ABSTRACT Objectives To examine the extent of the impact of the COVID-19 pandemic on the mental health and well-being of mental health professionals (MHPs) in the Netherlands and understand their needs during the COVID-19 pandemic. Design and setting A cross-sectional, mixed-methods study was conducted with MHPs from the Netherlands from June 2020 to October 2020, consisting of an online survey and three online focus group discussions. Participants Participants were MHPs from various occupational groups (psychologists, social workers, mental health nurses, developmental education workers, etc). Primary and secondary outcome measures The online survey included questions about work-related changes due to COVID-19 perceived resilience to stress, changes in lifestyle behaviours and mental health symptoms. The focus group discussions focused mostly on work experiences during the first wave of the COVID-19 pandemic. Results MHP’s reported an increase in experience workload during the pandemic (mean score 8.04 based on a scale of 1-10) compared to before the pandemic (mean score of 7). During the first wave of the pandemic, 50% of respondents reported increased stress, 32% increased sleeping problems and 24% increased mental health problems. Adverse occupational (eg, increased workload OR 1.72, 95% CI 1.28–2.32), psychological (eg, life satisfaction OR 0.63, 95% CI 0.52–0.75), lifestyle (eg, increased sleep problems OR 2.80, 95% CI 2.07–3.80) and physical factors (decline in physical health OR 3.56, 95% CI 2.61–4.85) were associated with a decline in mental health. Participants expressed significant concern in the focus group discussions about the duration of the pandemic, the high workload, less work-life balance and lack of contact with colleagues. Suggestions to improve working conditions included ensuring clear communication about guidelines and facilitating worker contact and support via peer-to- peer coaching where experiences can be shared. Conclusions The current study indicates that MHP experienced a decline in mental health status during the first wave of the COVID-19 pandemic, which should be taken into consideration by employers, policymakers and researchers.
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Background: Due to multimorbidity and geriatric problems, older people often require both psychosocial and medical care. Collaboration between medical and social professionals is a prerequisite to deliver high-quality care for community-living older people. Effective, safe, and person-centered care relies on skilled interprofessional collaboration and practice. Little is known about interprofessional education to increase interprofessional collaboration in practice (IPCP) in the context of community care for older people. This study examines the feasibility of the implementation of an IPCP program in three community districts and determines its potential to increase interprofessional collaboration between primary healthcare professionals caring for older people. Method: A feasibility study was conducted to determine the acceptability and feasibility of data collection and analysis regarding interprofessional collaboration in network development. A questionnaire was used to measure the learning experience and the acquisition of knowledge and skills regarding the program. Network development was assessed by distributing a social network survey among professionals attending the program as well as professionals not attending the program at baseline and 5.5 months after. Network development was determined by calculating the number, reciprocity, value, and diversity of contacts between professionals using social network analysis. Results: The IPCP program was found to be instructive and the knowledge and skills gained were applicable in practice. Social network analysis was feasible to conduct and revealed a spill-over effect regarding network development. Program participants, as well as non-program participants, had larger, more reciprocal, and more diverse interprofessional networks than they did before the program. Conclusions: This study showed the feasibility of implementing an IPCP program in terms of acceptability, feasibility of data collection, and social network analysis to measure network development, and indicated potential to increase interprofessional collaboration between primary healthcare professionals. Both program participants and non-program participants developed a larger, more collaborative, and diverse interprofessional network.
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Uit de RAAK-projecten van SIA blijkt dat er op een aantal thema’s veel projecten en onderzoeken plaatsvinden. Verspreid over de hogescholen in Nederland zijn onderzoekers actief op dezelfde onderwerpen. Met de Thematische Impulsen wil SIA overleg en afstemming stimuleren tussen de lectoren en landelijke kennisnetwerken onderling en de beroepspraktijk. Met elkaar stellen zij de state-of-the-art vast, bespreken de verwachtingen die zij hebben voor de toekomst en geven aan waar de zwaartepunten in praktijkgericht onderzoek moeten liggen. De Thematische Impuls sluit aan bij de doelstelling om kennisuitwisseling te bevorderen en daarmee het innovatief vermogen van de beroepspraktijk te vergroten. In dit artikel meer over het doen van praktijkgericht onderzoek op medische beeldvormende diagnostiek in de eerste lijn. Er zijn 3 lectoraten betrokken bij deze thematsiche impuls.
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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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Background: Follow‑up of curatively treated primary breast cancer patients consists of surveillance and aftercare and is currently mostly the same for all patients. A more personalized approach, based on patients’ individual risk of recurrence and personal needs and preferences, may reduce patient burden and reduce (healthcare) costs. The NABOR study will examine the (cost‑)effectiveness of personalized surveillance (PSP) and personalized aftercare plans (PAP) on patient‑reported cancer worry, self‑rated and overall quality of life and (cost‑)effectiveness. Methods: A prospective multicenter multiple interrupted time series (MITs) design is being used. In this design, 10 participating hospitals will be observed for a period of eighteen months, while they ‑stepwise‑ will transit from care as usual to PSPs and PAPs. The PSP contains decisions on the surveillance trajectory based on individual risks and needs, assessed with the ‘Breast Cancer Surveillance Decision Aid’ including the INFLUENCE prediction tool. The PAP contains decisions on the aftercare trajectory based on individual needs and preferences and available care resources, which decision‑making is supported by a patient decision aid. Patients are non‑metastasized female primary breast cancer patients (N= 1040) who are curatively treated and start follow‑up care. Patient reported outcomes will be measured at five points in time during two years of follow‑up care (starting about one year after treatment and every six months thereafter). In addition, data on diagnostics and hospital visits from patients’ Electronical Health Records (EHR) will be gathered. Primary outcomes are patient‑reported cancer worry (Cancer Worry Scale) and over‑all quality of life (as assessed with EQ‑VAS score). Secondary outcomes include health care costs and resource use, health‑related quality of life (as measured with EQ5D‑5L/SF‑12/EORTC‑QLQ‑C30), risk perception, shared decision‑making, patient satisfaction, societal participation, and cost‑effectiveness. Next, the uptake and appreciation of personalized plans and patients’ experiences of their decision‑making process will be evaluated. Discussion: This study will contribute to insight in the (cost‑)effectiveness of personalized follow‑up care and contributes to development of uniform evidence‑based guidelines, stimulating sustainable implementation of personalized surveillance and aftercare plans. Trial registration: Study sponsor: ZonMw. Retrospectively registered at ClinicalTrials.gov (2023), ID: NCT05975437.
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ABSTRACT. It is now generally accepted that the quality of the regulatory arrangements should be appraised not only by looking at the institutional design, but also by evaluating the factual enforcement and implementation of regulations. It is therefore advised that national governments take a more active stance in supervising the regulatory enforcement by different regulatory agencies. However, in some cases, government’s activism might be an impeding factor in regulatory enforcement. That this is not so crazy idea shows the analysis of the regulatory enforcement by Lithuanian Competition Authority in the area of competition policy during the years of integration to the European Union. For example, not only political and financial independence of the Competition Authority was difficult to establish, but also functions and competences of the regulatory agency were changed a number of times, which hampered the effectiveness of the agency’s performance while enforcing the competition law. In addition to often changes of functions, also the scope of competences was changing. As a result, the variety of tasks attributed to the Lithuanian Competition Authority caused the growing overload of work, which further hindered its regulatory practice. The question is who can be blamed for that? Was it just the inexperience of the government who was seeking for the best institutional design and could not stop with redesigning the regulatory agency or was it the intentional behaviour guided by some concrete interests as a result of a regulatory capture? The analysis of the regulatory enforcement during the period of 15 years does not allow for disregarding of the second possibility.
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Nationwide and across the globe, the quality, affordability, and accessibility of home-based healthcare are under pressure. This issue stems from two main factors: the rapidly growing ageing population and the concurrent scarcity of healthcare professionals. Older people aspire to live independently in their homes for as long as possible. Additionally, governments worldwide have embraced policies promoting “ageing in place,” reallocating resources from institutions to homes and prioritising home-based services to honour the desire of older people to continue living at home while simultaneously addressing the rising costs associated with traditional institutional care.Considering the vital role of district nursing care and the fact that the population of older people in need of assistance at home is growing, it becomes clear that district nursing care plays a crucial role in primary care. The aim of this thesis is twofold: 1) to strengthen the evidence base for district nursing care; and 2) to explore the use of outcomes for learning and improving in district nursing care. The first part of this thesis examines the current delivery of district nursing care and explores its challenges during the COVID-19 pandemic to strengthen the evidence base and get a better understanding of district nursing care. Alongside the goal of strengthening the evidence for district nursing care, the second part of this thesis explores the use of patient outcomes for learning and improving district nursing care. It focuses on nurse-sensitive patient outcomes relevant to district nursing care, their current measurement in practice, and what is needed to use outcomes for learning and improving district nursing practice.
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Full text via link. Mensen met financiële problemen hebben vaak een ongezondere leefstijl en vaker lichamelijke en psychische klachten dan mensen zonder geldzorgen. Dat is zorgwekkend, want financiële problemen komen veel voor. Eén op de vijf Nederlandse huishoudens heeft risicovolle of problematische schulden. Huisartsen die alert zijn op de doorwerking van financiële problemen realiseren zich dat het oplossen van de schulden soms de belangrijkste stap is om (op de lange termijn) de klachten op te lossen of te verminderen. Meer aandacht voor problematische schulden in de spreekkamer begint met meer kennis bij huisartsen over de invloed van geldzorgen op gezondheid en bij een warm netwerk om patiënten over te dragen aan partijen die de financiële problemen kunnen helpen oplossen
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