Intention of healthcare providers to use video-communication in terminal care: a cross-sectional study. Richard M. H. Evering, Marloes G. Postel, Harmieke van Os-Medendorp, Marloes Bults and Marjolein E. M. den Ouden BMC Palliative Care volume 21, Article number: 213 (2022) Cite this articleAbstractBackgroundInterdisciplinary collaboration between healthcare providers with regard to consultation, transfer and advice in terminal care is both important and challenging. The use of video communication in terminal care is low while in first-line healthcare it has the potential to improve quality of care, as it allows healthcare providers to assess the clinical situation in real time and determine collectively what care is needed. The aim of the present study is to explore the intention to use video communication by healthcare providers in interprofessional terminal care and predictors herein.MethodsIn this cross-sectional study, an online survey was used to explore the intention to use video communication. The survey was sent to first-line healthcare providers involved in terminal care (at home, in hospices and/ or nursing homes) and consisted of 39 questions regarding demographics, experience with video communication and constructs of intention to use (i.e. Outcome expectancy, Effort expectancy, Attitude, Social influence, Facilitating conditions, Anxiety, Self-efficacy and Personal innovativeness) based on the Unified Theory of Acceptance and Use of Technology and Diffusion of Innovation Theory. Descriptive statistics were used to analyze demographics and experiences with video communication. A multiple linear regression analysis was performed to give insight in the intention to use video communication and predictors herein.Results90 respondents were included in the analysis.65 (72%) respondents had experience with video communication within their profession, although only 15 respondents (17%) used it in terminal care. In general, healthcare providers intended to use video communication in terminal care (Mean (M) = 3.6; Standard Deviation (SD) = .88). The regression model was significant and explained 44% of the variance in intention to use video communication, with ‘Outcome expectancy’ and ‘Social influence’ as significant predictors.ConclusionsHealthcare providers have in general the intention to use video communication in interprofessional terminal care. However, their actual use in terminal care is low. ‘Outcome expectancy’ and ‘Social influence’ seem to be important predictors for intention to use video communication. This implicates the importance of informing healthcare providers, and their colleagues and significant others, about the usefulness and efficiency of video communication.
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In dit artikel wordt gekeken naar de relatie tussen het gebruik van mobiele applicaties en fysieke activiteit en gezonde leefstijl. Dit is gedaan op basis van een vragenlijst onder deelnemers aan een hardloopevenement, de Dam tot Damloop. Er werden aparte analyses gedaan voor 8km lopers en 16 km lopers. Een positieve relatie werd gevonden tussen app gebruik en meer bewegen en zich gezonder voelen. App gebruik was ook positief gerelateerd aan beter voelen over zichzelf, je voelen als een atleet, anderen motiveren om te gaan hardlopen en afvallen. Voor de 16 km lopers was app gebruik gerelateerd aan gezonder eten, zich meer energieker voelen en een hogere kans om het sportgedrag vol te houden. De resultaten van dit onderzoek laten zien dat app gebruik mogelijk een ondersteunende rol kunnen hebben in de voorbereiding op een hardloopevenemen, aangezien het gezondheid en fysieke activiteit stimuleert.
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BackgroundThe challenge of combining professional work and breastfeeding is a key reason why women choose not to breastfeed or to stop breastfeeding early. We posited that having access to a high-quality lactation room at the workplace could influence working mothers’ satisfaction and perceptions related to expressing breast milk at work, which could have important longer term consequences for the duration of breastfeeding. Specifically, we aimed to (1) develop a checklist for assessing the quality of lactation rooms and (2) explore how lactation room quality affects lactating mothers’ satisfaction and perceptions. Drawing on social ecological insights, we hypothesized that the quality of lactation rooms (operationalized as any space used for expressing milk at work) would be positively related to mothers’ satisfaction with the room, perceived ease of, and perceived support for milk expression at work.MethodsWe conducted two studies. In Study 1 we developed a lactation room quality checklist (LRQC) and assessed its reliability twice, using samples of 33 lactation rooms (Study 1a) and 31 lactation rooms (Study 1b). Data were collected in the Northern part of the Netherlands (between December 2016 and April 2017). Study 2 comprised a cross-sectional survey of 511 lactating mothers, working in a variety of Dutch organizations. The mothers were recruited through the Facebook page of a popular Dutch breastfeeding website. They completed online questionnaires containing the LRQC and measures aimed at assessing their satisfaction and perceptions related to milk expression at work (in June and July 2017).ResultsThe LRQC was deemed reliable and easy to apply in practice. As predicted, we found that objectively assessed higher-quality lactation rooms were associated with increased levels of satisfaction with the lactation rooms, perceived ease of milk expression at work, and perceived support from supervisors and co-workers for expressing milk in the workplace.ConclusionsThe availability of a high-quality lactation room could influence mothers’ decisions regarding breast milk expression at work and the commencement and/or continuation of breastfeeding. Future studies should explore whether and how lactation room quality affects breastfeeding choices, and which aspects are most important to include in lactation rooms.
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Objective: The aim of this cross-sectional study was to determine the associations between frailty and multimorbidity on the one hand and quality of life on the other in community-dwelling older people. Methods: A questionnaire was sent to all people aged 70 years and older belonging to a general practice in the Netherlands; 241 persons completed the questionnaire (response rate 47.5%). For determining multimorbidity, nine chronic diseases were examined by self-report. Frailty was assessed by the Tilburg Frailty Indicator, and quality of life was assessed by the World Health Organization Quality of Life Instrument—Older Adults Module. Results: Multimorbidity, physical, psychological, as well as social frailty components were negatively associated with quality of life. Multimorbidity and all 15 frailty components together explained 11.6% and 36.5% of the variance of the score on quality of life, respectively. Conclusion: Health care professionals should focus their interventions on the physical, psychological, and social domains of human functioning. Interprofessional cooperation between health care professionals and welfare professionals seems necessary to be able to meet the needs of frail older people.
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Limited evidence is available about (non)-representativeness of participants in health-promoting interventions. The Dutch Healthy Primary School of the Future (HPSF)-study is a school-based study aiming to improve health through altering physical activity and dietary behaviour, that started in 2015 (registered in ClinicalTrials.gov on14-06-2016, NCT02800616). The study has a response rate of 60%. A comprehensive non-responder analysis was carried out, and responders were compared with schoolchildren from the region and the Netherlands using a cross-sectional design. External sources were consulted to collect non-responder, regional, and national data regarding relevant characteristics including sex, demographics, health, and lifestyle. The Chi-square test, Mann-Whitney U test, or Student's t-test were used to analyse differences.
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Background Early detection of frail older people is important. Timely intervention may allow health care professionals to prevent or delay the occurrence of adverse outcomes such as disability, increases in health care utilization, and premature death. Objectives We assessed the construct and criterion validity of the SUNFRAIL tool, a questionnaire for measuring frailty among older people. Design, Setting and Participants This cross-sectional study was carried out in a sample of Dutch citizens. A total of 195 community-dwelling persons aged 71 years and older completed the questionnaire. Measurements Construct validity was examined by determining the correlation between the SUNFRAIL tool and the Tilburg Frailty Indicator (TFI). Criterion validity for the SUNFRAIL tool was determined by establishing the correlations with chronic diseases and adverse outcomes of frailty (disability, falls, indicators of health care utilization). Disability was measured using the Groningen Activity Restriction Scale. Participants also answered questions regarding falls and health care utilization. Results The construct validity of this tool was good and showed significant correlations with the TFI. The correlation between SUNFRAIL total and TFI total was 0.624. The criterion validity of the SUNFRAIL tool was good for chronic diseases and good-to-excellent for adverse outcomes disability, receiving nursing care, and falls. The area under the curve for these outcomes was 0.840 (95% CI 0.781–0.899), 0.782 (95% CI 0.696–0.868), and 0.769 (95% CI 0.686–0.859), respectively. Conclusions The results of our study suggest that the SUNFRAIL tool is a valid instrument for assessing frailty in community-dwelling older people. It is an attractive instrument for use in practice because it takes little time for health care professionals and older people to complete the questionnaire, and it expresses the integral functioning of human beings.
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Background: A higher protein intake is suggested to preserve muscle mass during aging and may therefore reduce the risk of sarcopenia.Objectives: We explored whether the amount and type (animal or vegetable) of protein intake were associated with 5-y change in mid-thigh muscle cross-sectional area (CSA) in older adults (n = 1561).Methods: Protein intake was assessed at year 2 by a Block foodfrequency questionnaire in participants (aged 70–79 y) of the Health, Aging, and Body Composition (Health ABC) Study, a prospective cohort study. At year 1 and year 6 mid-thigh muscle CSA in square centimeters was measured by computed tomography. Multiple linearregression analysis was used to examine the association between energy-adjusted protein residuals in grams per day (total, animal, and vegetable protein) and muscle CSA at year 6, adjusted for muscle CSA at year 1 and potential confounders including prevalent health conditions, physical activity, and 5-y change in fat mass.Results: Mean (95% CI) protein intake was 0.90 (0.88, 0.92) g ·kg–1 · d–1 and mean (95% CI) 5-y change in muscle CSA was −9.8 (−10.6, −8.9) cm2. No association was observed between energyadjusted total (β = −0.00; 95% CI: −0.06, 0.06 cm2; P = 0.982), animal (β = −0.00; 95% CI: −0.06, 0.05 cm2; P = 0.923), or plant(β = +0.07; 95% CI: −0.06, 0.21 cm2; P = 0.276) protein intake and muscle CSA at year 6, adjusted for baseline mid-thigh muscle CSA and potential confounders.Conclusions: This study suggests that a higher total, animal, or vegetable protein intake is not associated with 5-y change in midthigh muscle CSA in older adults. This conclusion contradicts some, but not all, previous research. This trial was registered at www.trialregister.nl as NTR6930.
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Light profoundly impacts many aspects of human physiology and behaviour, including the synchronization of the circadian clock, the production of melatonin, and cognition. These effects of light, termed the non-visual effects of light, have been primarily investigated in laboratory settings, where light intensity, spectrum and timing can be carefully controlled to draw associations with physiological outcomes of interest. Recently, the increasing availability of wearable light loggers has opened the possibility of studying personal light exposure in free-living conditions where people engage in activities of daily living, yielding findings associating aspects of light exposure and health outcomes, supporting the importance of adequate light exposure at appropriate times for human health. However, comprehensive protocols capturing environmental (e.g., geographical location, season, climate, photoperiod) and individual factors (e.g., culture, personal habits, behaviour, commute type, profession) contributing to the measured light exposure are currently lacking. Here, we present a protocol that combines smartphone-based experience sampling (experience sampling implementing Karolinska Sleepiness Scale, KSS ratings) and high-quality light exposure data collection at three body sites (near-corneal plane between the two eyes mounted on spectacle, neck-worn pendant/badge, and wrist-worn watch-like design) to capture daily factors related to individuals’ light exposure. We will implement the protocol in an international multi-centre study to investigate the environmental and socio-cultural factors influencing light exposure patterns in Germany, Ghana, Netherlands, Spain, Sweden, and Turkey (minimum n = 15, target n = 30 per site, minimum n = 90, target n = 180 across all sites). With the resulting dataset, lifestyle and context-specific factors that contribute to healthy light exposure will be identified. This information is essential in designing effective public health interventions.
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As the population ages, the risk of becoming malnourished increases. Research has shown that poor oral health can be a risk factor for malnutrition in institutionalized elderly. However, it remains unclear whether oral health problems, edentulousness and health-related quality of life also pose a risk for malnutrition in community-dwelling older adults. In this cross-sectional observational study, 1325 community-living elderly (≥75 years) were asked to complete questionnaires regarding nutritional status, oral status (edentulous, remaining teeth, or implant-supported overdentures), oral health problems, health-related quality of life (HRQoL), frailty, activities of daily living (ADL) and complexity of care needs. Univariate and multivariate logistic regression analyses were performed with nutritional status as dependent variable. Of the respondents, 51% (n = 521) were edentulous, 38.8% (n = 397) had remaining teeth and 10.2% (n = 104) had an implant-supported overdenture. Elderly with complex care needs were malnourished most frequently, followed by frail and robust elderly (10%, 4.5% and 2.9%, respectively). Malnourished elderly reported more frequent problems with chewing and speech when compared with well-nourished elderly (univariate analysis). However, multivariate analysis did not show an association between malnutrition and oral health problems and edentulousness, although HRQoL was associated with malnutrition (odds ratio (OR) 0.972, confidence interval (CI) 0.951–0.955). Based on the results of this cross-sectional study, it can be concluded that poor HRQoL is significantly associated with malnutrition; however, edentulousness and oral health problems are not.
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Background: The diffusion of telehealth into hospital care is still low, partially because of a lack of telehealth competence among nurses. In an earlier study, we reported on the knowledge, skills, and attitudes (KSAs) nurses require for the use of telehealth. The current study describes hospital nurses' confidence in possessing these telehealth KSAs. Method: In a cross-sectional study, we invited 3,543 nurses from three hospitals in the Netherlands to rate their self-confidence in 31 telehealth KSAs on a 5-point Likert scale, using an online questionnaire. Results: A total of 1,017 nurses responded to the survey. Nine KSAs were scored with a median value of 4.0, 19 KSAs with a median value of 3.0, and three KSAs with a median value of 2.0. Conclusion: Given that hospital nurses have self-confidence in only nine of the 31 essential telehealth KSAs, continuing education in additional KSAs is recommended to support nurses in gaining confidence in using telehealth.
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