Background: Patient participation and goal setting appear to be difficult in daily physiotherapy practice, and practical methods are lacking. An existing patient-specific instrument, Patient-Specific Complaints (PSC), was therefore optimized into a new Patient Specific Goal-setting method (PSG). The aims of this study were to examine the feasibility of the PSG in daily physiotherapy practice, and to explore the potential impact of the new method. Methods: We conducted a process evaluation within a non-controlled intervention study. Community-based physiotherapists were instructed on how to work with the PSG in three group training sessions. The PSG is a six-step method embedded across the physiotherapy process, in which patients are stimulated to participate in the goal-setting process by: identifying problematic activities, prioritizing them, scoring their abilities, setting goals, planning and evaluating. Quantitative and qualitative data were collected among patients and physiotherapists by recording consultations and assessing patient files, questionnaires and written reflection reports. Results: Data were collected from 51 physiotherapists and 218 patients, and 38 recordings and 219 patient files were analysed. The PSG steps were performed as intended, but the ‘setting goals’ and ‘planning treatment’ steps were not performed in detail. The patients and physiotherapists were positive about the method, and the physiotherapists perceived increased patient participation. They became aware of the importance of engaging patients in a dialogue, instead of focusing on gathering information. The lack of integration in the electronic patient system was a major barrier for optimal use in practice. Although the self-reported actual use of the PSG, i.e. informing and involving patients, and client-centred competences had improved, this was not completely confirmed by the objectively observed behaviour. Conclusion: The PSG is a feasible method and tends to have impact on increasing patient participation in the goal-setting process. However, its full potential for shared goal setting has not been utilized yet. More implementation effort is needed to achieve the required behaviour change and a truly client-centred attitude, to make physiotherapists totally ready for shared goal setting.
Stimulating patients to approach their pain from a biopsychosocial perspective is central to chronic pain rehabilitation. However, conversations between patients and their healthcare professionals about the social and psychological factors that may contribute to the continuation of pain and disability can be challenging. The current scientific literature does not sufficiently pinpoint the difficulties in patient–practitioner interaction on chronic pain, and it falls short of answering the question of how a joint exploration of the social and psychological factors that might be involved in the patient’s pain and evolving disability can be enhanced. In this theoretical article, we introduce discursive psychology as a potentially valuable research perspective to gain a better understanding of the difficulties in patient–practitioner interaction in the context of chronic pain rehabilitation. Discursive psychology focuses on features of people’s talk (e.g. that of patients and practitioners) and is concerned with the social practices that people perform as part of a specific interactional context. In this paper, we provide an introduction to the main theoretical notions of discursive psychology. We illustrate how discursive psychological analyses can inform our understanding of the specific sensitivities in conversations between patients with chronic pain and their practitioners. Finally, we address how a better understanding of these sensitivities offers a gateway towards improving these conversations. Een belangrijk principe in revalidatie bij chronische pijn is de benadering van de pijn vanuit een biopsychosociaal perspectief. Het blijkt echter een uitdaging voor patiënten en behandelaars om de sociale en psychologische factoren die een rol spelen bij chronische pijn te bespreken. In de huidige wetenschappelijke literatuur is hier nog niet voldoende aandacht voor; en wordt geen perspectief geboden voor verbetering van de gezamenlijke verkenning van sociale en psychologische factoren. In dit theoretische artikel introduceren we discursieve psychologie als een mogelijk waardevol onderzoeksperspectief om een beter begrip tot stand te brengen van de complexiteit van interactie in de context van chronische pijn revalidatie. Discursieve psychologie richt zich op kenmerken van interactie, in het bijzonder de sociale praktijken die tot stand worden gebracht binnen een specifieke interactionele context. We beschrijven de belangrijkste theoretische principes van discursieve psychologie en illustreren hoe een DP analyse licht kan werpen op de specifieke gevoeligheden in conversaties tussen patiënten met chronische pijn en hun behandelaars. Tot slot bespreken we hoe een beter begrip van deze gevoeligheden een ingang biedt tot het verbeteren van deze conversaties.
From the perspective of caregivers, social interaction is a dynamic process in which many aspects are involved. Caregivers reported about eight main themes across child factors, parental factors and environmental factors that influence real-time as well as long term processes of social interaction. Our proposed model of social interaction in preterm infants visualizes the interrelatedness of these themes. Recommendation: Development of social skills and social power could be strengthenend by paying more attention to the relatedness between real-time social interaction experiences and long-term outcome, with regard to possible cascading effects.
Developing and realizing an innovative concept for the Active Aging campus in two years, where students, teachers, companies, residents of surrounding Campus neighborhoods will be invited to do exercise, sports, play, meet and participate. This includes, on the one hand, providing input with regard to a mobility-friendly design from an infrastructural perspective and, on the other hand, organizing activities that contribute to Healthy Aeging of the Zernike site and the city of Groningen. It is not only about having an Active Aging campus with an iconic image, but also about the process. In the process of realization, students, teachers, researchers, companies and residents from surrounding districts will be explicitly involved. This includes hardware (physical environment / infrastructure), software (social environment) and orgware (interaction between the two).
The focus of the research is 'Automated Analysis of Human Performance Data'. The three interconnected main components are (i)Human Performance (ii) Monitoring Human Performance and (iii) Automated Data Analysis . Human Performance is both the process and result of the person interacting with context to engage in tasks, whereas the performance range is determined by the interaction between the person and the context. Cheap and reliable wearable sensors allow for gathering large amounts of data, which is very useful for understanding, and possibly predicting, the performance of the user. Given the amount of data generated by such sensors, manual analysis becomes infeasible; tools should be devised for performing automated analysis looking for patterns, features, and anomalies. Such tools can help transform wearable sensors into reliable high resolution devices and help experts analyse wearable sensor data in the context of human performance, and use it for diagnosis and intervention purposes. Shyr and Spisic describe Automated Data Analysis as follows: Automated data analysis provides a systematic process of inspecting, cleaning, transforming, and modelling data with the goal of discovering useful information, suggesting conclusions and supporting decision making for further analysis. Their philosophy is to do the tedious part of the work automatically, and allow experts to focus on performing their research and applying their domain knowledge. However, automated data analysis means that the system has to teach itself to interpret interim results and do iterations. Knuth stated: Science is knowledge which we understand so well that we can teach it to a computer; and if we don't fully understand something, it is an art to deal with it.[Knuth, 1974]. The knowledge on Human Performance and its Monitoring is to be 'taught' to the system. To be able to construct automated analysis systems, an overview of the essential processes and components of these systems is needed.Knuth Since the notion of an algorithm or a computer program provides us with an extremely useful test for the depth of our knowledge about any given subject, the process of going from an art to a science means that we learn how to automate something.
Nederland kent ongeveer 220.000 bedrijfsongevallen per jaar (met 60 mensen die overlijden). Vandaar dat elke werkgever verplicht is om bedrijfshulpverlening (BHV) te organiseren, waaronder BHV-trainingen. Desondanks brengt slechts een-derde van alle bedrijven de arbeidsrisico’s in kaart via een Risico-Inventarisatie & Evaluatie (RI&E) en blijft het aandeel werknemers met een arbeidsongeval hoog. Daarom wordt er continu geïnnoveerd om BHV-trainingen te optimaliseren, o.a. door middel van Virtual Reality (VR). VR is niet nieuw, maar is wel doorontwikkeld en betaalbaarder geworden. VR biedt de mogelijkheid om veilige realistische BHV-noodsimulaties te ontwikkelen waarbij de cursist het gevoel heeft daar echt te zijn. Ondanks de toename in VR-BHV-trainingen, is er weinig onderzoek gedaan naar het effect van VR in BHV-trainingen en zijn resultaten tegenstrijdig. Daarnaast zijn er nieuwe technologische ontwikkelingen die het mogelijk maken om kijkgedrag te meten in VR m.b.v. Eye-Tracking. Tijdens een BHV-training kan met Eye-Tracking gemeten worden hoe een instructie wordt opgevolgd, of cursisten worden afgeleid en belangrijke elementen (gevaar en oplossingen) waarnemen tijdens de simulatie. Echter, een BHV-training met VR en Eye-Tracking (interacties) bestaat niet. In dit project wordt een prototype ontwikkeld waarin Eye-Tracking wordt verwerkt in een 2021 ontwikkelde VR-BHV-training, waarin noodsituaties zoals een kantoorbrand worden gesimuleerd (de BHVR-toepassing). Door middel van een experiment zal het prototype getest worden om zo voor een deel de vraag te beantwoorden in hoeverre en op welke manier Eye-Tracking in VR een meerwaarde biedt voor (RI&E) BHV-trainingen. Dit project sluit daarmee aan op het missie-gedreven innovatiebeleid ‘De Veiligheidsprofessional’ en helpt het MKB dat vaak middelen en kennis ontbreekt voor onderzoek naar effectiviteit rondom innovatieve-technologieën in educatie/training. Het project levert onder meer een prototype op, een productie-rapport en onderzoeks-artikel, en staat open voor nieuwe deelnemers bij het schrijven van een grotere aanvraag rondom de toepassing en effect van VR en Eye-Tracking in BHV-trainingen.
