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In dit document is het logopedisch onderzoek bij broddelen beschreven waarover internationaal consensus bestaat. Dit document is gepresenteerd op de website van de International Cluttering Association
In het herstellen en behouden van zinvolle bezigheden voor mensen met een lichte of matige vorm van van de ziekte van Alzheimer is doelstelling van groot praktisch belang. De studies gericht op dit doel hebben vertrouwd op de verschillende strategieën van zelfmanagement van instruction cues. Zeven studies werden gevonden die plaats hadden in de periode 2008-2012 (dat wil zeggen, de periode waarin onderzoek op dit gebied daadwerkelijk vorm heeft gekregen). Die strategieën bestaan uit het gebruik van (1) verbale signalen aangeboden via audiorecorders, (2) visuele signalen aangeboden via computersystemen, en (3) een combinatie van verbale en visuele signalen gepresenteerd via computersystemen. Dit artikel geeft een overzicht van de hiervoor genoemde strategieën en bespreekt de resultaten daarvan, hun algemene doeltreffendheid, op prestaties en stemmingen, en hun geschiktheid en bruikbaarheid. Thema's voor toekomstig onderzoek werden eveneens onderzocht. ABSTRACT Helping people with mild or moderate Alzheimer's disease restore and maintain constructive occupations is an objective of great practical importance. Studies targeting this goal have relied on different strategies for self-management of instruction cues. Seven studies were identified in the period 2008- 2012 (i.e. the period in which research in this area has actually taken shape). These strategies consist of the use of (1) verbal cues presented via audio recording devices, (2) pictorial cues presented via computer-aided systems and (3) combinations of verbal and pictorial cues presented via computer-aided systems. This paper reviews these strategies and discusses their outcomes, their overall effectiveness on performance and mood, and their suitability and practicality. Issues for future research are also examined.
Background: Generally, a significant portion of healthcare spending consists of out-of-pocket (OOP) expenses. Patients indicate that, in practice, there are often some OOP expenses, incurred when they receive medical care, which are unexpected for them and should have been taken into account when deciding on a course of action. Patients are often reliant on their GP and may, therefore, expect their GP to provide them with information about the costs of treatment options, taking into consideration their individual insurance plan. This also applies to the Netherlands, where OOP expenses increased rapidly over the years. In the current study, we observed the degree to which matters around patients' insurance and OOP expenses are discussed in the Netherlands, using video recordings of consultations between patients and GPs. Methods: Video recordings were collected from patient-GP consultations in 2015-2016. In 2015, 20 GPs and 392 patients from the eastern part of the Netherlands participated. In 2016, another eight GPs and 102 patients participated, spread throughout the Netherlands. The consultations were coded by three observers using an observation protocol. We achieved an almost perfect inter-rater agreement (Kappa = .82). Results: In total, 475 consultations were analysed. In 9.5% of all the consultations, issues concerning patients' health insurance and OOP expenses were discussed. The reimbursement of the cost of medication was discussed most often and patients' current insurance and co-payments least often. In some consultations, the GP brought up the subject, while in others, the patient initiated the discussion. Conclusions: While GPs may often be in the position to provide patients with information about treatment alternatives, few patients discuss the financial effects of their referral or prescription with their GP. This result complies with existing literature. Policy makers, GPs and insurers should think about how GPs and patients can be facilitated when considering the OOP expenses of treatment. There are several factors why this study, analysing video recordings of routine GP consultations in the Netherlands, is particularly relevant: Dutch GPs play a gatekeeper function; OOP expenses have increased relatively swiftly; and patients have both the right to decide on their treatment, and to choose a provider.
Abstract Background: Many countries in Europe have implemented managed competition and patient choice during the last decade. With the introduction of managed competition, health insurers also became an important stakeholder. They purchase services on behalf of their customers and are allowed to contract healthcare providers selectively. It has, therefore, become increasingly important to take one's insurance into account when choosing a provider. There is little evidence that patients make active choices in the way that policymakers assume they do. This research aims to investigate, firstly, the role of patients in choosing a healthcare provider at the point of referral, then the role of the GP and, finally, the influence of the health insurer/insurance policies within this process. Methods: We videotaped a series of everyday consultations between Dutch GPs and their patients during 2015 and 2016. In 117 of these consultations, with 28 GPs, the patient was referred to another healthcare provider. These consultations were coded by three observers using an observation protocol which assessed the role of the patient, GP, and the influence of the health insurer during the referral. Results: Patients were divided into three groups: patients with little or no input, patients with some input, and those with a lot of input. Just over half of the patients (56%) seemed to have some, or a lot of, input into the choice of a healthcare provider at the point of referral by their GP. In addition, in almost half of the consultations (47%), GPs inquired about their patients' preferences regarding a healthcare provider. Topics regarding the health insurance or insurance policy of a patient were rarely (14%) discussed at the point of referral. Conclusions: Just over half of the patients appear to have some, or a lot of, input into their choice of a healthcare provider at the point of referral by their GP. However, the remainder of the patients had little or no input. If more patient choice continues to be an important aim for policy makers, patients should be encouraged to actively choose the healthcare provider who best fits their needs and preferences.
Diagnosing teachers are teachers who perceive diagnostic information about students’ learning process, interpret these aspects, decide how to respond, and act based on this diagnostic decision. During supervision meetings about the undergraduate thesis supervisors make in-the-moment decisions while interacting with their students. We regarded research supervision as a teaching process for the supervisor and a learning process for the student. We tried to grasp supervisors’ in-the-moment decisions and students’ perceptions of supervisors’ actions. Supervisor decisions and student perceptions were measured with video-stimulated recall interviews and coded using a content analysis approach. The results showed that the in-the-moment decisions our supervisors made had a strong focus on student learning. Supervisors often asked questions to empower students or to increase student understanding. These supervising strategies seemed to be adapted to students’ needs, as the latter had positive perceptions when their control increased or when they received stimuli to think for themselves.
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