1
|
Bakker NF, van Weely SFE, Hutting N, Heerkens YF, Engels JA, Staal JB, van der Leeden M, Boonen A, Vliet Vlieland TPM, Knoop J. Development of a Multimodal, Physiotherapist-Led, Vocational Intervention for People with Inflammatory Arthritis and Reduced Work Ability: A Mixed-Methods Design Study. J Occup Rehabil 2024:10.1007/s10926-023-10170-y. [PMID: 38316721 DOI: 10.1007/s10926-023-10170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE Work ability of people with rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) is reduced, but underexamined as a clinical treatment target. The evidence on vocational interventions indicates that delivery by a single healthcare professional (HCP) may be beneficial. Physiotherapist (PT)-led interventions have potential because PTs are most commonly consulted by RA/axSpA patients in the Netherlands. The aim was to develop a PT-led, vocational intervention for people with RA/axSpA and reduced work ability. METHODS Mixed-methods design based on the Medical Research Council (MRC) framework for developing and evaluating complex interventions, combining a rapid literature review and six group meetings with: patient representatives (n = 6 and 10), PTs (n = 12), (occupational) HCPs (n = 9), researchers (n = 6) and a feasibility test in patients (n = 4) and PTs (n = 4). RESULTS An intervention was developed and evaluated. Patient representatives emphasized the importance of PTs' expertise in rheumatic diseases and work ability. The potential for PTs to support patients was confirmed by PTs and HCPs. The feasibility test confirmed adequate feasibility and underlined necessity of training PTs in delivery. The final intervention comprised work-focussed modalities integrated into conventional PT treatment (10-21 sessions over 12 months), including a personalized work-roadmap to guide patients to other professionals, exercise therapy, patient education and optional modalities. CONCLUSION A mixed-methods design with stakeholder involvement produced a PT-led, vocational intervention for people with RA/axSpA and reduced work ability, tested for feasibility and ready for effectiveness evaluation.
Collapse
Affiliation(s)
- N F Bakker
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
| | - S F E van Weely
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - N Hutting
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Y F Heerkens
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - J A Engels
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - J B Staal
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M van der Leeden
- Reade, Rehabilitation and Rheumatology, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - A Boonen
- Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - T P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - J Knoop
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
| |
Collapse
|
2
|
Bakker NF, van Weely SFE, Hutting N, Heerkens YF, Engels JA, Staal JB, van der Leeden M, Boonen A, van den Hout WB, Vliet Vlieland TPM, Knoop J. Effectiveness and cost-effectiveness of a multimodal, physiotherapist-led, vocational intervention in people with inflammatory arthritis: study protocol of the Physiotherapy WORKs trial. BMC Rheumatol 2023; 7:31. [PMID: 37730637 PMCID: PMC10510245 DOI: 10.1186/s41927-023-00357-4] [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: 06/13/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Although reduced work ability is a substantial problem among people with inflammatory arthritis (IA), work ability is an underexposed area in clinical practice. Evidence on vocational interventions in IA is limited, but favourable results of delivery by a physiotherapist (PT) warrant the need for further research. Therefore, we aim to evaluate the (cost-)effectiveness of a multimodal, PT-led, vocational intervention in (self-)employed people with IA compared to usual care. METHODS This randomized controlled trial will include 140 people with rheumatoid arthritis (RA) or axial spondyloarthritis (axSpA) who are (self-)employed and have reduced work ability (Work Ability Index - Single Item Scale (WAS) ≤ 7/10) and/or RA/axSpA related sick leave (≤ 6 months). Participants will be randomized 1:1 to the intervention or control condition (usual care). The intervention, delivered by primary care PTs, will be personalized to each patient, consisting of 10 to 21 sessions over 12 months. The intervention will be multimodal, comprising of 1) exercise therapy and a physical activity plan, 2) education/self-management support, 3) work-roadmap to guide participants in finding relevant other care, with optionally 4) online self-management course and 5) workplace examination. Assessments will be performed at baseline and after 3, 6, and 12 months. The primary outcome measure of effectiveness is work ability, as measured with the WAS at 12 months. For the cost-effectiveness analysis, the EuroQol (EQ-5D-5L), self-reported healthcare use, sick leave and productivity while at work will be used to estimate the trial based cost-utility from a societal perspective. A process evaluation, including assessments of adherence and treatment fidelity, will be undertaken using the registrations of the PTs and semi-structured interviews at 12 months follow-up in a random sample of the intervention group. DISCUSSION The results of this study will provide insights in the (cost-)effectiveness of a multimodal, PT-led, vocational intervention in people with IA and a reduced work ability. TRIAL REGISTRATION This study is registered in the International Clinical Trial Registry Platform (ICTRP) under number NL9343.
Collapse
Affiliation(s)
- N F Bakker
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O.Box 9600, 2300 RC, Leiden, the Netherlands.
| | - S F E van Weely
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O.Box 9600, 2300 RC, Leiden, the Netherlands
| | - N Hutting
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Y F Heerkens
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - J A Engels
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - J B Staal
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Nijmegen, the Netherlands
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - M van der Leeden
- Reade, Rehabilitation and Rheumatology, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - A Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, the Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - W B van den Hout
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - T P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O.Box 9600, 2300 RC, Leiden, the Netherlands
| | - J Knoop
- Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Nijmegen, the Netherlands
| |
Collapse
|
3
|
Rolak M, Heerkens YF, van Bakel HJA, van der Klink JJL. Factors contributing to realizing valuable goals of students with dyslexia in higher education. Dyslexia 2023; 29:199-216. [PMID: 37434370 DOI: 10.1002/dys.1746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/27/2023] [Accepted: 06/06/2023] [Indexed: 07/13/2023]
Abstract
When students with dyslexia enter higher education, studying often creates challenges at different levels. Universities differ in the way they facilitate students with dyslexia in their educational careers. This study focusses on studying with dyslexia from a value-driven perspective. The aim of the study is to investigate valuable goals of students with dyslexia in higher education and the conversion factors that are stimulating and inhibiting in the realization of these valuable goals. Data were collected during focus groups: five focus groups of students with dyslexia (23 participants) and two focus groups of student counsellors (10 participants). Important values for students are their personal development and to prove they can succeed at university level. Not all students are able or being enabled to show their knowledge and skills and to grow within the educational system. Different personal and environmental factors are described that inhibit or facilitate the realization of valuable goals. The results are presented from two perspectives: of students and student counsellors. The implications of the results and guidelines for future research are discussed.
Collapse
Affiliation(s)
- Marzenka Rolak
- Dyslexie Scholing en Advies, Berkel en Rodenrijs, The Netherlands
- HAN University of Applied Sciences, Nijmegen, The Netherlands
| | | | - Hedwig J A van Bakel
- Tranzo, Scientific Centre for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Jac J L van der Klink
- Tranzo, Scientific Centre for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Optentia, North West University of South Africa, Vanderbijlpark, South Africa
| |
Collapse
|
4
|
Oswald W, Ummels I, Raaijmakers T, Baart P, Staal JB, Bieleman HJ, Nijhuis-van der Sanden MWG, Heerkens YF, Hutting N. Therapists' experiences and needs with regard to providing work-focused care: a focus group study. BMC Musculoskelet Disord 2021; 22:923. [PMID: 34727896 PMCID: PMC8565033 DOI: 10.1186/s12891-021-04806-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSDs) can create a temporary or permanent disability that reduce a person's ability to work. Physiotherapists (PTs), occupational therapists (OTs) and exercise therapists (ETs) are often involved in the early management of MSDs. There is a need for additional insights into therapists' experiences, barriers and needs to work-focused care. Moreover, there is no evidence on how OTs and ETs address work participation. Therefore, the aim of this qualitative study was 1) to investigate how generalist PTs, OTs and ETs provide work-focused healthcare and 2) to obtain insight into their perceived barriers and needs that affect their ability to address occupational factors. METHODS An exploratory qualitative study using three focus groups. Generalist PTs, OTs and ETs were eligible to participate if they treated working patients with MSDs. A semi-structured interview guide with open-ended questions was developed. Two moderators facilitated each focus group using the interview guide, and all the groups were audio recorded. Data were analysed using inductive thematic analysis. RESULTS Sixteen therapists (mean age 44 years, range 25-59) participated in this study. Participants were aware of the importance of taking occupational factors into account. Whether they address occupational factors is largely dependent on the patient's request for help. However, ETs and OTs consider it normal to ask about occupational factors during the diagnostic process, while PTs often address this in later consultations. Almost all participants were unaware of the existence of PTs, OTs or ETs who are specialised in occupational health. Moreover, almost all participants struggled with when to refer a patient to other (occupational) healthcare professionals. This study identified several needs of therapists. These included knowledge about laws and legislation and skills for identifying and addressing work-related or work-relevant complaints. CONCLUSIONS Participants in this qualitative study were aware of the importance of taking occupational factors into account. However, how PTs, OTs and ETs address work participation and the extent to which they do so can be improved. There was a lack of knowledge about and cooperation with occupational health professionals, including PTs, OTs or ETs specialised in occupational health.
Collapse
Affiliation(s)
- Wiebke Oswald
- School of Organisation and Development, HAN University of Applied Sciences, Research Group Occupation & Health, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands
- School for Allied Health, HAN University of Applied Sciences, Physical Therapy, Nijmegen, The Netherlands
| | - Inez Ummels
- School of Organisation and Development, HAN University of Applied Sciences, Research Group Occupation & Health, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands
| | | | - Paul Baart
- Centre Work Health, Amersfoort, The Netherlands
| | - J Bart Staal
- School for Allied Health, HAN University of Applied Sciences, Key Factors in Physiotherapy and Allied Health Research Group, Nijmegen, the Netherlands
- Radboud Institute for Health Sciences, Radboud University Medical Centre, IQ Healthcare, Nijmegen, the Netherlands
| | - Hendrik J Bieleman
- Saxion University of Applied Sciences, Research Group Health and Physical Activity, Enschede, The Netherlands
| | | | - Yvonne F Heerkens
- School of Organisation and Development, HAN University of Applied Sciences, Research Group Occupation & Health, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands
| | - Nathan Hutting
- School of Organisation and Development, HAN University of Applied Sciences, Research Group Occupation & Health, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands.
| |
Collapse
|
5
|
Sengers JH, Abma FI, Wilming L, Roelofs PDDM, Heerkens YF, Brouwer S. Content Validation of a Practice-Based Work Capacity Assessment Instrument Using ICF Core Sets. J Occup Rehabil 2021; 31:293-315. [PMID: 32803465 PMCID: PMC8172508 DOI: 10.1007/s10926-020-09918-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE A shift from providing long-term disability benefits to promoting work reintegration of people with remaining work capacity in many countries requires new instruments for work capacity assessments. Recently, a practice-based instrument addressing biopsychosocial aspects of functioning, the Social Medical Work Capacity instrument (SMWC), was developed. Our aim was to examine the content validity of the SMWC using ICF core sets. METHODS First, we conducted a systematic search to identify relevant ICF core sets for the working age population. Second the content of these core sets were mapped to assess the relevance and comprehensiveness of the SMWC. Next, we compared the content of the SMWC with the ICF-core sets. RESULTS Two work-related core sets and 31 disease-specific core sets were identified. The SMWC and the two work-related core sets overlap on 47 categories. Compared to the work-related core sets, the Body Functions and Activities and Participation are well represented in the new instrument, while the component Environmental factors is under-represented. Compared to the disease-specific core sets, items related to the social and domestic environmental factors are under-represented, while the SMWC included work-related factors complementary to the ICF. CONCLUSION The SMWC content seems relevant, but could be more comprehensive for the purpose of individual work capacity assessments. To improve assessing relevant biopsychosocial aspects, it is recommended to extend the instrument by adding personal and environmental (work- and social-related) factors as well as a more tailored use of the SMWC for assessing work capacity of persons with specific diseases or underlying illness.
Collapse
Affiliation(s)
- Johan H Sengers
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Dutch Social Security Institute: Institute for Employee Benefits Schemes (UWV), Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands
| | - Femke I Abma
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands.
| | - Loes Wilming
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands
| | - Pepijn D D M Roelofs
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands
| | - Yvonne F Heerkens
- HAN University of Applied Sciences, Nijmegen, The Netherlands
- Dutch Institute of Allied Health Care, Amersfoort, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands
| |
Collapse
|
6
|
Westerweel A, Heerkens YF, Oswald W, Post Sennehed C, Stigmar K, van Hees S, Lankveld WV, Hutting N. Translation, adaptation, validity and reliability of the Dutch version of the ‘blue flags’ questionnaire. European Journal of Physiotherapy 2021. [DOI: 10.1080/21679169.2021.1891283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Anne Westerweel
- Faculty of Medical Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Yvonne F. Heerkens
- School of Organisation and Development, Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Wiebke Oswald
- School for Allied Health, Physical Therapy, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Charlotte Post Sennehed
- Department of Clinical Sciences Lund, Orthopedics, Faculty of Medicine, Lund University, Lund, Sweden
| | - Kjerstin Stigmar
- Department of Health Sciences, Physiotherapy, Lund University, Lund, Sweden
| | - Suzanne van Hees
- School of Organisation and Development, Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Wim van Lankveld
- School for Allied Health, Musculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Nathan Hutting
- School of Organisation and Development, Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| |
Collapse
|
7
|
Hutting N, Boucaut R, Gross DP, Heerkens YF, Johnston V, Skamagki G, Stigmar K. Work-Focused Health Care: The Role of Physical Therapists. Phys Ther 2020; 100:2231-2236. [PMID: 32929495 DOI: 10.1093/ptj/pzaa166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/23/2020] [Accepted: 08/21/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Nathan Hutting
- School of Organisation and Development, Research Group Occupation and Health, HAN University of Applied Sciences, PO Box 6960, 6503 GL Nijmegen, the Netherlands
| | - Rose Boucaut
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Yvonne F Heerkens
- School of Organisation and Development, Research Group Occupation and Health, HAN University of Applied Sciences
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Glykeria Skamagki
- School of Health, Physiotherapy, Coventry University, Coventry, United Kingdom
| | | |
Collapse
|
8
|
Hutting N, Oswald W, Nijhuis-van der Sanden MWG, Filart M, Raaijmakers T, Bieleman HJ, Staal JB, Heerkens YF. The effects of integrating work-related factors and improving cooperation in musculoskeletal physical therapy practice: protocol for the 'WORK TO BE DONE' cluster randomised controlled trial. BMC Musculoskelet Disord 2020; 21:360. [PMID: 32513153 PMCID: PMC7281957 DOI: 10.1186/s12891-020-03375-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSDs) are the primary cause of disability worldwide and a major societal burden. Recent qualitative research found that although a patient's work is considered important, physical therapists take work participation insufficiently into account as a determining factor in the treatment of patients with MSDs. Therefore, the aim of this study is to improve the effectiveness of physical therapy (in primary healthcare) with respect to the work participation of employees with MSDs by increasing the knowledge and skills of generalist physical therapists and by improving the collaboration between generalist physical therapists and physical therapists specialised in occupational health. METHODS/DESIGN This trial is a two-arm non-blinded cluster randomised controlled trial. Working patients with MSDs visiting a physical therapy practice are the target group. The control group will receive normal physical therapy treatment. The intervention group will receive treatment from a physical therapist with more knowledge about work-related factors and skills in terms of integrating work participation into the patients' care. Data are gathered at baseline (T0), at four months (T1) and eight months (T2) follow-up. Most outcomes will be assessed with validated patient-reported questionnaires. Primary outcomes are the limitations in specific work-related activities and pain during work. Secondary outcomes include limitations in general work-related activities, general pain, quality of life, presenteeism, sick leave (absenteeism), estimated risk for future work disability, work-related psychosocial risk factors, job performance, and work ability. Based on a sample size calculation we need to include 221 patients in each arm (442 in total). During data analysis, each outcome variable will be analysed independently at T1 and at T2 as a dependent variable using the study group as an independent variable. In addition to the quantitative evaluation, a process evaluation will be performed by interviewing physical therapists as well as patients. DISCUSSION The trial is expected to result in a more effective physical therapy process for working patients with MSDs. This will lead to a substantial reduction of costs: lower costs thanks to a more effective physical therapy process and lower costs due to less or shorter sick leave and decreased presenteeism. TRIAL REGISTRATION Netherlands Trial Register, registration number: NL8518, date of registration 9 April 2020, URL registration: https://www.trialregister.nl/trial/8518.
Collapse
Affiliation(s)
- Nathan Hutting
- School of Organisation and Development, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands.
| | - Wiebke Oswald
- School of Organisation and Development, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands
- School of Allied Health, Physical Therapy, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | | | - Monique Filart
- School of Health, Physical Therapy, Saxion University of Applied Sciences, Enschede, The Netherlands
- Saxion University of Applied Sciences, Research Group Health and Physical Activity, Enschede, The Netherlands
| | | | - Hendrik J Bieleman
- Saxion University of Applied Sciences, Research Group Health and Physical Activity, Enschede, The Netherlands
| | - J Bart Staal
- Radboud Institute for Health Sciences, IQ healthcare, Radboud university medical centre, Nijmegen, The Netherlands
- School of Allied Health, Musculoskeletal Research Group, HAN University of Applied Sciences, Key factors in Physiotherapy and Allied Health Research Group, Nijmegen, The Netherlands
| | - Yvonne F Heerkens
- School of Organisation and Development, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands
| |
Collapse
|
9
|
van Dijk MJH, Smorenburg NTA, Heerkens YF, Mollema J, Kiers H, Nijhuis-van der Sanden MWG, Visser B. Assessment instruments of movement quality in patients with non-specific low back pain: A systematic review and selection of instruments. Gait Posture 2020; 76:346-357. [PMID: 31901525 DOI: 10.1016/j.gaitpost.2019.12.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/29/2019] [Accepted: 12/21/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Observing and analyzing movement quality (MQ) in patients with non-specific low back pain (NS-LBP) is important in the clinical reasoning of primary care physiotherapists and exercise therapists. However, there is no standardized form of assessment. RESEARCH QUESTION which MQ domains are measured with which instruments, and which activities are relevant, appropriate and methodologically sound for assessing MQ in patients with NS-LBP? METHODS The study had three phases. In phase 1 we conducted a systematic review in PubMed, CINAHL and SPORTDiscus of literature published until October 2018. The selected studies measured MQ domains with instruments that enabled us to 1) compare MQ in self-paced dynamic activities of patients with NS-LBP and healthy controls, and/or 2) determine change over time of MQ in patients with NS-LBP. In phase 2 we established relevant dynamic activities to assess in patients with NS-LBP. In phase 3 we determined appropriateness and methodological qualities of the selected instruments. RESULTS Thirty cross-sectional and three pre-post-test studies were eligible. The instruments consisted of complex (n = 19) and simple (n = 7) instrumented motion analysis systems and standardized observational tests (n = 7). We identified three domains representative for MQ: range of motion (ROM), inter-segmental coordination, and whole-body movements. In these domains, patients with NS-LBP significantly differed from healthy controls, respectively 7/12, 12/13 and 13/20 studies. Moreover, ROM and whole-body movements significantly improved over time in patients with NS-LBP (3/3 studies). Based on phase 3, we concluded that none of the instruments are appropriate to assess MQ in patients with NS-LBP in primary care. SIGNIFICANCE Forward bending, lifting, and walking seem the most relevant activities to evaluate in patients with NS-LBP. However, we found no suitable instruments to measure ROM, inter-segmental coordination, or whole-body movements as determinants of MQ in these activities in daily practice. We therefore recommend such an instrument be developed.
Collapse
Affiliation(s)
- Margriet J H van Dijk
- HU University of Applied Sciences, Institute for Human Movement Studies, Utrecht, the Netherlands.
| | - Nienke T A Smorenburg
- HU University of Applied Sciences, Institute for Human Movement Studies, Utrecht, the Netherlands
| | - Yvonne F Heerkens
- HAN University of Applied Sciences, Research Group Occupation & Health, Nijmegen & Dutch Institute of Allied Health Care, Amersfoort, the Netherlands
| | - Jurgen Mollema
- HU University of Applied Sciences, Institute for Human Movement Studies, Utrecht, the Netherlands
| | - Henri Kiers
- HU University of Applied Sciences, Institute for Human Movement Studies, Utrecht, the Netherlands
| | | | - Bart Visser
- Amsterdam University of Applied Sciences, ACHIEVE Centre of Expertise, Faculty of Health, Amsterdam, the Netherlands
| |
Collapse
|
10
|
Maas MJM, Driehuis F, Meerhoff GA, Heerkens YF, van der Vleuten CPM, Nijhuis-van der Sanden MWG, van der Wees PJ. Impact of Self- and Peer Assessment on the Clinical Performance of Physiotherapists in Primary Care: A Cohort Study. Physiother Can 2018; 70:393-401. [PMID: 30745725 DOI: 10.3138/ptc.2017-40.pc] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: This study evaluated the impact of a quality improvement programme based on self- and peer assessment to justify nationwide implementation. Method: Four professional networks of physiotherapists in The Netherlands (n = 379) participated in the programme, which consisted of two cycles of online self-assessment and peer assessment using video recordings of client communication and clinical records. Assessment was based on performance indicators that could be scored on a 5-point Likert scale, and online assessment was followed by face-to-face feedback discussions. After cycle 1, participants developed personal learning goals. These goals were analyzed thematically, and goal attainment was measured using a questionnaire. Improvement in performance was tested with multilevel regression analyses, comparing the self-assessment and peer-assessment scores in cycles 1 and 2. Results: In total, 364 (96%) of the participants were active in online self-assessment and peer assessment. However, online activities varied between cycle 1 and cycle 2 and between client communication and recordkeeping. Personal goals addressed client-centred communication (54%), recordkeeping (24%), performance and outcome measurement (15%), and other (7%). Goals were completely attained (29%), partly attained (64%), or not attained at all (7%). Self-assessment and peer-assessment scores improved significantly for both client communication (self-assessment = 11%; peer assessment = 8%) and recordkeeping (self-assessment = 7%; peer assessment = 4%). Conclusions: Self-assessment and peer assessment are effective in enhancing commitment to change and improving clinical performance. Nationwide implementation of the programme is justified. Future studies should address the impact on client outcomes.
Collapse
Affiliation(s)
- Marjo J M Maas
- Institute of Health Studies, HAN University of Applied Sciences.,Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen
| | - Femke Driehuis
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen
| | - Guus A Meerhoff
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen
| | - Yvonne F Heerkens
- Institute of Health Studies, HAN University of Applied Sciences.,Dutch Institute of Allied Healthcare, Amersfoort
| | - Cees P M van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Philip J van der Wees
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen
| |
Collapse
|
11
|
Stallinga HA, Dijkstra PU, Napel HT, Roodbol G, Peters JWB, Heerkens YF, Roodbol PF. Perceived usefulness of the International Classification of Functioning, Disability and Health (ICF) increases after a short training: A randomized controlled trial in master of advanced nursing practice students. Nurse Educ Pract 2018; 33:55-62. [PMID: 30243214 DOI: 10.1016/j.nepr.2018.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 08/07/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
Abstract
The Master program of Advanced Nursing Practice (MANP) educates nurses to become a nurse practitioner. Nurse practitioners are health care professionals focusing on the intersection of cure and care. However, a clear model covering that area is lacking. The use of the International Classification of Functioning, Disability and Health (ICF) may be considered for incorporation in curricula due to its focus on the integration of cure and care. The purpose of this study is to test the effects of a short (= 4-h instructor-led) ICF training on perceived usefulness of the ICF. In a randomized controlled trial, 76 MANP students were randomly allocated to intervention or control group. Data were collected using an 'ICF survey and learning assessment tool'. Data of 56 students were included for analysis. Perceived usefulness of the ICF increased significantly in the intervention group immediately after training (p = 0.001) but no longer at 3-months follow-up (p = 0.388). Attitude and knowledge related to the ICF were significantly increased in the intervention group at both post-training assessments (p < 0.001 and 0.02). The positive influence of the ICF training on perceived usefulness of the ICF is relevant for including ICF in MANP curriculum.
Collapse
Affiliation(s)
- Hillegonda A Stallinga
- University of Groningen, University Medical Center Groningen, Department of Health Science, Section of Nursing Research, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Pieter U Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Department of Oral and Maxillofacial Surgery, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Huib Ten Napel
- National Institute for Public Health and the Environment, World Health Organization-Family of International Classifications Collaborating Centre in the Netherlands, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.
| | - Gabriël Roodbol
- HAN University of Applied Sciences, Master Advanced Nursing Practice, P.O. Box 9029, 6500 JK, Nijmegen, the Netherlands.
| | - Jeroen W B Peters
- HAN University of Applied Sciences, Master Advanced Nursing Practice, P.O. Box 9029, 6500 JK, Nijmegen, the Netherlands.
| | - Yvonne F Heerkens
- Dutch Institute of Allied Health Care, Amersfoort, HAN University of Applied Sciences, Research Group Occupation & Health, P.O. Box 6960, 6503, GL, Nijmegen, the Netherlands.
| | - Petrie F Roodbol
- University of Groningen, University Medical Center Groningen, Department of Health Science, Section of Nursing Research, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| |
Collapse
|
12
|
Havermans BM, Boot CRL, Brouwers EPM, Houtman ILD, Heerkens YF, Zijlstra-Vlasveld MC, Twisk JWR, Anema JR, van der Beek AJ. Effectiveness of a digital platform-based implementation strategy to prevent work stress in a
healthcare organization: a 12-month follow-up controlled trial. Scand J Work Environ Health 2018; 44:613-621. [DOI: 10.5271/sjweh.3758] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
13
|
de Brouwer CPM, van Amelsvoort LGPM, Heerkens YF, Widdershoven GAM, Kant IJ. Implementing the ICF in Occupational Health; building a curriculum as an exemplary case. Work 2018; 57:173-186. [PMID: 28527235 DOI: 10.3233/wor-172548] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This paper addresses the need for a paradigm shift from post-diagnosis tertiary care towards maintenance and promotion of health across the lifespan, for healthcare in general and in occupational healthcare specifically. It is based on the assumption that the realization of this paradigm shift may be facilitated by teaching (future) occupational health professionals to use the International Classification of Functioning, Disability and Health (ICF). OBJECTIVE Describing the development of a an ICF based occupational health curriculum. METHODS Grafting a training trajectory in the ICF for educating the biopsychosocial health paradigm, onto a training trajectory in the Critical Appraisal of a Topic (CAT), a method for teaching evidence based practice skills. RESULTS The development process of the training trajectories in the master program Work, Health, and Career at Maastricht University is described as an example of an intervention for shifting the paradigm in healthcare curricula. The expected results are a shift from the biomedical towards the biopsychosocial paradigm, a reductionist approach towards a more holistic view on cases, a reactive way of working towards a more proactive work style, and from using a merely quantifiable evidence base towards using a broad evidence base. CONCLUSIONS Incorporating the biopsychosocial paradigm into the assessment and scientific reasoning skills of students is not only valuable in occupational healthcare but might be a valuable approach for all disciplines in healthcare for which contextual factors are important e.g. rehabilitation, psychiatry and nutritional science.
Collapse
Affiliation(s)
- Carin P M de Brouwer
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Ludovic G P M van Amelsvoort
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Yvonne F Heerkens
- Research Group Occupation and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands and Dutch Institute of Allied Health Care, Amersfoort, The Netherlands
| | - Guy A M Widdershoven
- Department of Medical Humanities, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
14
|
van Amelsvoort LGPM, de Brouwer CPM, Heerkens YF, Widdershoven GAM, Kant IJ. Fostering functioning of workers: A new challenge for prevention in occupational health. Work 2018; 57:153-156. [PMID: 28582941 DOI: 10.3233/wor-172549] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Given large changes in working conditions and society, occupational health care has to prioritize its efforts towards fostering health and functioning of workers and as such promote work participation. This requires that more emphasis is given on the application of biopsychological models in the care of workers. Although a biopsychological approach is often mentioned as essential part of occupational health care, it's application is often hampered in practice, by practical barriers and lack of practical knowledge. This is illustrated by a study that uncovered facilitating and hindering factors in the implementation process of a preventive strategy, proven effective in reducing the risk of long term sickness absence. To facilitate the use of biopsychological models in occupational health care, it is shown that setting up a training curriculum is possible, based on the International Classification of Functioning, Disability and Health (ICF) grafted on available training in evidence based practice skills is possible. Furthermore, there is a need for elaboration of the personal factors relevant for workers and the relevant work-related environmental factors to support practical application of ICF in occupational health care. A paradigm shift in occupational health care can facilitate widespread implementation of the biopsychosocial approach in occupational health and may stimulate occupational health professionals to further integrate this approach in their daily practice.
Collapse
Affiliation(s)
- Ludovic G P M van Amelsvoort
- Department of Epidemiology, Program of Functioning and Rehabilitation, CAPRHI School of Public Health, Maastricht University, Maastricht, The Netherlands
| | - Carin P M de Brouwer
- Department of Epidemiology, Program of Functioning and Rehabilitation, CAPRHI School of Public Health, Maastricht University, Maastricht, The Netherlands
| | - Yvonne F Heerkens
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Guy A M Widdershoven
- Department of Medical Humanities, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, Program of Functioning and Rehabilitation, CAPRHI School of Public Health, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
15
|
Gäbler GJ, Coenen M, Bolleurs C, Visser WK, Runia S, Heerkens YF, Stamm TA. Toward Harmonization of the Nutrition Care Process Terminology and the International Classification of Functioning, Disability and Health−Dietetics: Results of a Mapping Exercise and Implications for Nutrition and Dietetics Practice and Research. J Acad Nutr Diet 2018; 118:13-20.e13. [DOI: 10.1016/j.jand.2016.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Indexed: 11/30/2022]
|
16
|
Oswald W, Hutting N, Engels JA, Bart Staal J, Nijhuis-van der Sanden MWG, Heerkens YF. Work participation of patients with musculoskeletal disorders: is this addressed in physical therapy practice? J Occup Med Toxicol 2017; 12:27. [PMID: 28855953 PMCID: PMC5574154 DOI: 10.1186/s12995-017-0174-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 05/31/2017] [Accepted: 08/22/2017] [Indexed: 11/30/2022] Open
Abstract
Background Musculoskeletal disorders are the main complaints for visiting a physical therapist (PT) in primary health care; they have a negative effect on an individual’s quality of life and result in a major cost to society. Qualitative research has shown that physical therapists (PTs) treating patients with these disorders experience barriers in the integration of occupational factors within their practice, and also revealed a lack of cooperation between PTs and (other) occupational healthcare providers. The aim of this study is to quantitatively investigate how generalist PTs in the Netherlands, who treat patients with musculoskeletal disorders, currently integrate occupational factors within their practice, and to identify their opinions and needs with regard to enhancing the integration of the patient’s work within physical therapy practice. Methods A cross-sectional survey was conducted among generalist PTs who treat working-age (18–67 years) patients with musculoskeletal disorders. Generalist PTs were contacted for participation via digital news-mails and asked to fill out an online survey which was developed based on the results of a recent qualitative study. The survey consisted of: i) demographics of the participants, ii) questions on how generalist PTs currently integrate occupational factors within their practice, and iii) asked their opinion about the integration of occupational factors within physical therapy. The PTs were also asked about their needs with regard to the integration of occupational factors and with regard to cooperation with other (occupational) health professionals. All answers (using Likert scales) are presented as the number and percentage of the respondents reporting those specific answers, whereas all other answers are presented as means and standard deviations. Results Of the 142 respondents, 64% indicated that occupational factors should be addressed to a greater extent within physical therapy. To have the possibility to bill for a workplace assessment (60.6%) and more knowledge about laws and regulations (50%) were identified as needs of the respondents. Only 14.8% of the respondents indicated that they communicate with or consult a PT specialized in occupational health. Only 12.7% of the participants who do not have a specialized PT within their practice sometimes/regularly refer patients to a specialized PT. Conclusions Although generalist PTs address occupational factors within their practice, there is room for improvement. This study also identified a lack of cooperation between generalist PTs and PTs specialized in occupational health. Electronic supplementary material The online version of this article (10.1186/s12995-017-0174-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Wiebke Oswald
- Faculty of Health and Social Studies, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL Nijmegen, Netherlands.,Faculty of Health and Social Studies, Physical Therapy, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Nathan Hutting
- Faculty of Health and Social Studies, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL Nijmegen, Netherlands
| | - Josephine A Engels
- Faculty of Health and Social Studies, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL Nijmegen, Netherlands
| | - J Bart Staal
- Faculty of Health and Social Studies, Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, Netherlands.,Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Yvonne F Heerkens
- Faculty of Health and Social Studies, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL Nijmegen, Netherlands
| |
Collapse
|
17
|
Hoek RJA, Havermans BM, Houtman ILD, Brouwers EPM, Heerkens YF, Zijlstra-Vlasveld MC, Anema JR, van der Beek AJ, Boot CRL. Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial. BMC Public Health 2017; 18:26. [PMID: 28716117 PMCID: PMC5514515 DOI: 10.1186/s12889-017-4585-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 07/11/2017] [Indexed: 11/21/2022] Open
Abstract
Background Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative learning network. The digital platform contains a stepwise protocol to implement work-related stress-management interventions. It includes stress screeners, interventions and intervention providers to facilitate access to and the selection of matching work-related stress-management interventions. The collaborative learning network, including stakeholders from various organizations, plans meetings focussing on an exchange of experiences and good practices among organizations for the implementation of stress prevention measures. This paper describes the design of an integral stress-prevention strategy, Stress Prevention@Work, and the protocol for the evaluation of: 1) the effects of the strategy on perceived stress and work-related outcomes, and 2) the barriers and facilitators for implementation of the strategy. Methods The effectiveness of Stress Prevention@Work will be evaluated in a cluster controlled trial, in a large healthcare organization in the Netherlands, at six and 12 months. An independent researcher will match teams on working conditions and size and allocate the teams to the intervention or control group. Teams in the intervention group will be offered Stress Prevention@Work. For each intervention team, one employee is responsible for applying the strategy within his/her team using the digital platform and visiting the collaborative learning network. Using a waiting list design, the control group will be given access to the strategy after 12 months. The primary outcome is the employees’ perceived stress measured by the stress subscale of the Depression, Anxiety, and Stress Scale (DASS-21). Secondary outcome measures are job demands, job resources and the number of preventive stress measures implemented at the team level. Alongside the trial, a process evaluation, including barriers and facilitators of the implementation of Stress Prevention@Work, will be conducted in one healthcare organisation. Discussion If Stress Prevention@Work is found to be effective in one healthcare organisation, further implementation on a broader scale might lead to increased productivity and decreased stress and sick leave in other organizations. Results are expected in 2018. Trial registration NTR5527. Registered 7 Dec 2015.
Collapse
Affiliation(s)
- Rianne J A Hoek
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Body@Work TNO VUmc, Research Center on Physical Activity, Work and Health, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Bo M Havermans
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Body@Work TNO VUmc, Research Center on Physical Activity, Work and Health, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Irene L D Houtman
- Body@Work TNO VUmc, Research Center on Physical Activity, Work and Health, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Netherlands Organization for Applied Scientific Research TNO, Schipholweg 77-89, 2316 ZL, Leiden, The Netherlands
| | - Evelien P M Brouwers
- School of Social and Behavioural Sciences, Tranzo, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands
| | - Yvonne F Heerkens
- Department Occupation & Health, HAN University of Applied Sciences, Kapittelweg 33, 6525 EN, Nijmegen, The Netherlands
| | - Moniek C Zijlstra-Vlasveld
- Trimbos-institute, Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS, Utrecht, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Body@Work TNO VUmc, Research Center on Physical Activity, Work and Health, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.,Body@Work TNO VUmc, Research Center on Physical Activity, Work and Health, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. .,Body@Work TNO VUmc, Research Center on Physical Activity, Work and Health, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| |
Collapse
|
18
|
van Dijk M, Smorenburg N, Visser B, Heerkens YF, Nijhuis-van der Sanden MWG. How clinicians analyze movement quality in patients with non-specific low back pain: a cross-sectional survey study with Dutch allied health care professionals. BMC Musculoskelet Disord 2017; 18:288. [PMID: 28676048 PMCID: PMC5496645 DOI: 10.1186/s12891-017-1649-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 06/28/2017] [Indexed: 12/19/2022] Open
Abstract
Background Observation of movement quality (MQ) is an indelible element in the process of clinical reasoning for patients with non-specific low back pain (NS-LBP). However, the observation and evaluation of MQ in common daily activities are not standardized within allied health care. This study aims to describe how Dutch allied health care professionals (AHCPs) observe and assess MQ in patients with NS-LBP and whether AHCPs feel the need to have a specific outcome measure for assessing MQ in patients with NS-LBP. Methods In this cross-sectional digital survey study, Dutch primary care AHCPs (n = 114) answered one open and three closed questions about MQ in NS-LBP management. Qualitative and quantitative analyses were applied. Results Qualitative analyses of the answers to the open questions revealed four main themes: 1) movement pattern features, 2) motor control features, 3) environmental influences and 4) non-verbal expressions of pain and exertion. Quantitative analyses clearly indicated that AHCPs observe MQ in the diagnostic (92%), therapeutic (91%) and evaluation phases (86%), that they do not apply any objective measurement of MQ and that 63% of the AHCPs consider it important to have a specific outcome measure to assess MQ. The AHCPs expressed added benefits and critical notes regarding clinical reasoning and quality of care. Conclusion AHCPs recognize the importance of observing MQ in the assessment and management of LBP in a standardized way. However, there is no consensus amongst AHCPs how MQ should be standardized. Prior to standardization, it will be important to develop a theoretical framework to determine which observable and measurable dimensions of MQ are most valid and relevant for patients with NS-LBP to include in the assessment.
Collapse
Affiliation(s)
- Margriet van Dijk
- HU University of Applied Sciences, Institute for Human Movement Studies, Utrecht, the Netherlands.
| | - Nienke Smorenburg
- HU University of Applied Sciences, Institute for Human Movement Studies, Utrecht, the Netherlands
| | - Bart Visser
- Faculty of Health, ACHIEVE Centre of Expertise, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Yvonne F Heerkens
- Research Group Occupation and Health, Nijmegen and Dutch Institute of Allied Health Care, HAN University of Applied Sciences, Amersfoort, the Netherlands
| | - Maria W G Nijhuis-van der Sanden
- Research Institute for Health Sciences, Scientific Center for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
| |
Collapse
|
19
|
Heerkens YF, de Brouwer CP, Engels JA, van der Gulden JW, Kant IJ. Elaboration of the contextual factors of the ICF for Occupational Health Care. Work 2017; 57:187-204. [DOI: 10.3233/wor-172546] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Yvonne F. Heerkens
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Dutch Institute of Allied Health Care, Amersfoort, The Netherlands
| | | | - Josephine A. Engels
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Joost W.J. van der Gulden
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
20
|
Hutting N, Oswald W, Staal JB, Engels JA, Nouwens E, Nijhuis van-der Sanden MW, Heerkens YF. Physical therapists and importance of work participation in patients with musculoskeletal disorders: a focus group study. BMC Musculoskelet Disord 2017; 18:196. [PMID: 28511676 PMCID: PMC5434575 DOI: 10.1186/s12891-017-1546-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/04/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Musculoskeletal disorders are a major health problem resulting in negative effects on wellbeing and substantial costs to society. Work participation is associated with positive benefits for both mental and physical health. Potentially, generalist physical therapists (GPTs) can play an important role in reducing absenteeism, presenteeism and associated costs in patients with musculoskeletal disorders. However, work participation is often insufficiently addressed within generalist physical therapy practice (GPTP). Therefore, this study evaluates whether GPTs take work participation into account as a determining factor in patients with musculoskeletal disorders, and how this might be improved. METHODS This qualitative study consisted of seven focus groups involving 30 participants: 21 GPTs and 9 occupational physical therapists (OPTs). Based on an interview guide, participants were asked how they integrate work participation within their practice, how they collaborate with other professionals, and how GPTs can improve integration of the patient's work within their practice. RESULTS Although participants recognized the importance of work participation, they mentioned that the integration of this item in their GPTP could be improved. Generally, GPTs place insufficient priority on work participation. Moreover, there is a lack of cooperation between the generalist physical therapist and (other) occupational healthcare providers (including OPTs), and the borderlines/differences between generalist physcial therapy and occupational health physcial therapy were sometimes unclear. GPTs showed a lack of knowledge and a need for additional information about several important work-related factors (e.g. work content, physical and psychosocial working conditions, terms of employment). CONCLUSIONS Although a patient's work is important, GPTs take insufficient account of work participation as a determining factor in the treatment of patients with musculoskeletal disorders. GPTs often lack specific knowledge about work-related factors, and there is insufficient cooperation between OPTs and other occupational healthcare providers. The integration of work participation within GPTP, and the cooperation between GPTs and other occupational healthcare providers, show room for improvement.
Collapse
Affiliation(s)
- Nathan Hutting
- Faculty of Health and Social Studies, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503, GL, Nijmegen, Netherlands.
| | - Wiebke Oswald
- Faculty of Health and Social Studies, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503, GL, Nijmegen, Netherlands.,Faculty of Health and Social Studies, Physical Therapy, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - J Bart Staal
- Faculty of Health and Social Studies, Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, Netherlands.,Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
| | - Josephine A Engels
- Faculty of Health and Social Studies, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503, GL, Nijmegen, Netherlands
| | - Elvira Nouwens
- Faculty of Health and Social Studies, Physical Therapy, HAN University of Applied Sciences, Nijmegen, Netherlands
| | | | - Yvonne F Heerkens
- Faculty of Health and Social Studies, Research Group Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503, GL, Nijmegen, Netherlands
| |
Collapse
|
21
|
Hutting N, Detaille SI, Heerkens YF, Engels JA, Staal JB, Nijhuis-van der Sanden MWG. Experiences of Participants in a Self-Management Program for Employees with Complaints of the Arm, Neck or Shoulder (CANS): A Mixed Methods Study. J Occup Rehabil 2017; 27:35-48. [PMID: 26875155 PMCID: PMC5306216 DOI: 10.1007/s10926-016-9630-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Purpose To investigate the experiences of participants of a self-management program for employees with complaints of the arm, neck or shoulder (CANS). The program consisted of six group sessions combined with an eHealth module. Methods Semi-structured interviews with the first 31 consecutive participants of the intervention group participating in a randomized controlled trial. Participants were interviewed after their last group session. Semi-structured interviews were guided by an interview guide and audio-recorded. Data were analyzed using thematic analysis and the emerging themes were discussed. All participants in the intervention group were asked about their experiences with a questionnaire at three (n = 58) and 12-months (n = 53) follow-up. Results Most participants appreciated the diversity of the program and benefited from the interaction with their peers. The eHealth module, although not used by everyone, was generally experienced as positive, especially the section with the physical exercises. Participants obtained more insight into their complaints and increased awareness, which contributed to the acceptance of and coping with the complaints. There was also criticism about the content of the program and the lack of a follow-up session. Results of the questionnaires showed that participants had a high level of satisfaction. Conclusions In general, the intervention fitted the needs of employees with CANS. Participants obtained more knowledge and insight into their complaints, as well as increased awareness; all this contributed to a behavioral change and improved coping. Many participants made changes at work and during their leisure time, whereas some felt that continuing their 'changed' behavior would be a challenge.
Collapse
Affiliation(s)
- Nathan Hutting
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands.
- Research Group Occupation and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands.
| | - Sarah I Detaille
- Research Group Occupation and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands
- HAN Seneca, Expertise Centre for Sports, Work and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Yvonne F Heerkens
- Research Group Occupation and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands
| | - Josephine A Engels
- Research Group Occupation and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands
| | - J Bart Staal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
- Research Group Musculoskeletal Rehabilitation, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | | |
Collapse
|
22
|
van Dijk MJH, Smorenburg NTA, Visser B, Nijhuis–van der Sanden MWG, Heerkens YF. Description of movement quality in patients with low back pain: A qualitative study as a first step to a practical definition. Physiother Theory Pract 2017; 33:227-237. [DOI: 10.1080/09593985.2017.1282998] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Margriet J. H van Dijk
- Institute for Human Movement Studies, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Nienke T. A. Smorenburg
- Institute for Human Movement Studies, Utrecht University of Applied Sciences, Utrecht, The Netherlands
| | - Bart Visser
- ACHIEVE–Amsterdam Centre for Innovative Health Practice, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | | | - Yvonne F. Heerkens
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Dutch Institute of Allied Health Care, Amersfoort, The Netherlands
| |
Collapse
|
23
|
Maas MJM, Nijhuis-van der Sanden MWG, Driehuis F, Heerkens YF, van der Vleuten CPM, van der Wees PJ. Feasibility of peer assessment and clinical audit to self-regulate the quality of physiotherapy services: a mixed methods study. BMJ Open 2017; 7:e013726. [PMID: 28188156 PMCID: PMC5306504 DOI: 10.1136/bmjopen-2016-013726] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 01/12/2017] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To evaluate the feasibility of a quality improvement programme aimed to enhance the client-centeredness, effectiveness and transparency of physiotherapy services by addressing three feasibility domains: (1) acceptability of the programme design, (2) appropriateness of the implementation strategy and (3) impact on quality improvement. DESIGN Mixed methods study. PARTICIPANTS AND SETTING 64 physiotherapists working in primary care, organised in a network of communities of practice in the Netherlands. METHODS The programme contained: (1) two cycles of online self-assessment and peer assessment (PA) of clinical performance using client records and video-recordings of client communication followed by face-to-face group discussions, and (2) clinical audit assessing organisational performance. Assessment was based on predefined performance indicators which could be scored on a 5-point Likert scale. Discussions addressed performance standards and scoring differences. All feasibility domains were evaluated qualitatively with two focus groups and 10 in-depth interviews. In addition, we evaluated the impact on quality improvement quantitatively by comparing self-assessment and PA scores in cycles 1 and 2. RESULTS We identified critical success features relevant to programme development and implementation, such as clarifying expectations at baseline, training in PA skills, prolonged engagement with video-assessment and competent group coaches. Self-reported impact on quality improvement included awareness of clinical and organisational performance, improved evidence-based practice and client-centeredness and increased motivation to self-direct quality improvement. Differences between self-scores and peer scores on performance indicators were not significant. Between cycles 1 and 2, scores for record keeping showed significant improvement, however not for client communication. CONCLUSIONS This study demonstrated that bottom-up initiatives to improve healthcare quality can be effective. The results justify ongoing evaluation to inform nationwide implementation when the critical success features are addressed. Further research is necessary to explore the sustainability of the results and the impact on client outcomes in a full-scale study.
Collapse
Affiliation(s)
- Marjo J M Maas
- Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Femke Driehuis
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Yvonne F Heerkens
- Institute of Health Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Dutch Institute of Allied Healthcare, Amersfoort, The Netherlands
| | - Cees P M van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Philip J van der Wees
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
24
|
Heerkens YF, de Weerd M, Huber M, de Brouwer CPM, van der Veen S, Perenboom RJM, van Gool CH, Ten Napel H, van Bon-Martens M, Stallinga HA, van Meeteren NLU. Reconsideration of the scheme of the international classification of functioning, disability and health: incentives from the Netherlands for a global debate. Disabil Rehabil 2017; 40:603-611. [PMID: 28129712 DOI: 10.1080/09638288.2016.1277404] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE The ICF (International Classification of Functioning, Disability and Health) framework (used worldwide to describe 'functioning' and 'disability'), including the ICF scheme (visualization of functioning as result of interaction with health condition and contextual factors), needs reconsideration. The purpose of this article is to discuss alternative ICF schemes. METHOD Reconsideration of ICF via literature review and discussions with 23 Dutch ICF experts. Twenty-six experts were invited to rank the three resulting alternative schemes. RESULTS The literature review provided five themes: 1) societal developments; 2) health and research influences; 3) conceptualization of health; 4) models/frameworks of health and disability; and 5) ICF-criticism (e.g. position of 'health condition' at the top and role of 'contextual factors'). Experts concluded that the ICF scheme gives the impression that the medical perspective is dominant instead of the biopsychosocial perspective. Three alternative ICF schemes were ranked by 16 (62%) experts, resulting in one preferred scheme. CONCLUSIONS There is a need for a new ICF scheme, better reflecting the ICF framework, for further (inter)national consideration. These Dutch schemes should be reviewed on a global scale, to develop a scheme that is more consistent with current and foreseen developments and changing ideas on health. Implications for Rehabilitation We propose policy makers on community, regional and (inter)national level to consider the use of the alternative schemes of the International Classification of Functioning, Disability and Health within their plans to promote functioning and health of their citizens and researchers and teachers to incorporate the alternative schemes into their research and education to emphasize the biopsychosocial paradigm. We propose to set up an international Delphi procedure involving citizens (including patients), experts in healthcare, occupational care, research, education and policy, and planning to get consensus on an alternative scheme of the International Classification of Functioning, Disability and Health. We recommend to discuss the alternatives for the present scheme of the International Classification of Functioning, Disability and Health in the present update and revision process within the World Health Organization as a part of the discussion on the future of the International Classification of Functioning, Disability and Health framework (including ontology, title and relation with the International Classification of Diseases). We recommend to revise the definition of personal factors and to draft a list of personal factors that can be used in policy making, clinical practice, research, and education and to put effort in the revision of the present list of environmental factors to make it more useful in, e.g., occupational health care.
Collapse
Affiliation(s)
- Yvonne F Heerkens
- a Dutch Institute of Allied Health Care , Amersfoort , The Netherlands.,b Research Group Occupation & Health , HAN University of Applied Sciences , Nijmegen , The Netherlands
| | | | - Machteld Huber
- d Institute for Positive Health , Amersfoort , The Netherlands
| | - Carin P M de Brouwer
- e Department of Epidemiology, Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands
| | - Sabina van der Veen
- f Innovation Health Care Professions & Education , Dutch Health Care Institute , Diemen , The Netherlands
| | | | - Coen H van Gool
- g WHO Collaborating Centre for the Family of International Classifications in The Netherlands, National Institute for Public Health and the Environment , Bilthoven , The Netherlands
| | - Huib Ten Napel
- g WHO Collaborating Centre for the Family of International Classifications in The Netherlands, National Institute for Public Health and the Environment , Bilthoven , The Netherlands
| | - Marja van Bon-Martens
- h The Trimbos Institute, Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands
| | - Hillegonda A Stallinga
- i School of Nursing & Health, University Medical Center, University of Groningen , Groningen , The Netherlands
| | - Nico L U van Meeteren
- j Topsector Life Sciences and Health (Health ∼ Holland) , The Hague , The Netherlands.,k CAPHRI, Maastricht University , Maastricht , The Netherlands
| |
Collapse
|
25
|
Abstract
The Netherlands has established a high quality system of child health care based on a unique standardized digital preventive child health program underpinned by legislation. Stringent assessment of the implementation of the new Youth Act is needed to fulfill the United Nations' child rights to health. The impact of national child health care systems on the well-being of children with long-term conditions should be evaluated by using international (World Health Organization) comparable coding to document the benefit of preventive child health care programs and their outcomes.
Collapse
Affiliation(s)
| | | | | | - Yvonne F Heerkens
- Dutch Institute of Allied Health Professions, Amersfoort, and Hogeschool van Arnhem en Nijmegen University of Applied Sciences, Nijmegen, The Netherlands
| |
Collapse
|
26
|
Maas MJM, van Dulmen SA, Sagasser MH, Heerkens YF, van der Vleuten CPM, Nijhuis-van der Sanden MWG, van der Wees PJ. Critical features of peer assessment of clinical performance to enhance adherence to a low back pain guideline for physical therapists: a mixed methods design. BMC Med Educ 2015; 15:203. [PMID: 26563246 PMCID: PMC4643538 DOI: 10.1186/s12909-015-0484-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 11/03/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Clinical practice guidelines are intended to improve the process and outcomes of patient care. However, their implementation remains a challenge. We designed an implementation strategy, based on peer assessment (PA) focusing on barriers to change in physical therapy care. A previously published randomized controlled trial showed that PA was more effective than the usual strategy "case discussion" in improving adherence to a low back pain guideline. Peer assessment aims to enhance knowledge, communication, and hands-on clinical skills consistent with guideline recommendations. Participants observed and evaluated clinical performance on the spot in a role-play simulating clinical practice. Participants performed three roles: physical therapist, assessor, and patient. This study explored the critical features of the PA program that contributed to improved guideline adherence in the perception of participants. METHODS Dutch physical therapists working in primary care (n = 49) organized in communities of practice (n = 6) participated in the PA program. By unpacking the program we identified three main tasks and eleven subtasks. After the program was finished, a questionnaire was administered in which participants were asked to rank the program tasks from high to low learning value and to describe their impact on performance improvement. Overall ranking results were calculated. Additional semi-structured interviews were conducted to elaborate on the questionnaires results and were transcribed verbatim. Questionnaires comments and interview transcripts were analyzed using template analysis. RESULTS Program tasks related to performance in the therapist role were perceived to have the highest impact on learning, although task perceptions varied from challenging to threatening. Perceptions were affected by the role-play format and the time schedule. Learning outcomes were awareness of performance, improved attitudes towards the guideline, and increased self-efficacy beliefs in managing patients with low back pain. Learning was facilitated by psychological safety and the quality of feedback. CONCLUSION The effectiveness of PA can be attributed to the structured and performance-based design of the program. Participants showed a strong cognitive and emotional commitment to performing the physical therapist role. That might have contributed to an increased awareness of strength and weakness in clinical performance and a motivation to change routine practice.
Collapse
Affiliation(s)
- Marjo J M Maas
- HAN University of Applied Sciences, Institute for Health Studies, Kapittelweg 33, 5425 EN, Nijmegen, The Netherlands.
- Radboud University Medical Center, Institute for Health Sciences, IQ healthcare, Geert Grooteplein 21, 6525 EZ, Nijmegen, The Netherlands.
| | - Simone A van Dulmen
- Radboud University Medical Center, Institute for Health Sciences, IQ healthcare, Geert Grooteplein 21, 6525 EZ, Nijmegen, The Netherlands.
| | - Margaretha H Sagasser
- Radboud University Medical Center Department of Primary and Community Care, Nijmegen, The Netherlands.
| | - Yvonne F Heerkens
- HAN University of Applied Sciences, Institute for Health Studies, Kapittelweg 33, 5425 EN, Nijmegen, The Netherlands.
- Dutch Institute of Allied Health Care, Amersfoort, The Netherlands.
| | - Cees P M van der Vleuten
- Maastricht University, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands.
| | - Maria W G Nijhuis-van der Sanden
- Radboud University Medical Center, Institute for Health Sciences, IQ healthcare, Geert Grooteplein 21, 6525 EZ, Nijmegen, The Netherlands.
| | - Philip J van der Wees
- Radboud University Medical Center, Institute for Health Sciences, IQ healthcare, Geert Grooteplein 21, 6525 EZ, Nijmegen, The Netherlands.
| |
Collapse
|
27
|
Hutting N, Staal JB, Engels JA, Heerkens YF, Detaille S, Nijhuis-van der Sanden MWG. Effect evaluation of a self-management programme for employees with complaints of the arm, neck or shoulder: a randomised controlled trial. Occup Environ Med 2015; 72:852-61. [DOI: 10.1136/oemed-2015-103089] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 08/11/2015] [Indexed: 11/04/2022]
|
28
|
Viehoff PB, Pelzer L, Heerkens YF, van Ravensberg DC, Neumann M. Functioning in lymphoedema from the health professionals' perspective using the international classification of functioning, disability and health as a reference. Phlebology 2015; 31:554-63. [PMID: 26338844 DOI: 10.1177/0268355515603556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To capture the views of different health care providers involved in the treatment of patients with lymphoedema from various countries around the world on the functioning of lymphoedema patients and the factors influencing functioning of these patients using the international classification of functioning, disability and health (ICF). METHOD A worldwide e-mail survey with questions based on components of the ICF. RESULTS In total, 142 health professionals from seven different health professions and 20 different countries answered the questions. The aspects of functioning that were named by the health professionals could be linked to 359 different ICF categories. Of these categories, 109 belonged to body functions (30.4%), 55 to body structures (15.3%), 121 to activities and participation (33.7%) and 74 to environmental factors (20.6%). Overall, the most mentioned items were health services, systems and policies, immunological system functions, looking after one's health, products and technology for personal use in daily life and dressing. CONCLUSIONS The ICF provided a valuable reference for identifying concepts in statements from international health care professionals experienced in the treatment of lymphoedema patients. The results of this research will be used in the development of ICF core sets for lymphoedema.
Collapse
Affiliation(s)
- Peter B Viehoff
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Lianne Pelzer
- Faculty of Healthcare dept. of Skin Therapy, HU University of Applied Sciences Utrecht, the Netherlands
| | - Yvonne F Heerkens
- Dutch Institute of Allied Health Care, Amersfoort, the Netherlands Research Centre for Rehabilitation, Work, and Sports, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | | | - Martino Neumann
- Department of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands
| |
Collapse
|
29
|
Hutting N, Detaille SI, Engels JA, Heerkens YF, Staal JB, Nijhuis-van der Sanden MW. Development of a self-management program for employees with complaints of the arm, neck, and/or shoulder: an intervention mapping approach. J Multidiscip Healthc 2015; 8:307-20. [PMID: 26170689 PMCID: PMC4492641 DOI: 10.2147/jmdh.s82809] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To develop a self-management program with an additional eHealth module, using the six steps of the intervention mapping (IM) protocol, to help employees with complaints of the arm, neck, and/or shoulder (CANS) cope with their problems. Methods In Step 1 of the IM protocol, a needs assessment was performed consisting of a review of the Dutch multidisciplinary guidelines on CANS, and of focus group sessions with employees with CANS (n=15) and with relevant experts (n=17). After the needs assessment, the objectives of the intervention and the determinants of self-management at work were formulated (Step 2). Furthermore, theory-based intervention methods and practical strategies were selected (Step 3), and an intervention program (including the eHealth module) was developed (Step 4). Finally, plans for implementation and evaluation of the program were developed (Steps 5 and 6). Results Step 1 of the IM protocol revealed that employees with CANS should be stimulated to search for information about the cause of their complaints, about how to deal with their complaints, and in which manner they can influence their complaints themselves. In Step 2, the overall goal of the intervention was defined as “self-management behavior at work” with the aim to alleviate the perceived disability of the participants. Step 3 described how the intervention methods were translated into practical strategies, and goal setting was introduced as an important method for increasing self-efficacy. The product of Step 4 was the final program plan, consisting of 6-weekly group sessions of 2.5 hours each and an eHealth module. In Step 5, a recruitment plan and course materials were developed, a steering committee was set up, trainers were recruited, and the final program was tested. In Step 6, an evaluation plan was developed, which consists of a randomized controlled trial with a 12-month follow-up period and a qualitative evaluation (interviews) with some of the participants. Conclusion This study resulted in a theory- and practice-based self-management program, based on behavioral change theories, guideline-related evidence, and practice-based knowledge that fits the needs of employees with CANS.
Collapse
Affiliation(s)
- Nathan Hutting
- Radboud University Medical Center, Radboud Institute for Health Sciences, the Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands ; Hogeschool van Arnhem en Nijmegen (HAN) University of Applied Sciences, Faculty of Health and Social Studies, Research Group Occupation and Health, Nijmegen, the Netherlands
| | - Sarah I Detaille
- Hogeschool van Arnhem en Nijmegen (HAN) University of Applied Sciences, Faculty of Health and Social Studies, Research Group Occupation and Health, Nijmegen, the Netherlands ; HAN University of Applied Sciences, Department HAN Seneca, Nijmegen, the Netherlands
| | - Josephine A Engels
- Hogeschool van Arnhem en Nijmegen (HAN) University of Applied Sciences, Faculty of Health and Social Studies, Research Group Occupation and Health, Nijmegen, the Netherlands
| | - Yvonne F Heerkens
- Hogeschool van Arnhem en Nijmegen (HAN) University of Applied Sciences, Faculty of Health and Social Studies, Research Group Occupation and Health, Nijmegen, the Netherlands
| | - J Bart Staal
- Radboud University Medical Center, Radboud Institute for Health Sciences, the Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands ; HAN University of Applied Sciences, Faculty of Health and Social Studies, Research Group Musculoskeletal Rehabilitation, Nijmegen, the Netherlands
| | - Maria Wg Nijhuis-van der Sanden
- Radboud University Medical Center, Radboud Institute for Health Sciences, the Scientific Institute for Quality of Healthcare, Nijmegen, the Netherlands
| |
Collapse
|
30
|
Brouwers LAM, Engels JA, Heerkens YF, van der Beek AJ. Development of a Vitality Scan related to workers' sustainable employability: a study assessing its internal consistency and construct validity. BMC Public Health 2015; 15:551. [PMID: 26076659 PMCID: PMC4467054 DOI: 10.1186/s12889-015-1894-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 05/29/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Most validated sustainable employability questionnaires are extensive and difficult to obtain. Our objective was to develop a usable and valid tool, a Vitality Scan, to determine possible signs of stagnation in one's functioning related to sustainable employability and to establish the instrument's internal consistency and construct validity. METHODS A literature review was performed and expert input was obtained to develop an online survey of 31 items. A sample of 1722 Dutch employees was recruited. Internal consistency was assessed by Cronbach's alpha. The underlying theoretical concepts were extracted by factor analysis using a principal component method. For construct validity, a priori hypotheses were defined for expected differences between known subgroups: 1) older workers would report more stagnation than younger workers, and 2) less educated workers would report more problems than the highly educated ones. Both hypotheses were statistically tested using ANOVA. RESULTS Internal consistency measures and factor analysis resulted in five subscales with acceptable to good reliability (Cronbach's alpha 0.72-0.87). These subscales included: balance and competence, motivation and involvement, resilience, mental and physical health, and social support at work. Three items were removed following these analyses. In accordance with our a priori hypothesis 1, the ANOVA showed that older workers reported the most problems, while younger workers reported the least problems. However, hypothesis 2 was not confirmed: no significant differences were found for education level. CONCLUSIONS The developed Vitality Scan - with the 28 remaining items - showed good measurement properties. It is applicable as a user-friendly, evaluative instrument for worker's sustainable employability. The scan's value for determining whether or not the employee is at risk for a decrease in functioning during present and future work, should be further tested.
Collapse
Affiliation(s)
- Livia A M Brouwers
- Research Group Occupation and Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands.
| | - Josephine A Engels
- Research Group Occupation and Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands.
| | - Yvonne F Heerkens
- Research Group Occupation and Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands.
| | - Allard J van der Beek
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| |
Collapse
|
31
|
Hutting N, Engels JA, Staal JB, Heerkens YF, Nijhuis-van der Sanden MWG. Development of a self-management intervention for employees with complaints of the arm, neck and/or shoulder (CANS): a focus group study with experts. J Occup Med Toxicol 2015; 10:9. [PMID: 25745509 PMCID: PMC4349775 DOI: 10.1186/s12995-015-0051-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 02/18/2015] [Indexed: 11/20/2022] Open
Abstract
Background Many people suffer from complaints of the arm, neck and/or shoulder (CANS). The complaints are persistent and there is a need for intervention programs for those with longstanding CANS. Studies suggest that a behavioural change is needed in employees with CANS. A self-management program with an add-on eHealth module might be an effective option to achieve the behavioural change needed to manage the complaints in employees with CANS. The aim of this study was to determine the content and strategies of the intervention and to gain insight into possible barriers and facilitators for implementation. Therefore, we examined the views of experts on the problems and characteristics associated with employees with CANS as well as their opinion on a self-management program consisting of self-management sessions and an eHealth module. Methods A qualitative study was performed consisting of three focus groups involving a total of 17 experts (with experience with CANS, self-management and/or eHealth interventions). Experts were asked their opinion about the content and requirements of a self-management program for employees with CANS, including an eHealth module. Data were analysed using qualitative data analysis. After coding, the emergent themes were used to organise the data into main categories, expressing the ideas and opinions of experts on CANS, self-management and/or eHealth interventions. Results The experts pointed out that the intervention should focus on increasing employees’ self-efficacy and empowerment, and address topics related to the possible risk factors for CANS, symptoms, work environment, social environment and personal factors. The eHealth module should be self-explanatory and attractive, and the information provided should be brief, clear and concise. Conclusions Experts appeared to see a role for a self-management program for employees with CANS. They indicated that the combination of group sessions and eHealth can work well. Experts provided valuable information with regard to the content of the self-management intervention and the design of the eHealth module.
Collapse
Affiliation(s)
- Nathan Hutting
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands ; Research Group Occupation and Health, HAN University of Applied Sciences, PO Box 6960, Nijmegen, 6503 GL The Netherlands
| | - Josephine A Engels
- Research Group Occupation and Health, HAN University of Applied Sciences, PO Box 6960, Nijmegen, 6503 GL The Netherlands
| | - J Bart Staal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands ; Research Group Occupation and Health, HAN University of Applied Sciences, PO Box 6960, Nijmegen, 6503 GL The Netherlands
| | - Yvonne F Heerkens
- Research Group Occupation and Health, HAN University of Applied Sciences, PO Box 6960, Nijmegen, 6503 GL The Netherlands
| | | |
Collapse
|
32
|
Viehoff PB, Heerkens YF, Van Ravensberg CD, Hidding J, Damstra RJ, Ten Napel H, Neumann HAM. Development of consensus International Classification of Functioning, Disability and Health (ICF) core sets for lymphedema. Lymphology 2015; 48:38-50. [PMID: 26333213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
To understand the challenges of patients with lymphedema it is important to describe functioning and to measure the effectiveness of treatment in changing functioning. The International Classification of Functioning, Disability and Health (ICF) offers an international framework to classify functioning of persons in their personal environment. ICF Core Sets are lists of selected ICF categories concerning those important aspects of functioning that are most likely to be affected by a specific health problem or disease. These Core Sets make it easier and faster to describe and communicate the patient's problems and to define treatment goals. Furthermore, they are available to health care providers of all professions, researchers, health insurance companies and policy-makers. The objective of this document is to present the outcomes of a consensus conference held to determine the first versions of the ICF Core Sets for lymphedema. Frequency rankings were made of the ICF categories derived from four preparatory studies, being: a) a systematic review; b) a qualitative study; c) an expert survey; and d) a cross-sectional study. By means of working group discussions and plenary sessions, a final consensus on ICF categories was achieved and Comprehensive and Brief Core Sets for lymphedema for the upper limb, lower limb, and midline lymphedema were defined. These ICF Core Sets contain different items in each region. Future validation of these Core Sets for health professions and for countries is needed.
Collapse
|
33
|
Viehoff PB, Gielink PDC, Damstra RJ, Heerkens YF, van Ravensberg DC, Neumann MHA. Functioning in lymphedema from the patients' perspective using the International Classification of Functioning, Disability and health (ICF) as a reference. Acta Oncol 2015; 54:411-21. [PMID: 25152221 DOI: 10.3109/0284186x.2014.952389] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To identify and quantify meaningful concepts in lymphedema from the patients' perspectives using the International Classification of Functioning, Disability and Health (ICF). METHODS Six focus group interviews in five different centers were organized, audiotaped, transcribed verbatim and analyzed. RESULTS A total of 2681 relevant ICF linkings were performed with the focus group data, resulting in 130 different second-level categories. Of these 130 second-level categories, 41 (31.5%) categories were categorized as Body Functions, 20 (15.5%) as Body Structures, 41 (31.5%) as Activities and Participation, and 28 (21.5%) as Environmental Factors. Overall, the most important issues according to the patients were the use of hosiery and bandages, support and relationships, and the shape of structures related to movement. CONCLUSION Based on their experiences with lymphedema, patients reported activity limitations and participation restrictions combined with impaired body functioning. Anatomical changes (Body Structures) were also often mentioned as a problem in daily life. Environmental factors may act as a barrier or facilitator for patient functioning. The ICF provides a valuable reference to identify concepts in statements from lymphedema patients. The results of this research will be used in the development of ICF Core Sets for lymphedema.
Collapse
Affiliation(s)
- Peter B Viehoff
- Department of Dermatology, Erasmus Medical Centre , Rotterdam , The Netherlands
| | | | | | | | | | | |
Collapse
|
34
|
Viehoff PB, Potijk F, Damstra RJ, Heerkens YF, van Ravensberg CD, van Berkel DM, Neumann HAM. Identification of relevant ICF (International Classification of Functioning, Disability and Health) categories in lymphedema patients: A cross-sectional study. Acta Oncol 2015; 54:1218-24. [PMID: 25629588 DOI: 10.3109/0284186x.2014.1001873] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To describe functioning and health of lymphedema patients and to identify their most common problems using the International Classification of Functioning, Disability and Health (ICF) as part of the preparatory studies for the development of ICF Core Sets for lymphedema. METHODS Cross-sectional study in a population of lymphedema patients (n = 200), undergoing treatment in a Dutch lymphedema-specialized hospital. The second-level categories of the ICF were used to collect information on patients' problems in daily functioning. RESULTS The mean age of the study group was 56 years (22-84). In total 78.5% of the patients were female. The most frequent mentioned items were: In the Body Functions component: muscle power and mobility of joints, in the Activities and Participation component: doing housework, and changing and maintaining a body position, in the Environmental Factors: Health professionals, who can act as both facilitators and barriers. Interestingly, patients assessed their health more positively than health professionals do. CONCLUSION By using the ICF, a considerable part of the broad spectrum of problems in functioning of lymphedema patients was reported.
Collapse
Affiliation(s)
- P B Viehoff
- a Department of Dermatology , Erasmus Medical Centre , Rotterdam , The Netherlands
| | | | | | | | | | | | | |
Collapse
|
35
|
Koopman FS, Brehm MA, Heerkens YF, Nollet F, Beelen A. Measuring fatigue in polio survivors: content comparison and reliability of the Fatigue Severity Scale and the Checklist Individual Strength. J Rehabil Med 2014; 46:761-7. [PMID: 24941350 DOI: 10.2340/16501977-1838] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To compare the content of the Fatigue Severity Scale and the subscale "subjective experience of fatigue" of the Checklist Individual Strength, and (ii) to assess the reliability of both questionnaires in polio survivors. DESIGN Repeated-measures at a 3-week interval. SUBJECTS Consecutive series of 61 polio survivors. METHODS Concepts contained in the questionnaire items were linked to the International Classification of Functioning, Disability and Health (ICF), using standardized linking rules. Reliability analyses included tests of internal consistency, test-retest reliability and measurement error. RESULTS Questionnaires differed in the extent to which they measured other than fatigue-related aspects of functioning (represented ICF components: "Body functions": 50% and 80%, "Activities and Participation": 30% and 0%, for the Fatigue Severity Scale and Checklist Individual Strength, respectively). Internal consistency and test-retest reliability were considered acceptable, while measurement error was large (Cronbach's α: 0.90 and 0.93, intraclass correlation coefficient: 0.80 and 0.85, smallest detectable change: 28.7% and 29.4% for the Fatigue Severity Scale and Checklist Individual Strength, respectively). CONCLUSION Considering the acceptable clinimetric properties, we conclude that both the Fatigue Severity Scale and the Checklist Individual Strength can be applied in research on post-poliomyelitis syndrome when measuring fatigue. However, because the 2 questionnaires differ in content they cannot be used interchangeably.
Collapse
Affiliation(s)
- Fieke S Koopman
- Department of Rehabilitation , Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | | | | | | | | |
Collapse
|
36
|
Maas MJM, Sluijsmans DMA, van der Wees PJ, Heerkens YF, Nijhuis-van der Sanden MWG, van der Vleuten CPM. Why peer assessment helps to improve clinical performance in undergraduate physical therapy education: a mixed methods design. BMC Med Educ 2014; 14:117. [PMID: 24928420 PMCID: PMC4064265 DOI: 10.1186/1472-6920-14-117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 06/02/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Peer Assessment (PA) in health professions education encourages students to develop a critical attitude towards their own and their peers' performance. We designed a PA task to assess students' clinical skills (including reasoning, communication, physical examination and treatment skills) in a role-play that simulated physical therapy (PT) practice. Students alternately performed in the role of PT, assessor, and patient. Oral face-to-face feedback was provided as well as written feedback and scores.This study aims to explore the impact of PA on the improvement of clinical performance of undergraduate PT students. METHODS The PA task was analyzed and decomposed into task elements. A qualitative approach was used to explore students' perceptions of the task and the task elements. Semi-structured interviews with second year students were conducted to explore the perceived impact of these task elements on performance improvement. Students were asked to select the elements perceived valuable, to rank them from highest to lowest learning value, and to motivate their choices. Interviews were transcribed verbatim and analyzed, using a phenomenographical approach and following template analysis guidelines. A quantitative approach was used to describe the ranking results. RESULTS Quantitative analyses showed that the perceived impact on learning varied widely. Performing the clinical task in the PT role, was assigned to the first place (1), followed by receiving expert feedback (2), and observing peer performance (3). Receiving peer feedback was not perceived the most powerful task element.Qualitative analyses resulted in three emerging themes: pre-performance, true-performance, and post-performance triggers for improvement. Each theme contained three categories: learning activities, outcomes, and conditions for learning.Intended learning activities were reported, such as transferring prior learning to a new application context and unintended learning activities, such as modelling a peer's performance. Outcomes related to increased self-confidence, insight in performance standards and awareness of improvement areas. Conditions for learning referred to the quality of peer feedback. CONCLUSIONS PA may be a powerful tool to improve clinical performance, although peer feedback is not perceived the most powerful element. Peer assessors in undergraduate PT education use idiosyncratic strategies to assess their peers' performance.
Collapse
Affiliation(s)
- Marjo JM Maas
- HAN University of Applied Sciences, Department Allied Health Studies, Kapittelweg 33, 5425 EN Nijmegen, The Netherlands
- Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Geert Grooteplein 21, 6525 EZ Nijmegen, The Netherlands
| | | | - Philip J van der Wees
- Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Geert Grooteplein 21, 6525 EZ Nijmegen, The Netherlands
| | - Yvonne F Heerkens
- Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Geert Grooteplein 21, 6525 EZ Nijmegen, The Netherlands
- Dutch Institute of Allied Health Care, Amersfoort, The Netherlands
| | - Maria WG Nijhuis-van der Sanden
- Radboud University Medical Center, Scientific Institute for Quality of Healthcare, Geert Grooteplein 21, 6525 EZ Nijmegen, The Netherlands
| | - Cees PM van der Vleuten
- Maastricht University, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands
| |
Collapse
|
37
|
Stallinga HA, Dijkstra PU, Bos I, Heerkens YF, Roodbol PF. The ambiguity of the concept of participation in measurement instruments: operationalization of participation influences research outcomes. Clin Rehabil 2014; 28:1225-36. [DOI: 10.1177/0269215514537092] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective: This study explores, based on the International Classification of Functioning, Disability and Health, the consequences of different operationalizations of participation in regression models predicting participation in one sample of patients. Design: Cross-sectional, comparative study. Setting: Department of Neurology of a University Hospital. Subjects: A total of 677 patients with a Neuromuscular Disease. Measures: Participation was measured using the Neuromuscular Disease Impact Profile questionnaire, the RAND-36 Item Health Survey (social functioning, role limitations—physical, role limitations—emotional) and the Impact on Participation and Autonomy questionnaire (autonomy outdoors, social relations). Potential predictors of participation included type of neuromuscular disease, body functions (measured with Neuromuscular Disease Impact Profile), activities (measured with Neuromuscular Disease Impact Profile), environmental factors (measured with Neuromuscular Disease Impact Profile), and personal factors (measured with the 13-item Sense of Coherence questionnaire). The results were controlled for patient characteristics. Results: Participation was statistically predicted by different determinants depending on the operationalization used for participation. Additionally, the regression coefficients differed significantly. Body functions and activities were predictors in five out of six operationalizations of participation. Sense of coherence predicted participation in all of the operationalizations. The explained variance of the different models ranged from 25% (RAND-36 role limitations—emotional) to 65% (Neuromuscular Disease Impact Profile). Conclusions: Different operationalizations of participation result in different prediction models. Lack of conceptual consensus makes participation an ambiguous concept in research, and this ambiguity makes evidence-based decisions directed at enhancing participation difficult. Participation needs to be operationalized in an unambiguous and standard way in order to improve the comparability of outcomes.
Collapse
Affiliation(s)
| | - Pieter U Dijkstra
- Department of Rehabilitation Medicine, University of Groningen, Groningen, The Netherlands
- Department of Oral and Maxillofacial Surgery, University of Groningen, Groningen, The Netherlands
| | - Isaac Bos
- Department of Neurology, University of Groningen, Groningen, The Netherlands
| | - Yvonne F Heerkens
- Dutch Institute of Allied Health Professions, Amersfoort, The Netherlands
- Department of Occupation and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Petrie F Roodbol
- Wenckebach Institute, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
38
|
Hutting N, Engels JA, Heerkens YF, Staal JB, Nijhuis-van der Sanden MWG. Development and measurement properties of the Dutch version of the Stanford Presenteeism Scale (SPS-6). J Occup Rehabil 2014; 24:268-277. [PMID: 23868673 DOI: 10.1007/s10926-013-9453-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To develop a Dutch version of the Stanford Presenteeism Scale (SPS-6) and examine the reliability and discriminant, discriminative and structural validity of the Dutch SPS-6 (DSPS-6). METHODS The original SPS-6 (English-language) was translated and adapted to the Dutch culture. Thirty participants filled in the DSPS-6 at baseline (T0) and after 5 days (T1). Internal consistency (Cronbach's alpha), test-retest reliability (Spearman's correlation coefficient, Spearman's rho), item-to-total correlations, discriminant validity (association with job stress and job satisfaction), discriminative validity (patients reporting a (work) disability compared with those indicating that they had no disability; Spearman's rho, t tests), structural validity (Varimax rotation with Kaiser Normalization) and floor and ceiling effects were examined. RESULTS Cronbach's alpha for the DSPS-6 was 0.89. Test-retest Spearman's rho was 0.82 (p < 0.01). Item-to-total correlations ranged from 0.60 to 0.82. Subjects reporting a work disability had significantly lower DSPS scores (discriminative validity). Spearman's rho for the DSPS-6 score and job satisfaction were 0.38 (p = 0.05; at T0) and 0.27 (at T1), respectively. Spearman's rho for the association between the DSPS-6 and job stress were -0.52 (p = 0.01; at T0) and -0.42 (p = 0.05; at T1), respectively (discriminant validity). The two factors derived from the principal components analysis account for 77.5 % of the variance of responses (structural validity). A ceiling effect was present. CONCLUSIONS The DSPS-6 showed good reliability and structural validity. The discriminative validity of the DSPS-6 is partly supported. The concept of presenteeism is not sufficiently distinct from the constructs of job stress and job satisfaction (discriminant validity). The results of the present study show that the adaptation of the SPS-6 into Dutch was successful. Further research on the reliability, validity and responsiveness of the DSPS-6 in a larger group of participants is recommended.
Collapse
Affiliation(s)
- Nathan Hutting
- Department of Occupation and Health, HAN University of Applied Sciences, P.O. Box 6960, 6503 GL, Nijmegen, The Netherlands,
| | | | | | | | | |
Collapse
|
39
|
Minis MAH, Satink T, Kinébanian A, Engels JA, Heerkens YF, van Engelen BGM, Nijhuis-van der Sanden MWG. How persons with a neuromuscular disease perceive employment participation: a qualitative study. J Occup Rehabil 2014; 24:52-67. [PMID: 23645359 DOI: 10.1007/s10926-013-9447-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
INTRODUCTION A qualitative study was carried out to understand how people with a slow progressive adult type neuromuscular disease (NMD) perceive employment participation. METHODS 16 paid employed persons with NMD were interviewed in open, in-depth interviews. Data were analyzed using the constant comparison method. RESULTS Four themes were identified in the analyses: (1) Experiences regarding the meaning of work; (2) Solving problems oneself; (3) Reaching a turning point; and (4) Taking into account environmental aspects. Persons with NMD highlighted benefits of staying at work as well as the tension they felt how to shape decisions to handle progressive physical hindrances in job retention. This study shows how participants at work with NMD were challenged to keep up appearances at work and at home, the tension felt around when and if to disclose, the effect of their condition on colleagues and work reorganisation challenges. Participants experienced that disclosure did not always make things better. With increasing disability participants' focus shifted from the importance of assistive products towards considerate colleague, in particular superior's willingness in supporting job retention. CONCLUSIONS Implications for health professionals might include awareness of the significant impact of changes in physical condition on employment. Timely communication and if appropriate referral to a health or occupational professional may empower employees with NMD to handle employment issues at a for themselves appropriate way. Assistive products and a supportive superior might enhance employment participation.
Collapse
Affiliation(s)
- Marie-Antoinette H Minis
- Department of Occupation and Health, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands,
| | | | | | | | | | | | | |
Collapse
|
40
|
Hutting N, Staal JB, Heerkens YF, Engels JA, Sanden MWGNVD. A self-management program for employees with complaints of the arm, neck, or shoulder (CANS): study protocol for a randomized controlled trial. Trials 2013; 14:258. [PMID: 23958154 PMCID: PMC3751728 DOI: 10.1186/1745-6215-14-258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 08/01/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Complaints of the arm, neck, or shoulder (CANS) have a multifactorial origin and cause considerable work problems, including decreased work productivity, sickness absence, and, ultimately, job loss. There is a need for intervention programs for people with CANS. Self-management is an approach used in chronic disease care to improve self-efficacy and wellness behaviors to facilitate participants to make informed choices and carry them out. This study will evaluate the effectiveness of a self-management program (including ehealth) and compare it to usual care among employees with chronic CANS (lasting >3 months). METHODS/DESIGN This is a randomized controlled trial in which 142 participants will be recruited and randomized (with pre-stratification) to either the intervention group (IG) or control group (CG). The IG will participate in a self-management program consisting of six group sessions and an ehealth module. The CG is allowed to use all usual care available. The primary outcome of the study is the self-reported disability of arm, shoulder, and hand, measured with the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Secondary outcomes include: absenteeism, pain in the previous week, quality of life, catastrophizing pain, self-efficacy, workstyle, presenteeism, fatigue, the use of usual care, and limitations experienced on the job. Data are collected at baseline and at 3, 6, and 12 months follow-up. DISCUSSION Following the process of intervention mapping we developed a self-management program to suit and alleviate the problems and needs of employees with CANS. A strength of the study is that our intervention is specifically tailored to match the needs of employees with CANS. The study also has some potential weaknesses (for example, use of co-interventions, combination of group sessions and ehealth, self-reporting of data and possible contamination, Hawthorne effect, and recall or information bias) which are discussed. TRIAL REGISTRATION The trial is registered with the Dutch Trial Register (http://www.trialregister.nlNTR3816): (January 2013). The first participant was randomized in September 2012.
Collapse
Affiliation(s)
- Nathan Hutting
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department of Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503, Nijmegen, GL, The Netherlands
| | - J Bart Staal
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department of Physical Therapy, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Yvonne F Heerkens
- Department of Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503, Nijmegen, GL, The Netherlands
| | - Josephine A Engels
- Department of Occupation & Health, HAN University of Applied Sciences, P.O. Box 6960, 6503, Nijmegen, GL, The Netherlands
| | - Maria WG Nijhuis-van der Sanden
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
- Department of Physical Therapy, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
41
|
Detaille SI, Heerkens YF, Engels JA, van der Gulden JWJ, van Dijk FJH. Effect evaluation of a self-management program for dutch workers with a chronic somatic disease: a randomized controlled trial. J Occup Rehabil 2013; 23:189-99. [PMID: 23690087 DOI: 10.1007/s10926-013-9450-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE The objective of this study is to investigate the effect of a Self-Management Program for workers with a chronic disease. This program is based on the Chronic Disease Self-Management Program of Stanford University, modified for workers with a chronic somatic disease. METHODS In a randomized controlled trial, the effectiveness of a Self-Management Program was evaluated. Participants were randomly assigned to the experimental group (n = 57) and the control group (n = 47). The experimental group received an intervention, the control group received care as usual. Primary outcome measures were self-efficacy at work and the attitude towards self-management at work. Secondary outcomes were the SF-12 health survey questionnaire, job satisfaction and intention to change job. The results were measured at baseline, after the intervention and 8 months after the intervention. RESULTS The attitude towards self-management at work (enjoyment) improved after 8 months for the intervention group (p = 0.030). No other outcome variable differed significantly. As an interaction effect, it was found that low educated workers developed a better physical health quality (SF-12) in the intervention group compared with the control group. The attitude towards self-management at work (importance) improved in the intervention group for older and female workers and the attitude toward enjoying self-management at work improved for female workers only. CONCLUSION The results show that low educated workers, older workers and women benefit significantly more from the training than higher educated workers, younger workers and men.
Collapse
Affiliation(s)
- S I Detaille
- HAN Seneca, HAN University of Applied Sciences, Professor Molkenboerstraat 3, PO Box 6960, 6503 GL, Nijmegen, The Netherlands.
| | | | | | | | | |
Collapse
|
42
|
Wijlhuizen GJ, Perenboom RJM, Garre FG, Heerkens YF, van Meeteren N. Impact of multimorbidity on functioning: evaluating the ICF Core Set approach in an empirical study of people with rheumatic diseases. J Rehabil Med 2013; 44:664-8. [PMID: 22729794 DOI: 10.2340/16501977-1002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Chronic conditions can lead to considerable deterioration in functioning. Several condition-specific Core Sets, selections of categories from the International Classification of Functioning, Disability and Health (ICF), have been developed to facilitate the rehabilitation process. Considering the increase in patients with more than one specific condition, we evaluated the impact of multimorbidity on functioning and the implications for the Core Set approach. DESIGN Internet survey. SUBJECTS A total of 127 people with a rheumatic disease and 707 people with rheumatic disease and multimorbidity were included. METHODS Self-report information on chronic conditions and perceived functioning using the IMPACT-S (ICF Measure of Participitation and Activities Screener) questionnaire, measuring the ICF component activities and participation (32 items). RESULTS The mean number of reported serious limitations/restrictions was 5.6 (standard deviation (SD) 5.7) for respondents with rheumatic disease and 6.7 (SD 6.8) for respondents with rheumatic disease and multimorbidity (p < 0.05). Seventeen items were relevant (more than 20% of the respondents reported serious limitations/restrictions) for individuals with rheumatic disease and multimorbidity, and 12 items were relevant for individuals with rheumatic disease only. CONCLUSION Multimorbidity seriously aggravates the already existing functioning problems of people with rheumatic disease. We recommend that in the ICF Core Set approach more emphasis is given to systematic empirical analysis of the impact of multimorbidity on functioning.
Collapse
|
43
|
Minis MA, Cup EH, Heerkens YF, Engels JA, van Engelen BG, Oostendorp RA. Exploring employment in consultation reports of patients with neuromuscular diseases. Arch Phys Med Rehabil 2012; 93:2276-80. [PMID: 22543016 DOI: 10.1016/j.apmr.2012.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 04/12/2012] [Accepted: 04/15/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients with neuromuscular diseases (NMDs). DESIGN Retrospective study of multidisciplinary reports. SETTING An outpatient neuromuscular clinic at a university hospital. PARTICIPANTS Reports (N=102) of patients with NMDs. INTERVENTIONS Based on one-off consultations by occupational therapists, physical therapists, and speech therapists and a multidisciplinary meeting, recommendations were developed regarding therapy content and volume in primary care or rehabilitation settings. MAIN OUTCOME MEASURES A checklist has been developed to examine employment characteristics. A general questionnaire has been used including demographic variables and data on employment. RESULTS Of the 102 reports available, 86 were included for analysis. Sixty-nine reports contained information on employment. Thirty-seven patients (43%) with NMD were employed, most in white-collar or moderately strenuous jobs. Of the 37 employed patients, 28 (76%) worked using adaptations. Thirty-two (87%) had employment problems; of these, 15 (40%) needed improvement in 1 or more environmental factors. Twenty patients (54%) needed advice regarding participation in employment, of whom 19 were referred to primary care or rehabilitation settings for treatment to enhance employment participation. CONCLUSIONS Eighty percent of the included consultation reports contained information on employment. Less than half the patients with NMD were employed, most in office-related jobs, using some kind of adaptations. Nineteen of 20 patients who agreed to recommendations regarding therapy were adequately referred by occupational therapists and physical therapists for treatment of employment problems.
Collapse
Affiliation(s)
- Marie-Antoinette Minis
- HAN University of Applied Sciences, Department Occupational Health, Prevention and Reintegration, Nijmegen, The Netherlands.
| | | | | | | | | | | |
Collapse
|
44
|
Perenboom RJM, Wijlhuizen GJ, Garre FG, Heerkens YF, van Meeteren NLU. An empirical exploration of the relations between the health components of the International Classification of Functioning, Disability and Health (ICF). Disabil Rehabil 2012; 34:1556-61. [DOI: 10.3109/09638288.2011.647233] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
45
|
van der Mei SF, Dijkers MPJM, Heerkens YF. Participation as an outcome measure in psychosocial oncology: content of cancer-specific health-related quality of life instruments. Qual Life Res 2011; 20:1617-27. [PMID: 21479851 PMCID: PMC3220821 DOI: 10.1007/s11136-011-9900-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2011] [Indexed: 11/12/2022]
Abstract
PURPOSE To examine to what extent the concept and the domains of participation as defined in the International Classification of Functioning, Disability and Health (ICF) are represented in general cancer-specific health-related quality of life (HRQOL) instruments. METHODS Using the ICF linking rules, two coders independently extracted the meaningful concepts of ten instruments and linked these to ICF codes. RESULTS The proportion of concepts that could be linked to ICF codes ranged from 68 to 95%. Although all instruments contained concepts linked to Participation (Chapters d7-d9 of the classification of 'Activities and Participation'), the instruments covered only a small part of all available ICF codes. The proportion of ICF codes in the instruments that were participation related ranged from 3 to 35%. 'Major life areas' (d8) was the most frequently used Participation Chapter, with d850 'remunerative employment' as the most used ICF code. CONCLUSIONS The number of participation-related ICF codes covered in the instruments is limited. General cancer-specific HRQOL instruments only assess social life of cancer patients to a limited degree. This study's information on the content of these instruments may guide researchers in selecting the appropriate instrument for a specific research purpose.
Collapse
Affiliation(s)
- Sijrike F van der Mei
- Department of Health Sciences, Graduate School for Health Research SHARE, University Medical Center Groningen, University of Groningen, PO Box 196, 9700 AD Groningen, The Netherlands.
| | | | | |
Collapse
|
46
|
Detaille SI, Heerkens YF, Engels JA, van der Gulden JWJ, van Dijk FJH. Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies. Scand J Work Environ Health 2010; 35:261-81. [PMID: 19562236 DOI: 10.5271/sjweh.1337] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Based on prospective and retrospective disease cohort studies, the aim of this review was to determine common prognostic factors for work disability among employees with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease (IHD). METHODS A systematic literature search in Medline (1990-2008) and Embase (1990-2008) was carried out to identify relevant cohort studies using a well-defined list of inclusion and quality criteria. RESULTS We identified 43 relevant cohort studies with sufficient methodological quality (20 for rheumatoid arthritis, 3 for asthma and 20 for IHD). The common prognostic factors for work disability found in all the diseases were: perceived health complaints, limitation in daily physical activities caused by the disease (high versus low), heavy manual work, and female gender. The common positive prognostic factors for rheumatoid arthritis and IHD were age (high versus low) and sickness absence. The common negative factors for rheumatoid arthritis and IHD were education (high versus low) and ethnic origin (white versus non-white). CONCLUSIONS As many prognostic factors for work disability are similar for employees with various chronic diseases, it is possible to detect high risk groups. This information supports the development and implementation of a general disability management intervention for employees suffering from a chronic disease to overcome health-related limitations at work.
Collapse
Affiliation(s)
- Sarah I Detaille
- Seneca, Expertise Centre for Sport, Work and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands.
| | | | | | | | | |
Collapse
|
47
|
Detaille SI, van der Gulden JWJ, Engels JA, Heerkens YF, van Dijk FJH. Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands. BMC Public Health 2010; 10:353. [PMID: 20565925 PMCID: PMC2908090 DOI: 10.1186/1471-2458-10-353] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 06/21/2010] [Indexed: 11/23/2022] Open
Abstract
Background Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme. Methods The method of intervention mapping (Bartholomew 2006) was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed. Results The intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease) and work-related personal factors (such as self-efficacy at work). The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease. Conclusion Intervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care.
Collapse
Affiliation(s)
- Sarah I Detaille
- Seneca, Expertise Centre for Sports, Work and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands.
| | | | | | | | | |
Collapse
|
48
|
Detaille SI, Heerkens YF, Engels JA, van der Gulden JWJ, van Dijk FJH. Author’s reply to Coggon commentary on epidemiological investigation of prognosis. Scand J Work Environ Health 2009; 35:479. [DOI: 10.5271/sjweh.1351] [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: 11/11/2022] Open
|
49
|
Halbertsma J, Heerkens YF, Hirs WM, de Kleijn-de Vrankrijker MW, Dorine Van Ravensberg CD, Napel HT. Towards a new ICIDH. International Classification of Impairments, Disabilities and Handicaps. Disabil Rehabil 2000; 22:144-56. [PMID: 10749037 DOI: 10.1080/096382800297006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In 1995 a special issue of Disability and Rehabilitation was published on the use of the International Classification of Impairments, Disabilities and Handicaps (ICIDH) which was issued by WHO in 1980. Since 1995 a lot of energy has been spent by WHO and other organizations aiming at the development of a new and improved ICIDH. In 1997, a draft ICIDH-2 (Beta-1 version) was circulated by WHO in order to be tested in the field. This paper informs the reader about the content of the draft ICIDH, the revision process planning and some Dutch comments relating to the actual draft.
Collapse
Affiliation(s)
- J Halbertsma
- WHO Collaborating Centre for the ICIDH in The Netherlands, RIVM, Bilthoven.
| | | | | | | | | | | |
Collapse
|
50
|
Abstract
BACKGROUND AND PURPOSE The purpose of this study was to evaluate the interobserver and intraobserver reliability of assessments of impairments and disabilities. SUBJECTS AND METHODS One physical therapist's assessments were examined for intraobserver reliability. Judgments of two pairs of therapists were used to examine interobserver reliability. Reliability was assessed by Cohen's kappa. RESULTS Of the 42 impairments and disabilities assessed by the physical therapist in the intraobserver reliability study, kappa values could be calculated for 33 items. For 31 items (94%), kappa values ranged from .40 to .91, and 2 items (6%) had kappa values of less than .40. To determine interobserver reliability, 37 items were assessed in one practice. Kappa values could be calculated for 34 items, with 30 items (88%) having kappa values ranging from .41 to .80 and 4 items (12%) showing "poor" agreement. In the second practice, 47 items were assessed for interobserver reliability. Kappa values could be calculated for 40 items, with 11 items (27.5%) having kappa values ranging from .41 to .84. Poor agreement was shown for the remaining 29 items (72.5%). CONCLUSION AND DISCUSSION Assessments of impairments and disabilities are potentially reliable. The differences between practices of the interobserver reliability study can be explained by the fact that one of the therapists did not receive training in the use of the assessment form. More generalizable conclusions will require further study with more subjects and therapists.
Collapse
Affiliation(s)
- E J Hendriks
- Dutch National Institute of Allied Health Professions, Amersfoort, The Netherlands
| | | | | | | | | |
Collapse
|