nursing Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Marjo Maas
- IQ Health Science Department, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marian Adriaansen
- Institute of Nursing Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Hester Vermeulen
- IQ Health Science Department, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Philip van der Wees
- IQ Health Science Department, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- IQ Health Science Department, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
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Alarslan G, Mennes R, Kieft R, Heinen M. Patients involvement in the discharge process from hospital to home: A patient's journey. J Adv Nurs 2023. [PMID: 38050898 DOI: 10.1111/jan.15984] [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: 09/05/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 12/07/2023]
Abstract
AIMS The aims of the study were to gain insight in the transfer process from hospital to homecare or rehabilitation centre from a patient's perspectives and to describe the experienced involvement, information provision and information needs patients. DESIGN A multiple case study with a phenomenological approach. METHODS Observations and interviews were employed, between May 2019 and August 2019, to capture the patient's perspectives and experiences on involvement, information provision and needs. Observations were executed during the discharge process from hospital to homecare (n = 6) or revalidation centre (n = 1) and during admission interviews with community nurses (n = 6). Interviews were conducted at the patient's home and the revalidation centre. RESULTS Eight themes were identified within three phases of the transfer process. The Sign-up phase contained two themes: 'organizing follow-up care' and 'planning the moment of discharge from the hospital'. The two themes in the Transfer phase were, 'verbal information provision' and 'written information provision'. Four themes were identified in the End phase: 'nursing supplies', 'medication', 'the electronic patient portal' and 'continuation of (para)medical care'. CONCLUSIONS Patient participation in the transition process from the hospital to follow-up care can be improved. This study indicates that unsafe situations could be prevented by patient involvement and clear perceptions of the role and responsibilities of patients, family and healthcare professionals. IMPLICATIONS TO PATIENT CARE Patient and family involvement has the potential to improve transition of care and techniques for shared decision-making can be applied to a greater extent. IMPACT This paper highlights that patients and families should be acknowledged as key figures in the transfer process and gives direction to healthcare professionals on how to increase involvement in the transfer process by actively inviting patients to participate in the transfer process. REPORTING METHOD COREQ guidelines for qualitative reporting. No patient or public contribution. CONTRIBUTION TO GLOBAL CLINICAL COMMUNITY This paper gives insights in patients' and families' perspectives on transition of nursing care and their involvement during the whole transfer process. This paper gives direction how to improve patient participation during the discharge process from hospital to follow-up care.
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Affiliation(s)
- Güven Alarslan
- Department of Social Sciences, Wageningen University and Research, Wageningen, The Netherlands
| | - Rosa Mennes
- Radboud Institute for Healthcare Sciences, IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Maud Heinen
- Radboud Institute for Healthcare Sciences, IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands
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Muntlin Å, Jangland E, Laugesen B, Voldbjerg SL, Gunningberg L, Greenway K, Merriman C, Grønkjær M, Heinen M, Huisman-de Waal G. Bedside nurses' perspective on the Fundamentals of Care framework and its application in clinical practice: A multi-site focus group interview study. Int J Nurs Stud 2023; 145:104526. [PMID: 37390582 DOI: 10.1016/j.ijnurstu.2023.104526] [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: 07/12/2022] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND A changing nursing workforce and an increase in demands for care together with more complex care, raise arguments that leading and guiding nursing practice is more challenging than ever. Therefore, nurses need to have a shared agenda and a common language to show the importance of nursing care and the consequences of not addressing this in an appropriate way. In response to this the Fundamentals of Care framework was developed to also contribute to the delivery of person-centred care in an integrated way. However, to gain acceptance and applicability we need to ensure the framework's relevance to clinical practice from bedside nurses' perspectives. OBJECTIVE To describe bedside nurses' perspectives on the Fundamentals of Care framework and how it can be applied in clinical practice. DESIGN A descriptive qualitative design informed by the Fundamentals of Care framework. SETTING(S) The study was undertaken at seven hospitals in Sweden, Denmark and the Netherlands during 2019. PARTICIPANTS A total sample of 53 registered nurses working at the bedside participated. Participants had a wide variety of clinical experience and represented a range of different nursing practice areas. METHODS Twelve focus group interviews were used to collect data and analysed with a deductive content analysis approach. RESULTS Bedside nurses perceived that the Fundamentals of Care framework was adequate, easy to understand and recognised as representative for the core of nursing care. The definition for fundamental care covered many aspects of nursing care, but was also perceived as too general and too idealistic in relation to the registered nurses' work. The participants recognised the elements within the framework, but appeared not to be using this to articulate their practice. Three main categories emerged for implications for clinical practice; guiding reflection on one's work; ensuring person-centred fundamental care and reinforcing nursing leadership. CONCLUSIONS The Fundamentals of Care framework is perceived by bedside nurses as a modern framework describing the core of nursing. The framework was recognised as having clinical relevance and provides bedside nurses with a common language to articulate the complexity of nursing practice. This knowledge is crucial for bedside nurses both in clinical practice and in leadership roles to be able to speak up for the need to integrate all dimensions of care to achieve person-centred fundamental care. Various activities for reflection, person-centred care and leadership to apply the framework in clinical practice were presented, together with minor suggestions for development of the framework. TWEETABLE ABSTRACT Bedside nurses recognise their clinical practice within the Fundamentals of Care framework, showing the core of modern nursing.
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Affiliation(s)
- Åsa Muntlin
- Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden; Department of Medical Sciences/Clinical Epidemiology, Uppsala University, Uppsala, Sweden; College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
| | - Eva Jangland
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Brit Laugesen
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Centre for Clinical Guidelines, Aalborg University, Denmark
| | - Siri Lygum Voldbjerg
- Clinical Nursing Research Unit, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University, Denmark; School of Nursing, University College Nordjylland, Denmark
| | - Lena Gunningberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Kathleen Greenway
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, England, United Kingdom of Great Britain and Northern Ireland.
| | - Clair Merriman
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, England, United Kingdom of Great Britain and Northern Ireland.
| | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University, Denmark
| | - Maud Heinen
- Radboud University Medical Center, Radboud Institute for Healthcare Sciences, IQ Health, Nijmegen, the Netherlands.
| | - Getty Huisman-de Waal
- Radboud University Medical Center, Radboud Institute for Healthcare Sciences, IQ Health, Nijmegen, the Netherlands.
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4
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Bahlman-van Ooijen W, van Belle E, Bank A, de Man-Van Ginkel J, Huisman-de Waal G, Heinen M. Nursing leadership to facilitate patient participation in fundamental care: An ethnographic qualitative study. J Adv Nurs 2023; 79:1044-1055. [PMID: 35748056 DOI: 10.1111/jan.15329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/25/2022] [Accepted: 05/07/2022] [Indexed: 11/28/2022]
Abstract
AIMS To explore and describe hospital nurses' perceptions of leadership behaviours in facilitating patient participation in fundamental care. DESIGN An ethnographic interview study. METHODS Individual semi-structured interviews with 12 nurses with a bachelor's or master's degree working at a university medical centre were conducted between February and April 2021. The interview data were analysed using thematic analysis. RESULTS Six themes were derived from the data: (1) nursing leadership; (2) patient participation; (3) using patients' preferences; (4) building relationships; (5) task-focused nursing; (6) need for role modelling. CONCLUSION Nurses indicated leadership behaviour to facilitate patient participation in fundamental care as inviting patients to participate and eliciting and supporting patients' preferences. Although nurses also regarded leadership as motivating colleagues to act and enhancing evidence-based practice, they appeared not to practise this themselves about patient participation. Role modelling was indicated as a need for improvement. IMPACT The findings established that not all leadership behaviours mentioned were used in practice about patient participation in fundamental care. Role modelling and the use of evidence-based practice are needed to increase patient participation. Further research will be necessary to develop and test leadership interventions to improve patient participation in fundamental care.
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Affiliation(s)
| | - Elise van Belle
- Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Scientific center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center Nijmegen, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Arnold Bank
- Department of Nursing Staff, Tergooi Hospital, Hilversum, The Netherlands
| | - Janneke de Man-Van Ginkel
- Nursing Science, Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands.,Nursing Science Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Getty Huisman-de Waal
- Department of surgery, Radboud University Medical Center, Nijmegen, The Netherlands.,Scientific center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center Nijmegen, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Maud Heinen
- Scientific center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center Nijmegen, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Wickramasinghek K, Williams J, Rakovac I, Grosso G, Heinen M. Key messages of the WHO European Regional Obesity Report. Eur J Public Health 2022. [PMCID: PMC9620081 DOI: 10.1093/eurpub/ckac129.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Obesity is a complex multifactorial disease defined by excessive adiposity and is linked to an increased risk for many noncommunicable diseases (NCDs). Overweight and obesity affect almost 60% of adults and nearly one in three children in the WHO European Region. Recent estimates suggest that overweight and obesity is the fourth most common risk factor for NCDs in the Region, after high blood pressure, dietary risks and tobacco. It is also the leading risk factor for disability and obesity is linked to greater morbidity and mortality from COVID-19. And obesity is considered a cause of at least 13 different types of cancer including cancers of the breast, colorectum, kidney, liver and ovary, multiple myeloma and meningioma. None of the countries in the Region are on track to achieve the obesity related target set in 2013. Early studies from a number of countries in the Region indicate that the prevalence of overweight and obesity and/or mean body mass index has increased in children and adolescents during the COVID-19 pandemic. This latest WHO European report on obesity examines the growing challenge and impact of obesity in the Region, building on past publications and aligning with initiatives to tackle cancer. The report focuses on managing obesity throughout the life course and tackling obesogenic environments; it also considers more recent challenges, including problematic digital marketing to children and the impact of the COVID-19 pandemic on obesity prevalence. Policy options to prevent obesity are outlined for consideration by Member States together with a suite of population-level approaches. The report highlights the importance of including prevention and control of obesity within measures to build back better in the wake of the COVID-19 pandemic. Whilst highlighting that single intervention will not be sufficient in any country, it examines the challenges faced by countries to implement known interventions to tackle obesity.
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Affiliation(s)
- K Wickramasinghek
- WHO European Office for NCD, WHO Regional Office for Europe , Copenhagen, Denmark
| | - J Williams
- WHO European Office for NCD, WHO Regional Office for Europe , Copenhagen, Denmark
| | - I Rakovac
- WHO European Office for NCD, WHO Regional Office for Europe , Copenhagen, Denmark
| | - G Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania , Catania, Italy
| | - M Heinen
- WHO European Office for NCD, WHO Regional Office for Europe , Copenhagen, Denmark
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Theys S, van Belle E, Heinen M, Malfait S, Eeckloo K, Beeckman D, Verhaeghe S, Van Hecke A. Individualised care in Flemish and Dutch hospitals: Comparing patients' and nurses' perceptions. Scand J Caring Sci 2021; 36:635-649. [PMID: 34241909 DOI: 10.1111/scs.13016] [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] [Received: 10/22/2020] [Accepted: 06/12/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Patient-centred care has been recognised as vital for today's healthcare quality. This type of care puts patients at the centre, contributing to positive patient outcomes such as patient autonomy. Empirical research comparing nurses' and patients' perceptions of the support and provision of patient-centred care is limited and focuses solely on nurses and patients working and staying on surgical wards. AIMS AND OBJECTIVES Comparing patients' and nurses' perceptions of patient-centred care on different types of hospital wards, and exploring if patient empowerment, health literacy, and certain sociodemographic and context-related variables are associated with these perceptions. DESIGN Cross-sectional design. METHODS Data were collected in ten Flemish (February-June 2016) and two Dutch (December 2014-May 2015) hospitals using the Individualised Care Scale (ICS). A linear mixed model was fitted. Data from 845 patients and 569 nurses were analysed. As the ICS was used to measure the concept of patient-centred care, it is described using the term 'individualised care.' RESULTS Nurses perceived that they supported and provided individualised care more compared with patients as they scored significantly higher on the ICS compared with patients. Patients with higher empowerment scores, higher health literacy, a degree lower than bachelor, a longer hospital stay, and patients who were employed and who were admitted to Dutch hospitals scored significantly higher on some of the ICS subscales/subsections. Nurses who were older and more experienced and those working in Dutch hospitals, regional hospitals and maternity wards scored significantly higher on some of the ICS subscales/subsections. CONCLUSION Nurses perceived that they supported and provided individualised care more compared with patients. RELEVANCE TO CLINICAL PRACTICE Creating a shared understanding towards the support and provision of individualised care should be a priority as this could generate more effective nursing care that takes into account the individuality of the patient.
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Affiliation(s)
- Sofie Theys
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Elise van Belle
- IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | | | - Kristof Eeckloo
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Ghent University Hospital, Ghent, Belgium
| | - Dimitri Beeckman
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Skin Integrity Research Group (SKINT), Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,School of Health Sciences, Örebro University, Örebro, Sweden
| | - Sofie Verhaeghe
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Department Health Care, VIVES University College, Roeselare, Belgium
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.,Nursing Department, Ghent University Hospital, Ghent, Belgium
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Coolen E, Engbers R, Draaisma J, Heinen M, Fluit C. The use of SBAR as a structured communication tool in the pediatric non-acute care setting: bridge or barrier for interprofessional collaboration? J Interprof Care 2020:1-10. [PMID: 33190546 DOI: 10.1080/13561820.2020.1816936] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
SBAR (Situation, Background, Assessment and Recommendation) is a structured method developed for communicating critical information that requires immediate action. In 2016 the SBAR tool was introduced at the Amalia Children's Hospital in the Netherlands to improve communication between healthcare workers. Despite formal training and the introduction of aids to facilitate implementation, observed adherence to the tool was low. A qualitative study was undertaken to study the use of SBAR by pediatric residents and nurses in the non-acute clinical care setting of an academic children's hospital. Semi-structured focus group sessions were conducted and qualitatively analyzed using a constructed coding template to search for facilitators and barriers in the use of SBAR by different professionals. We found professionals' use of SBAR was influenced by departmental, cultural, and individual factors. Important themes for effective implementation and use of SBAR in an interprofessional setting, like situation dependency, learning climate and professional identity had not been addressed during the initial implementation. To facilitate SBAR's use it is important to identify professionals' needs to use the tool effectively, to take into account how tasks and responsibilities are perceived by different professions, and to stimulate interprofessional feedback and role modeling.
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Affiliation(s)
- Ester Coolen
- Department of Pediatrics, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Rik Engbers
- Radboud Health Academy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jos Draaisma
- Department of Pediatrics, Radboud University Medical Center Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Maud Heinen
- IQ Health Care, Radboud Institute for Health Sciences, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Cornelia Fluit
- Radboud Health Academy, Radboud University Medical Center, Nijmegen, The Netherlands
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Mondaca-Duarte FD, Heinen M, van Mourik S. Performance analysis method for model-based irrigation strategies under uncertainty. MethodsX 2020; 7:101075. [PMID: 33088728 PMCID: PMC7562963 DOI: 10.1016/j.mex.2020.101075] [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: 07/03/2020] [Accepted: 09/21/2020] [Indexed: 11/25/2022] Open
Abstract
A Richards equation-based soil water model was combined with an evapotranspiration model to compute drainage and crop water stress resulting from irrigation within a MATLAB programming environment. Monte Carlo sampling was used to simulate how uncertainty in soil parameters and evapotranspiration propagates into predictions of drainage, water use and crop water stress. Soil water pressure head was used as a threshold value to indicate crop water stress based on soil profile interactions with the crop root zone.
There is a necessity to increase the performance of food production in agriculture, this means, that precise management support in farming systems is required to reduce water use and drainage while avoiding crop stress. Management support based on model predictions is used to increase the performance of food production. However, sources of uncertainty affect the model predictions. Uncertainty in soil properties and uncertain evapotranspiration translate into uncertain predictions, and consequently in risk of performance loss. This paper presents the code and method to analyze performance uncertainty (and risk of performance loss) due to uncertain circumstances. The method is based on using the De Graaf evapotranspiration model and the EMMAN3G model, a Richards equation-based soil water model, as modules to conduct a performance uncertainty study.
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Affiliation(s)
- F D Mondaca-Duarte
- Wageningen University, Farm Technology Group, P.O. Box 16, 6700 AH Wageningen, the Netherlands
| | - M Heinen
- Wageningen Environmental Research, Wageningen UR, P.O. Box 47, 6700 AA Wageningen, the Netherlands
| | - S van Mourik
- Wageningen University, Farm Technology Group, P.O. Box 16, 6700 AH Wageningen, the Netherlands
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van Belle E, Huisman‐De Waal G, Vermeulen H, Heinen M. Feasibility and early effectiveness of the Tell-us Card communication tool to increase in-hospital patient participation: a cluster randomised controlled pilot study. Scand J Caring Sci 2020; 35:911-922. [PMID: 32964468 PMCID: PMC8451905 DOI: 10.1111/scs.12909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/04/2020] [Accepted: 08/12/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Patient participation is fundamental to nursing care and has beneficial effects on patient outcomes. However, it is not well embedded yet and little is known on how nurses could effectively stimulate patient participation in hospital care. The Tell-us Card is a communication tool for inviting patients to talk about their preferences and needs, and to increase patient participation in daily care. OBJECTIVES To assess feasibility and early effectiveness of the Tell-us Card communication tool for enhanced patient participation during hospitalisation. DESIGN AND METHOD A pilot cluster randomised controlled study design was used including four nursing wards. Effectiveness was measured with the Individualized Care Scale (ICS) and the Quality from the Patients' Perspective (QPP) questionnaire. Linear mixed model analysis was used for analysis. Feasibility was assessed with an evaluative questionnaire for patients and nurses and by reviewing the content of Tell-us Cards using the Fundamentals of Care Framework (FOCF) for analysis. Ethical approval was attained. RESULTS Data of 265 patients showed a significant increase at one intervention ward on the ICS (effect size 0.61, p = 0.02) and most ICS subscales. No effect was visible on the QPP. The majority of patients regarded the intervention as beneficial; nurses however experienced barriers with incorporating the Tell-us Card into daily care. Analysis of the Tell-us Card content showed many elements of the FOCF being mentioned, with most patients indicating psychosocial needs like being involved and informed. CONCLUSIONS This pilot study showed a positive early effect of the Tell-us Card communication tool on patient participation, although integration in daily nursing care appeared to be complex and an optimal fit has not yet been reached. Patients were positive about the intervention and wrote meaningful issues on the Tell-us Cards. More research is needed on how to incorporate patient participation effectively in complex hospital care.
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Affiliation(s)
- Elise van Belle
- Radboud Institute for Health SciencesIQ HealthcareRadboud University Medical CenterNijmegenThe Netherlands
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Getty Huisman‐De Waal
- Radboud Institute for Health SciencesIQ HealthcareRadboud University Medical CenterNijmegenThe Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health SciencesIQ HealthcareRadboud University Medical CenterNijmegenThe Netherlands
- Faculty of Health and Social StudiesHAN University of Applied SciencesNijmegenThe Netherlands
| | - Maud Heinen
- Radboud Institute for Health SciencesIQ HealthcareRadboud University Medical CenterNijmegenThe Netherlands
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10
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Spoon D, Rietbergen T, Huis A, Heinen M, van Dijk M, van Bodegom-Vos L, Ista E. Implementation strategies used to implement nursing guidelines in daily practice: A systematic review. Int J Nurs Stud 2020; 111:103748. [PMID: 32961463 DOI: 10.1016/j.ijnurstu.2020.103748] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/29/2020] [Accepted: 08/10/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Research specifically addressing implementation strategies regarding nursing guidelines is limited. The objective of this review was to provide an overview of strategies used to implement nursing guidelines in all nursing fields, as well as the effects of these strategies on patient-related nursing outcomes and guideline adherence. Ideally, the findings would help guideline developers, healthcare professionals and organizations to implement nursing guidelines in practice. DESIGN Systematic review. PROSPERO registration number: CRD42018104615. DATA SOURCES We searched the Embase, Medline, PsycINFO, Web of Science, Cochrane, CINAHL and Google Scholar databases until August 2019 as well as the reference lists of relevant articles. REVIEW METHODS Studies were included that described quantitative data on the effect of implementation strategies and implementation outcomes of any type of a nursing guideline in any setting. No language or date of publication restriction was used. The Cochrane Effective Practice and Organisation of Care taxonomy was used to categorize the implementation strategies. Studies were classified as effective if a significant change in either patient-related nursing outcomes or guideline adherence was described. Strength of the evidence was evaluated using the 'Cochrane risk of bias tool' for controlled studies, and the 'Newcastle-Ottawa Quality Assessment form' for cohort studies. RESULTS A total of 54 articles regarding 53 different guideline implementation studies were included. Fifteen were (cluster) Randomized Controlled Trials or controlled before-after studies and 38 studies had a before-after design. The topics of the implemented guidelines were diverse, mostly concerning skin care (n = 9) and infection prevention (n = 7). Studies were predominantly performed in hospitals (n = 34) and nursing homes (n = 11). Thirty studies showed a positive significant effect in either patient-related nursing outcomes or guideline adherence (68%, n = 36). The median number of implementation strategies used was 6 (IQR 4-8) per study. Educational strategies were used in nearly all studies (98.1%, n = 52), followed by deployment of local opinion leaders (54.7%, n = 29) and audit and feedback (41.5%, n = 22). Twenty-three (43.4%) studies performed a barrier assessment, nineteen used tailored strategies. CONCLUSIONS A wide variety of implementation strategies are used to implement nursing guidelines. Not one single strategy, or combination of strategies, can be linked directly to successful implementation of nursing guidelines. Overall, thirty-six studies (68%) reported a positive significant effect of the implementation of guidelines on patient-related nursing outcomes or guideline adherence. Future studies should use a standardized reporting checklist to ensure a detailed description of the used implementation strategies to increase reproducibility and understanding of outcomes.
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Affiliation(s)
- Denise Spoon
- Department of Internal Medicine, Section Nursing Science, Erasmus MC University Medical Centre, Room Rg-532, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands.
| | - Tessa Rietbergen
- Department of Biomedical Data Sciences, section Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - Anita Huis
- Radboud university medical centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands
| | - Maud Heinen
- Radboud university medical centre, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands
| | - Monique van Dijk
- Department of Internal Medicine, Section Nursing Science, Erasmus MC University Medical Centre, Room Rg-532, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands; Department of Paediatric Surgery and Intensive Care, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Leti van Bodegom-Vos
- Department of Biomedical Data Sciences, section Medical Decision Making, Leiden University Medical Centre, Leiden, The Netherlands
| | - Erwin Ista
- Department of Internal Medicine, Section Nursing Science, Erasmus MC University Medical Centre, Room Rg-532, P.O. Box 2040, Rotterdam, CA 3000, The Netherlands; Department of Paediatric Surgery and Intensive Care, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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11
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Rietbergen T, Spoon D, Brunsveld-Reinders AH, Schoones JW, Huis A, Heinen M, Persoon A, van Dijk M, Vermeulen H, Ista E, van Bodegom-Vos L. Effects of de-implementation strategies aimed at reducing low-value nursing procedures: a systematic review and meta-analysis. Implement Sci 2020; 15:38. [PMID: 32450898 PMCID: PMC7249362 DOI: 10.1186/s13012-020-00995-z] [Citation(s) in RCA: 17] [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: 03/17/2020] [Accepted: 04/29/2020] [Indexed: 11/11/2022] Open
Abstract
Background In the last decade, there is an increasing focus on detecting and compiling lists of low-value nursing procedures. However, less is known about effective de-implementation strategies for these procedures. Therefore, the aim of this systematic review was to summarize the evidence of effective strategies to de-implement low-value nursing procedures. Methods PubMed, Embase, Emcare, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar were searched till January 2020. Additionally, reference lists and citations of the included studies were searched. Studies were included that described de-implementation of low-value nursing procedures, i.e., procedures, test, or drug orders by nurses or nurse practitioners. PRISMA guideline was followed, and the ‘Cochrane Effective Practice and Organisation of Care’ (EPOC) taxonomy was used to categorize de-implementation strategies. A meta-analysis was performed for the volume of low-value nursing procedures in controlled studies, and Mantel–Haenszel risk ratios (95% CI) were calculated using a random effects model. Results Twenty-seven studies were included in this review. Studies used a (cluster) randomized design (n = 10), controlled before-after design (n = 5), and an uncontrolled before-after design (n = 12). Low-value nursing procedures performed by nurses and/or nurse specialists that were found in this study were restraint use (n = 20), inappropriate antibiotic prescribing (n = 3), indwelling or unnecessary urinary catheters use (n = 2), ordering unnecessary liver function tests (n = 1), and unnecessary antipsychotic prescribing (n = 1). Fourteen studies showed a significant reduction in low-value nursing procedures. Thirteen of these 14 studies included an educational component within their de-implementation strategy. Twelve controlled studies were included in the meta-analysis. Subgroup analyses for study design showed no statistically significant subgroup effect for the volume of low-value nursing procedures (p = 0.20). Conclusions The majority of the studies with a positive significant effect used a de-implementation strategy with an educational component. Unfortunately, no conclusions can be drawn about which strategy is most effective for reducing low-value nursing care due to a high level of heterogeneity and a lack of studies. We recommend that future studies better report the effects of de-implementation strategies and perform a process evaluation to determine to which extent the strategy has been used. Trial registration The review is registered in Prospero (CRD42018105100).
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Affiliation(s)
- Tessa Rietbergen
- Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Denise Spoon
- Department of Internal Medicine, Nursing Science, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Jan W Schoones
- Leiden University Medical Center, Walaeus Library, Leiden, The Netherlands
| | - Anita Huis
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anke Persoon
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Monique van Dijk
- Department of Internal Medicine, Nursing Science, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Hester Vermeulen
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Erwin Ista
- Department of Internal Medicine, Nursing Science, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Leti van Bodegom-Vos
- Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
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12
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Theys S, Van Hecke A, Akkermans R, Heinen M. The Dutch Individualised Care Scale for patients and nurses - a psychometric validation study. Scand J Caring Sci 2020; 35:308-318. [PMID: 32301170 PMCID: PMC7984034 DOI: 10.1111/scs.12853] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 03/17/2020] [Indexed: 12/03/2022]
Abstract
Aims and objectives Translating and psychometrically assessing the Individualised Care Scale (ICS) for patients and nurses for the Flemish and Dutch healthcare context. Background Individualised care interventions have positive effects on health outcomes. However, there are no valid and reliable instruments for evaluating individualised care for the Flemish and Dutch healthcare context. Design Psychometric validation study. Setting and participants In Flemish hospitals, data were collected between February and June 2016, and in Dutch hospitals, data were collected between December 2014 and May 2015. Nurses with direct patient contact and a working experience of minimum 6 months on the wards could participate. Patient inclusion criteria were being an adult, being mentally competent, having an expected hospital stay of minimum 1 day, and being able to speak and read the Dutch language. In total, 845 patients and 569 nurses were included. Methods The ICS was translated into Dutch using a forward–backward translation process. Minimal linguistic adaptations to the Dutch ICS were made to use the scale as a Flemish equivalent. Omega, Cronbach’s Alpha, mean inter‐item correlations and standardised subscale correlations established the reliability and confirmatory factor analysis the construct validity of the ICS. Results Internal consistency using Omega (Cronbach’s Alpha) ranged from 0.83 to 0.96 (0.82–0.95) for the ICS‐Nurse and from 0.88 to 0.96 (0.87–0.96) for the ICS‐Patient. Fit indices of the confirmatory factor analysis indicated a good model fit, except for the root mean square error of approximation, which indicated only moderate model fit. Conclusion The Dutch version of the ICS showed acceptable psychometric performance, supporting its use for the Dutch and Flemish healthcare context. Relevance to clinical practice Knowledge of nurses’ and patients’ perceptions on individualised care will aid to target areas in the Dutch and Flemish healthcare context in which work needs to be undertaken to provide individualised nursing care.
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Affiliation(s)
- Sofie Theys
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care - University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care - University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Reinier Akkermans
- IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Maud Heinen
- Nursing Science and Allied Healthcare, Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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13
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van Noort HHJ, Heinen M, van Asseldonk M, Ettema RGA, Vermeulen H, Huisman-de Waal G. Using intervention mapping to develop an outpatient nursing nutritional intervention to improve nutritional status in undernourished patients planned for surgery. BMC Health Serv Res 2020; 20:152. [PMID: 32106862 PMCID: PMC7047387 DOI: 10.1186/s12913-020-4964-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 11/14/2018] [Accepted: 02/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Undernutrition in surgical patients leads to a higher risk of postoperative complications like infections and delayed recovery of gastrointestinal functions, often resulting in a longer hospital stay and lower quality of life. Nurses at outpatient clinics can deliver nutritional care during outpatient preoperative evaluation of health status to ensure that patients are properly fed in preparation for hospital admission for surgery. However, nutritional nursing care was not determined in research yet. This paper describes the structural development of an Outpatient Nursing Nutritional Intervention (ONNI). METHODS A project group followed the steps of the Intervention Mapping. The needs assessment included assessment of delivery of nutritional care and nutritional care needs at two anaesthesia outpatient clinics of an academic and a teaching hospital. Also, outpatient clinic nurses and patients at risk for undernutrition were interviewed. Determinants resulted from these methods were matched with theories on behaviour change and nutritional support. RESULTS Both patients and nurses were unaware of the consequences of undernutrition, and nurses were also unaware of their roles with regard to nutritional support. The intervention goals were: 1) enabling surgical patients to improve or maintain their nutritional status before hospital admission for surgery, and 2) enabling nurses to deliver nutritional support. The ONNI was developed for outpatients at risk for or with undernutrition. A training was developed for nurses. The ONNI included the five following components: 1) identification of the causes of undernutrition; 2) provision of a nutritional care plan including general and individually tailored advice; 3) self-monitoring of nutrient intake; 4) counselling and encouragement; and 5) support during a telephone follow-up meeting. The intervention and training were tested. A multifaceted implementation strategy was used to deliver the intervention in daily practice. CONCLUSIONS Despite the unique position of the nurses at outpatient clinics, nurses were unaware of their role with regard to nutritional care. The ONNI was developed and implemented along with a training program for nurses. The test confirmed that the training can improve nurses' knowledge, skills, and sense of responsibility for nutritional support. The intervention may empower patients to actively improve their nutritional status.
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Affiliation(s)
- Harm H J van Noort
- Department of Nutrition, Physical Activity and Sports, Department of Surgery, Gelderse Vallei Hospital, P.O. Box 9025, 6710, HN, Ede, The Netherlands. .,Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Maud Heinen
- Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Monique van Asseldonk
- Department of Gastroenterology and Hepatology - Dietetics and Intestinal Failure, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roelof G A Ettema
- Julius Center for Health Sciences and Primary Care, University Utrecht Str. 6.131, P.O. Box 85500, 3508, GA, Utrecht, The Netherlands.,Research Center Health and Sustainable Living, Utrecht University of Applied Sciences, P.O. Box 12011, 3501, AA, Utrecht, The Netherlands
| | - Hester Vermeulen
- Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.,Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
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14
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Cate D, Ettema RGA, Huisman‐de Waal G, Bell JJ, Verbrugge R, Schoonhoven L, Schuurmans MJ, Zwakhalen S, Vermeulen H, Man‐van Ginkel J, Heinen M, Metzelthin S, Verstraten C, Belle E, Noort H, Berg G, Manen A. Interventions to prevent and treat malnutrition in older adults to be carried out by nurses: A systematic review. J Clin Nurs 2020; 29:1883-1902. [DOI: 10.1111/jocn.15153] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Debbie Cate
- Research Group Chronic Diseases Utrecht University of Applied Sciences Utrecht The Netherlands
- Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht The Netherlands
- Institute of Nursing Studies Utrecht University of Applied Sciences Utrecht The Netherlands
| | - Roelof G. A. Ettema
- Research Group Chronic Diseases Utrecht University of Applied Sciences Utrecht The Netherlands
- Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht The Netherlands
- Institute of Nursing Studies Utrecht University of Applied Sciences Utrecht The Netherlands
| | - Getty Huisman‐de Waal
- Radboud University Medical Centre Radboud Institute for Health Sciences IQ Healthcare Nijmegen The Netherlands
| | - Jack J. Bell
- School of Human Movement and Nutrition Sciences The University of Queensland & The Prince Charles Hospital Brisbane QLD Australia
| | - Remco Verbrugge
- Institute of Nursing Studies Utrecht University of Applied Sciences Utrecht The Netherlands
| | - Lisette Schoonhoven
- Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht The Netherlands
| | - Marieke J. Schuurmans
- Education Center UMC Utrecht Academy University Medical Center Utrecht Utrecht University Utrecht The Netherlands
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15
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van Kraaij J, van Oostveen C, Vermeulen H, Heinen M, Huis A, Adriaansen M, Peters J. Nurse practitioners' perceptions of their ability to enact leadership in hospital care. J Clin Nurs 2019; 29:447-458. [PMID: 31738466 DOI: 10.1111/jocn.15105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 09/26/2019] [Accepted: 11/10/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVE To gain insight into nurse practitioners' (NP) leadership roles in Dutch hospital care, by exploring the perceptions regarding their current leadership role and the differences with their previous role as a registered specialised nurse. BACKGROUND To meet today's challenges of the increasing healthcare demands, the employment of NPs is proliferating. NPs have the ideal position to play a pivotal role within healthcare reforms, yet full expansion of their scope of practice and expertise is having limited success. Long-term sustainability of NPs depends on the ability to perform and develop a leading role. DESIGN AND METHODS This qualitative descriptive study was conducted in fifteen Dutch hospitals. Data were collected from April-July 2018, and purposive sampling was used for eighteen semi-structured interviews. This study is conducted and reported according to the COREQ checklist. RESULTS Three main themes concerning NPs' current leadership role emerged, and they were all linked to a successful positioning of NPs. All themes seemed to be of influence on NPs' scope of daily practice. Direct patient care was emphasised, and leadership on other levels appeared to be underused. Most NPs desired to reshape their profession. However, unprofitable use of their leadership skills especially on professional and organisational level and lack of supportive factors seemed to hinder them. CONCLUSIONS An adequate use of leadership is crucial for role development and positioning of NPs. Further development of the NP profession can help to better differentiate between the tasks of registered specialised nurses and NPs. RELEVANCE TO CLINICAL PRACTICE Leadership in nursing contributes to the improvement of the quality and efficiency of health care. Further positioning of the NP profession depends on a profitable use of leadership competencies. Besides, NPs should collaborate with healthcare organisations, educational institutions and professional associations to value the NP profession in the current healthcare system.
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Affiliation(s)
- Julia van Kraaij
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Catharina van Oostveen
- Spaarne Gasthuis Academy, Spaarne Gasthuis Hospital, Haarlem, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hester Vermeulen
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.,HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Maud Heinen
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Anita Huis
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | | | - Jeroen Peters
- HAN University of Applied Sciences, Master Advanced Nursing Practice, Nijmegen, Netherlands
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16
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Theys S, Lust E, Heinen M, Verhaeghe S, Beeckman D, Eeckloo K, Malfait S, Van Hecke A. Barriers and enablers for the implementation of a hospital communication tool for patient participation: A qualitative study. J Clin Nurs 2019; 29:1945-1956. [DOI: 10.1111/jocn.15055] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Sofie Theys
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care – University Centre for Nursing and Midwifery Ghent University Ghent Belgium
| | - Elisa Lust
- Dienstverleningscentrum voor personen met verstandelijke beperkingen vzw Heilig Hart Deinze Belgium
| | - Maud Heinen
- Nursing Science and Allied Healthcare Radboud Institute for Health Sciences IQ Healthcare Radboud University Medical Center Nijmegen The Netherlands
| | - Sofie Verhaeghe
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care – University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Department Health Care VIVES University College Roeselare Belgium
| | - Dimitri Beeckman
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care – University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Skin Integrity Research Group (SKINT) Department of Public Health and Primary Care– University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- School of Health Sciences Örebro University Örebro Sweden
- School of Nursing and Midwifery Royal College of Surgeons in Ireland Dublin Ireland
| | - Kristof Eeckloo
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care Ghent University Hospital Ghent Belgium
| | | | - Ann Van Hecke
- Faculty of Medicine and Health Sciences Department of Public Health and Primary Care – University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Nursing Department Ghent University Hospital Ghent Belgium
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17
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van Belle E, Giesen J, Conroy T, van Mierlo M, Vermeulen H, Huisman-de Waal G, Heinen M. Exploring person-centred fundamental nursing care in hospital wards: A multi-site ethnography. J Clin Nurs 2019; 29:1933-1944. [PMID: 31408557 PMCID: PMC7319433 DOI: 10.1111/jocn.15024] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/02/2019] [Accepted: 08/05/2019] [Indexed: 11/30/2022]
Abstract
Objective To explore how nurses in hospitals enact person‐centred fundamental care delivery. Background Effective person‐centred care is at the heart of fundamental nursing care, but it is deemed to be challenging in acute health care as there is a strong biomedical focus and most nurses are not trained in person‐centred fundamental care delivery. We therefore need to know if and how nurses currently incorporate a person‐centred approach during fundamental care. Design Focused ethnography approach. Methods Observations of 30 nurses on three different wards in two Dutch hospitals during their morning shift. Data were collected through passive observations and analysed using framework analysis based on the fundamentals of care framework. The COREQ guideline was used for reporting. Results Some nurses successfully integrate physical, psychosocial and relational elements of care in patient interactions. However, most nurses were observed to be mainly focused on physical care and did not take the time at their patients’ bedside to care for their psychosocial and relational needs. Many had a task‐focused way of working and communicating, seldom incorporating patients’ needs and experiences or discussing care planning, and often disturbing each other. Conclusions This study demonstrates that although some nurses manage to do so, person‐centred fundamental care delivery remains a challenge in hospitals, as most nurses have a task‐focused approach and therefore do not manage to integrate the physical, relational and physical elements of care. For further improvement, attention needs to be paid to integrated fundamental care and clinical reasoning skills. Relevance to clinical practice Although most nurses have a compassionate approach, this study shows that nurses do not incorporate psychosocial care or encourage patient participation when helping patients with their physical fundamental care needs, even though there seems to be sufficient opportunity for them to do so.
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Affiliation(s)
- Elise van Belle
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeltje Giesen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tiffany Conroy
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Marloes van Mierlo
- Clinical Research Department, Rijnstate Hospital, Arnhem, The Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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18
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Heinen M, van Oostveen C, Peters J, Vermeulen H, Huis A. An integrative review of leadership competencies and attributes in advanced nursing practice. J Adv Nurs 2019; 75:2378-2392. [PMID: 31162695 PMCID: PMC6899698 DOI: 10.1111/jan.14092] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [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: 08/29/2018] [Revised: 03/10/2019] [Accepted: 04/08/2019] [Indexed: 12/17/2022]
Abstract
Aim To establish what leadership competencies are expected of master level‐educated nurses like the Advanced Practice Nurses and the Clinical Nurse Leaders as described in the international literature. Background Developments in health care ask for well‐trained nurse leaders. Advanced Practice Nurses and Clinical Nurse Leaders are ideally positioned to lead healthcare reform in nursing. Nurses should be adequately equipped for this role based on internationally defined leadership competencies. Therefore, identifying leadership competencies and related attributes internationally is needed. Design Integrative review. Methods Embase, Medline and CINAHL databases were searched (January 2005–December 2018). Also, websites of international professional nursing organizations were searched for frameworks on leadership competencies. Study and framework selection, identification of competencies, quality appraisal of included studies and analysis of data were independently conducted by two researchers. Results Fifteen studies and seven competency frameworks were included. Synthesis of 150 identified competencies led to a set of 30 core competencies in the clinical, professional, health systems. and health policy leadership domains. Most competencies fitted in one single domain the health policy domain contained the least competencies. Conclusions This synthesis of 30 core competencies within four leadership domains can be used for further development of evidence‐based curricula on leadership. Next steps include further refining of competencies, addressing gaps, and the linking of knowledge, skills, and attributes. Impact These findings contribute to leadership development for Advanced Practice Nurses and Clinical Nurse Leaders while aiming at improved health service delivery and guiding of health policies and reforms.
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Affiliation(s)
- Maud Heinen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands
| | - Catharina van Oostveen
- Spaarne Gasthuis Hospital, Spaarne Gasthuis Academy, Haarlem, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jeroen Peters
- Hogeschool van Arnhem en Nijmegen, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands.,HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Anita Huis
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare, Nijmegen, The Netherlands
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19
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Somerville R, Khalil H, Segurado R, Mehegan J, Viljoen K, Heinen M, Murrin C, Kelleher CC. Childhood central adiposity at ages 5 and 9 shows consistent relationship with that of the maternal grandmother but not other grandparents. Pediatr Obes 2018; 13:778-785. [PMID: 29745039 DOI: 10.1111/ijpo.12290] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 02/10/2018] [Accepted: 03/13/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The importance of a life course approach to childhood obesity has been emphasized; however, few studies can prospectively investigate relationships in three-generation families. OBJECTIVE To prospectively investigate the relationship between grandparental and grandchild waist circumference (WC) at ages 5 and 9 down maternal and paternal lines. METHODS At baseline in the Lifeways Cross-Generation Cohort, 1094 children were born to 1082 mothers; 585 were examined at age 5 and 298 at age 9. Of the total 589 children with measured WC, data were also available from 745 grandparents. Child WC was standardized for age and sex, and theory-based hierarchical linear regression was used. RESULTS Maternal grandmother (MGM) WC was predictive of grandchild WC at both time points. At age 5, grandchild's standardized birth weight (B = 0.266, p = 0.001), mother's means tested eligibility for free medical care (B = 1.029, p = 0.001) and grandchild seeing maternal grandparents daily (B = 0.312, p = 0.048) were significant alongside MGM WC (B = 0.015, p = 0.019). At age 9, only MGM WC (B = 0.022, p = 0.033) and mother's WC (B = 0.032, p = 0.005) were significant. Mediation analysis with mother's WC showed significant direct relationship of MGM and grandchild WC. CONCLUSIONS This prospective cross-generational cohort shows consistent patterns of association between MGM and grandchild WC, not seen in other grandparental lineages.
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Affiliation(s)
- R Somerville
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - H Khalil
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - R Segurado
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - J Mehegan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - K Viljoen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - M Heinen
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - C Murrin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - C C Kelleher
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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20
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Abstract
AIMS AND OBJECTIVES To explore the perspectives of nursing students on their education concerning basic nursing care, learned either during theoretical education or clinical placement, with a specific focus on nutrition and communication. BACKGROUND Basic care activities lie at the core of nursing, but are ill-informed by evidence and often poorly delivered. Nursing students' education on basic care might be lacking, and the question remains how they learn to deliver basic care in clinical practice. DESIGN Descriptive study, using an online questionnaire. METHODS Nursing students at the vocational and bachelor level of six nursing schools in the Netherlands were invited to complete an online questionnaire regarding their perception of basic nursing care education in general (both theoretical education and clinical placement) and specifically in relation to nutrition and communication. RESULTS Nursing students (n = 226 bachelor students, n = 30 vocational students) completed the questionnaire. Most students reported that they learned more about basic nursing care during clinical placement than during theoretical education. Vocational students also reported learning more about basic nursing care in both theoretical education and clinical practice than bachelor students. In terms of nutrition, low numbers of students from both education levels reported learning about nutrition protocols and guidelines during theoretical education. In terms of communication, vocational students indicated that they learned more about different aspects of communication during clinical practice than theoretical education and were also more likely to learn about communication (in both theoretical education and clinical practice) than were bachelor students. CONCLUSION Basic nursing care seems to be largely invisible in nursing education, especially at the bachelor level and during theoretical education. RELEVANCE TO CLINICAL PRACTICE Improved basic nursing care will enhance nurse-sensitive outcomes and patient satisfaction and will contribute to lower healthcare costs. This study shows that there is scope within current nurse education in the Netherlands to focus more systematically and explicitly on basic nursing care.
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Affiliation(s)
- Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rebecca Feo
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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21
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van Belle E, Zwakhalen SMG, Caris J, Van Hecke A, Huisman-de Waal G, Heinen M. Tailoring of the Tell-us Card communication tool for nurses to increase patient participation using Intervention Mapping. J Clin Nurs 2018; 27:621-630. [PMID: 28722789 DOI: 10.1111/jocn.13968] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe the tailoring of the Tell-us Card intervention for enhanced patient participation to the Dutch hospital setting using Intervention Mapping as a systematic approach. BACKGROUND Even though patient participation is essential in any patient-to-nurse encounter, care plans often fail to take patients' preferences into account. The Tell-us Card intervention seems promising, but needs to be tailored and tested before implementation in a different setting or on large scale. DESIGN Description of the Intervention Mapping framework to systematically tailor the Tell-us Card intervention to the Dutch hospital setting. METHODS Intervention Mapping consists of: (i) identification of the problem through needs assessment and determination of fit, based on patients and nurses interviews and focus group interviews; (ii) developing a logic model of change and matrices, based on literature and interviews; (iii) selection of theory-based methods and practical applications; (iv) producing programme components and piloting; (v) planning for adoption, implementation and sustainability; and (vi) preparing for programme evaluation. RESULTS Knowledge, attitude, outcome expectations, self-efficacy and skills were identified as the main determinants influencing the use of the Tell-us Card. Linking identified determinants and performance objectives with behaviour change techniques from the literature resulted in a well-defined and tailored intervention and evaluation plan. CONCLUSIONS The Tell-us Card intervention was adapted to fit the Dutch hospital setting and prepared for evaluation. The Medical Research Council framework was followed, and the Intervention Mapping approach was used to prepare a pilot study to confirm feasibility and relevant outcomes. RELEVANCE TO CLINICAL PRACTICE This article shows how Intervention Mapping is applied within the Medical Research Council framework to adapt the Tell-us Card intervention, which could serve as a guide for the tailoring of similar interventions.
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Affiliation(s)
- Elise van Belle
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sandra M G Zwakhalen
- Research School CAPHRI, Department of Health Services Research, Maastricht University, MD Maastricht, The Netherlands
| | - Josien Caris
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Ann Van Hecke
- Faculty of Medicine and Health Sciences, University Center for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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22
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Quirke B, Heinen M, Daly L, Kelleher C. 4.2-O2Using the Population structure from the All Ireland Traveller Health Study 2007-2010 to facilitate comparison with other Indigenous Ethnic Minority populations globally. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.126] [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: 11/14/2022] Open
Affiliation(s)
- B Quirke
- University College Dublin, Ireland
| | - M Heinen
- University College Dublin, Ireland
| | - L Daly
- University College Dublin, Ireland
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23
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Zwakhalen SM, Hamers JP, Metzelthin SF, Ettema R, Heinen M, de Man-Van Ginkel JM, Vermeulen H, Huisman-de Waal G, Schuurmans MJ. Basic nursing care: The most provided, the least evidence based - A discussion paper. J Clin Nurs 2018; 27:2496-2505. [DOI: 10.1111/jocn.14296] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Sandra M.G. Zwakhalen
- Department of Health Services Research; Research School CAPHRI; Maastricht University; Maastricht The Netherlands
| | - Jan P.H. Hamers
- Department of Health Services Research; Research School CAPHRI; Maastricht University; Maastricht The Netherlands
| | - Silke F. Metzelthin
- Department of Health Services Research; Research School CAPHRI; Maastricht University; Maastricht The Netherlands
| | - Roelof Ettema
- University of Professional Education Utrecht; Utrecht The Netherlands
| | - Maud Heinen
- Radboud University Medical Center; Radboud Institute for Health Sciences; IQ Healthcare; Nijmegen The Netherlands
| | - Janneke M. de Man-Van Ginkel
- Department of Rehabilitation, Nursing Science and Sport; Nursing Science; University Medical Center Utrecht; Brain Center Rudolf Magnus; Utrecht The Netherlands
- Nursing Science; Program in Clinical Health Sciences; University Medical Center Utrecht; Utrecht The Netherlands
| | - Hester Vermeulen
- Radboud University Medical Center; Radboud Institute for Health Sciences; IQ Healthcare; Nijmegen The Netherlands
| | - Getty Huisman-de Waal
- Radboud University Medical Center; Radboud Institute for Health Sciences; IQ Healthcare; Nijmegen The Netherlands
| | - Marieke J. Schuurmans
- Department of Rehabilitation, Nursing Science and Sport; Nursing Science; University Medical Center Utrecht; Brain Center Rudolf Magnus; Utrecht The Netherlands
- Nursing Science; Program in Clinical Health Sciences; University Medical Center Utrecht; Utrecht The Netherlands
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24
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Abstract
Ferrogels consist of magnetic colloidal particles embedded in an elastic polymer matrix. As a consequence, their structural and rheological properties are governed by a competition between magnetic particle-particle interactions and mechanical matrix elasticity. Typically, the particles are permanently fixed within the matrix, which makes them distinguishable by their positions. Over time, particle neighbors do not change due to the fixation by the matrix. Here we present a classical density functional approach for such ferrogels. We map the elastic matrix-induced interactions between neighboring colloidal particles distinguishable by their positions onto effective pairwise interactions between indistinguishable particles similar to a 'pairwise pseudopotential'. Using Monte-Carlo computer simulations, we demonstrate for one-dimensional dipole-spring models of ferrogels that this mapping is justified. We then use the pseudopotential as an input into classical density functional theory of inhomogeneous fluids and predict the bulk elastic modulus of the ferrogel under various conditions. In addition, we propose the use of an 'external pseudopotential' when one switches from the viewpoint of a one-dimensional dipole-spring object to a one-dimensional chain embedded in an infinitely extended bulk matrix. Our mapping approach paves the way to describe various inhomogeneous situations of ferrogels using classical density functional concepts of inhomogeneous fluids.
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Affiliation(s)
- P Cremer
- Institut für Theoretische Physik II: Weiche Materie, Heinrich-Heine-Universität Düsseldorf, D-40225 Düsseldorf, Germany
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25
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Anderson P, Bendtsen P, Spak F, Reynolds J, Drummond C, Segura L, Keurhorst MN, Palacio-Vieira J, Wojnar M, Parkinson K, Colom J, Kłoda K, Deluca P, Baena B, Newbury-Birch D, Wallace P, Heinen M, Wolstenholme A, van Steenkiste B, Mierzecki A, Okulicz-Kozaryn K, Ronda G, Kaner E, Laurant MGH, Coulton S, Gual T. Improving the delivery of brief interventions for heavy drinking in primary health care: outcome results of the Optimizing Delivery of Health Care Intervention (ODHIN) five-country cluster randomized factorial trial. Addiction 2016; 111:1935-1945. [PMID: 27237081 DOI: 10.1111/add.13476] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [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: 08/18/2015] [Revised: 11/27/2015] [Accepted: 05/25/2016] [Indexed: 12/19/2022]
Abstract
AIM To test if training and support, financial reimbursement and option of referring screen-positive patients to an internet-based method of giving advice (eBI) can increase primary health-care providers' delivery of Alcohol Use Disorders Identification Test (AUDIT)-C-based screening and advice to heavy drinkers. DESIGN Cluster randomized factorial trial with 12-week implementation and measurement period. SETTING Primary health-care units (PHCU) in different locations throughout Catalonia, England, the Netherlands, Poland and Sweden. PARTICIPANTS A total of 120 PHCU, 24 in each of Catalonia, England, the Netherlands, Poland and Sweden. INTERVENTIONS PHCUs were randomized to one of eight groups: care as usual, training and support (TS), financial reimbursement (FR) and eBI; paired combinations of TS, FR and eBI, and all of FR, TS and eBI. MEASUREMENTS The primary outcome measure was the proportion of eligible adult (age 18+ years) patients screened during a 12-week implementation period. Secondary outcome measures were proportion of screen-positive patients advised; and proportion of consulting adult patients given an intervention (screening and advice to screen-positives) during the same 12-week implementation period. FINDINGS During a 4-week baseline measurement period, the proportion of consulting adult patients who were screened for their alcohol consumption was 0.059 per PHCU (95% CI 0.034 to 0.084). Based on the factorial design, the ratio of the logged proportion screened during the 12-week implementation period was 1.48 (95% CI = 1.13-1.95) in PHCU that received TS versus PHCU that did not receive TS; for FR, the ratio was 2.00 (95% CI = 1.56-2.56). The option of referral to eBI did not lead to a higher proportion of patients screened. The ratio for TS plus FR was 2.34 (95% CI = 1.77-3.10), and the ratio for TS plus FR plus eBI was1.68 (95% CI = 1.11-2.53). CONCLUSIONS Providing primary health-care units with training, support and financial reimbursement for delivering Alcohol Use Disorders Identification Test-C-based screening and advice to heavy drinkers increases screening for alcohol consumption. Providing primary health-care units with the option of referring screen-positive patients to an internet-based method of giving advice does not appear to increase screening for alcohol consumption.
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Affiliation(s)
- Peter Anderson
- Institute of Health and Society, Newcastle University, Newcastle, UK. .,Department of Family Medicine, Maastricht University, Maastricht, the Netherlands.
| | - Preben Bendtsen
- Department of Medical Specialist and Department of Medicine and Health, Linköping University, Motala, Sweden
| | - Fredrik Spak
- Department of Social Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jillian Reynolds
- Institut Clínic de Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Colin Drummond
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK.,National Institute for Health Research Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lidia Segura
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - Myrna N Keurhorst
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, the Netherlands
| | - Jorge Palacio-Vieira
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Kathryn Parkinson
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Joan Colom
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - Karolina Kłoda
- Independent Laboratory of Family Physician Education, Pomeranian Medical University, Szczecin, Poland
| | - Paolo Deluca
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
| | - Begoña Baena
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | | | - Paul Wallace
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Maud Heinen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, the Netherlands
| | - Amy Wolstenholme
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
| | - Ben van Steenkiste
- Department of Family Medicine, Maastricht University, Maastricht, the Netherlands
| | - Artur Mierzecki
- Independent Laboratory of Family Physician Education, Pomeranian Medical University, Szczecin, Poland
| | | | - Gaby Ronda
- Department of Family Medicine, Maastricht University, Maastricht, the Netherlands
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Miranda G H Laurant
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, the Netherlands.,HAN University of Applied Sciences, Faculty of Health and Social Studies, Nijmegen, the Netherlands
| | - Simon Coulton
- Centre for Health Service Studies, University of Kent, Canterbury, UK
| | - Toni Gual
- Institut Clínic de Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
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26
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Holmqvist P, Mohanty PS, Nägele G, Schurtenberger P, Heinen M. Erratum: Structure and Dynamics of Loosely Cross-Linked Ionic Microgel Dispersions in the Fluid Regime [Phys. Rev. Lett. 109, 048302 (2012)]. Phys Rev Lett 2016; 117:179901. [PMID: 27824457 DOI: 10.1103/physrevlett.117.179901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Indexed: 06/06/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.109.048302.
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27
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Van Hecke A, Heinen M, Fernández-Ortega P, Graue M, Hendriks JM, Høy B, Köpke S, Lithner M, Van Gaal BG. Systematic literature review on effectiveness of self-management support interventions in patients with chronic conditions and low socio-economic status. J Adv Nurs 2016; 73:775-793. [DOI: 10.1111/jan.13159] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ann Van Hecke
- Faculty of Medicine and Health Sciences; University Center for Nursing and Midwifery; Ghent University; Belgium
| | - Maud Heinen
- Nursing Science and Allied Healthcare; Radboud Institute for Health Sciences, IQ healthcare; Radboud University Medical Center; Nijmegen The Netherlands
| | | | - Marit Graue
- Faculty of Health and Social Sciences; Centre for Evidence-Based Practice; Bergen University College; Norway
| | - Jeroen M.L. Hendriks
- Centre for Heart Rhythm Disorders; Royal Adelaide Hospital and University of Adelaide; South Australia Australia
| | - Bente Høy
- Department of Health care and Social Sciences; VIA University College; Aarhus Denmark
| | - Sascha Köpke
- Institute for Social Medicine and Epidemiology; Nursing Research Unit; University of Lübeck; Germany
| | - Maria Lithner
- Department of Surgery; Skane University Hospital Lund; Sweden
| | - Betsie G.I. Van Gaal
- Nursing Science and Allied Healthcare; Radboud Institute for Health Sciences, IQ healthcare; Radboud University Medical Center; Nijmegen The Netherlands
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28
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Khalil H, Segurado R, Mehegan J, Somerville R, Heinen M, Murrin C, Kelleher CC. P58 Trajectories of Body Mass Index By Age 9 in The Lifeways Cross Generation Cohort Study Children in The Republic Of Ireland. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.157] [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: 11/03/2022]
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29
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Somerville R, Khalil H, Segurado R, Mehegan J, Heinen M, Murrin C, Kelleher CC. P43 The Healthy Worker Effect? Socio-economic and health status determinants of changing self-rated health in older people in the Lifeways Cross-Generation Study of a Thousand Families. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.142] [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: 11/04/2022]
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30
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Keurhorst M, Anderson P, Heinen M, Bendtsen P, Baena B, Brzózka K, Colom J, Deluca P, Drummond C, Kaner E, Kłoda K, Mierzecki A, Newbury-Birch D, Okulicz-Kozaryn K, Palacio-Vieira J, Parkinson K, Reynolds J, Ronda G, Segura L, Słodownik L, Spak F, van Steenkiste B, Wallace P, Wolstenholme A, Wojnar M, Gual A, Laurant M, Wensing M. Impact of primary healthcare providers' initial role security and therapeutic commitment on implementing brief interventions in managing risky alcohol consumption: a cluster randomised factorial trial. Implement Sci 2016; 11:96. [PMID: 27422283 PMCID: PMC4947288 DOI: 10.1186/s13012-016-0468-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 07/07/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Brief interventions in primary healthcare are cost-effective in reducing drinking problems but poorly implemented in routine practice. Although evidence about implementing brief interventions is growing, knowledge is limited with regard to impact of initial role security and therapeutic commitment on brief intervention implementation. METHODS In a cluster randomised factorial trial, 120 primary healthcare units (PHCUs) were randomised to eight groups: care as usual, training and support, financial reimbursement, and the opportunity to refer patients to an internet-based brief intervention (e-BI); paired combinations of these three strategies, and all three strategies combined. To explore the impact of initial role security and therapeutic commitment on implementing brief interventions, we performed multilevel linear regression analyses adapted to the factorial design. RESULTS Data from 746 providers from 120 PHCUs were included in the analyses. Baseline role security and therapeutic commitment were found not to influence implementation of brief interventions. Furthermore, there were no significant interactions between these characteristics and allocated implementation groups. CONCLUSIONS The extent to which providers changed their brief intervention delivery following experience of different implementation strategies was not determined by their initial attitudes towards alcohol problems. In future research, more attention is needed to unravel the causal relation between practitioners' attitudes, their actual behaviour and care improvement strategies to enhance implementation science. TRIAL REGISTRATION ClinicalTrials.gov: NCT01501552.
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Affiliation(s)
- M. Keurhorst
- Radboud Institute for Health Sciences, Radboud Center for Quality of Healthcare (IQ healthcare), Radboud university medical center, Nijmegen, The Netherlands
- Centre for Nursing Research, Saxion University of Applied Sciences, Deventer, Enschede The Netherlands
| | - P. Anderson
- Institute of Health and Society, Newcastle University, Newcastle, England, UK
- Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - M. Heinen
- Radboud Institute for Health Sciences, Radboud Center for Quality of Healthcare (IQ healthcare), Radboud university medical center, Nijmegen, The Netherlands
| | - Preben Bendtsen
- Department of Medical Specialist and Department of Medicine and Health Sciences, Linköping University, Motala, Sweden
| | - Begoña Baena
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - Krzysztof Brzózka
- State Agency for Prevention of Alcohol-Related Problems, Warsaw, Poland
| | - Joan Colom
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - Paolo Deluca
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Colin Drummond
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Newcastle, England, UK
| | - Karolina Kłoda
- Independent Laboratory of Family Physician Education, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Artur Mierzecki
- Independent Laboratory of Family Physician Education, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | | | | | - Jorge Palacio-Vieira
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - Kathryn Parkinson
- Institute of Health and Society, Newcastle University, Newcastle, England, UK
| | - Jillian Reynolds
- Hospital Clínic de Barcelona, Fundació Clínic per a la Recerca Biomèdica, Barcelona, Spain
| | - Gaby Ronda
- Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Lidia Segura
- Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain
| | - Luiza Słodownik
- State Agency for Prevention of Alcohol-Related Problems, Warsaw, Poland
| | - Fredrik Spak
- Department of Social Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Ben van Steenkiste
- Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Paul Wallace
- Department of Primary Care and Population Health, University College London, London, UK
| | - Amy Wolstenholme
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | | | - Antoni Gual
- Hospital Clínic de Barcelona, IDIBAPS, Barcelona, Spain
| | - M. Laurant
- Radboud Institute for Health Sciences, Radboud Center for Quality of Healthcare (IQ healthcare), Radboud university medical center, Nijmegen, The Netherlands
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - M. Wensing
- Radboud Institute for Health Sciences, Radboud Center for Quality of Healthcare (IQ healthcare), Radboud university medical center, Nijmegen, The Netherlands
- Department of General Practice and Health Services Research, University Heidelberg Hospital, Heidelberg, Germany
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31
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Cambier L, Heinen M, Antoine N, Mignon B. Développement d’un modèle de dermatophytose sur souris. J Mycol Med 2016. [DOI: 10.1016/j.mycmed.2016.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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32
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Keurhorst M, van de Glind I, Bitarello do Amaral-Sabadini M, Anderson P, Kaner E, Newbury-Birch D, Braspenning J, Wensing M, Heinen M, Laurant M. Implementation strategies to enhance management of heavy alcohol consumption in primary health care: a meta-analysis. Addiction 2015; 110:1877-900. [PMID: 26234486 DOI: 10.1111/add.13088] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 01/15/2015] [Accepted: 07/28/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Screening and brief interventions (SBI) delivered in primary health care (PHC) are cost-effective in decreasing alcohol consumption; however, they are underused. This study aims to identify implementation strategies that focus on SBI uptake and measure impact on: (1) heavy drinking and (2) delivery of SBI in PHC. METHODS Meta-analysis was conducted of controlled trials of SBI implementation strategies in PHC to reduce heavy drinking. Key outcomes included alcohol consumption, screening, brief interventions and costs in PHC. Predictor measures concerned single versus multiple strategies, type of strategy, duration and physician-only input versus that including mid-level professionals. Standardized mean differences (SMD) were calculated to indicate the impact of implementation strategies on key outcomes. Effect sizes were aggregated using meta-regression models. RESULTS The 29 included studies were of moderate methodological quality. Strategies had no overall impact on patients' reported alcohol consumption [SMD=0.07; 95% confidence interval (CI)=-0.02 to 0.16], despite improving screening (SMD=0.53; 95% CI=0.28-0.78) and brief intervention delivery (SMD=0.64;95% CI=0.27-1.02). Multi-faceted strategies, i.e. professional and/or organizational and/or patient-orientated strategies, seemed to have strongest effects on patients' alcohol consumption (P<0.05, compared with professional-orientated strategies alone). Regarding SBI delivery, combining professional with patient-orientated implementation strategies had the highest impact (P<0.05). Involving other staff besides physicians was beneficial for screening (P<0.05). CONCLUSIONS To increase delivery of alcohol screening and brief interventions and decrease patients' alcohol consumption, implementation strategies should include a combination of patient-, professional- and organizational-orientated approaches and involve mid-level health professionals as well as physicians.
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Affiliation(s)
- Myrna Keurhorst
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands.,Saxion University of Applied Sciences, Centre for Nursing Research, Deventer/Enschede, Sao Paulo, the Netherlands
| | - Irene van de Glind
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | | | - Peter Anderson
- Newcastle University, Institute of Health and Society, Newcastle, UK.,Maastricht University, School Caphri, Department of Family Medicine, Maastricht, the Netherlands
| | - Eileen Kaner
- Newcastle University, Institute of Health and Society, Newcastle, UK
| | | | - Jozé Braspenning
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | - Michel Wensing
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | - Maud Heinen
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | - Miranda Laurant
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands.,HAN University of Applied Sciences, Faculty of Health and Social Studies, Nijmegen, the Netherlands
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33
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Van Hecke A, Heinen M, Fernandez-Ortega P, Graue M, Hendriks J, Høy B, Köpke S, Lithner M, van Gaal B. Access to effective healthcare: effective self-management support intervention for patients with a chronic condition and a low social economic status: a systematic review. BMC Nurs 2015. [PMCID: PMC4610065 DOI: 10.1186/1472-6955-14-s1-s7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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van de Glind I, Heinen M, Geense W, Mesters I, Wensing M, van Achterberg T. Making the connection-factors influencing implementation of evidence supported and non-evaluated lifestyle interventions in healthcare: a multiple case study. Health Educ Res 2015; 30:521-541. [PMID: 26025211 DOI: 10.1093/her/cyv020] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 04/28/2015] [Indexed: 06/04/2023]
Abstract
Many implementation barriers relate to lifestyle interventions (LIs) being developed by scientists. Exploring whether implementation of non-evaluated LIs is less complicated, might offer insight how to improve the use of effective interventions. This study aimed to identify influencing factors for implementation and compare factors between evidence supported and non-evaluated LIs. Evidence-supported (n = 7) and non-evaluated LIs (n = 7) in hospitals, general practices and community care organizations were included as cases. Semi-structured interviews (n = 46) were conducted. Additionally, documents (n = 207) were collected describing intervention, implementation process, and policy. We used a stepwise approach to inductively identify factors, organize them by diffusion phase, and an existing framework. A total of 37 factors were identified. 'Dissemination' factors were mainly observed in evidence-supported LIs. 'Compatibility to existing structures' ('adoption'), 'funding' and 'connection to existing care processes' ('implementation') was factors identified in all cases. 'Quality control' and 'ongoing innovation' ('maintenance') were reported in evidence-supported interventions. In all domains of the framework factors were observed. Factors identified in this study are in line with the literature. The findings do not support the assumption that implementation of non-evaluated LIs is perceived as less complex.
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Affiliation(s)
- Irene van de Glind
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maud Heinen
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wytske Geense
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ilse Mesters
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michel Wensing
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Theo van Achterberg
- Radboud Institute for Health Sciences, Department of IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
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McKey S, Heinen M, Segurado R, Mehegan J, Murrin C, Kelleher C. Infant birth weight and risk factors for adult cardiovascular disease including body mass index in the lifeways cross-generation cohort study of a thousand families. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.179] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Makai P, Perry M, Robben SHM, Schers H, Heinen M, Olde Rikkert MGM, Melis RJF. Which frail older patients use online health communities and why? A mixed methods process evaluation of use of the Health and Welfare portal. J Med Internet Res 2014; 16:e278. [PMID: 25519769 PMCID: PMC4275472 DOI: 10.2196/jmir.3609] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/04/2014] [Accepted: 10/20/2014] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Frail older people often receive fragmented care from multiple providers. According to the literature, there is an urgent need for coordination of care. Online and eHealth tools are increasingly used to improve coordination. However, there are significant barriers to their implementation in frail older people. OBJECTIVE Our aim was to (1) evaluate differences in use of a personal online health community (POHC) for frail older people in relation to personal characteristics, and (2) explore barriers and facilitators for use as experienced by older people and their informal caregivers, using the case of the Health and Welfare Information Portal (ZWIP). METHODS This is a mixed methods study. For the quantitative analysis, we used POHC usage information (2 years follow-up) and baseline characteristics of frail older people. For the qualitative analysis, we used semistructured interviews with older people and their informal caregivers. Participants were recruited from 11 family practices in the east of the Netherlands and frail older people over 70 years. The ZWIP intervention is a personal online health community for frail older people, their informal caregivers, and their providers. ZWIP was developed at the Geriatrics Department of Radboud University Medical Center. We collected data on POHC use for 2 years as well as relevant patient characteristics. Interview topics were description of use, reasons for use and non-use, and user profiles. RESULTS Of 622 frail patients in the intervention group, 290 were connected to ZWIP; 79 used ZWIP regularly (at least monthly). Main predictors for use were having an informal caregiver, having problems with activities of daily living, and having a large number of providers. Family practice level predictors were being located in a village, and whether the family practitioners had previously used electronic consultation and cared for a large percentage of frail older people. From 23 interviews, main reasons for use were perceiving ZWIP to be a good, quick, and easy way of communicating with providers and the presence of active health problems. Important reasons for non-use were lack of computer skills and preferring traditional means of consultation. CONCLUSIONS Only 27.2% (79/290) of frail older enrolled in the POHC intervention used the POHC frequently. For implementation of personal online health communities, older people with active health problems and a sizable number of health care providers should be targeted, and the informal caregiver, if present, should be involved in the implementation process. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 11165483; http://www.controlled-trials.com/isrctn/pf/11165483 (Archived by WebCite at http://www.webcitation.org/6U3fZovoU).
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Affiliation(s)
- Peter Makai
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Netherlands.
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Keurhorst M, van Beurden I, Anderson P, Heinen M, Akkermans R, Wensing M, Laurant M. GPs' role security and therapeutic commitment in managing alcohol problems: a randomised controlled trial of a tailored improvement programme. BMC Fam Pract 2014; 15:70. [PMID: 24742032 PMCID: PMC4021502 DOI: 10.1186/1471-2296-15-70] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/09/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND General practitioners with more positive role security and therapeutic commitment towards patients with hazardous or harmful alcohol consumption are more involved and manage more alcohol-related problems than others. In this study we evaluated the effects of our tailored multi-faceted improvement implementation programme on GPs' role security and therapeutic commitment and, in addition, which professional related factors influenced the impact of the implementation programme. METHODS In a cluster randomised controlled trial, 124 GPs from 82 Dutch general practices were randomised to either the intervention or control group. The tailored, multi-faceted programme included combined physician, organisation, and patient directed alcohol-specific implementation strategies to increase role security and therapeutic commitment in GPs. The control group was mailed the national guideline and patients received feedback letters. Questionnaires were completed before and 12 months after start of the programme. We performed linear multilevel regression analysis to evaluate effects of the implementation programme. RESULTS Participating GPs were predominantly male (63%) and had received very low levels of alcohol related education before start of the study (0.4 h). The programme increased therapeutic commitment (p = 0.005; 95%-CI 0.13 - 0.73) but not role security (p = 0.58; 95%-CI -0.31 - 0.54). How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs' reported proportion of patients asked about alcohol consumption at baseline, contributed to the effect of the programme on therapeutic commitment. CONCLUSIONS A tailored, multi-faceted programme aimed at improving GP management of patients with hazardous and harmful alcohol consumption improved GPs' therapeutic commitment towards patients with alcohol-related problems, but failed to improve GPs' role security. How important GPs thought it was to improve their care for problematic alcohol consumption, and the GPs' reported proportion of patients asked about alcohol consumption at baseline, both increased the impact of the programme on therapeutic commitment. It might be worthwhile to monitor proceeding of role security and therapeutic commitment throughout the year after the implementation programme, to see whether the programme is effective on short term but faded out on the longer term. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00298220.
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Affiliation(s)
- Myrna Keurhorst
- Radboud university medical center, Scientific Institute for Quality of Healthcare (IQ healthcare), P,O, Box 9101, 114 IQ healthcare, 6500 HB Nijmegen, The Netherlands.
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Heinen M, Palberg T, Löwen H. Coupling between bulk- and surface chemistry in suspensions of charged colloids. J Chem Phys 2014; 140:124904. [DOI: 10.1063/1.4869338] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ausserhofer D, Zander B, Busse R, Schubert M, De Geest S, Rafferty AM, Ball J, Scott A, Kinnunen J, Heinen M, Sjetne IS, Moreno-Casbas T, Kózka M, Lindqvist R, Diomidous M, Bruyneel L, Sermeus W, Aiken LH, Schwendimann R. Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study. BMJ Qual Saf 2013; 23:126-35. [PMID: 24214796 DOI: 10.1136/bmjqs-2013-002318] [Citation(s) in RCA: 357] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Little is known of the extent to which nursing-care tasks are left undone as an international phenomenon. AIM The aim of this study is to describe the prevalence and patterns of nursing care left undone across European hospitals and explore its associations with nurse-related organisational factors. METHODS Data were collected from 33 659 nurses in 488 hospitals across 12 European countries for a large multicountry cross-sectional study. RESULTS Across European hospitals, the most frequent nursing care activities left undone included 'Comfort/talk with patients' (53%), 'Developing or updating nursing care plans/care pathways' (42%) and 'Educating patients and families' (41%). In hospitals with more favourable work environments (B=-2.19; p<0.0001), lower patient to nurse ratios (B=0.09; p<0.0001), and lower proportions of nurses carrying out non-nursing tasks frequently (B=2.18; p<0.0001), fewer nurses reported leaving nursing care undone. CONCLUSIONS Nursing care left undone was prevalent across all European countries and was associated with nurse-related organisational factors. We discovered similar patterns of nursing care left undone across a cross-section of European hospitals, suggesting that nurses develop informal task hierarchies to facilitate important patient-care decisions. Further research on the impact of nursing care left undone for patient outcomes and nurse well-being is required.
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Schnaidt J, Heinen M, Jusys Z, Behm R. Oxidation of 1-propanol on a Pt film electrode studied by combined electrochemical, in situ IR spectroscopy and online mass spectrometry measurements. Electrochim Acta 2013. [DOI: 10.1016/j.electacta.2012.12.139] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Schnaidt J, Heinen M, Jusys Z, Behm R. Mechanistic aspects of the electro-oxidation of ethylene glycol on a Pt-film electrode: A combined in situ IR spectroscopy and online mass spectrometry study of kinetic isotope effects. Catal Today 2013. [DOI: 10.1016/j.cattod.2012.05.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Robben S, van Kempen J, Heinen M, Zuidema S, Olde Rikkert M, Schers H, Melis R. Preferences for receiving information among frail older adults and their informal caregivers: a qualitative study. Fam Pract 2012; 29:742-7. [PMID: 22532402 DOI: 10.1093/fampra/cms033] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient involvement in clinical decision making is increasingly advocated. Although older patients may be more reluctant to become involved, most do appreciate being informed. However, knowledge about their experiences with and preferences for receiving information is limited, and even less is known about these topics for frail older people. OBJECTIVE To explore the experiences of frail older people and informal caregivers with receiving information from health care professionals as well as their preferences for receiving information. METHODS We conducted semi-structured interviews with frail older people (n = 11, 65-90 years) and informal caregivers (n = 11, 55-87 years). Interviews were transcribed verbatim and analysed using a grounded theory approach. RESULTS Frail older people and informal caregivers varied in their information needs and discussed both positive and negative experiences with receiving information. They preferred receiving verbal information from their physician during the consultation; yet would appreciate receiving brief, clearly written information leaflets in addition. They employed several strategies to enhance the information provided, i.e. advocacy, preparing for a consultation and searching their own information. Contextual factors for receiving information, such as having enough time and having a good relationship with professionals involved, were considered of great importance. CONCLUSIONS Participants described a wide range of experiences with and preferences for receiving information. However, even if the information provided would meet all their preferences, this would be of limited significance if not provided within the context of an ongoing trusting relationship with a professional, such as a GP or practice nurse, who genuinely cared for them.
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Affiliation(s)
- Sarah Robben
- Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Holmqvist P, Mohanty PS, Nägele G, Schurtenberger P, Heinen M. Structure and dynamics of loosely cross-linked ionic microgel dispersions in the fluid regime. Phys Rev Lett 2012; 109:048302. [PMID: 23006114 DOI: 10.1103/physrevlett.109.048302] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Indexed: 06/01/2023]
Abstract
We report a comprehensive experimental-theoretical study of the temperature- and concentration-dependent swelling behavior of weakly cross-linked PNiPAm ionic microgel particles in the deionized fluid phase. The particles swell reversibly when the dispersion is cooled from the collapsed state to lower temperatures. While the collapsed state shows no dependence on the microgel number density, the swelling at lower T is more pronounced at lower concentrations. The static pair correlations and short-time diffusion functions, and the concentration and temperature dependence of the microgel radius and effective charge, are studied using static and dynamic light scattering in combination with state-of-the-art analytical theoretical schemes based on a Yukawa-type effective pair potential and a core-shell model. We show that only such a combined, simultaneous fit of static and dynamic scattering functions allows for an unambiguous determination of the microgel radius and effective charge.
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Affiliation(s)
- P Holmqvist
- Institute of Complex Systems (ICS-3), Forschungszentrum Jülich, Jülich D-52425, Germany.
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Aiken LH, Sermeus W, Van den Heede K, Sloane DM, Busse R, McKee M, Bruyneel L, Rafferty AM, Griffiths P, Moreno-Casbas MT, Tishelman C, Scott A, Brzostek T, Kinnunen J, Schwendimann R, Heinen M, Zikos D, Sjetne IS, Smith HL, Kutney-Lee A. Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ 2012; 344:e1717. [PMID: 22434089 PMCID: PMC3308724 DOI: 10.1136/bmj.e1717] [Citation(s) in RCA: 1019] [Impact Index Per Article: 84.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries. DESIGN Cross sectional surveys of patients and nurses. SETTING Nurses were surveyed in general acute care hospitals (488 in 12 European countries; 617 in the United States); patients were surveyed in 210 European hospitals and 430 US hospitals. PARTICIPANTS 33 659 nurses and 11 318 patients in Europe; 27 509 nurses and more than 120 000 patients in the US. MAIN OUTCOME MEASURES Nurse outcomes (hospital staffing, work environments, burnout, dissatisfaction, intention to leave job in the next year, patient safety, quality of care), patient outcomes (satisfaction overall and with nursing care, willingness to recommend hospitals). RESULTS The percentage of nurses reporting poor or fair quality of patient care varied substantially by country (from 11% (Ireland) to 47% (Greece)), as did rates for nurses who gave their hospital a poor or failing safety grade (4% (Switzerland) to 18% (Poland)). We found high rates of nurse burnout (10% (Netherlands) to 78% (Greece)), job dissatisfaction (11% (Netherlands) to 56% (Greece)), and intention to leave (14% (US) to 49% (Finland, Greece)). Patients' high ratings of their hospitals also varied considerably (35% (Spain) to 61% (Finland, Ireland)), as did rates of patients willing to recommend their hospital (53% (Greece) to 78% (Switzerland)). Improved work environments and reduced ratios of patients to nurses were associated with increased care quality and patient satisfaction. In European hospitals, after adjusting for hospital and nurse characteristics, nurses with better work environments were half as likely to report poor or fair care quality (adjusted odds ratio 0.56, 95% confidence interval 0.51 to 0.61) and give their hospitals poor or failing grades on patient safety (0.50, 0.44 to 0.56). Each additional patient per nurse increased the odds of nurses reporting poor or fair quality care (1.11, 1.07 to 1.15) and poor or failing safety grades (1.10, 1.05 to 1.16). Patients in hospitals with better work environments were more likely to rate their hospital highly (1.16, 1.03 to 1.32) and recommend their hospitals (1.20, 1.05 to 1.37), whereas those with higher ratios of patients to nurses were less likely to rate them highly (0.94, 0.91 to 0.97) or recommend them (0.95, 0.91 to 0.98). Results were similar in the US. Nurses and patients agreed on which hospitals provided good care and could be recommended. CONCLUSIONS Deficits in hospital care quality were common in all countries. Improvement of hospital work environments might be a relatively low cost strategy to improve safety and quality in hospital care and to increase patient satisfaction.
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Affiliation(s)
- Linda H Aiken
- Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA.
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Heinen M, Borm G, van der Vleuten C, Evers A, Oostendorp R, van Achterberg T. The Lively Legs self-management programme increased physical activity and reduced wound days in leg ulcer patients: Results from a randomized controlled trial. Int J Nurs Stud 2012; 49:151-61. [DOI: 10.1016/j.ijnurstu.2011.09.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 08/31/2011] [Accepted: 09/07/2011] [Indexed: 10/17/2022]
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Robben S, Perry M, van Nieuwenhuijzen L, van Achterberg T, Rikkert MO, Schers H, Heinen M, Melis R. Impact of interprofessional education on collaboration attitudes, skills, and behavior among primary care professionals. J Contin Educ Health Prof 2012; 32:196-204. [PMID: 23008082 DOI: 10.1002/chp.21145] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
INTRODUCTION Care for the frail elderly is often provided by several professionals. Collaboration between them is essential, but remains difficult to achieve. Interprofessional education (IPE) can improve this collaboration. We developed a 9-hour IPE program for primary care professionals from 7 disciplines caring for the frail elderly, and aimed to establish whether the program improved professionals' interprofessional attitudes and attitudes toward collaboration, collaboration skills, and collaborative behavior. We also evaluated learners' reactions to the program. METHODS Before-after study, using the Interprofessional Attitudes Questionnaire (IAQ, score:1 to 7); Attitudes Toward Health Care Teams Scale (ATHCTS, score: 0 to 105); and Team Skills Scale (TSS, score:17 to 85). Additionally, semistructured interviews were conducted with 10 selected participants. RESULTS Participants' (N = 80) overall interprofessional attitudes improved (IAQ baseline: 5.49; follow-up: 5.67, p = 0.001); attitudes toward geriatric teams did not change (ATHCTS baseline: 69.9; follow-up: 69.1, p = 0.32). Participants' self-reported team skills improved (TSS baseline: 45.7; follow-up: 48.1, p = 0.001). In the interviews, many interviewees reported increased collaboration with professionals of other disciplines due to the program. Interviewees considered the program's interprofessional nature and attending the program with local professionals important contributing factors to the experienced improvements in collaboration. However, they also noted that not all parts of the program had met the needs of all participating disciplines, due to differences in professional background and knowledge. DISCUSSION A brief IPE program can improve interprofessional attitudes, collaboration skills, and collaborative behavior. That such a program allows professionals to get acquainted with each other and each other's viewpoints appears to be as important as the educational content.
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Affiliation(s)
- Sarah Robben
- Department of Geriatric Medicine, Radboud University Nijmegen Medical Centre.
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Van Hecke A, Goeman C, Beeckman D, Heinen M, Defloor T. Development and psychometric evaluation of an instrument to assess venous leg ulcer lifestyle knowledge among nurses. J Adv Nurs 2011; 67:2574-85. [DOI: 10.1111/j.1365-2648.2011.05683.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Heinen M, Kull HJ. Radiation boundary conditions for the numerical solution of the three-dimensional time-dependent Schrödinger equation with a localized interaction. Phys Rev E Stat Nonlin Soft Matter Phys 2009; 79:056709. [PMID: 19518595 DOI: 10.1103/physreve.79.056709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Indexed: 05/27/2023]
Abstract
Exact radiation boundary conditions on the surface of a sphere are presented for the single-particle time-dependent Schrödinger equation with a localized interaction. With these boundary conditions, numerical computations of spatially unbounded outgoing wave solutions can be restricted to the finite volume of a sphere. The boundary conditions are expressed in terms of the free-particle Green's function for the outside region. The Green's function is analytically calculated by an expansion in spherical harmonics and by the method of Laplace transformation. For each harmonic number a discrete boundary condition between the function values at adjacent radial grid points is obtained. The numerical method is applied to quantum tunneling through a spherically symmetric potential barrier with different angular-momentum quantum numbers l . Calculations for l=0 are compared to exact theoretical results.
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Affiliation(s)
- M Heinen
- Soft Condensed Matter, Research Centre Jülich, Institute of Solid State Research, 52425 Jülich, Germany.
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Bachmann A, Heinen M. Steigende Anforderungen an Zahnradpumpen – erfolgreiche Lösungen für die Praxis. CHEM-ING-TECH 2008. [DOI: 10.1002/cite.200800015] [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: 11/10/2022]
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Heinen M, Chen Y, Jusys Z, Behm R. CO adsorption kinetics and adlayer build-up studied by combined ATR-FTIR spectroscopy and on-line DEMS under continuous flow conditions. Electrochim Acta 2007. [DOI: 10.1016/j.electacta.2007.05.020] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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